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https://www.readbyqxmd.com/read/27919874/diltiazem-versus-metoprolol-for-rate-control-in-atrial-fibrillation-with-rapid-ventricular-response-in-the-emergency-department
#1
Michelle C Hines, Brent N Reed, Vijay Ivaturi, Laura J Bontempo, Michael C Bond, Bryan D Hayes
PURPOSE: The impact of patient-specific factors on the choice of β-blocker versus calcium channel blocker therapy for rate control in emergency department (ED) patients treated for atrial fibrillation (AF) was investigated. METHODS: A retrospective cohort study was conducted to evaluate the influence of demographics, prior medication use, hemodynamic and clinical characteristics, and other variables on selection of first-line therapy for AF among patients admitted to the ED of an academic medical center over a 22-month period (October 2012-July 2014) who received i...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27909526/achieving-bidirectional-long-delays-in-pulmonary-vein-antral-lines-prior-to-bidirectional-block-in-patients-with-paroxysmal-atrial-fibrillation-the-bi-bi-technique-for-atrial-fibrillation-ablation
#2
Adel F Mina Md Facc Fhrs, Nicholas L Warnecke Pa-C
Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. With this we tried to achieve long delays in the pulmonary veins antral lines prior to complete isolation comparable to those delays found in patient with bidirectional block of atrial flutter lines...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908945/norwood-procedure-for-palliation-of-hypoplastic-left-heart-syndrome-right-ventricle-to-pulmonary-artery-conduit-vs-modified-blalock-taussig-shunt
#3
Dorothy M Beke
Patients with hypoplastic left heart syndrome undergo a series of operations to separate the pulmonary and systemic circulations. The first of at least 3 operations occurs in the newborn period, with a stage I palliation. The goal of stage I palliation is to provide pulmonary blood flow and create an unobstructed systemic outflow tract. Advances in surgical techniques and intraoperative and postoperative care have helped decrease morbidity and mortality for patients with hypoplastic left heart syndrome who have the stage I Norwood operation, but the patients continue to be at increased risk for hemodynamic collapse and adverse outcomes...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908824/arteriographic-patterns-of-atherosclerosis-and-the-association-between-diabetes-mellitus-and-ethnicity-in-chronic-critical-limb-ischemia
#4
Jayer Chung, J Gregory Modrall, Martyn Knowles, Qun Xiang, Lawrence A Lavery, Carlos H Timaran, R James Valentine
BACKGROUND: Disparate outcomes in critical limb ischemia (CLI) persist between ethnicities. The contribution of modifiable factors versus intrinsic biologic differences remains unclear. Hence, we aimed to quantify the associations between ethnicity and anatomic patterns of arterial occlusive disease in CLI, adjusting for known atherosclerotic risk factors. METHODS: We performed a retrospective, single-center review of consecutive patients presenting to the vascular surgery service with CLI...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27906936/analgesic-effect-of-nalbuphine-when-added-to-intravenous-regional-anesthesia-a-randomized-control-trial
#5
Mohamed Hassan Bakri, Eman Ahmed Ismail, Sayed Kaoud Abd-Elshafy
BACKGROUND: Different adjuvant drugs are currently added to lidocaine for intravenous regional anesthesia (IVRA) to decrease tourniquet and postoperative pain. OBJECTIVE: The aim of the study was to examine the effect of nalbuphine when added toIVRA. STUDY DESIGN: Prospective, randomized, double-blind, controlled clinical trial. SETTING: Assiut University Hospitals. METHODS: One hundred-six adult patients scheduled for unilateral hand surgery under IVRA were randomized into 2 equal groups...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27905492/high-fidelity-computational-simulation-of-thrombus-formation-in-thoratec-heartmate-ii-continuous-flow-ventricular-assist-device
#6
Wei-Tao Wu, Fang Yang, Jingchun Wu, Nadine Aubry, Mehrdad Massoudi, James F Antaki
Continuous flow ventricular assist devices (cfVADs) provide a life-saving therapy for severe heart failure. However, in recent years, the incidence of device-related thrombosis (resulting in stroke, device-exchange surgery or premature death) has been increasing dramatically, which has alarmed both the medical community and the FDA. The objective of this study was to gain improved understanding of the initiation and progression of thrombosis in one of the most commonly used cfVADs, the Thoratec HeartMate II...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#7
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27898687/effects-of-chronologic-age-and-young-child-exposure-on-respiratory-syncytial-virus-disease-among-us-preterm-infants-born-at-32-to-35-weeks-gestation
#8
Eric A F Simões, Evan J Anderson, Xionghua Wu, Christopher S Ambrose
OBJECTIVE: To estimate the incidence of respiratory syncytial virus (RSV) disease as a function of chronologic age and exposure to young children in US preterm infants. METHODS: In the RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study, preterm infants born at 32-35 weeks gestational age (wGA) were enrolled from 188 US clinics and followed September-May of 2009-2010 or 2010-2011. Infants with medically-attended acute respiratory illness had nasal/pharyngeal swabs collected for viral testing...
