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Emergency cardiology

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https://www.readbyqxmd.com/read/28100274/using-medical-specialty-and-selection-criteria-clusters-to-study-specialty-selection-by-israeli-medical-students
#1
Yoram G Weiss, Rachel Yaffa Zisk-Rony, Howard Tandeter, Uriel Elchalal, Alex Avidan, Josh E Schroeder, Charles Weissman
BACKGROUND: During their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues. METHODS: Questionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria...
January 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28092248/-pulmonary-thromboembolism-recent-experience-of-4-years-at-a-cardiology-hospital
#2
Erick Ramírez-Arias, Martin Rosas-Peralta, Gabriela Borrayo-Sánchez, Luis Antonio Moreno-Ruiz, Jorge Guillermo Arenas-Fonseca, Víctor Manuel Arzola-Covarrubias, Luis Efrén Santos-Martínez, Efraín Arizmendi-Uribe
It comprised a series of cases over a period of 4 years, held at the Hospital of Cardiology of the Centro Médico Nacional Siglo XXI, IMSS. From 2008 to 2011, admitted to Emergency 184 patients with suspected pulmonary embolism, of which 41 were removed; of the 143 remaining cases, only 127 patients was diagnosed with PE. The other 16 patients had other diagnoses. In 86% of patients showed electrocardiographic pattern S1Q3T3 and 39% had RBBB, in 17 (13.3%) patients there was hemodynamic instability, and in 94...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#3
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28072628/clinical-recommendations-of-cardiac-magnetic-resonance-part-i-ischemic-and-valvular-heart-disease-a-position-paper-of-the-working-group-applicazioni-della-risonanza-magnetica-of-the-italian-society-of-cardiology
#4
Giovanni Donato Aquaro, Gianluca Di Bella, Silvia Castelletti, Viviana Maestrini, Pierluigi Festa, Lamia Ait-Ali, Pier Giorgio Masci, Lorenzo Monti, Gabriella di Giovine, Manuel De Lazzari, Alberto Cipriani, Andrea I Guaricci, Santo Dellegrottaglie, Alessia Pepe, Martina Perazzolo Marra, Gianluca Pontone
Cardiac magnetic resonance (CMR) has emerged as a reliable and accurate diagnostic tool for the evaluation of patients with cardiac disease in several clinical settings and with proven additional diagnostic and prognostic value compared with other imaging modalities. This document has been developed by the working group on the 'application of CMR' of the Italian Society of Cardiology to provide a perspective on the current state of technical advances and clinical applications of CMR and to inform cardiologists on how to implement their clinical and diagnostic pathways with the inclusion of this technique in clinical practice...
January 7, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28057368/genomic-translational-research-paving-the-way-to-individualized-cardiac-functional-analyses-and-personalized-cardiology
#5
REVIEW
Ares Pasipoularides
For most of Medicine's past, the best that physicians could do to cope with disease prevention and treatment was based on the expected response of an average patient. Currently, however, a more personalized/precise approach to cardiology and medicine in general is becoming possible, as the cost of sequencing a human genome has declined substantially. As a result, we are witnessing an era of precipitous advances in biomedicine and bourgeoning understanding of the genetic basis of cardiovascular and other diseases, reminiscent of the resurgence of innovations in physico-mathematical sciences and biology-anatomy-cardiology in the Renaissance, a parallel time of radical change and reformation of medical knowledge, education and practice...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28050472/use-of-lung-ultrasound-for-diagnosing-acute-heart-failure-in-emergency-department-of-southern-india
#6
Manav Aggarwal, Mrigakshi Gupta, Vikrant Vijan, Anjith Vupputuri, Sanjeev Chintamani, Bishnukiran Rajendran, Rajesh Thachathodiyal, Rajiv Chandrasekaran
INTRODUCTION: Diagnosing heart failure is often a challenge for the healthcare providers due to it's non-specific and usually subtle physical presentations. The outcomes for treatment are strongly related to the stage of the disease. Considering the importance of early and accurate diagnosis, it is important to have an easy, inexpensive, non-invasive, reliable and reproducible method for diagnosis of heart failure. Recent advancement in radiology and cardiology are supporting the emerging technique of lung ultrasound through B-line evaluation for identifying extravascular lung water...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043708/emerging-roles-of-sodium-glucose-cotransporter-2-inhibitors-in-cardiology
#7
REVIEW
Atsushi Tanaka, Koichi Node
The ultimate goal of treatment in people with diabetes mellitus is to prevent development of cardiovascular (CV) disease, resulting in prolongation of healthy life expectancy. Although impaired glycemic metabolism has a central role in its pathology, a number of studies have demonstrated that remedy for its imbalance cannot necessarily be accomplished as a therapeutic goal. A comprehensive medical approach against multi-factorial pathologies in diabetes, such as insulin resistance, obesity, hypertension, and dyslipidemia, in addition to diet and exercise therapy should be rather performed in the routine clinical setting...
