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https://www.readbyqxmd.com/read/29781954/range-and-consistency-of-outcomes-reported-in-randomized-trials-conducted-in-kidney-transplant-recipients-a-systematic-review
#1
Bénédicte Sautenet, Allison Tong, Jeremy R Chapman, Anthony N Warrens, David Rosenbloom, Germaine Wong, John Gill, Klemens Budde, Lionel Rostaing, Lorna Marson, Michelle A Josephson, Peter P Reese, Timothy L Pruett, Nicole Evangelidis, Jonathan C Craig
BACKGROUND: The potential for clinical trials to impact patient care may be limited if the outcomes reported vary by trial and lack direct relevance to patients. Despite the many trials conducted in kidney transplantation, premature death due to cardiovascular disease, infection and malignancy remains high. We aimed to assess the range and consistency of outcomes reported in trials in kidney transplantation. METHODS: We searched for randomized trials conducted in kidney transplantation...
May 16, 2018: Transplantation
https://www.readbyqxmd.com/read/29781070/antiplatelet-therapy-for-patients-undergoing-coronary-artery-bypass-surgery
#2
Christine M DeStephan, David J Schneider
Considerable variation in the use and duration of antiplatelet medications during the perioperative and postoperative care of patients undergoing coronary artery bypass grafting (CABG) reflects limited studies focused directly on these patients as well as variation in the results reported. In this review we will highlight the incidence and mechanisms of graft closure as well as the evidence in support of antiplatelet therapy that is balanced by the impact of antiplatelet therapy on the risk of bleeding to provide recommendations for the use of antiplatelet therapy in patients undergoing CABG...
May 21, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29778317/appropriate-use-of-noninvasive-ischemia-testing-to-guide-revascularization-decision-making-following-acute-st-elevation-myocardial-infarction-in-latin-american-countries-results-from-an-expert-panel-meeting-of-the-international-atomic-energy-agency
#3
I Berrocal, A Peix, F Mut, L J Shaw, G Karthikeyan, E Estrada Lobato, D Paez
Across Latin American and Caribbean countries, cardiovascular disease and especially ischemic heart disease is currently the main cause of death both in men and in women. For most Latin American and Caribbean countries, public and community health efforts aim to define care strategies which are both clinically and cost effective and promote primary and secondary prevention, resulting in improved patient outcomes. The optimal approach to deal with acute events such as ST-elevation myocardial infarction (STEMI) is a matter of controversy; however, there is an expanding role for assessing residual ischemic burden in STEMI patients following primary percutaneous coronary intervention...
May 16, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/29777554/development-and-feasibility-testing-of-an-avatar-based-education-application-for-patients-with-acute-coronary-syndrome
#4
Jintana Tongpeth, Hui Yun Du, Robyn A Clark
AIMS: To develop and evaluate an interactive, avatar-based education application, for improving patients' knowledge of, and response to, ACS symptoms. BACKGROUND: A patient's ability to recognise and respond to the symptoms of acute coronary syndrome (ACS) is imperative for seeking timely medical intervention. Innovative patient education interventions are needed to support patient education and patient self-care. METHODS: Participatory action research methods were used to engage consumers with cardiac and IT experts to develop an avatar-based education application...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#5
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29773575/measuring-physical-activity-with-implanted-cardiac-devices-a-systematic-review
#6
Lindsey Rosman, Rachel Lampert, Samuel F Sears, Matthew M Burg
BACKGROUND: Physical activity is predictive of cardiovascular outcomes in patients with cardiovascular implantable electronic devices, yet it is not regularly assessed in routine care. Current-generation cardiovascular implantable electronic devices, however, continuously monitor patient activity through a built-in accelerometer, which provides new opportunities to remotely assess patient activity, detect changes in clinical status, and incorporate these data in risk stratification models...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29769203/early-and-chronic-dipeptidyl-peptidase-iv-inhibition-and-cardiovascular-events-in-patients-with-type-2-diabetes-mellitus-after-an-acute-coronary-syndrome-a-landmark-analysis-of-the-examine-trial
#7
Abhinav Sharma, Christopher P Cannon, William B White, Yuyin Liu, George L Bakris, William C Cushman, Faiez Zannad
BACKGROUND: Antihyperglycemic therapies may increase the risk of cardiovascular events including hospitalization for heart failure. There is a paucity of data evaluating the cardiovascular safety of antihyperglycemic therapies in the high-risk period following an acute coronary syndrome (ACS). METHODS AND RESULTS: The EXAMINE (Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care) trial randomized 5380 patients who were 15 to 90 days post ACS to the dipeptidyl dipeptidase-IV (DPP-IV) inhibitor alogliptin versus placebo; mean follow-up was 18 months...