2016: PloS One
https://www.readbyqxmd.com/read/27896702/safety-of-regadenoson-stress-testing-in-patients-with-pulmonary-hypertension
#9
Victor M Moles, Thomas Cascino, Ashraf Saleh, Krasimira Mikhova, John J Lazarus, Michael Ghannam, Hong J Yun, Matthew Konerman, Richard L Weinberg, Edward P Ficaro, James R Corbett, Vallerie V McLaughlin, Venkatesh L Murthy
OBJECTIVES: We sought to determine the safety of regadenoson stress testing in patients with PH. BACKGROUND: PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease. Because of their physical limitations, patients with PH are unable to adequately exercise. Regadenoson can potentially have an adverse impact due to their tenuous hemodynamics. Current guidelines suggest performing a coronary angiography in patients with PH who have angina or multiple coronary risk factors...
November 28, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27896466/early-hemodynamic-assessment-and-treatment-of-elderly-patients-in-the-medical-icu
#10
Gorazd Voga, Lucija Gabršček-Parežnik
BACKGROUND AND OBJECTIVES: The aim of this retrospective study was to analyze differences in the initial hemodynamic assessment and its impact on the treatment in patients aged 80 years or older compared to younger patients during the first 6 h after admission to the medical intensive care unit (ICU). RESULTS: We analyzed 615 consecutive patients admitted to the medical ICU of which 124 (20%) were aged 80 years or more. The older group had a significantly higher acute physiology and chronic health evaluation (APACHE II) score, an overall mortality in the ICU and a presence of pre-existing cardiac disease...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895464/selexipag-in-the-treatment-of-pulmonary-arterial-hypertension-design-development-and-therapy
#11
REVIEW
Elizabeth Ashley Hardin, Kelly M Chin
Pulmonary arterial hypertension is characterized by abnormalities in the small pulmonary arteries including increased vasoconstriction, vascular remodeling, proliferation of smooth muscle cells, and in situ thrombosis. Selexipag, a novel, oral prostacyclin receptor agonist, has been shown to improve hemodynamics in a phase II clinical trial and reduce clinical worsening in a large phase III clinical trial involving patients with pulmonary arterial hypertension. In this paper, we describe the prostacyclin signaling pathway, currently available oral prostanoid medications, and the development and clinical use of selexipag...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27895025/medical-treatment-of-aortic-stenosis
#12
Guillaume Marquis-Gravel, Björn Redfors, Martin B Leon, Philippe Généreux
Untreated, severe, symptomatic aortic stenosis is associated with a dismal prognosis. The only treatment shown to improve survival is aortic valve replacement; however, before symptoms occur, aortic stenosis is preceded by a silent, latent phase characterized by a slow progression at the molecular, cellular, and tissue levels. In theory, specific medical therapy should halt aortic stenosis progression, reduce its hemodynamic repercussions on left ventricular function and remodeling, and improve clinical outcomes...
