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Acute heart failure in adults

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https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#1
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28625702/national-trends-in-the-frequency-of-bladder-catheterization-and-physician-diagnosed-catheter-associated-urinary-tract-infections-results-from-the-medicare-patient-safety-monitoring-system
#2
Mark L Metersky, Noel Eldridge, Yun Wang, Eric M Mortensen, Jennifer Meddings
BACKGROUND: It is unclear if bladder catheterization and catheter-associated urinary tract infection (CAUTI) rates have changed since the implementation of public reporting in 2011. METHODS: We analyzed data from the Medicare Patient Safety Monitoring System, a national, chart abstraction-based surveillance system, for hospitalized adults with a principal discharge diagnosis of heart failure (HF), acute myocardial infarction (AMI), or pneumonia and patients who had undergone certain major surgeries...
June 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28614216/refractory-adult-onset-still-disease-complicated-by-macrophage-activation-syndrome-and-acute-myocarditis-a-case-report-treated-with-high-doses-8%C3%A2-mg-kg-d-of-anakinra
#3
Federico Parisi, Annamaria Paglionico, Valentina Varriano, Gianfranco Ferraccioli, Elisa Gremese
RATIONALE: Myocarditis is a rare but potentially fatal complication of Still's disease (about 7% of total cases). PATIENT CONCERNS: A 42-year-old woman was admitted to our ward with high-grade fever, rash and polyarthralgia, lasting since 4 weeks and rapidly complicated by MAS and acute heart failure. DIAGNOSES: Adult Onset Still's Disease rapidly developping macrophage activation syndrome and disseminated intravascular coagulopathy, further complicated by iperacute myocarditis with cardiac arrest...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28606799/patterns-of-readmissions-for-three-common-conditions-among-younger-u-s-adults
#4
Devraj Sukul, Shashank S Sinha, Andrew M Ryan, Michael W Sjoding, Scott L Hummel, Brahmajee K Nallamothu
BACKGROUND: Thirty-day readmissions among elderly Medicare patients are an important hospital quality measure. Although plans for employing 30-day readmission measures are under consideration for younger patients, little is known about readmission in younger patients or the relationship between readmissions in younger and elderly patients at the same hospital. METHODS: Using the 2014 Nationwide Readmissions Database, we examined readmission patterns in younger patients (18- to 64-years-old) using hierarchical models to evaluate associations between hospital 30-day risk-standardized readmission rates (RSRRs) in elderly Medicare patients and readmission risk in younger patients with acute myocardial infarction, heart failure, or pneumonia...
June 9, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28602377/end-of-life-care-in-the-treatment-of-heart-failure-in-older-adults
#5
REVIEW
John Arthur McClung
Heart failure presents unique challenges to the clinician who desires to provide excellent and humane care near the end of life. Accurate prediction of mortality in the individual patient is complicated by a chronic disease that is punctuated by recurrent acute episodes and sudden death. Health care providers continue to have difficulty communicating effectively with terminally ill patients and their caregivers regarding end-of-life care preferences, all of which needs to occur earlier rather than later. This article also discusses various means of providing palliative care, and specific issues regarding device therapy, cardiopulmonary resuscitation, and palliative sedation with concurrent discussion of the ethical ramifications and pitfalls of each...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28591965/-predictive-value-of-early-changes-in-sublingual-microcirculation-on-organ-failure-of-patients-with-septic-shock
#6
Xue-Ying Zeng, Xue-Lian Liao, Yan Kang, Yao Chen, Wan-Hong Yin, Liang Zhao
OBJECTIVES: To determine the predictive value of early changes in sublingual microcirculation on organ failure of patients with septic shock. METHODS: Side-streamdark field imaging (SDF) videomicroscopy was performed to assess sublingual microcirculation of 34 adult patients at 0 h, 6 h and 24 h after they were diagnosed with septic shock.The patients were subject to sequential organ failure assessment (SOFA24 h-0 h). The patients with ΔSOFA24 h-0 h≥1 (deteriorated conditions) were compared with those with ΔSOFA24 h-0 h<1 in regard to sublingual microcirculation and the traditional hemodynamic indicators such as heart rate, mean arterial pressure, central venous pressure, urine output and lactate...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28574157/diffuse-myocardial-fibrosis-among-healthy-pediatric-heart-transplant-recipients-correlation-of-histology-cardiovascular-magnetic-resonance-and-clinical-phenotype
#7
Brian Feingold, Cláudia M Salgado, Miguel Reyes-Múgica, Stacey E Drant, Susan A Miller, Mark Kennedy, Peter Kellman, Erik B Schelbert, Timothy C Wong
Fibrosis is commonly described in heart allografts lost late after transplantation. CMR-derived ECV is a validated measure of DMF in native adult hearts that may predict heart failure and mortality. We explored associations of ECV with histologic myocardial fibrosis and clinical features after pediatric heart transplantation. Twenty-five recipients (7.0±6.3 years at transplant and 10.7±6.5 years post-transplant) were prospectively recruited for CMR and BNP measurement at the time of surveillance biopsy...
