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https://www.readbyqxmd.com/read/28932559/pupillary-abnormalities-in-non-selected-critically-ill-patients-an-observational-study
#1
Philippe Portran, Martin Cour, Romain Hernu, Sylvie de la Salle, Laurent Argaud
BACKGROUND: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. METHODS: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28923845/high-sensitivity-cardiac-troponin-i-as-a-gatekeeper-for-coronary-computed-tomography-angiography-and-stress-testing-in-patients-with-acute-chest-pain
#2
Maros Ferencik, Thomas Mayrhofer, Michael T Lu, Pamela K Woodard, Quynh A Truong, W Frank Peacock, Fabian Bamberg, Benjamin C Sun, Jerome L Fleg, John T Nagurney, James E Udelson, Wolfgang Koenig, James L Januzzi, Udo Hoffmann
BACKGROUND: Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS: We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing...
September 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28923806/improving-the-health-of-patients-and-communities-evolving-practice-based-research-pbr-and-collaborations
#3
Kevin Fiscella
This issue illustrates how research from practice-based research networks has evolved to span a spectrum from improving patient-level care and practice quality to improving health within local and global communities. Articles address patient-level improvements (a biomarker for cardiovascular disease progression, late-onset anorexia nervosa, complementary health approaches used by patients, and patient preferences related to antibiotics for acute respiratory infections); practice-level improvements (selection of types of fecal immunochemical tests, practice facilitation, practice registry implementation, community-based outreach, and bidirectional texting); and community-level improvements (primary care-public health partnership, influenza surveillance, and establishing family medicine training abroad)...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923394/a-contemporary-phone-based-cardiac-coaching-program-evolution-and-cross-cultural-utility
#4
Peita Price, Mark Tacey, Voula Koufariotis, Daniela Stramandinoli, Ruth Vincent, Leeanne Grigg, Dominica Zentner
BACKGROUND: The Hospital Admission Risk Program (HARP) Cardiac Coach Program at Royal Melbourne Hospital has evolved to include a Greek and Italian service, developed in response to the diverse local community and supported by evidence that Culturally and Linguistically Diverse (CALD) groups both perceive health and respond to health care services and information, differently. This paper aims to evaluate if a phone-based cardiac coaching program can be adapted to the Greek and Italian populations using the English cohort as a comparator...
August 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28914276/appropriate-reconciliation-of-cardiovascular-medications-after-elective-surgery-and-postdischarge-acute-hospital-and-ambulatory-visits
#5
Jonathan S Lee, Ralph Gonzales, Eric Vittinghoff, Kitty K Corbett, Kirsten E Fleischmann, Neil Sehgal, Andrew D Auerbach
OBJECTIVE: To describe appropriate discharge reconciliation of cardiovascular medications and assess associations with postdischarge healthcare utilization in surgical patients. DESIGN: Retrospective cohort study from January 2007 to December 2011. SETTING: An academic medical center. PATIENTS: Seven hundred and fifty-two adults undergoing elective noncardiac surgery and taking antiplatelet agents, beta-blockers, renin-angiotensin system inhibitors, or statin lipid-lowering agents before surgery...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5%C3%A2-years-of-the-clarify-registry
#6
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
September 14, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28910237/effects-of-once-weekly-exenatide-on-cardiovascular-outcomes-in-type-2-diabetes
#7
Rury R Holman, M Angelyn Bethel, Robert J Mentz, Vivian P Thompson, Yuliya Lokhnygina, John B Buse, Juliana C Chan, Jasmine Choi, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Steven P Marso, Peter Öhman, Neha J Pagidipati, Neil Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez
Background The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. Methods We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28905004/gastroenteritis-aggressive-versus-slow-treatment-for-rehydration-gastro-a-pilot-rehydration-study-for-severe-dehydration-who-plan-c-versus-slower-rehydration
#8
Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland
BACKGROUND: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28892959/prevalence-of-conventional-risk-factors-and-evaluation-of-baseline-indices-among-young-and-elderly-patients-with-coronary-artery-disease
#9
Arsalan Majeed Adam, Aiman Rehan, Nageen Waseem, Unzela Iqbal, Hira Saleem, Muhammad Armughan Ali, Ali Tariq Shaikh, Ansab Godil
INTRODUCTION: Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality worldwide, manifesting in a variety of clinical spectrums such as an asymptomatic disease or acute coronary syndrome. It has become highly prevalent in Southeast Asia, including Pakistan. There has been little work done on the prevalence of traditional risk factors in different age groups and genders and there is a dire need to gauge the importance of baseline indices in CAD patients. AIM: To determine the prevalence of conventional risk factors and evaluate the variations in lipid profiles, electrolyte levels and haematological indices among patients with CAD in different age groups and gender...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28882733/-risk-of-fatal-non-fatal-events-in-patients-with-previous-coronary-heart-disease-acute-myocardial-infarction-and-treatment-with-non-steroidal-anti-inflammatory-drugs
#10
REVIEW
L Muñoz Olmo, J Juan Armas, J J Gomariz García
BACKGROUND: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk...
