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EMERGENCY ECG

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https://www.readbyqxmd.com/read/29779201/clinical-acceptability-of-trimetazidine-modified-release-80-mg-once-daily-versus-trimetazidine-modified-release-35-mg-twice-daily-in-stable-angina-pectoris
#1
Yuri M Pozdnyakov
INTRODUCTION: Trimetazidine (TMZ) is an anti-ischemic metabolic agent that has been shown to be efficacious in angina treatment, both in monotherapy and in combination. A new formulation of TMZ modified-release (MR) 80 mg was developed, which is to be taken once daily (od), instead of twice daily (bid) for the currently available TMZ MR 35 mg, with the aim of simplifying the medication regimen. METHODS: The present study was an international, multicenter, randomized, double-blind, parallel-group phase III study with a 12-week treatment period...
May 19, 2018: Cardiology and Therapy
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#2
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29768314/medication-administration-delays-in-non-st-elevation-myocardial-infarction-analysis-of-1002-patients-admitted-to-an-academic-medical-center
#3
LeAnn N Denlinger, Ellen C Keeley
Our goal was to assess adherence to American College of Cardiology/American Heart Association guideline-based medical therapy in patients admitted with type I non-ST elevation myocardial infarction (NSTEMI) and to determine factors associated with medication administration delay. We performed a retrospective analysis using data from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry. Baseline patient demographics, 12-lead electrocardiogram (ECG) findings, laboratory values, medications administered and the time they were administered, and in-hospital clinical outcomes were collected...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29753793/short-term-prognosis-of-myocardial-injury-type-1-and-type-2-myocardial-infarction-in-the-emergency-unit
#4
Alain Putot, Sophie Buet Derrida, Marianne Zeller, Aurélie Avondo, Patrick Ray, Patrick Manckoundia, Yves Cottin
BACKGROUND: Type 2 myocardial infarction and non-ischemic myocardial injury, corresponding to troponin elevation without atherothrombosis, are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles and short-term prognoses remain to be investigated. METHODS: Among all the patients admitted from January 2014 to December 2016 in a university hospital ED (n=33,669), those with elevated conventional troponin Ic (≥0...
May 10, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29740046/assessment-of-ecg-and-respiration-recordings-from-simulated-emergency-landings-of-ultra-light-aircraft
#5
Ondřej Bruna, Tomáš Levora, Jan Holub
Pilots of ultra light aircraft have limited training resources, but with the use of low cost simulators it might be possible to train and test some parts of their training on the ground. The purpose of this paper is to examine possibility of stress inducement on a low cost flight simulator. Stress is assessed from electrocardiogram and respiration. Engine failure during flight served as a stress inducement stimuli. For one flight, pilots had access to an emergency navigation system. There were recorded some statistically significant changes in parameters regarding breathing frequency...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29738675/the-role-of-technology-and-telemetry-medicine-in-the-initial-management-of-a-st-segment-elevated-myocardial-infarction-in-a-rural-emergency-department
#6
Michael L Hood
CONTEXT: The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29738425/a-pilot-open-label-8-week-study-evaluating-desvenlafaxine-for-treatment-of-major-depression-in-methadone-maintained-individuals-with-opioid-use-disorder
#7
Cynthia El Hage, Maykel F Ghabrash, Simon Dubreucq, Suzanne Brissette, François Lespérance, Paul Lespérance, Clairélaine Ouellet-Plamondon, Julie Bruneau, Didier Jutras-Aswad
Depression is one of the most prevalent psychiatric disorders among opioid-dependent individuals. Clinical trials testing selective serotonin reuptake inhibitors among depressed patients on methadone maintenance therapy (MMT) failed to show efficacy, whereas those on tricyclic antidepressants produced mixed results with potential for cardiotoxicity. Desvenlafaxine (DESV) is a SNRI with minimal cardiotoxicity and drug interactions. This study sought to assess feasibility and tolerability of using DESV in depressed patients on MMT...
May 7, 2018: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29736558/modifiable-factors-associated-with-prolonged-door-to-balloon-time-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#8
Masahiko Noguchi, Junya Ako, Takeshi Morimoto, Yosuke Homma, Takashi Shiga, Kotaro Obunai, Hiroyuki Watanabe
Door to balloon (D2B) time was reported an important factor of the clinical outcome of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). D2B time is influenced by various factors; however, modifiable factors have not been adequately evaluated. The purpose of this study was to identify modifiable factors associated with prolonged D2B time. We historically included 239 consecutive STEMI patients who visited emergency department and underwent primary PCI between April 2013 and September 2016...
