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Acute cardiovascular care

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https://www.readbyqxmd.com/read/29339356/kidney-biomarkers-and-decline-in-egfr-in-patients-with-type-2-diabetes
#1
Katherine G Garlo, William B White, George L Bakris, Faiez Zannad, Craig A Wilson, Stuart Kupfer, Muthiah Vaduganathan, David A Morrow, Christopher P Cannon, David M Charytan
BACKGROUND AND OBJECTIVES: Biomarkers may improve identification of individuals at risk of eGFR decline who may benefit from intervention or dialysis planning. However, available biomarkers remain incompletely validated for risk stratification and prediction modeling. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined serum cystatin C, urinary kidney injury molecule-1 (uKIM-1), and urinary neutrophil gelatinase-associated lipocalin (UNGAL) in 5367 individuals with type 2 diabetes mellitus and recent acute coronary syndromes enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial...
January 16, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29322358/anti-hypotensive-drug-induced-cardiotoxicity-an-in-vitro-study
#2
Aditi Jain, Vibha Rani
Cardiotoxic side effects of broad range of drugs have emerged as an important cause of developing cardiovascular complications, as patients recover from one disease but develop another. Both cardiovascular and non-cardiovascular drugs may lead to the toxicity in the heart. Many drugs were initially not screened for cardiotoxicity, which is now an essential concern for drug discovery. Levophed is used for treating hypotension in critical care patients. Being a neurotransmitter, its concentration increases significantly in stress conditions and administration of this drug to patients' results in developing acute as well as persistent cardiac complications...
January 10, 2018: In Vitro Cellular & Developmental Biology. Animal
https://www.readbyqxmd.com/read/29320330/cardiovascular-manifestations-and-complications-of-loeys-dietz-syndrome-ct-and-mr-imaging-findings
#3
William W Loughborough, Kishore S Minhas, Jonathan C L Rodrigues, Stephen M Lyen, Helen E Burt, Nathan E Manghat, Marcus J Brooks, Graham Stuart, Mark C K Hamilton
Loeys-Dietz syndrome (LDS) is a recently described genetic connective tissue disorder with a wide spectrum of multisystem involvement. LDS is characterized by rapidly progressive aortic and peripheral arterial aneurysmal disease. LDS and the other inherited aortopathies such as Marfan syndrome have overlapping phenotypic features. However, LDS is characterized by a more aggressive vascular course; patient morbidity and mortality occur at an early age, with complications developing at relatively smaller aortic dimensions...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29318022/clinical-trial-experience-with-ca4p-anticancer-therapy-focus-on-efficacy-cardiovascular-adverse-events-and-hypertension-management
#4
REVIEW
Rachel Grisham, Bonnie Ky, Krishnansu S Tewari, David J Chaplin, Joan Walker
Combretastatin A4-phosphate (CA4P) is a vascular-disrupting agent (VDA) in clinical development for the treatment of ovarian and other cancers. In contrast to antiangiogenic agents, such as bevacizumab, which suppress the development of new tumor vasculature, VDAs target established tumor vasculature. These differing but complementary mechanisms of action are currently being explored in clinical trials combining CA4P and bevacizumab. Clinical experience to date has highlighted an important need to better understand the cardiovascular adverse events of CA4P, both alone and in combination with antiangiogenic agents, which can also be associated with cardiovascular adverse events...
2018: Gynecologic Oncology Research and Practice
https://www.readbyqxmd.com/read/29310674/ezetimibe-prescriptions-in-older-canadian-adults-after-an-acute-myocardial-infarction-a-population-based-cohort-study
#5
Kristin K Clemens, Salimah Z Shariff, Eric McArthur, Robert A Hegele
BACKGROUND: The utility of ezetimibe in preventing cardiovascular outcomes remains controversial. To guide future assessments of the effectiveness of ezetimibe in routine care, we evaluated how this medication has been prescribed to high-risk older adults in Ontario, Canada. METHODS: Using linked healthcare databases, we carried out a population-based cohort study of older adults who were discharged from hospital following an acute myocardial infarction from 2005 until 2014...
