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https://www.readbyqxmd.com/read/29786535/evaluating-the-importance-of-sham-controlled-trials-in-the-investigation-of-medical-devices-in-interventional-cardiology
#1
Robert A Byrne, Davide Capodanno, Felix Mahfoud, Jean Fajadet, Stephan Windecker, Peter Jüni, Andreas Baumbach, William Wijns, Michael Haude
Cardiovascular medicine is one of the specialties that has relied most heavily on evidence from randomized clinical trials in determining best practice for the management of common disease conditions. When comparing treatment approaches, trials incorporating random allocation are the most appropriate method for protecting against treatment allocation bias. In order to protect against performance and ascertainment bias, trial designs including placebo control are preferable where feasible. In contrast to testing of medicines, treatments based on procedures or use of medical devices are more challenging to assess, as sham procedures are necessary to facilitate blinding of participants...
May 22, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29706056/changes-in-medical-care-due-to-the-absence-of-internal-medicine-physicians-in-emergency-departments
#2
Kyoung Ho Kim, Jang Young Lee, Won Suk Lee, Won Young Sung, Sang Won Seo
Objective: Especially in emergency departments (EDs), a lack of internal medicine (IM) residents in charge causes difficulties in medical care and ED overcrowding. Thus, protocols without IM residents in EDs is needed. This study aimed to investigate changes in medical care when emergency medicine residents replaced the roles of IM residents. Methods: This study was conducted at a single-site ED of a university medical center. The study group contained patients admitted to the IM department between September and December 2015, during which IM residents were absent in the ED...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29694994/predicting-the-future-delivery-room-planning-of-congenital-heart-disease-diagnosed-by-fetal-echocardiography
#3
Mary T Donofrio
Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29692482/post-procedural-complications-of-cardiac-implants-done-in-a-resource-limited-setting-under-c-arm-a-single-centre-experience
#4
A Jayachandra, Vivek Aggarwal, Sandeep Kumar, I V Nagesh
Background: Cardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm. Methods: This study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities...
April 2018: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29687878/anthracycline-and-trastuzumab-induced-cardiotoxicity-in-breast-cancer
#5
M A Nicolazzi, A Carnicelli, M Fuorlo, A Scaldaferri, R Masetti, R Landolfi, A M R Favuzzi
OBJECTIVE: Breast cancer is the most common cancer among women. In the last twenty years early diagnosis, neoadjuvant and adjuvant systemic treatment that targeted to specific molecular targets have significantly reduced the mortality from breast cancer. However, the increase in survival has allowed to observe the cardiotoxic effects of anticancer therapy and increased mortality from cardiovascular causes, resulting in a large literature where experts try to identify the correct management of this critical problem...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#6
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29670358/multidisciplinary-approach-to-the-management-of-pulmonary-embolism-patients-the-pulmonary-embolism-response-team-pert
#7
REVIEW
Christopher W Root, David M Dudzinski, Bishoy Zakhary, Oren A Friedman, Akhilesh K Sista, James M Horowitz
Pulmonary embolism (PE) is a potentially fatal disease with a broad range of treatment options that spans multiple specialties. The rapid evolution and expansion of novel therapies to treat PE make it a disease process that is well suited to a multidisciplinary approach. In order to facilitate a rapid, robust response to the diagnosis of PE, some hospitals have established multidisciplinary pulmonary embolism response teams (PERTs). The PERT model is based on existing multidisciplinary teams such as heart teams and rapid response teams...
2018: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#8
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29529170/focus-cardiac-ultrasound-core-curriculum-and-core-syllabus-of-the-european-association-of-cardiovascular-imaging%C3%A2
#9
Aleksandar N Neskovic, Henry Skinner, Susanna Price, Gabriele Via, Stefan De Hert, Ivan Stankovic, Maurizio Galderisi, Erwan Donal, Denisa Muraru, Erik Sloth, Luna Gargani, Nuno Cardim, Alexandros Stefanidis, Matteo Cameli, Gilbert Habib, Bernard Cosyns, Patrizio Lancellotti, Thor Edvardsen, Bogdan A Popescu
There is a growing trend of using ultrasound examination of the heart as a first-line diagnostic tool for initial patient evaluation in acute settings. Focus cardiac ultrasound (FoCUS) is a standardized but restricted cardiac ultrasound examination that may be undertaken by a range of medical professionals with diverse backgrounds. The intention of this core curriculum and syllabus is to define a unifying framework for educational and training processes/programmes that should result in competence in FoCUS for various medical professionals dealing with diagnostics and treatment of cardiovascular emergencies...
February 26, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29477388/a-health-economics-approach-to-us-value-assessment-frameworks-introduction-an-ispor-special-task-force-report-1
#10
Peter J Neumann, Richard J Willke, Louis P Garrison
Concerns about rising spending on prescription drugs and other areas of health care have led to multiple initiatives in the United States designed to measure and communicate the value of pharmaceuticals and other technologies for decision making. In this section we introduce the work of the International Society for Pharmacoeconomics and Outcomes Research Special Task Force on US Value Assessment Frameworks formed to review relevant perspectives and appropriate approaches and methods to support the definition and use of high-quality value frameworks...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29475399/noacs-only-for-those-who-cannot-tolerate-a-vka-where-is-the-evidence
#11
Vinai C Bhagirath, Bernard Cosyns, John W Eikelboom
The 2016 European Society of Cardiology Guidelines recommend non-vitamin K antagonist oral anticoagulants (NOACs) in preference to vitamin K antagonists (VKA) for stroke prevention in atrial fibrillation. A recent report from the Belgian Healthcare Knowledge Centre (KCE) raised concerns about the results of the phase 3 randomised trials that led to the approval of the NOACs for this indication and concluded that NOACs should only be used for patients who fail or cannot undergo treatment with a vitamin K antagonist because they cannot achieve stable INR values...
