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Emergency cardiology

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https://www.readbyqxmd.com/read/28610773/contrast-induced-acute-kidney-injury-in-interventional-cardiology-emerging-evidence-and-unifying-mechanisms-of-protection-by-remote-ischemic-conditioning
#1
REVIEW
Adebayo C Atanda, Oladipupo Olafiranye
Contrast-induced acute kidney injury (CI-AKI) is a common complication of many diagnostic and therapeutic cardiovascular procedures. It is associated with longer in-hospital stay, more complicated hospitalization course, and higher in-hospital morbidity and mortality. With increasing use of contrast media in various diagnostic and interventional procedures, the prevalence of CI-AKI is expected to rise. Although pre-hydration with intravenous normal saline is recommended in patients with elevated risk of CI-AKI, this approach is often not feasible in many clinical settings...
June 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28600099/integrating-interventional-cardiology-and-heart-failure-management-for-cardiogenic-shock
#2
REVIEW
Navin K Kapur, Carlos D Davila, Marwan F Jumean
Cardiogenic shock remains one of the most common causes of in-hospital death. Recent data have identified an overall increase in patient complexity, with cardiogenic shock in the setting of acute myocardial infarction. The use of percutaneous acute mechanical circulatory support (AMCS) has steadily grown in the past decade. Guidelines and consensus statements addressing proper patient selection, timing of AMCS implantation, device choice, and postimplantation protocol are appearing. The emerging role of interventional heart failure specialists within the heart team includes integration and understanding of advanced hemodynamic and cathether-based therapies, with the goal of improving outcomes...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#3
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28596069/validation-of-the-effect-questionnaire-for-competence-based-clinical-teaching-in-residency-training-in-lithuania
#4
Eglė Vaižgėlienė, Žilvinas Padaiga, Daiva Rastenytė, Algimantas Tamelis, Kęstutis Petrikonis, Rima Kregždytė, Cornelia Fluit
BACKGROUND AND AIM: In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into a competency-based medical education curriculum. To assess the quality of clinical teaching in residency training, we chose the EFFECT (evaluation and feedback for effective clinical teaching) questionnaire designed and validated at the Radboud University Medical Centre in the Netherlands. The aim of this study was to validate the EFFECT questionnaire for quality assessment of clinical teaching in residency training...
May 26, 2017: Medicina
https://www.readbyqxmd.com/read/28552843/cost-of-elective-percutaneous-coronary-intervention-in-malaysia-a-multicentre-cross-sectional-costing-study
#5
Kun Yun Lee, Tiong Kiam Ong, Ee Vien Low, Siow Yen Liow, Lawrence Anchah, Syuhada Hamzah, Houng Bang Liew, Rosli Mohd Ali, Omar Ismail, Wan Azman Wan Ahmad, Mas Ayu Said, Maznah Dahlui
OBJECTIVES: Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. DESIGN: This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014...
May 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28540209/myocardial-blood-flow-quantification-for-evaluation-of-coronary-artery-disease-by-computed-tomography
#6
REVIEW
Filippo Cademartiri, Sara Seitun, Alberto Clemente, Ludovico La Grutta, Patrizia Toia, Giuseppe Runza, Massimo Midiri, Erica Maffei
During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#7
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28513209/caregiver-determinants-of-patient-clinical-event-risk-in-heart-failure
#8
Julie T Bidwell, Ercole Vellone, Karen S Lyons, Fabio D'Agostino, Barbara Riegel, Marco Paturzo, Shirin O Hiatt, Rosaria Alvaro, Christopher S Lee
BACKGROUND: Preventing hospitalization and improving event-free survival are primary goals of heart failure (HF) treatment according to current European Society of Cardiology guidelines; however, substantial uncertainty remains in our ability to predict risk and improve outcomes. Although caregivers often assist patients to manage their HF, little is known about their influence on clinical outcomes. AIMS: To quantify the influence of patient and caregiver characteristics on patient clinical event risk in HF...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28513114/when-cardioversion-may-be-complicated
#9
Marina Leitman, Vladimir Tyomkin, Eli Peleg, Therese Fuchs, Ziad Gabara, Zvi Vered
BACKGROUND: In recent years cardioversion of atrial fibrillation has become a routine procedure, enabling symptomatic functional improvement in most cases. However, some patients develop complications after cardioversion. Identifying these individuals is an important step toward improving patient outcome. OBJECTIVES: To characterize those patients who may not benefit from cardioversion or who may develop complications following cardioversion. METHODS: We retrospectively analyzed 186 episodes of cardioversion in 163 patients with atrial fibrillation who were admitted to our cardiology department between 2008 and 2013 based on their clinical and echocardiographic data...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28507228/understanding-principles-of-integration-and-segregation-using-whole-brain-computational-connectomics-implications-for-neuropsychiatric-disorders
#10
REVIEW
Louis-David Lord, Angus B Stevner, Gustavo Deco, Morten L Kringelbach
To survive in an ever-changing environment, the brain must seamlessly integrate a rich stream of incoming information into coherent internal representations that can then be used to efficiently plan for action. The brain must, however, balance its ability to integrate information from various sources with a complementary capacity to segregate information into modules which perform specialized computations in local circuits. Importantly, evidence suggests that imbalances in the brain's ability to bind together and/or segregate information over both space and time is a common feature of several neuropsychiatric disorders...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28507227/when-two-wrongs-make-a-right-synchronized-neuronal-bursting-from-combined-electrical-and-inhibitory-coupling
#11
Reimbay Reimbayev, Kevin Daley, Igor Belykh
Synchronized cortical activities in the central nervous systems of mammals are crucial for sensory perception, coordination and locomotory function. The neuronal mechanisms that generate synchronous synaptic inputs in the neocortex are far from being fully understood. In this paper, we study the emergence of synchronization in networks of bursting neurons as a highly non-trivial, combined effect of electrical and inhibitory connections. We report a counterintuitive find that combined electrical and inhibitory coupling can synergistically induce robust synchronization in a range of parameters where electrical coupling alone promotes anti-phase spiking and inhibition induces anti-phase bursting...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28503386/mechanical-thrombectomy-for-acute-ischemic-stroke-after-cardiac-surgery
#12
Ali S Haider, Prabhat Garg, Ian T Watson, Dean Leonard, Umair Khan, Ahmed Haque, Phu Nguyen, Kennith F Layton
Ischemic stroke is a rare yet devastating complication that may occur following cardiothoracic surgery. Fibrinolytic treatment is contraindicated due to elevated risk for hemorrhage. Mechanical thrombectomy entails a catheterized approach wherein the thrombus is physically removed from the vessel without the use of fibrinolytics, minimizing the possibility of intracranial hemorrhage. Here, we present two original cases of mechanical thrombectomy as treatment for patients experiencing emergent large vessel occlusion following cardiothoracic surgery...