December 30, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28026995/scale-up-production-and-characterization-of-anti-human-cardiac-troponin-i-monoclonal-antibody-in-ascitic-fluid-of-balb-c-mice
#8
Asiabanha Rezaee Majid, Rasaee Mohammad Javad, Paknejad Malihe, Mohammadnejad Javad
The Human Cardiac Troponin I (hcTnI) is a 210 amino acid protein, 23 kDa in molecular weight. This biomarker is commonly used to diagnose myocardial infarction, micro injury, and acute coronary syndrome (ACS) in patients referring to emergency departments. The American Heart Association (AHA) and European Society of Cardiology (ESC) proposed troponin I as the gold biomarker for early detection of heart attack, especially in myocardial infarction (MI). Therefore, developing monoclonal antibodies against this biomarker could help in for early detection of heart attack...
December 27, 2016: Journal of Immunoassay & Immunochemistry
https://www.readbyqxmd.com/read/28017276/patient-journey-in-decompensated-heart-failure-an-analysis-in-departments-of-cardiology-and-geriatrics-in-the-greater-paris-university-hospitals
#9
Florent Laveau, Nadjib Hammoudi, Emmanuelle Berthelot, Joël Belmin, Patrick Assayag, Ariel Cohen, Thibaud Damy, Denis Duboc, Olivier Dubourg, Albert Hagege, Olivier Hanon, Richard Isnard, Guillaume Jondeau, Florian Labouree, Damien Logeart, Nicolas Mansencal, Christophe Meune, Eric Pautas, Yves Wolmark, Michel Komajda
BACKGROUND: Hospitalization for worsening/acute heart failure is increasing in France, and limited data are available on referral/discharge modalities. AIM: To evaluate patients' journeys before and after hospitalization for this condition. METHODS: On 1 day per week, between October 2014 and February 2015, this observational study enrolled 260 consecutive patients with acute/worsening heart failure in all 10 departments of cardiology and four of the departments of geriatrics in the Greater Paris University Hospitals...
December 21, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28012071/depression-contributing-to-dyslipidemic-cardiovascular-risk-in-the-metabolic-syndrome
#10
A V Lemche, O S Chaban, E Lemche
PURPOSE: Triglycerides are considered an emerging risk factor for cardiovascular mortality. Recent evidence relating depression and metabolic syndrome (MetS) implicated triglyceride levels. We thus investigated interrelations of self-reported depression severity (Zung) and MetS-related biological measures with CVD risk estimates in MetS patients. METHODS: N = 101 patients fulfilling International Diabetes Federation criteria for MetS from a nationwide sampled treatment cohort for MetS with familial T2DM risk or manifest T2DM in a Ukrainian governmental health care system were participants...
December 23, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28007362/best-clinical-practice-controversies-in-outpatient-management-of-acute-pulmonary-embolism
#11
Brit Long, Alex Koyfman
BACKGROUND: Pulmonary embolism (PE) is a common condition managed in the emergency department (ED), with a wide range of morbidity and mortality. Patients are classically admitted for treatment and monitoring of anticoagulation. OBJECTIVE: We sought to evaluate the controversy concerning outpatient therapy for patients with acute PE and investigate the feasibility, safety, and efficacy of outpatient management. DISCUSSION: Patients with venous thromboembolism have historically been admitted for treatment and monitoring for concern of worsening disease or side effects of anticoagulation (bleeding)...
December 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28003014/antiplatelet-and-anticoagulation-therapy-in-structural-heart-disease-interventions-beyond-tavi
#12
Manolis Vavuranakis, Konstantinos Dean Boudoulas, Ourania Katsarou, Dimitrios A Vrachatis, Konstantinos I Kalogeras, Theodore G Papaioannou, Gerasimos Siasos, Evangelos Oikonomou, George Lazaros, Michael-Andreas Vavuranakis, Spyridon Deftereos, Dimitrios Tousoulis
Transcatheter interventions for structural heart disease represent an emerging field in interventional cardiology. Undoubtedly, there is an absolute necessity for antiplatelet and/or anticoagulation treatment prior, during and post such interventions. However, currently administered regimens are mainly based in expert consensus recommendations. In the present review we aim to summarize data regarding anti platelet and/or anticoagulation treatment in the following transcatheter structural heart interventions: left atrial appendage closure, atrial septal defect closure, patent foramen oval closure, paravalvular leak closure...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27992015/analysis-of-the-costs-and-quality-of-cardiovascular-care-in-oncological-monitoring
#13
Élide Sbardellotto Mariano da Costa, Adriano Hyeda
Objective: To analyze the health care costs specifically related to cardiovascular diseases, which were spent by patients of a private healthcare provider in southern Brazil, after their diagnosis of cancer. Method: We developed an observational, cross-sectional, retrospective study, with a qualitative-quantitative strategy, through the activity of analytical internal audit of medical accounts. Results: 860 accounts from 2012 to 2015 were analyzed, 73% referred to female users, with average age of 62...