May 16, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29764435/use-of-hospital-palliative-care-according-to-the-place-of-death-and-disease-one-year-before-death-in-2013-a-french-national-observational-study
#8
Claire Poulalhon, Laureen Rotelli-Bihet, Sébastien Moine, Anne Fagot-Campagna, Régis Aubry, Philippe Tuppin
BACKGROUND: Only limited data are available concerning the diseases managed before death and hospital palliative care (HPC) use according to place of death in France. We therefore conducted an observational study based on administrative health data in a large population to identify the diseases treated one year before death in 2013, the place of stay with or without hospital palliative care, and the place of death. METHODS: French health insurance general scheme beneficiaries were identified in the National Health data Information System (Snds) with a selection of information...
May 16, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#9
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29757882/american-association-of-nurse-practitioners-national-nurse-practitioner-sample-survey-update-on-acute-care-nurse-practitioner-practice
#10
Ruth Kleinpell, Michelle L Cook, Diane L Padden
BACKGROUND AND PURPOSE: Data from national surveys on the practice of nurse practitioners (NPs) provides valuable information on aspects of practice, demographic characteristics of providers and patients, plans for continued employment, and role satisfaction. The American Association of Nurse Practitioners (AANP) has been conducting the AANP Sample Survey since 1988. METHODS: The most recent AANP Sample Survey was conducted in 2016 with a random stratified survey of 40,000 NPs...
March 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29754965/gender-based-outcome-differences-for-emergency-department-presentation-ofnon-stemi-acute-coronary-syndrome
#11
James R Langabeer, Tiffany Champagne-Langabeer, Raymond Fowler, Timothy Henry
BACKGROUND: It is known that women generally have worse mortality outcomes than men with regards to ST-segment elevation myocardial infarction. However, less is known about contemporary gender differences in non-STEMI acute coronary syndrome, particularly those presenting to emergency departments within a regionalized system of care with standardized protocols. METHODS: Retrospective registry data from 2010 to 2016 were examined from the North Texas Mission: Lifeline system of care, representing 33 hospitals around the Dallas Texas metropolitan area...
May 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29754661/catheter-ablation-versus-antiarrhythmic-drug-therapy-for-atrial-fibrillation-cabana-trial-study-rationale-and-design
#12
Douglas L Packer, Daniel B Mark, Richard A Robb, Kristi H Monahan, Tristram D Bahnson, Kathleen Moretz, Jeanne E Poole, Alice Mascette, Yves Rosenberg, Neal Jeffries, Hussein R Al-Khalidi, Kerry L Lee
The Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA,NCT00911508)(1) trial is testing the hypothesis that the treatment strategy of percutaneous left atrial catheter ablation for the purpose of eliminating atrial fibrillation (AF) is superior to current state-of-the-art pharmacologic therapy. This international 140-center clinical trial was designed to randomize 2200 patients to a strategy of catheter ablation versus state-of-the-art rate or rhythm control drug therapy. Inclusion criteria include: 1) age> 65, or ≤65 with≥ 1 risk factor for stroke, 2) documented AF warranting treatment, and 3) eligibility for both catheter ablation and≥ 2 anti-arrhythmic or≥ 2 rate control drugs...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29748219/frequency-reasons-and-impact-of-premature-ticagrelor-discontinuation-in-patients-undergoing-coronary-revascularization-in-routine-clinical-practice-results-from-the-bern-percutaneous-coronary-intervention-registry
#13
Thomas Zanchin, Fabrice Temperli, Alexios Karagiannis, Christian Zanchin, Markus Räsänen, Konstantinos C Koskinas, Stefan Stortecky, Lukas Hunziker, Fabien Praz, Stefan Blöchlinger, Christina Moro, Aris Moschovitis, Christian Seiler, Michael Billinger, Dik Heg, Thomas Pilgrim, Marco Valgimigli, Stephan Windecker, Lorenz Räber
BACKGROUND: Although ticagrelor has improved clinical outcomes among patients with acute coronary syndrome compared with clopidogrel, adherence to this new antiplatelet agent in real-world practice has not been fully investigated. METHODS AND RESULTS: Between November 2011 and June 2014, 1278 of 4831 consecutive patients (26.5%) undergoing percutaneous coronary intervention at a tertiary care center were treated with ticagrelor. Premature ticagrelor cessation was categorized into (1) change, when ticagrelor was replaced by prasugrel; (2) de-escalation, when ticagrelor was replaced by clopidogrel; and (3) premature discontinuation, when ticagrelor was discontinued without P2Y12 inhibitor replacement...
May 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29733839/placenta-percreta-is-associated-with-more-frequent-severe-maternal-morbidity-than-placenta-accreta
#14
Louis Marcellin, Pierre Delorme, Marie Pierre Bonnet, Gilles Grange, Gilles Kayem, Vassilis Tsatsaris, François Goffinet
BACKGROUND: Abnormally invasive placentation is the leading cause of obstetric hysterectomy and can cause poor to disastrous maternal outcomes. Most previous studies of peripartum management and maternal morbidity have included variable proportions of severe and less severe cases. OBJECTIVE: The aim of this study was to compare maternal morbidity from placenta percreta and accreta. STUDY DESIGN: This retrospective study at a referral center in Paris includes all women with abnormally invasive placentation from 2003 to 2017...
