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https://www.readbyqxmd.com/read/28441614/learning-from-an-analysis-of-closed-malpractice-litigation-involving-myocardial-infarction
#1
Kuan-Han Wu, Yung-Lin Yen, Chien-Hung Wu, Chi-Yuan Hwang, Shih-Yu Cheng
OBJECTIVE: To examine the epidemiologic data, identify the pattern of dispute, and determine clinical litigious errors by analyzing closed malpractice claims involving myocardial infarction (MI) in Taiwanese courts. METHODS: A retrospective descriptive study was performed to analyze the verdicts pertaining to MI from the population-based database of the Taiwan judicial system between 2002 and 2013. The results of adjudication, involved specialists, primary dispute leading to lawsuits, and litigious errors were recorded...
April 13, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28439951/incidence-and-risk-factors-of-hypotension-after-intravenous-fosphenytoin-administration
#2
H K Kim, I G Hwang, I-S Koh, D W Kim
WHAT IS KNOWN AND OBJECTIVE: Fosphenytoin (FOS) administered intravenously offers several benefits over intravenously administered phenytoin, including a faster infusion rate, decreased pain and irritation at the infusion site, and fewer cardiovascular complications. However, some studies suggest that the intravenous administration of FOS in some patients may also induce adverse cardiovascular events. Here, we investigated the clinical characteristics of patients who experienced hypotension following an intravenous infusion of a FOS loading dose...
April 24, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28439651/contrast-enhanced-t1-mapping-based-extracellular-volume-fraction-independently-predicts-clinical-outcome-in-patients-with-non-ischemic-dilated-cardiomyopathy-a-prospective-cohort-study
#3
Jong-Chan Youn, Yoo Jin Hong, Hye-Jeong Lee, Kyunghwa Han, Chi Young Shim, Geu-Ru Hong, Young Joo Suh, Jin Hur, Young Jin Kim, Byoung Wook Choi, Seok-Min Kang
OBJECTIVES: We aimed to evaluate the prognostic role of cardiac magnetic resonance imaging (CMR)-based extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) and compare it with late gadolinium enhancement (LGE) parameters. METHODS: This was a single-center, prospective, cohort study of 117 NIDCM patients (71 men, 51.9 ± 16.7 years) who underwent clinical 3.0-T CMR. Myocardial ECV and LGE were quantified on the left ventricular myocardium...
April 24, 2017: European Radiology
https://www.readbyqxmd.com/read/28438028/cardiac-rehabilitation-programme-as-a-non-pharmacological-platelet-inhibitory-tool-in-acute-coronary-syndrome-survivors
#4
Emese Tóth-Zsámboki, Zsófia Horváth, László Hajtman, Sarolta Leé, Éva Pállinger, Eszter Kuklis, Ádám Tahy, György Fekete, László Kohut, Róbert G Kiss
Background Acute coronary syndrome is associated with platelet hyperactivity, which in its persistent form, promotes recurrent thrombotic events. Complex cardiac rehabilitation after acute coronary syndrome improves clinical outcome; however, its effect on platelet hyperactivity is unknown. Design and methods We enrolled 84 acute coronary syndrome patients on dual antiplatelet therapy, who underwent a new complex cardiac rehabilitation programme (NovaCord physiotherapy, lifestyle counselling, strict diet, stress management and regular coaching) and 51 control acute coronary syndrome patients with traditional cardiac rehabilitation...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#5
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437748/rational-and-timely-haemostatic-interventions-following-cardiac-surgery-coagulation-factor-concentrates-or-blood-bank-products
#6
Mariann Tang, Christian Fenger-Eriksen, Per Wierup, Jacob Greisen, Jørgen Ingerslev, Vibeke Hjortdal, Benny Sørensen
BACKGROUND: Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery...
April 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28436207/racial-differences-in-the-association-between-heart-rate-variability-and-left-ventricular-mass
#7
LaBarron K Hill, Lana L Watkins, Alan L Hinderliter, James A Blumenthal, Andrew Sherwood
PURPOSE: Increased left ventricular mass (LVM) is an early precursor of target organ damage due to hypertension. Diminished parasympathetic cardiac control has been linked to both hypertension onset and left ventricular impairment; however, emerging evidence suggests that this pattern may be different in African Americans. The present study sought to determine if race impacts the relationship between parasympathetic cardiac control and LVM. METHODS: LVM was assessed via echocardiography in a sample (N = 148) of African American and White adults (Mean age = 33...