February 23, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29456363/inadvertent-central-arterial-catheterization-an-unusual-cause-of-ischemic-stroke
#12
Nakul Katyal, Amanda Korzep, Christopher Newey
Central venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29440830/impact-of-intensive-care-unit-attending-physician-training-background-on-outcomes-in-children-undergoing-heart-operations
#13
Priya Bhaskar, Mallikarjuna Rettiganti, Jeffrey M Gossett, Punkaj Gupta
Background: The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim: To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design: Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015)...
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29422726/audit-of-postoperative-surgical-intensive-care-unit-admissions
#14
Shaili K Patel, Samir M Kacheriwala, Dipesh D Duttaroy
Objective: The objective of this study was to conduct an audit of Surgical Intensive Care Unit (SICU) for identifying the admission risk factors and evaluating the outcomes of postoperative surgical patients. Design: This was a prospective, observational study. Setting: This study was conducted at SICU of a 1500-bedded tertiary care university hospital in Western India. Subject and Methods: Two hundred and forty patients admitted to the SICU postoperatively over a period of 15 months...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29394481/transitioning-patients-from-the-intensive-care-unit-to-the-general-pediatric-unit-a-piece-of-the-puzzle-in-family-centered-care
#15
Lisa Manente, Terri McCluskey, Rachel Shaw
Transitioning patients from one unit to another is a nursing function that occurs daily. When done effectively, it streamlines continuity of care, decreases anxiety, ensures patients and families maintain confidence in care providers, and avoids readmissions to the intensive care unit (ICU). This article describes a transition plan for transferring patients from the ICU to the general pediatric unit developed by an inpatient, non-critical care cardiology/neuro logical unit to facilitate a smooth and informational transition from the ICU to the non-critical unit...
March 2017: Pediatric Nursing
https://www.readbyqxmd.com/read/29345005/-there-s-no-acknowledgement-of-what-this-does-to-people-a-qualitative-exploration-of-mental-health-among-parents-of-children-with-critical-congenital-heart-defects
#16
Sarah E Woolf-King, Emily Arnold, Sandra Weiss, David Teitel
AIMS AND OBJECTIVES: The purpose of this study was to explore the psychological impact of parenting a child with a critical congenital heart defect and the feasibility and acceptability of integrating psychological services into paediatric cardiology care. BACKGROUND: Children with critical congenital heart defect are at an increased risk for long-term behavioural, social and emotional difficulties. Data suggest that this risk is partially attributable to parental mental health, which is a stronger predictor of long-term behavioural problems in congenital heart defect children than disease-specific and surgical factors...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29327527/role-and-relevance-of-blood-pressure-variability-in-hypertension-related-co-morbidities
#17
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29301631/primary-prevention-with-statins-in-the-elderly
#18
REVIEW
Martin Bødtker Mortensen, Erling Falk
The burden of atherosclerotic cardiovascular disease (ASCVD) in high-income countries is mostly borne by the elderly. With increasing life expectancy, clear guidance on sensible use of statin therapy to prevent a first and potentially devastating ASCVD event is critically important to ensure a healthy aging population. Since 2013, 5 major North American and European guidelines on statin use in primary prevention of ASCVD have been released by the American College of Cardiology/American Heart Association, the UK National Institute for Health and Care Excellence, the Canadian Cardiovascular Society, U...
January 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29275030/testosterone-and-cardiovascular-health
#19
REVIEW
Andrew Elagizi, Tobias S Köhler, Carl J Lavie
There is an ongoing debate in the medical community regarding the effects of testosterone on cardiovascular (CV) health. For decades, there has been conflicting evidence regarding the association of endogenous testosterone levels and CV disease (CVD) events that has resulted in much debate and confusion among health care providers and patients alike. Testosterone therapy has become increasingly widespread, and after the emergence of studies that reported increased CVD events in patients receiving testosterone therapy, the US Food and Drug Administration (FDA) released a warning statement about testosterone and its potential risk regarding CV health...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29214676/platelet-function-monitoring-for-stent-thrombosis-in-critically-iii-patients-with-an-acute-coronary-syndrome
#20
Lisa Tilemann, Sarah K Mohr, Michael Preusch, Emanuel Chorianopoulos, Evangelos Giannitsis, Hugo A Katus, Oliver J Müller
BACKGROUND: Patients after cardiac arrest or in cardiogenic shock due to acute coronary syndrome (ACS) are at high risk for stent thrombosis (ST) and recurrent cardiovascular events after primary percutaneous coronary intervention (PCI). High post-interventional platelet reactivity (HPR) might be an additional risk factor for ST in these critically ill patients. METHODS: Between 2006 and 2016, 401 critically ill patients from a cardiologic intensive care unit underwent platelet function testing after primary PCI using whole blood impedance aggregometry...
December 6, 2017: Journal of Interventional Cardiology
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