January 8, 2018: Lipids in Health and Disease
https://www.readbyqxmd.com/read/29310390/takotsubo-cardiomyopathy-caused-by-acute-respiratory-stress-from-extubation-a-case-report
#6
Kohei Taniguchi, Syogo Takashima, Ryo Iida, Koshi Ota, Masahiko Nitta, Kazushi Sakane, Tomohiro Fujisaka, Nobukazu Ishizaka, Osamu Umegaki, Kazuhisa Uchiyama, Akira Takasu
RATIONAL: Takotsubo cardiomyopathy (TCM) is a transient systolic dysfunction of the left ventricular apex without stenosis of coronary arteries and is induced by various psychological and physical factors. TCM sometimes causes lethal complications such as arrhythmia, thrombogenesis, and even cardiac rupture, and thus it should be diagnosed appropriately and managed carefully. Intensive care unit (ICU) patients are exposed to overstress during the treatment process and therefore can are at potential risk for TCM...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29308763/-distribution-and-epidemiological-characteristics-of-disease-spectrum-in-patients-with-pre-hospital-care-in-hohhot-in-2016-a-case-analysis-in-28-325-patients
#7
Shuqing Huang, da Man, Tejin Ba, Qier Mu
OBJECTIVE: To analyze the distribution and epidemiological characteristics of patients in pre-hospital emergency in Hohhot. METHODS: The data of 28 325 pre-hospital emergency patients in 7 first-aid stations in Hohhot from January 1st to December 31st in 2016 were analyzed retrospectively. The gender, age, call time, disease spectrum of patients served as investigation elements, the data were collected into Excel 2010 form, and statistical analysis was carried out...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29302540/a-chart-review-of-morbidity-patterns-among-adult-patients-attending-primary-care-setting-in-urban-odisha-india-an-international-classification-of-primary-care-experience
#8
Subhashisa Swain, Sandipana Pati, Sanghamitra Pati
Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE) at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29300792/management-of-acute-coronary-syndromes-in-patients-with-diabetes
#9
Peter P Toth
Given the heightened risk for adverse cardiovascular outcomes in patients with diabetes mellitus, it is important that primary care clinicians be comfortable with the routine management of acute coronary syndromes (ACS) in this patient population. Notably, patients with diabetes are more likely to present atypically during an ACS. To improve health outcomes, patients with a history of diabetes and ACS should be evaluated for peripheral arterial disease and encouraged to pursue cardiac rehabilitation. Clinicians should also be cognizant of the high rate of polypharmacy in patients with diabetes and the potential glycemic and cardioprotective impact of medications they prescribe for these patients...
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29300236/contemporary-risk-factors-and-outcomes-of-transfusion-associated-circulatory-overload
#10
Nareg H Roubinian, Jeanne E Hendrickson, Darrell J Triulzi, Jerome L Gottschall, Michael Michalkiewicz, Dhuly Chowdhury, Daryl J Kor, Mark R Looney, Michael A Matthay, Steven H Kleinman, Donald Brambilla, Edward L Murphy
OBJECTIVES: Transfusion-associated circulatory overload is characterized by hydrostatic pulmonary edema following blood transfusion. Restrictive transfusion practice may affect the occurrence and severity of transfusion-associated circulatory overload in critically ill patients. We sought to examine contemporary risk factors and outcomes for transfusion-associated circulatory overload. DESIGN: Case-control study. SETTING: Four tertiary care hospitals...
January 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29299356/fluoropyrimidine-induced-cardiac-toxicity-challenging-the-current-paradigm
#11
Suparna C Clasen, Bonnie Ky, Rupal O'Quinn, Bruce Giantonio, Ursina Teitelbaum, Joseph R Carver
Background: Fluoropyrimidine chemotherapy [5-fluorouracil (5-FU) and capecitabine] are commonly used agents in the treatment of various solid malignancies. However, their use has been limited by cardiac toxicity, presenting as a wide spectrum of asymptomatic (e.g., EKG changes) and symptomatic (e.g., chest pain) manifestations related to coronary vasospasm leading to myocardial ischemia. Historically, patients with suspected coronary vasospasm have been treated with traditional acute ischemic workup and various combinations of anti-anginal therapies...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29297082/enhancing-recovery-from-sepsis-a-review
#12
REVIEW
Hallie C Prescott, Derek C Angus
Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29295829/medication-therapy-management-after-hospitalization-in-ckd-a-randomized-clinical-trial
#13
Katherine R Tuttle, Radica Z Alicic, Robert A Short, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling M McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Cynthia F Corbett
BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited...