September 4, 2017: Semergen
https://www.readbyqxmd.com/read/28882655/brief-psychological-intervention-in-phase-i-of-cardiac-rehabilitation-after-acute-coronary-syndrome
#11
Ana Cláudia Fernandes, Teresa McIntyre, Rui Coelho, Joana Prata, Maria Júlia Maciel
INTRODUCTION: Acute coronary syndrome (ACS) is an important cause of mortality and significant personal and financial costs. Cardiac rehabilitation (CR) programs have shown positive effects in reducing cardiovascular mortality and improving functional capacity. However, adherence is low and appears to be influenced by psychosocial factors, such as patients' cognitions and emotional state. The objective was to evaluate the efficacy of a brief in-hospital psychological intervention to promote cognitive and emotional adaptation after ACS...
September 4, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28874297/patients-with-non-st-segment-elevation-acute-coronary-syndromes-managed-without-coronary-revascularization-a-population-needing-treatment-improvement
#12
Alberto Menozzi, Stefano De Servi, Roberta Rossini, Marco Ferlini, Daniela Lina, Maurizio Giuseppe Abrignani, Piera Capranzano, Nazario Carrabba, Marcello Galvani, Alfredo Marchese, Gianfranco Mazzotta, Luciano Moretti, Nicola Signore, Massimo Uguccioni, Zoran Olivari, Leonardo De Luca
NSTE-ACS patients are a heterogeneous population, with different clinical features and prognosis. A large proportion of them is medically managed, without any revascularization. In the EYSHOT and FAST-MI registries such patients were 40% and 35%, respectively. These patients are at higher risk of adverse cardiovascular events and have a worse prognosis compared with those receiving revascularization. Medically managed NSTE-ACS patients consist of different subgroups: those not undergoing coronary angiography, those without significant coronary artery disease, and those with coronary stenoses not referred to revascularization...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28871657/seasonality-of-mortality-and-graft-failure-among-kidney-transplant-recipients-in-the-us
#13
Brad C Astor, M L Melamed, D A Mandelbrot, Arjang Djamali
Mortality in the general population and in patients on chronic hemodialysis is significantly higher in winter than summer. It is unknown whether such a seasonal difference exists for mortality or graft failure among kidney transplant recipients. We analyzed United Network for Organ Sharing (UNOS) data to assess whether the annual distribution of deaths and graft failures differed significantly from expected. There was significant annual variation in both deaths (n=52,523) and graft failures (n=50,301; both p<0...
September 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28868074/update-on-pharmacological-treatment-of-acute-coronary-syndrome-without-persistent-st-segment-elevation-myocardial-infarction-in-the-elderly
#14
REVIEW
Coşkun Usta, Aslı Bedel
The increase in cardiovascular disease prevalence with ageing has been attributed to several age-related changes such as changes in the vascular wall elasticity, the coagulation and haemostatic system and endothelial dysfunction, among other causes. There is a 50% increased mortality risk per 10-year increase in age starting at 65 years old. Here, we aimed to discuss pharmacological treatment in acute coronary syndrome (ACS) without persistent ST segment elevation myocardial infarction in the elderly. The main aim of ACS treatment in elderly people is at preventing ischemia, myocardial damage and complications...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28860319/reducing-the-global-burden-of-cardiovascular-disease-part-2-prevention-and-treatment-of-cardiovascular-disease
#15
REVIEW
Darryl P Leong, Philip G Joseph, Martin McKee, Sonia S Anand, Koon K Teo, Jon-David Schwalm, Salim Yusuf
In this second part of a 2-part series on the global burden of cardiovascular disease, we review the proven, effective approaches to the prevention and treatment of cardiovascular disease. We specifically review the management of acute cardiovascular diseases, including acute coronary syndromes and stroke; the care of cardiovascular disease in the ambulatory setting, including medical strategies for vascular disease, atrial fibrillation, and heart failure; surgical strategies for arterial revascularization, rheumatic and other valvular heart disease, and symptomatic bradyarrhythmia; and approaches to the prevention of cardiovascular disease, including lifestyle factors, blood pressure control, cholesterol-lowering, antithrombotic therapy, and fixed-dose combination therapy...