May 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29729173/indscators-of-blood-lipid-profile-acute-phase-reactions-and-uric-acid-in-patients-with-arterial-hypertension-combined-with-connective-tissue-dysplasia
#9
Yevheniya H Zaremba, Nataliya O Rak, Olha V Zaremba, Olena V Zaremba-Fedchyshyn, Marianna M Virna, Liliya O Odnorih
OBJECTIVE: Introduction:Changes in the cardiovascular system can be divided into 2 groups due to the connective tissue dysplasia (CTD) and changes in the circulatory system, caused by pathological processes that arose on the basis of the connective structures failure. One of the risk factors of arterial hypertension (AH) remaining insufficiently studied is collagen pathology - nondifferentiated connective tissue dysplasia (NCTD). The presence of connective tissue in all organs and systems, the common origin of smooth muscles, blood and lymph from mesenchyma leads to dysplastic changes in any organ and system...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29724744/measuring-outcome-differences-associated-with-stemi-screening-and-diagnostic-performance-a-multicentred-retrospective-cohort-study-protocol
#10
Maame Yaa A B Yiadom, Bryn E Mumma, Christopher W Baugh, Brian W Patterson, Angela M Mills, Gilberto Salazar, Mary Tanski, Cathy A Jenkins, Timothy J Vogus, Karen F Miller, Brittney E Jackson, Christoph U Lehmann, Stephen C Dorner, Jennifer L West, Thomas J Wang, Sean P Collins, Robert S Dittus, Gordon R Bernard, Alan B Storrow, Dandan Liu
INTRODUCTION: Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29724738/gender-disparities-in-first-medical-contact-and-delay-in-st-elevation-myocardial-infarction-a-prospective-multicentre-swedish-survey-study
#11
Sofia Sederholm Lawesson, Rose-Marie Isaksson, Maria Ericsson, Karin Ängerud, Ingela Thylén
OBJECTIVES: Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately. DESIGN: Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital. SETTING: Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29720178/a-new-approach-for-analysis-of-heart-rate-variability-and-qt-variability-in-long-term-ecg-recording
#12
Hau-Tieng Wu, Elsayed Z Soliman
BACKGROUND AND PURPOSE: With the emergence of long-term electrocardiogram (ECG) recordings that extend several days beyond the typical 24-48 h, the development of new tools to measure heart rate variability (HRV) and QT variability is needed to utilize the full potential of such extra-long-term ECG recordings. METHODS: In this report, we propose a new nonlinear time-frequency analysis approach, the concentration of frequency and time (ConceFT), to study the HRV QT variability from extra-long-term ECG recordings...
May 3, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29714427/electrocardiograms-a-guide-to-rhythm-recognition-for-emergency-nurses
#13
Anthony McGrath, Michael Sampson
Electrocardiogram (ECG) is one of the most commonly performed investigations in emergency departments (EDs), and is an extremely useful adjunct that guides diagnosis, prognosis and treatment. In most cases nurses are the first healthcare professional to assess patients and record an ECG, yet anecdotal evidence suggests that few emergency nurses review, interpret and act on ECG findings. Research suggests this may be due to lack of confidence in, or knowledge about, interpretation of results, often because of inadequate training...
May 1, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29705553/dictionary-based-monitoring-of-premature-ventricular-contractions-an-ultra-low-cost-point-of-care-service
#14
S Chandra Bollepalli, S Sastry Challa, Laxminarayana Anumandla, Soumya Jana
While cardiovascular diseases (CVDs) are prevalent across economic strata, the economically disadvantaged population is disproportionately affected due to the high cost of traditional CVD management, involving consultations, testing and monitoring at medical facilities. Accordingly, developing an ultra-low-cost alternative, affordable even to groups at the bottom of the economic pyramid, has emerged as a societal imperative. Against this backdrop, we propose an inexpensive yet accurate home-based electrocardiogram (ECG) monitoring service...
April 25, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29691271/unusual-congenital-coronary-artery-anomaly-in-a-young-adult-presenting-as-sudden-cardiac-arrest
#15
Manuel Cortes, Carlos A Roldan, Stacey Clegg
A previously asymptomatic young female with no previous medical or cardiac history collapsed during indoor exercise. A portable automatic external defibrillator showed a shockable rhythm. She received multiple electrical shocks with return to normal sinus rhythm without ischaemic ECG changes. Her troponin level was mildly elevated. A transthoracic echocardiogram revealed moderately reduced left ventricular ejection fraction with global hypokinesis. During emergent coronary angiography, the left main coronary artery could not be found...