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29291427/pulmonary-embolism-care-standards-in-2018
#14
REVIEW
Ariel Borohovitz, Mitchell D Weinberg, Ido Weinberg
Pulmonary embolism (PE) is a leading cause of cardiovascular mortality worldwide. Clinical presentation can be diverse, and clinicians should have a high index of suspicion regarding the diagnosis. Evaluation should include detailed history of possible risk factors, physical examination and laboratory tests that would support the diagnosis and help risk-stratify patients. Finally, a dedicated imaging study should be performed in order to make a definitive diagnosis. Decisions regarding short-term, immediate, treatment are dictated by PE risk category...
December 29, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29289543/comparison-of-3-frailty-instruments-in-a-geriatric-acute-care-setting-in-a-low-middle-income-country
#15
Sumika Mori Lin, Márlon Juliano Romero Aliberti, Sileno de Queiroz Fortes-Filho, Juliana de Araújo Melo, Ivan Aprahamian, Claudia Kimie Suemoto, Wilson Jacob Filho
OBJECTIVE: Comparison of frailty instruments in low-middle income countries, where the prevalence of frailty may be higher, is scarce. In addition, less complex diagnostic tools for frailty are important in these settings, especially in acutely ill patients, because of limited time and economic resources. We aimed to compare the performance of 3 frailty instruments for predicting adverse outcomes after 1 year of follow-up in older adults with an acute event or a chronic decompensated disease...
December 27, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29289400/shared-decision-making-as-the-future-of-emergency-cardiology
#16
REVIEW
Marc A Probst, Peter A Noseworthy, Juan P Brito, Erik P Hess
Shared decision-making is playing an increasingly large role in emergency cardiovascular care. Although there are many challenges to successfully performing shared decision-making in the emergency department, there are numerous clinical scenarios in which it should be used. In this article, we explore new research and emerging decision aids in the following emergency care scenarios: (1) low-risk chest pain; (2) new-onset atrial fibrillation; and (3) moderate-risk syncope. These decision aids are designed to engage patients and facilitate shared decision-making for specific treatment and disposition (admit vs discharge) decisions...
September 22, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29288982/c-terminal-and-intact-fgf23-in-critical-illness-and-their-associations-with-acute-kidney-injury-and-in-hospital-mortality
#17
Karolina Rygasiewicz, Tomasz Hryszko, Andrzej Siemiatkowski, Szymon Brzosko, Alicja Rydzewska-Rosolowska, Beata Naumnik
BACKGROUND: FGF23 proved its value in prognostication of cardiovascular events and mortality among renal patients and general population. Limited data exist whether FGF23 may have any use in prediction of negative outcomes among critically ill patients admitted to intensive care unit (ICU). METHODS: Single center cohort study performed among patients admitted to ICU. The primary exposure was FGF23 plasma concentration measured within 24 h of ICU admission. The primary outcome was incident Acute Kidney Injury (AKI) and in-hospital mortality during the ICU stay...
December 27, 2017: Cytokine
https://www.readbyqxmd.com/read/29284402/the-utility-of-personal-activity-trackers-fitbit-charge-2-on-exercise-capacity-in-patients-post-acute-coronary-syndrome-up-step-acs-trial-a-randomised-controlled-trial-protocol
#18
Jason Nogic, Paul Min Thein, James Cameron, Sam Mirzaee, Abdul Ihdayhid, Arthur Nasis
BACKGROUND: The benefits of physical activity and cardiovascular rehabilitation on the reduction of cardiovascular risk are well documented. Despite this, significant barriers and challenges remain in optimizing patient risk factors post acute coronary syndromes (ACS) and ensuring patient compliance. Consumer wearable personal activity trackers represent a cost effective and readily available technology that may aid in this endeavour. METHODS: UP-STEP ACS is a prospective single-blinded, two-arm, parallel, randomized control trial with an aim to enrol 200 patients all undertaking cardiac rehabilitation...
December 29, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29281605/trends-in-cardiovascular-risk-profiles
#19
REVIEW
Samir Kapadia
Outcomes for patients with coronary artery disease (CAD) have improved in the past 20 years likely due to advances in clinical care such as angiotensin-converting enzyme inhibitors, antiplatelet agents, and reduced time to cardiac cauterization procedures. But how have the risk factors for CAD changed in the past 2 decades? Analysis of nearly 4,000 patients with ST-elevation myocardial infarction (STEMI) at a tertiary care center found that patients presenting with acute STEMI are younger and more obese than in the past...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29280782/management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-pancreas-committee
#20
Maisam Abu-El-Haija, Soma Kumar, Jose Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, Alvin Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
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