September 1, 2017: Circulation Research
https://www.readbyqxmd.com/read/28857800/outcomes-in-patients-undergoing-cardiac-surgery-who-decline-transfusion-and-received-erythropoietin-compared-to-patients-who-did-not-a-matched-cohort-study
#16
Lorent Duce, Mary L Cooter, Sharon L McCartney, Frederick W Lombard, Nicole R Guinn
BACKGROUND: Erythropoiesis-stimulating agents, such as erythropoietin (EPO), can be used to treat preoperative anemia. Some studies suggest an increased risk of mortality and thrombotic events, and use in cardiovascular surgery remains off-label. This study compares outcomes in cardiac surgery patients declining blood transfusion who received EPO with a matched cohort who did not. METHODS: After institutional review board approval, we conducted a retrospective review of all patients who decline blood transfusion who underwent cardiac surgery and received EPO between January 1, 2004, and June 15, 2015, at a single institution...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28854085/liraglutide-and-renal-outcomes-in-type-2-diabetes
#17
RANDOMIZED CONTROLLED TRIAL
Johannes F E Mann, David D Ørsted, Kirstine Brown-Frandsen, Steven P Marso, Neil R Poulter, Søren Rasmussen, Karen Tornøe, Bernard Zinman, John B Buse
BACKGROUND: In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown...
August 31, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28844478/-descriptive-and-comparative-study-of-cardiovascular-risk-factors-and-physical-activity-in-patients-with-acute-coronary-syndrome
#18
Maria Isabel Vazquez-Arce, Elena Marques-Sule
AIM: To analyse several cardiovascular risk factors by means of the physical activity performed by patients with acute coronary syndrome (ACS). DESIGN: Cross-sectional study. LOCATION: Cardiovascular prevention service (Health Department, Valencia, Spain). PARTICIPANTS: The study included 401 individuals with acute coronary syndrome and discharged from hospital 2-3months before the assessment. The inclusion criteria included age between 30 and 80years-old, no contraindication for physical activity, and no previous participation in cardiac rehabilitation programmes...
August 22, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28838093/sex-differences-in-post-traumatic-stress-disorder-in-cardiovascular-patients-after-the-great-east-japan-earthquake-a-report-from-the-chart-2-study
#19
Takeo Onose, Yasuhiko Sakata, Kotaro Nochioka, Masanobu Miura, Takeshi Yamauchi, Kanako Tsuji, Ruri Abe, Takuya Oikawa, Shintaro Kasahara, Masayuki Sato, Takashi Shiroto, Satoshi Miyata, Jun Takahashi, Hiroaki Shimokawa
Aims: The temporal changes and sex differences in post-traumatic stress disorder (PTSD) after natural disasters remain unclear. Therefore, we examined the prevalence, prognostic impacts, and determinant factors of PTSD after the Great East Japan Earthquake (GEJE) of 11 March 2011 in cardiovascular (CV) patients registered in the Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-2 Study (n = 10 219), with a special reference to sex. Methods and results: By self-completion questionnaires of the Japanese-language version of the Impact of Event Scale-Revised (IES-R-J), the prevalence of PTSD, defined as IES-R-J score ≥25, was 14...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28837512/the-management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-naspghan-pancreas-committee
#20
Maisam Abu-El-Haija, Soma Kumar, J Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, A 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: While the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The NASPGHAN Pancreas committee performed a MEDLINE review using several pre-selected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
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