April 24, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29689039/-electrocardiographic-diagnosis-when-qrs-is-wide
#16
Matilde Conti, Enrico Rino Bregani
Differential diagnosis of one or more wide QRS complexes on an electrocardiogram under emergency conditions takes into account three main sets of clinical conditions: ventricular pre-excitation, aberrant conduction and ventricular beats and it is based on the morphological analysis of the ECG and patient's anamnestic data. Several criteria can facilitate the differential diagnosis and if properly used and integrated with clinic data they can achieve good diagnostic accuracy in most cases. In this review several criteria based on evidence and literature are presented, paying attention in recognizing some morphologic pathways that can be used in emergency room and allow a correct ECG assessment...
April 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29685372/emergency-physician-risk-estimates-and-admission-decisions-for-chest-pain-a-web-based-scenario-study
#17
David L Schriger, Michael Menchine, Warren Wiechmann, Guy Carmelli
STUDY OBJECTIVE: We conducted this study to better understand how emergency physicians estimate risk and make admission decisions for patients with low-risk chest pain. METHODS: We created a Web-based survey consisting of 5 chest pain scenarios that included history, physical examination, ECG findings, and basic laboratory studies, including a negative initial troponin-level result. We administered the scenarios in random order to emergency medicine residents and faculty at 11 US emergency medicine residency programs...
April 20, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29685360/incidental-lad-stenosis-identified-on-non-gated-chest-cta
#18
Nicholas Chan, Brian M Yuen, Ji Yang, Stuart L Cohen, Loukas Boutis, John N Makaryus
A 57-year-old male former smoker presented to the Emergency Department (ED) with blurry vision, headache, and generalized weakness. He was hypoxic on room air and ECG showed sinus tachycardia. A CT pulmonary angiogram was ordered in the ED and revealed no pulmonary embolism but incidentally noted a likely significant stenosis in the proximal LAD. Subsequent cardiac catheterization revealed a 90% stenotic lesion with percutaneous coronary intervention leading to symptom resolution. Unlike coronary CTA, CTPA is performed with non-ECG gated helical scanning and generates motion artifacts associated with myocardial contraction...
April 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29684148/antiviral-activity-of-oral-jnj-53718678-in-healthy-adult-volunteers-challenged-with-respiratory-syncytial-virus-a-placebo-controlled-study
#19
Marita Stevens, Sarah Rusch, John DeVincenzo, Young-In Kim, Lisa Harrison, Elizabeth A Meals, Alison Boyers, Juin Fok-Seang, Dymphy Huntjens, Nacer Lounis, Kris Mari N, Bart Remmerie, Dirk Roymans, Anil Koul, René Verloes
Background: Respiratory syncytial virus (RSV) disease has no effective treatment. JNJ-53718678 is a fusion inhibitor with selective activity against RSV. Methods: After confirmation of RSV infection or 5 days post inoculation with RSV, participants (n=69) were randomized to JNJ-53718678 75 mg (n=15), 200 mg (n=17), 500 mg (n=18), or placebo (n=17), orally once-daily for 7 days. Antiviral effects were evaluated by assessing RSV RNA viral load (VL) area-under-the-curve (AUC) from baseline (prior to the first dose) until discharge, time-to-peak VL, duration of viral shedding, clinical symptoms, and quantity of nasal secretions...
April 19, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29676832/circulating-mirnas-in-acute-new-onset-atrial-fibrillation-and-their-target-mrna-network
#20
Ananília Medeiros Gomes da Silva, Jéssica Nayara Góes de Araújo, Katiene Macêdo de Oliveira, Ana Eloísa Melo Novaes, Mariana Borges Lopes, Júlio César Vieira de Sousa, Antônio Amorim de Araújo Filho, André Ducati Luchessi, Adriana Augusto de Rezende, Mário Hiroyuki Hirata, Vivian Nogueira Silbiger
BACKGROUND: MicroRNAs (miRNAs) are involved in the pathogenesis of atrial fibrillation (AF), acting on development and progression. Our pilot study investigated the expression of six miRNAs and their miRNA-mRNA interactions in patients with acute new-onset AF, well-controlled AF, and normal sinus rhythm (controls). METHODS AND RESULTS: Plasma of acute new-onset AF patients (n = 5) was collected in the emergency room when patients presented with irregular and fast-atrial fibrillation rhythm...
April 20, 2018: Journal of Cardiovascular Electrophysiology
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