November 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27984357/perceptions-of-teamwork-in-the-interprofessional-bedside-rounding-process
#14
Genevieve Beaird, John M Dent, Jessica Keim-Malpass, Abigail Guo Jian Muller, Nicole Nelson, Valentina Brashers
Patient perceptions of teamwork have been a relatively undiscovered domain. Our study investigated the use of the Patients' Insights and Views of Teamwork (PIVOT) survey on an acute cardiology unit in an academic teaching hospital with patients receiving Rounding with Heart, an interprofessional bedside rounding initiative, and others receiving traditional rounding processes. Sixty-three subjects were surveyed during their hospital stay. We found a significant difference (p = .006) in PIVOT scores between those receiving interprofessional rounding and those not receiving this rounding structure...
December 9, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27968771/treatment-of-acute-cardiac-failure-in-the-emergency-department-improve-our-practices-data-from-the-resurcor-network
#15
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/27968760/door-in-door-out-assessment-of-patients-admitted-with-acute-st-segment-elevation-myocardial-infarction-in-hospitals-without-catheterization-facilities
#16
S Clot, T Rocher, C Morvan, C Rubio, S Sainvoirin, P Usseglio, L Belle, V Descotes-Genon, G Vanzetto
BACKGROUND: Many patients with acute ST-segment elevation myocardial infarction (STEMI) are admitted to emergency departments (EDs) of centres without percutaneous coronary intervention (PCI) facilities. The 2012 European Society of Cardiology guidelines recommend transfer to a PCI centre with a "door in - door out" (DI-DO) time≤30min. PURPOSE: To report DI-DO times in a registry of patients with acute STEMI. METHODS: The RESeau des Urgences CORonarienne (RESUCOR) is a permanent registry of patients admitted with acute STEMI in 16 hospitals in the north French Alps since 2002...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27965999/uncontrolled-hypertension-among-patients-managed-in-primary-healthcare-facilities-in-kinshasa-democratic-republic-of-the-congo
#17
T M Kika, F B Lepira, P K Kayembe, J R Makulo, E K Sumaili, E V Kintoki, J R M'Buyamba-Kabangu
BACKGROUND: Uncontrolled hypertension remains an important issue in daily clinical practice worldwide. Although the majority of patients are treated in primary care, most of the data on blood pressure control originate from population-based studies or secondary healthcare. OBJECTIVE: The aim of this study was to evaluate the frequency of uncontrolled hypertension and associated risk factors among hypertensive patients followed at primary care facilities in Kinshasa, the capital city of Democratic Republic of the Congo...
November 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27932271/deactivation-of-left-ventricular-assist-devices-differing-perspectives-of-cardiology-and-hospice-palliative-medicine-clinicians
#18
Colleen K McIlvennan, Sara E Wordingham, Larry A Allen, Daniel D Matlock, Jacqueline Jones, Shannon M Dunlay, Keith M Swetz
BACKGROUND: Beliefs around deactivation of a left ventricular assist device (LVAD) vary substantially between clinicians, institutions, and patients. Therefore, we sought to understand perspectives regarding LVAD deactivation among cardiology and hospice/palliative medicine (HPM) clinicians. METHODS AND RESULTS: We administered a 41-item survey via electronic mail to members of 3 cardiology and 1 HPM professional societies. A convergent parallel mixed methods design was used...
December 5, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27924340/exosome-like-silica-nanoparticles-a-novel-ultrasound-contrast-agent-for-stem-cell-imaging
#19
Fang Chen, Ming Ma, Junxin Wang, Fang Wang, Shi-Xiong Chern, Eric Ruike Zhao, Anamik Jhunjhunwala, Sean Darmadi, Hangrong Chen, Jesse V Jokerst
Ultrasound is critical in many areas of medicine including obstetrics, oncology, and cardiology with emerging applications in regenerative medicine. However, one critical limitation of ultrasound is the low contrast of target tissue over background. Here, we describe a novel cup-shaped silica nanoparticle that is reminiscent of exosomes and that has significant ultrasound impedance mismatch for labelling stem cells for regenerative medicine imaging. These exosome-like silica nanoparticles (ELS) were created through emulsion templating and the silica precursors bis(triethoxysilyl)ethane (BTSE) and bis(3-trimethoxysilyl-propyl)amine (TSPA)...
January 7, 2017: Nanoscale
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#20
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
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