June 2, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28557302/dynamic-changes-and-prognostic-value-of-pulmonary-congestion-by-lung-ultrasound-in-acute-and-chronic-heart-failure-a-systematic-review
#8
Elke Platz, Allison A Merz, Pardeep S Jhund, Ali Vazir, Ross Campbell, John J McMurray
AIMS: Pulmonary congestion is an important finding in patients with heart failure (HF) that can be quantified by lung ultrasound (LUS). We conducted a systematic review to describe dynamic changes in LUS findings of pulmonary congestion (B-lines) in HF and to examine the prognostic utility of B-lines in HF. METHODS AND RESULTS: We searched online databases for studies conducted in patients with chronic or acute HF that used LUS to assess dynamic changes or the prognostic value of pulmonary congestion...
May 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28556898/hemoglobin-concentration-influences-n-terminal-pro-b-type-natriuretic-peptide-levels-in-hospitalized-older-adults-with-and-without-heart-failure
#9
Diana Lelli, Raffaele Antonelli Incalzi, Claudio Pedone
OBJECTIVES: To investigate the relationship between hemoglobin and N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration in hospitalized older adults with or without a diagnosis of heart failure (HF). DESIGN: Cross-sectional study based on retrospective hospital records review. SETTING: Geriatric acute care ward. PARTICIPANTS: Individuals aged 65 and older (N = 226; mean age 81.1), with (n = 104) and without (n = 122) a diagnosis of HF...
May 29, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28550957/feasibility-of-a-supraglottic-airway-device-for-transbronchial-lung-cryobiopsy-a-retrospective-analysis
#10
Axel Schmutz, Thorsten Dürk, Marco Idzko, Thomas Koehler, Johannes Kalbhenn, Torsten Loop
OBJECTIVES: To determine the feasibility of a supraglottic airway device for transbronchial cryobiopsy in adults. DESIGN: Retrospective analysis of anesthetic and pulmonary records between March 2015 and August 2016. SETTING: Single university medical center. PARTICIPANTS: One hundred thirty-two patients who underwent transbronchial cryobiopsy procedures performed under general anesthesia. INTERVENTIONS: Not applicable...
February 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28541747/evidence-based-utilization-of-non-invasive-ventilation-and-patient-outcomes
#11
Anuj B Mehta, Ivor S Douglas, Allan J Walkey
RATIONALE: Strong evidence supports use of non-invasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure (strong evidence conditions). Despite unclear benefits of NIV for other causes of acute respiratory failure, utilization for conditions with weaker evidence is increasing despite evidence demonstrating higher mortality for patients who suffer NIV failure (progression from NIV to invasive mechanical ventilation (IMV)) compared to being treated initially with IMV...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28528661/right-sided-cardiac-dysfunction-in-heart-failure-with-preserved-ejection-fraction-and-worsening-renal-function
#12
Monica Mukherjee, Kavita Sharma, Jose A Madrazo, Ryan J Tedford, Stuart D Russell, Allison G Hays
In urban populations, worsening renal function (WRF) is well established in patients hospitalized with acute decompensated heart failure with preserved ejection fraction (HFpEF). However, the mechanisms for development of WRF in the setting of acute HF in HFpEF are unclear. In the present study, we sought to characterize conventional echocardiographic measures of right ventricular (RV) chamber size and function to determine whether RV dysfunction and/or adverse RV remodeling is related to WRF in patients with HFpEF...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28525411/beta-blockers-and-traumatic-brain-injury-a-systematic-review-meta-analysis-and-eastern-association-for-the-surgery-of-trauma-guideline
#13
Aziz S Alali, Kaushik Mukherjee, Victoria A McCredie, Eyal Golan, Prakesh S Shah, James M Bardes, Susan E Hamblin, Elliott R Haut, James C Jackson, Kosar Khwaja, Nimitt J Patel, Satish R Raj, Laura D Wilson, Avery B Nathens, Mayur B Patel
OBJECTIVE: To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI). BACKGROUND: There have been no new inpatient pharmacologic therapies to improve TBI outcomes in a half-century. Treatment of TBI patients with β-blockers offers a potentially beneficial approach. METHODS: Using MEDLINE, EMBASE, and CENTRAL databases, eligible articles for our systematic review and meta-analysis (PROSPERO CRD42016048547) included adult (age ≥ 16 years) blunt trauma patients admitted with TBI...
