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https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#1
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28056987/blood-pressure-control-in-type-2-diabetic-patients
#2
REVIEW
Alon Grossman, Ehud Grossman
Diabetes mellitus (DM) and essential hypertension are common conditions that are frequently present together. Both are considered risk factors for cardiovascular disease and microvascular complications and therefore treatment of both conditions is essential. Many papers were published on blood pressure (BP) targets in diabetic patients, including several works published in the last 2 years. As a result, guidelines differ in their recommendations on BP targets in diabetic patients. The method by which to control hypertension, whether pharmacological or non-pharmacological, is also a matter of debate and has been extensively studied in the literature...
January 6, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28011188/mid-range-ejection-fraction-does-not-permit-risk-stratification-among-patients-hospitalized-for-heart-failure
#3
Inés Gómez-Otero, Andreu Ferrero-Gregori, Alfonso Varela Román, José Seijas Amigo, Domingo A Pascual-Figal, Juan Delgado Jiménez, Jesús Álvarez-García, Francisco Fernández-Avilés, Fernando Worner Diz, Luis Alonso-Pulpón, Juan Cinca, José Ramón Gónzalez-Juanatey
INTRODUCTION AND OBJECTIVES: European Society of Cardiology heart failure guidelines include a new patient category with mid-range (40%-49%) left ventricular ejection fraction (HFmrEF). HFmrEF patient characteristics and prognosis are poorly defined. The aim of this study was to analyze the HFmrEF category in a cohort of hospitalized heart failure patients (REDINSCOR II Registry). METHODS: A prospective observational study was conducted with 1420 patients classified according to ejection fraction as follows: HFrEF, < 40%; HFmrEF, 40%-49%; and HFpEF, ≥ 50%...
December 20, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27968771/treatment-of-acute-cardiac-failure-in-the-emergency-department-improve-our-practices-data-from-the-resurcor-network
#4
L Belle, G Courtiol, L Lamboley, P Debax, P Pili, G Deschane, M Latappy, J Oberlin, A Drouet, C Ricard, C Morvan, F-X Ageron
BACKGROUND: In 2015, the European Society of cardiology published guidelines on the pre-hospital and early hospital management of acute cardiac failure (ACF), which included: - use of intravenous vasodilators (nitrates) when systolic blood pressure is>110mmHg; - non-invasive ventilation if oxygen saturation is<90% and/or respiratory rate is>25/min despite nasal oxygen; - using a reduced dose of intravenous furosemide (20-40mg or equivalent of the oral morning dose if already on chronic diuretic therapy) and; - early performance of echocardiography...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27955682/health-effectiveness-and-cost-effectiveness-of-telehealthcare-for-heart-failure-study-protocol-for-a-randomized-controlled-trial
#5
Simon Lebech Cichosz, Lars Holger Ehlers, Ole Hejlesen
BACKGROUND: Several heart failure studies have shown promising results for implementing telehealthcare. These studies have led to clinical and political interest in telehealthcare as a way to improve heart failure outcomes and lower costs. However, there is a need for large-scale clinical trials with cost-effectiveness assessments. METHODS/DESIGN: The present study is known as the TeleCare North Heart Failure Trial in Denmark. We are studying the health effectiveness and cost-effectiveness of a telehealth (Telekit) solution compared with usual care for patients with heart failure...
December 12, 2016: Trials
https://www.readbyqxmd.com/read/27927632/associations-between-blood-pressure-and-outcomes-among-blacks-in-the-jackson-heart-study
#6
Tiffany C Randolph, Melissa A Greiner, Chidiebube Egwim, Adrian F Hernandez, Kevin L Thomas, Lesley H Curtis, Paul Muntner, Wei Wang, Robert J Mentz, Emily C O'Brien
BACKGROUND: In 2014, new hypertension guidelines liberalized blood pressure goals for persons 60 years and older. Little is known about the implications for blacks. METHODS AND RESULTS: Using data from 2000 through 2011 for 5280 participants in the Jackson Heart Study, a community-based black cohort in Jackson, Mississippi, we examined whether higher blood pressure was associated with greater risk of mortality and heart failure hospitalization, and whether the risk was the same across age groups...