April 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28435322/spinal-anesthesia-after-intraoperative-cardiac-arrest-during-general-anesthesia-in-an-infant
#8
Emmett E Whitaker, Veronica Miler, Jason Bryant, Stephanie Proicou, Rama Jayanthi, Joseph D Tobias
Although generally safe and effective, severe perioperative complications, including cardiac arrest, may occur during general anesthesia in infants. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. We present a case of cardiac arrest during general anesthesia in an infant who required urologic surgery. During the subsequent anesthetic care, spinal anesthesia was offered as an alternative to general anesthesia...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28434707/in-hospital-complications-after-implantation-of-cardiac-implantable-electronic-devices-analysis-of-a-national-inpatient-database-in-japan
#9
Sandeep Shakya, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Complications after implantation of cardiac implantable electronic devices (CIEDs), including permanent pacemakers (PMs) and other CIEDs, are associated with increased patient mortality and healthcare costs. This study aimed to investigate overall complications after implantation of CIEDs, analyze the associated risk factors, and compare complications after PM implantation between hospitals that performed only PM implantations (PM-only hospitals) and hospitals that implanted other CIEDs, as well as PMs (all-CIED hospitals)...
April 20, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28434264/exploring-effects-of-remote-ischemic-preconditioning-in-a-pig-model-of-hypothermic-circulatory-arrest
#10
Johanna Herajärvi, Tuomas Anttila, Elitsa Y Dimova, Tuomas Laukka, Mikko Myllymäki, Henri Haapanen, Benjamin A Olenchock, Hannu Tuominen, Ulla Puistola, Peeter Karihtala, Kai Kiviluoma, Peppi Koivunen, Vesa Anttila, Tatu Juvonen
OBJECTIVES: During aortic and cardiac surgery, risks for mortality and morbidity are inevitable. Surgical setups involving deep hypothermic circulatory arrest (DHCA) are effective to achieve organ protection against ischemic injury. The aim of this study was to identify humoural factors mediating additive protective effects of remote ischemic preconditioning (RIPC) in a porcine model of DHCA. DESIGN: Twenty-two pigs were randomized into the RIPC group (n = 11) and the control group (n = 11)...
April 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28434143/the-mtor-signaling-pathway-in-myocardial-dysfunction-in-type-2-diabetes-mellitus
#11
REVIEW
Tomohiro Suhara, Yuichi Baba, Briana K Shimada, Jason K Higa, Takashi Matsui
PURPOSE OF REVIEW: T2DM (type 2 diabetes mellitus) is a risk factor for heart failure. The mTOR (mechanistic target of rapamycin) is a key mediator of the insulin signaling pathway. We will discuss the role of mTOR in myocardial dysfunction in T2DM. RECENT FINDINGS: In T2DM, chronically activated mTOR induces multiple pathological events, including a negative feedback loop that suppresses IRS (insulin receptor substrate)-1. While short-term treatment with rapamycin, an mTOR inhibitor, is a promising strategy for cardiac diseases such as acute myocardial infarction and cardiac hypertrophy in T2DM, there are many concerns about chronic usage of rapamycin...
June 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28432849/upper-extremity-deep-venous-thrombosis-and-stenosis-after-implantation-of-pacemakers-and-defibrillators-a-prospective-study
#12
Morteza Safi, Mohammad Ali Akbarzadeh, Azadeh Azinfar, Mohammad Hasan Namazi, Isa Khaheshi
BACKGROUND: Obstruction of the access vein following cardiac pacemaker and defibrillator implantation is a common complication. However, the exact incidence and contributing risk factors are unknown. The aim of this study is to determine the incidence and analyze the contribution of each risk factor. METHODS: 57 consecutive patients candidate for their first transvenous pacemaker, implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy device implantation were enrolled...
April 22, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28432842/low-grade-inflammation-and-tryptophan-kynurenine-pathway-activation-are-associated-with-adverse-cardiac-remodeling-in-primary-hyperparathyroidism-the-epath-trial
#13
Nicolas Verheyen, Andreas Meinitzer, Martin Robert Grübler, Klemens Ablasser, Ewald Kolesnik, Astrid Fahrleitner-Pammer, Evgeny Belyavskiy, Christian Trummer, Verena Schwetz, Elisabeth Pieske-Kraigher, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo Alberto Sechi, Helmut Brussee, Dirk von Lewinski, Winfried März, Burkert Pieske, Stefan Pilz, Andreas Tomaschitz
BACKGROUND: Primary hyperparathyroidism (pHPT) is associated with low-grade inflammation, left ventricular hypertrophy and increased cardiovascular mortality, but the association between inflammatory markers and parameters of adverse cardiac remodeling is unknown. We investigated the relationship between C-reactive protein (CRP), the essential amino acid tryptophan and its pro-inflammatory derivatives kynurenine and quinolinic acid (QUIN) with echocardiographic parameters. METHODS: Cross-sectional baseline data from the "Eplerenone in Primary Hyperparathyroidism" trial were analyzed...