April 11, 2017: Curēus
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#13
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28498030/prevalence-of-anemia-and-its-influence-on-hospital-readmissions-and-emergency-department-visits-in-outpatients-with-heart-failure
#14
Youn-Jung Son, Bo Hwan Kim
BACKGROUND: Anemia is a frequent comorbidity in patients with heart failure. However, the incidence of anemia in patients with heart failure varies widely, and there is limited evidence on the association between anemia and rehospitalization and on the health consequences of anemia in patients with heart failure. AIMS: We aimed to identify the prevalence of anemia and its influence on hospital readmissions and emergency department visits in outpatients with heart failure...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28472598/supportive-cardiology-moving-palliative-care-upstream-for-patients-living-with-advanced-heart-failure
#15
Warren Harris Lewin, Wendy Cheung, A Nina Horvath, Shana Haberman, Archna Patel, Dorothy Sullivan
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL)...
May 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28471545/eleven-year-trends-of-inpatient-pacemaker-implantation-in-patients-diagnosed-with-sick-sinus-syndrome
#16
Avirup Guha, Xiao Xiang, Devin Haddad, Benjamin Buck, Xu Gao, Michael Dunleavy, Ellen Liu, Dilesh Patel, Vadim V Fedorov, Emile G Daoud
BACKGROUND: Pacemakers (PM) are used for managing sick sinus syndrome (SSS). This study evaluates predictors and trends of PM implantation for SSS. METHODS: Patients were identified from the National Inpatient Sample dataset (2003-13). Included patients were ≥18 years old, had a diagnosis of sinus node dysfunction and atrial arrhythmia (i.e., SSS). Patients who died, transferred out, who had prior device or had a defibrillator or resynchronization therapy device implanted were excluded...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28460039/prognostic-value-of-elevated-high-sensitivity-cardiac-troponin-t-in-patients-admitted-to-an-emergency-department-with-atrial-fibrillation
#17
Kiril M Stoyanov, Evangelos Giannitsis, Moritz Biener, Matthias Mueller-Hennessen, Katharina Arens, Hugo A Katus, Mehrshad Vafaie
Aims: Elevated levels of high-sensitivity cardiac troponin T (hsTnT) indicate underlying heart disease and are known to predict adverse outcomes in various patient populations. Their role in atrial fibrillation (AF) is still under debate. Methods and results: This retrospective study included 2898 consecutive patients presenting with AF to the emergency department of the Department of Cardiology, Heidelberg University Hospital. Multivariable Cox regression was used to assess associations between hsTnT and mortality...
April 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28458558/impact-of-around-the-clock-in-house-cardiology-fellow-coverage-on-door-to-balloon-time-in-an-academic-medical-center
#18
Luke C Kohan, Vijaiganesh Nagarajan, Michael A Millard, Michael J Loguidice, Nancy M Fauber, Ellen C Keeley
OBJECTIVES: To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI) program. BACKGROUND: Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm. The night float fellow remained in-house until the morning...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28457798/cardiology-consultation-in-the-emergency-department-reduces-re-hospitalizations-for-low-socioeconomic-patients-with-acute-decompensated-heart-failure
#19
Corey E Tabit, Mitchell J Coplan, Kirk T Spencer, Charina F Alcain, Thomas Spiegel, Adam S Vohra, Daniel Adelman, James K Liao, Rupa Mehta Sanghani
BACKGROUND: Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the Emergency Department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and healthcare costs for low-socioeconomic urban patients with acute decompensated heart failure. METHODS: 392 patients treated at our center for acute decompensated heart failure received standardized education and follow-up...
April 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28454832/rationale-and-design-of-the-coronary-computed-tomographic-angiography-for-selective-cardiac-catheterization-relation-to-cardiovascular-outcomes-cost-effectiveness-and-quality-of-life-conserve-trial
#20
Sang-Eun Lee, Fay Y Lin, Yao Lu, Hyuk-Jae Chang, James K Min
Although coronary computed tomography angiography (CCTA) has shown promise as a "gatekeeper" to invasive coronary angiography (ICA) in longitudinal cohort studies, it remains unknown whether the strategy of selective ICA by initial performance of CCTA is either safe or effective when compared with a direct ICA strategy in patients with an American Heart Association (AHA)/American College of Cardiology (ACC) guideline-directed indication for ICA. OBJECTIVES: The CONSERVE trial is a prospective randomized multicenter trial to determine the clinical effectiveness of "selective catheterization" vs "direct catheterization" strategies for stable patients with suspected but without known coronary artery disease, who meet AHA/ACC guideline indication for ICA...
April 2017: American Heart Journal
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