December 7, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27923668/health-associations-with-meeting-new-24-hour-movement-guidelines-for-canadian-children-and-youth
#7
Valerie Carson, Jean-Philippe Chaput, Ian Janssen, Mark S Tremblay
The study objective was to examine whether meeting the new Canadian 24-hour movement guidelines was associated with health indicators in a representative sample of Canadian children and youth. Cross-sectional findings are based on 4157 (1239 fasting subsample) children and youth aged 6-17years from cycles 1-3 of the Canadian Health Measures Survey (CHMS). Sleep and screen time were subjectively measured while moderate- to vigorous-intensity physical activity (MVPA) was accelerometer-determined. Health indicators in the full sample (body mass index (BMI) z-scores, waist circumference, blood pressure, behavioral strengths and difficulties score (lower=better), and aerobic fitness) and fasting subsample (triglycerides, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, and insulin) were measured...
December 5, 2016: Preventive Medicine
https://www.readbyqxmd.com/read/27900971/chronic-kidney-disease-stages-among-diabetes-patients-in-the-cape-coast-metropolis
#8
Richard K D Ephraim, Eric Arthur, W K B A Owiredu, Prince Adoba, Hope Agbodzakey, Ben A Eghan
Diabetes patients worldwide are at a high risk of chronic kidney disease (CKD) which affects their quality of life and increases the risk of early death. This study used the new kidney disease improving global outcomes (KDIGO) guidelines to establish the prevalence and also identify the factors associated with CKD among diabetes patients in the Cape Coast Metropolis. Two hundred (200) diabetes patients were randomly recruited from the diabetic clinic of the Cape Coast Teaching Hospital from January to April 2014...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27887644/copenhagen-comorbidity-in-hiv-infection-cocomo-study-a-study-protocol-for-a-longitudinal-non-interventional-assessment-of-non-aids-comorbidity-in-hiv-infection-in-denmark
#9
Andreas Ronit, Judith Haissman, Ditte Marie Kirkegaard-Klitbo, Thomas Skårup Kristensen, Anne-Mette Lebech, Thomas Benfield, Jan Gerstoft, Henrik Ullum, Lars Køber, Andreas Kjær, Klaus Kofoed, Jørgen Vestbo, Børge Nordestgaard, Jens Lundgren, Susanne Dam Nielsen
BACKGROUND: Modern combination antiretroviral therapy (cART) has improved survival for people living with HIV (PLWHIV). Non-AIDS comorbidities have replaced opportunistic infections as leading causes of mortality and morbidity, and are becoming a key health concern as this population continues to age. The aim of this study is to estimate the prevalence and incidence of non-AIDS comorbidity among PLWHIV in Denmark in the cART era and to determine risk factors contributing to the pathogenesis...
November 26, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27884231/guidelines-for-the-management-of-hypertension
#10
REVIEW
Aram V Chobanian
This article summarizes pertinent data from clinical trials on the effects of antihypertensive therapy on cardiovascular complications. Prior definitions of hypertension and blood pressure goals of therapy are discussed, and differences between national and international guidelines on such goals are summarized. The results of the SPRINT study are summarized, and the impact of this study on future goals of treatment is discussed. New recommendations are provided on blood pressure goals, and the effects such goals might have on clinical practice are discussed...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27855640/long-term-secondary-prevention-of-acute-myocardial-infarction-sepat-guidelines-adherence-and-outcome
#11
Constantinos Ergatoudes, Erik Thunström, Annika Rosengren, Lena Björck, Kristina Bengtsson Boström, Kristin Falk, Michael Fu
BACKGROUND: A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. METHODS: Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden...