May 18, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28522680/geographic-clustering-of-emergency-department-presentations-for-acute-coronary-syndromes-and-heart-failure-in-alberta-a-population-based-study
#14
Rhonda J Rosychuk, Brian H Rowe, Finlay A McAlister
BACKGROUND: Collectively, the most common acute cardiac presentations to emergency departments are acute coronary syndromes (ACSs) and heart failure. We examined geographic variation and clustering in emergency department presentations by adults for ACS or heart failure in Alberta in 2010/11. METHODS: All emergency department presentations for ACS or heart failure made by Alberta residents aged 35 years or more during 2010/11 were extracted from 5 linked population-based Alberta administrative health databases...
May 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28517030/gerbode-defect-and-multivalvular-dysfunction-complex-complications-in-adult-congenital-heart-disease
#15
Catarina Ruivo, Joana Guardado, Fernando Montenegro Sá, Fátima Saraiva, Alexandre Antunes, Joana Correia, João Morais
We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. A true left ventricular-to-right atrial shunt confirmed a direct Gerbode defect...
May 18, 2017: Echocardiography
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#16
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28499978/salt-taste-recognition-in-a-heart-failure-cohort
#17
Laura P Cohen, Scott L Hummel, Mathew S Maurer, Sara López-Pintado, Jeffrey D Wessler
BACKGROUND: Heart failure (HF) disproportionately affects older adults. Dietary sodium indiscretion is frequently implicated in HF decompensation. The affinity for and ability to taste salt in this process is unexplored. We sought to evaluate differences in salt taste by age and HF diagnosis and to map changes after hospitalization for acute decompensated heart failure (ADHF). METHODS: Seventy-two subjects underwent initial salt-taste testing during hospitalization for ADHF...
May 10, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28477282/implantation-of-carillon-%C3%A2-mitral-contour-system-with-transvenous-left-ventricular-lead-in-place
#18
T Wengenmayer, J Reinöhl, J Steinfurt, A Mittag, C Bode, J Biermann
BACKGROUND: Cardiac resynchronisation therapy (CRT) is an established treatment option for chronic heart failure patients with left bundle branch block. Although a concomitant functional mitral regurgitation is often reduced by CRT, many patients need additional mitral valve repair. Placing a CARILLON(®) Mitral Contour System (CMCS) over a transvenous CRT lead is currently not recommended, since both of them are implanted in the coronary sinus (CS). The aim of this study was to investigate the feasibility of sequential implantation of a transvenous LV lead followed by CMCS implantation, and to assess LV lead performance and possibility of extraction...
May 5, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28475215/effect-of-inpatient-dobutamine-vs-milrinone-on-out-of-hospital-mortality-in-patients-with-acute-decompensated-heart-failure
#19
Jordan B King, Rashmee U Shah, Amy Sainski-Nguyen, Joseph Biskupiak, Mark A Munger, Adam P Bress
STUDY OBJECTIVE: To determine the effect of dobutamine versus milrinone on out-of-hospital mortality in treatment of patients with acute decompensated heart failure (ADHF). DESIGN: Propensity score weighted, retrospective cohort study with mortality as primary outcome. SETTING: An academic health-care system. PATIENTS: 500 adult patients with a prior history of heart failure, who survived a hospitalization for ADHF that included treatment with dobutamine or milrinone between January 1, 2006 and April 30, 2014...
May 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28468613/low-mean-perfusion-pressure-is-a-risk-factor-for-progression-of-acute-kidney-injury-in-critically-ill-patients-a-retrospective-analysis
#20
Marlies Ostermann, Anna Hall, Siobhan Crichton
BACKGROUND: The aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients. METHODS: Retrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I...
May 3, 2017: BMC Nephrology
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