May 4, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29730761/clinical-pharmacokinetics-and-pharmacodynamics-of-dalcetrapib
#15
REVIEW
Donald M Black, Darren Bentley, Sunny Chapel, Jongtae Lee, Emily Briggs, Therese Heinonen
The cholesterol ester transfer protein (CETP) inhibitor dalcetrapib has been under evaluation for its potential to prevent cardiovascular (CV) events for almost two decades. The current clinical development program, representing new advances in precision medicine and focused on a genetically defined population with acute coronary syndrome (ACS), is supported by a large body of pharmacokinetic and pharmacodynamic data as well as substantial clinical experience in over 13,000 patients and volunteers. Dalcetrapib treatment of 600 mg/day produces significant inhibition of CETP activity, and has been utilized in phase II and III studies, including CV endpoint trials...
May 5, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29723926/variation-in-cardiovascular-risk-related-to-individual-antimuscarinic-drugs-used-to-treat-overactive-bladder-a-cohort-study-in-the-uk
#16
Alejandro Arana, Andrea V Margulis, Lisa J McQuay, Ryan Ziemiecki, Jennifer L Bartsch, Kenneth J Rothman, Billy Franks, Milbhor D Silva, Kwame Appenteng, Cristina Varas-Lorenzo, Susana Perez-Gutthann
BACKGROUND: Blocking muscarinic receptors could have an effect upon cardiac function, especially among elderly patients with overactive bladder (OAB). STUDY OBJECTIVE: To investigate the risk of cardiovascular events in users of antimuscarinic drugs to treat OAB. DESIGN, SETTING AND PARTICIPANTS: Cohort study of new users of darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, or trospium, aged ≥18 years old in the United Kingdom's Clinical Practice Research Datalink (CPRD), 2004-2012...
May 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29716933/taking-the-reins-on-systems-of-care-for-st-segment-elevation-myocardial-infarction-patients-a-report-from-the-american-heart-association-mission-lifeline-program
#17
Jacqueline L Green, Alice K Jacobs, DaJuanicia Holmes, Karen Chiswell, Rosalia Blanco, Eric R Bates, William French, Douglas F Kupas, Greg Mears, Matthew Roe, Brahmajee K Nallamothu
BACKGROUND: Early success with regionalization of ST-segment-elevation myocardial infarction (STEMI) care has led many states to adopt statewide prehospital STEMI hospital destination policies, allowing emergency medical services to bypass non-percutaneous coronary intervention-capable hospitals. The association between adoption of these policies and patterns of care among STEMI patients is unknown. METHODS AND RESULTS: Using data from January 1, 2013, to December 31, 2014, from the National Cardiovascular Data Registry and Acute Coronary Treatment and Intervention Outcomes Network Registry, 6 states with bypass policies (cases included Delaware, Iowa, Maryland, North Carolina, Pennsylvania, and Massachusetts) were matched to 6 states without bypass policies (controls included South Carolina, Minnesota, Virginia, Texas, New York, and Connecticut) a priori on region, hospital density, and percent state participation in the registry...
May 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29716787/management-of-acute-retinal-ischemia-follow-the-guidelines
#18
REVIEW
Valérie Biousse, Fadi Nahab, Nancy J Newman
Acute retinal arterial ischemia, including vascular transient monocular vision loss (TMVL) and branch (BRAO) and central retinal arterial occlusions (CRAO), are ocular and systemic emergencies requiring immediate diagnosis and treatment. Guidelines recommend the combination of urgent brain magnetic resonance imaging with diffusion-weighted imaging, vascular imaging, and clinical assessment to identify TMVL, BRAO, and CRAO patients at highest risk for recurrent stroke, facilitating early preventive treatments to reduce the risk of subsequent stroke and cardiovascular events...
April 28, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29703193/patient-house-calls-in-attica-and-thessaloniki-greece-2005-2015-a-model-for-out-of-hospital-multispecialty-emergency-medicine
#19
George Theocharis, Spyridon G Barbas, Theodore Spiropoulos, Petroula E Stamouli, Dimitrios N Perdikis, Matthew E Falagas
BACKGROUND: The SOS-doctors are a network of physicians who perform house-call visits in the areas of Attica and Thessaloniki, Greece. METHODS: Patients requesting medical services by the SOS doctors during the period 1/1/2005 - 31/12/2015 were eligible for inclusion in this retrospective analysis. RESULTS: During this period 335, 212 home visits were performed. Females used this service more frequently compared to males (60.5% versus 39.5%)...
April 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#20
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
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