November 29, 2016: Circulation
https://www.readbyqxmd.com/read/27884237/diastolic-dysfunction-and-hypertension
#13
REVIEW
Wilson Nadruz, Amil M Shah, Scott D Solomon
Left ventricular (LV) diastolic dysfunction (LVDD) is characterized by alterations in LV diastolic filling, and is a strong predictor of cardiovascular events and heart failure. Hypertension is the most important risk factor for LVDD in the community and promotes LVDD through several mechanisms, including hemodynamic overload and myocardial ischemia. Associated factors such as age, ethnicity, dietary sodium, obesity, diabetes mellitus, and chronic kidney disease also contribute to LVDD in hypertensive individuals...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27882105/a-pilot-study-of-perioperative-esmolol-for-myocardial-protection-during-on-pump-cardiac-surgery
#14
Xue Liu, Fengxia Shao, Liu Yang, Youhai Jia
The protective effects of preprocedural esmolol on myocardial injury and hemodynamics have not, to date, been investigated in patients who were scheduled for cardiac surgeries under a cardiopulmonary bypass (CPB). A pilot randomized controlled trial was performed at The First Affiliated Hospital of Dalian Medical University (Dalian, China). Patients scheduled for elective open-heart surgeries under CBP were included, and were randomized to esmolol and control groups. For patients in the esmolol groups, intravenous esmolol (70 µg/kg/min) was administered at the time of incision until CPB was performed...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#15
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27876104/a-cohort-study-of-unstable-overdose-patients-treated-with-intravenous-lipid-emulsion-therapy
#16
Shazma Mithani, Kathryn Dong, Ashlea Wilmott, Heather Podmoroff, Nadim Lalani, Rhonda J Rosychuk, Ryan Chuang, Mark C Yarema
OBJECTIVES: Intravenous lipid emulsion (ILE) has been used increasingly over the last decade for a range of drug overdoses. Although the use of ILE in local anesthetic toxicity (LAST) is well established, the hemodynamic effectiveness of ILE in non-LAST poisonings is still unclear. Thus, the primary objective of this study was to examine a cohort of poisoned patients in whom ILE was administered. METHODS: Consecutive patients were identified by calls to a regional poison center from May 1, 2012 to May 30, 2014...
November 23, 2016: CJEM
https://www.readbyqxmd.com/read/27875190/combined-visualization-of-vessel-deformation-and-hemodynamics-in-cerebral-aneurysms
#17
Monique Meuschke, Samuel Voss, Oliver Beuing, Bernhard Preim, Kai Lawonn
We present the first visualization tool that combines patient-specific hemodynamics with information about the vessel wall deformation and wall thickness in cerebral aneurysms. Such aneurysms bear the risk of rupture, whereas their treatment also carries considerable risks for the patient. For the patient-specific rupture risk evaluation and treatment analysis, both morphological and hemodynamic data have to be investigated. Medical researchers emphasize the importance of analyzing correlations between wall properties such as the wall deformation and thickness, and hemodynamic attributes like the Wall Shear Stress and near-wall flow...
January 2017: IEEE Transactions on Visualization and Computer Graphics
https://www.readbyqxmd.com/read/27871567/intraoperative-medications-associated-with-hemodynamically-significant-anaphylaxis
#18
Robert E Freundlich, Neal M Duggal, Michelle Housey, Tyler T Tremper, Milo C Engoren, Sachin Kheterpal
STUDY OBJECTIVE: To facilitate the identification of drugs and patient factors associated with hemodynamically significant anaphylaxis. DESIGN: Using an existing database containing complete perioperative records, instances of hemodynamically significant anaphylaxis were identified using a physiologic and treatment-based screening algorithm. All cases were manually reviewed by 2 clinicians, with a third adjudicating disagreements, and confirmed cases were matched 3:1 with control cases...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867865/perioperative-hemodynamic-instability-in-patients-undergoing-laparoscopic-adrenalectomy-for-pheochromocytoma
#19
REVIEW
Magdalena Pisarska, Michał Pędziwiatr, Andrzej Budzyński
Perioperative hemodynamic instability still remains the biggest surgical and anesthetic challenge in surgery for pheochromocytoma. The aim of this review was to discuss pre-, intra- and postoperative factors that may impact on hemodynamic condition of a patient. It describes patients' preparation with appropriate medication, principles of surgical technique as well as risk factors for development of hemodynamic instability in postoperative period. Currently the gold standard in the treatment of pheochromocytoma is preoperative use of alpha-blockers and laparoscopic surgery...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27867292/new-impella-cardiac-power-device-used-in-patient-with-cardiogenic-shock-due-to-nonischemic-cardiomyopathy
#20
Marek Cena, Frances Karam, Rajesh Ramineni, Wissam Khalife, Alejandro Barbagelata
The new percutaneous Impella CP (Cardiac Power; Abiomed, Inc., Danvers, MA) was designed to provide a higher level of support than Impella 2.5 (Abiomed, Inc.). We present the first documented case of a patient that was transitioned from the Impella 2.5 to Impella CP. A 48-year-old male patient with no medical history was transferred to our institution with a one day history of worsening shortness of breath. The patient was unstable and found to have monomorphic ventricular tachycardia at 220 beats/min that was cardioverted to normal sinus rhythm...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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