April 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28432810/liver-cirrhosis-is-a-risk-factor-for-atrial-fibrillation-a-nationwide-population-based-study
#14
HyunJung Lee, Eue-Keun Choi, Tae-Min Rhee, So-Ryoung Lee, Woo-Hyun Lim, Si-Hyuck Kang, Kyung-Do Han, Myung-Jin Cha, Seil Oh
BACKGROUND & AIMS: Information is lacking regarding whether liver cirrhosis (LC) is associated with atrial fibrillation (AF) development. We aimed to investigate the incidence and clinical significance of AF in cirrhotic patients. METHODS: LC patients (n = 3,596; mean age, 54.7 ± 12.3 years; male, 72.5%) without previous AF were selected from the Korean National Health Insurance Service National Sample Cohort database between 2004 and 2008. Age- and sex-matched controls (n=17,980) were randomly sampled in a 5:1 ratio from non-LC individuals...
April 22, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28432794/posttraumatic-stress-and-anxiety-in-patients-with-an-implantable-cardioverter-defibrillator-trajectories-and-vulnerability-factors
#15
M Habibović, J Denollet, S S Pedersen
BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy is first-line treatment for the primary and secondary prevention of sudden cardiac death. Despite the unequivocal medical benefits, living with an ICD may affect patients' psychological functioning and general well-being. We examined the trajectories of symptoms of posttraumatic stress disorder (PTSD) and anxiety in patients with an ICD and the vulnerability factors associated with an increased risk of symptoms of PTSD and anxiety...
April 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28432402/predictors-of-missed-appointments-in-patients-referred-for-congenital-or-pediatric-cardiac-magnetic-resonance
#16
Jimmy C Lu, Ray Lowery, Sunkyung Yu, Maryam Ghadimi Mahani, Prachi P Agarwal, Adam L Dorfman
BACKGROUND: Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities. OBJECTIVE: To characterize the rate of missed appointments and identify modifiable predictors. MATERIALS AND METHODS: This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan...
April 21, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28432158/risk-score-for-cardiac-surgery-in-active-left-sided-infective-endocarditis
#17
Carmen Olmos, Isidre Vilacosta, Gilbert Habib, Luis Maroto, Cristina Fernández, Javier López, Cristina Sarriá, Erwan Salaun, Salvatore Di Stefano, Manuel Carnero, Sandrine Hubert, Carlos Ferrera, Gabriela Tirado, Afonso Freitas-Ferraz, Carmen Sáez, Javier Cobiella, Juan Bustamante-Munguira, Cristina Sánchez-Enrique, Pablo Elpidio García-Granja, Cecile Lavoute, Benjamin Obadia, David Vivas, Ángela Gutiérrez, José Alberto San Román
OBJECTIVE: To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery. METHODS: Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28431832/unravelling-the-mysteries-of-sudden-unexpected-death-in-epilepsy
#18
K G Hampel, R Rocamora Zuñiga, C M Quesada
INTRODUCTION: Sudden unexpected death in epilepsy (SUDEP) is the most frequent cause of premature death in epileptic patients. Most SUDEP events occur at night and frequently go unnoticed; the exact pathophysiological mechanisms of this phenomenon therefore remain undetermined. Nevertheless, most cases of SUDEP are attributed to an infrequent yet extremely severe complication of epileptic seizures. DEVELOPMENT: We conducted a systematic literature search on PubMed...
April 18, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28431474/previous-hypertensive-hemorrhage-increases-the-risk-for-bleeding-and-ischemia-for-pci-patients-on-dual-antiplatelet-therapy
#19
Manli Qiao, Qi Bi, Paul Fu, Yixin Wang, Zhe Song, Fang Guo
OBJECTIVES: The use of antiplatelet therapy after intracerebral hemorrhage remains controversial, while the use of dual antiplatelet therapy (DAPT) is required after cardiac stenting. In this study, we examine the risk of bleeding and ischemic events for PCI patients with a history of hypertensive hemorrhage on DAPT. METHODS: A total of 128 cases and 153 controls were selected from Chinese patients with cardiac stenting on dual anti-platelet therapy for a single-center retrospective case-control study...
April 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28431059/cardiac-structural-and-functional-profile-of-patients-with-delayed-qrs-transition-zone-and-sudden-cardiac-death
#20
Aapo L Aro, Derek Phan, Carmen Teodorescu, Audrey Uy-Evanado, Kyndaron Reinier, Karen Gunson, Jonathan Jui, Heikki V Huikuri, Sumeet S Chugh
Aims: Delayed QRS transition zone in the precordial leads of the 12-lead electrocardiogram (ECG) has been recently associated with increased risk of sudden cardiac death (SCD), but the underlying mechanisms are unknown. We correlated echocardiographic findings with ECG and clinical characteristics to investigate how alterations in cardiac structure and function contribute to this risk marker. Methods and Results: From the ongoing population-based Oregon Sudden Unexpected Death Study (catchment population ∼1 million), SCD cases with prior ECG available (n = 627) were compared with controls (n = 801)...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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