November 17, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27811309/baseline-characteristics-of-the-3096-patients-recruited-into-the-triple-antiplatelets-for-reducing-dependency-after-ischemic-stroke-trial
#12
Philip Mw Bath, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Stuart Pocock, Annemarei Ranta, Thompson G Robinson, Katie Flaherty, Polly Scutt, Graham S Venables, Lisa J Woodhouse, Nikola Sprigg
BACKGROUND: The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. DESIGN: The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack...
November 3, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27810041/the-cardiovascular-risk-of-white-coat%C3%A2-hypertension
#13
Stanley S Franklin, Lutgarde Thijs, Kei Asayama, Yan Li, Tine W Hansen, José Boggia, Lotte Jacobs, Zhenyu Zhang, Masahiro Kikuya, Kristina Björklund-Bodegård, Takayoshi Ohkubo, Wen-Yi Yang, Jørgen Jeppesen, Eamon Dolan, Tatiana Kuznetsova, Katarzyna Stolarz-Skrzypek, Valérie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri Nikitin, Lars Lind, Edgardo Sandoya, Kalina Kawecka-Jaszcz, Jan Filipovský, Yutaka Imai, Ji-Guang Wang, Eoin O'Brien, Jan A Staessen
BACKGROUND: The role of white-coat hypertension (WCH) and the white-coat-effect (WCE) in development of cardiovascular disease (CVD) risk remains poorly understood. OBJECTIVES: Using data from the population-based, 11-cohort IDACO (International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes), this study compared daytime ambulatory blood pressure monitoring with conventional blood pressure measurements in 653 untreated subjects with WCH and 653 normotensive control subjects...
November 8, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27771852/threshold-and-target-for-blood-pressure-lowering-in-the-elderly
#14
Guido Grassi, Fosca Quarti-Trevano, Anna Casati, Raffaella Dell'Oro
PURPOSE OF REVIEW: Detection of elevated blood pressure values in elderly patients represents a common clinical condition associated with an increased cardiovascular risk. This has been shown to be the case in both systodiastolic and isolated systolic hypertension as well. However, despite the evidence of the benefits of the blood pressure lowering intervention in terms of reduction of cardiovascular morbidity and mortality, at least two issues related to antihypertensive drug treatment in aged individuals are still undefined: (1) the blood pressure threshold at which antihypertensive drug should be initiated and (2) the blood pressure goals of the therapeutic intervention...
December 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27760797/the-effects-of-music-on-pain-a-meta-analysis
#15
Jin Hyung Lee
BACKGROUND: Numerous meta-analyses have been conducted on the topic of music and pain, with the latest comprehensive study published in 2006. Since that time, more than 70 randomized controlled trials (RCTs) have been published, necessitating a new and comprehensive review. OBJECTIVE: The aim of this meta-analysis was to examine published RCT studies investigating the effect of music on pain. METHODS: The present study included RCTs published between 1995 and 2014...
2016: Journal of Music Therapy
https://www.readbyqxmd.com/read/27754279/hw-03-2-effect-of-cpap-on-the-treatment-of-resistant-hypertension
#16
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754160/pl-03-1-hypertension-management-in-the-era-of-digital-information-and-communication-technologies
#17
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754015/br-04-1management-of-treatment-resistant-hypertension
#18
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754006/js-ish-esh-2-update-on-the-detection-and-follow-up-of-early-hypertensive-heart-disease
#19
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753863/chl-01-2-central-hypertension
#20
Chen-Huan Chen
Blood pressure (BP) is conventionally measured with a pressure cuff over an upper arm and a cutoff of 140/90 mmHg in the office is the current criteria for diagnosing hypertension. Recently, out of office BP has been suggested as the reference standard for the management of hypertension, due to its better prognostic value over office BP.However, the above BP parameters are all measured at brachial arteries and may be different from the central blood pressure (CBP) measured in the ascending aorta or carotid arteries...
September 2016: Journal of Hypertension
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