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https://www.readbyqxmd.com/read/29331270/severe-beta-blocker-and-calcium-channel-blocker-overdose-role-of-high-dose-insulin
#1
Karan Seegobin, Satish Maharaj, Ansuya Deosaran, Pramod Reddy
A 54-year-old female presented after taking an overdose of an unknown amount of hydrochlorothiazide, doxazocin, atenolol and amlodipine. She was initially refractory to treatment with conventional therapy (intravenous fluids, activated charcoal, glucagon 5 mg followed with glucagon drip, calcium gluconate 10%, and atropine). Furthermore, insulin at 4 U/kg was not effective in improving her hemodynamics. Shortly after high dose insulin was achieved with 10 U/kg, there was dramatic improvement in hemodynamics resulting in three of five vasopressors being weaned off in 8 h...
January 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29327797/potassium-and-the-use-of-renin-angiotensin-aldosterone-system-inhibitors-in-heart-failure-with-reduced-ejection-fraction-data-from-biostat-chf
#2
Joost C Beusekamp, Jasper Tromp, Haye H van der Wal, Stefan D Anker, John G Cleland, Kenneth Dickstein, Gerasimos Filippatos, Pim van der Harst, Hans L Hillege, Chim C Lang, Marco Metra, Leong L Ng, Piotr Ponikowski, Nilesh J Samani, Dirk J van Veldhuisen, Aeilko H Zwinderman, Patrick Rossignol, Faiez Zannad, Adriaan A Voors, Peter van der Meer
BACKGROUND: Hyperkalaemia is a common co-morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Whether it affects the use of renin-angiotensin-aldosterone system inhibitors and thereby negatively impacts outcome is unknown. Therefore, we investigated the association between potassium and uptitration of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and its association with outcome. METHODS AND RESULTS: Out of 2516 patients from the BIOSTAT-CHF study, potassium levels were available in 1666 patients with HFrEF...
January 12, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29326185/enhancing-prescribing-of-guideline-recommended-medications-for-ischaemic-heart-diseases-a-systematic-review-and-meta-analysis-of-interventions-targeted-at-healthcare-professionals
#3
Thang Nguyen, Hoa Q Nguyen, Niken N Widyakusuma, Thao H Nguyen, Tam T Pham, Katja Taxis
OBJECTIVES: Ischaemic heart diseases (IHDs) are a leading cause of death worldwide. Although prescribing according to guidelines improves health outcomes, it remains suboptimal. We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs. METHODS: We systematically searched PubMed and EMBASE for studies published between 1 January 2000 and 31 August 2017. We included original studies of interventions targeted at healthcare professionals to enhance prescribing guideline-recommended medications for IHDs...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325962/systematic-review-of-factors-influencing-surgical-performance-practical-recommendations-for-microsurgical-procedures-in-neurosurgery
#4
Evgenii Belykh, Naomi R Onaka, Iraklii T Abramov, Kaan Yağmurlu, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
BACKGROUND: Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations. MATERIALS AND METHODS: A literature search of factors that may impact microsurgical performance was conducted using PubMed and Embase...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29322605/declare-timi-58-participants-baseline-characteristics
#5
Itamar Raz, Ofri Mosenzon, Marc P Bonaca, Avivit Cahn, Eri T Kato, Michael G Silverman, Deepak L Bhatt, Lawrence A Leiter, Darren K McGuire, John Wilding, Ingrid Am Gause-Nilsson, Anna Maria Langkilde, Peter A Johansson, Marc S Sabatine, Stephen D Wiviott
BACKGROUND: Cardiovascular (CV) outcome trials with new glucose lowering agents (GLA) are designed to prove CV safety in high CV risk populations. However, the level of CV risk differs greatly among trials, which may influence comparability and generalizability of results. AIM: We describe baseline characteristics of participants randomized in the Dapagliflozin Effect on CardiovascuLAR Events (DECLARE-TIMI 58) trial, the pivotal study to assess CV outcomes with dapagliflozin...
January 11, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29318637/factors-increasing-the-risk-for-a-severe-reaction-in-anaphylaxis-an-analysis-of-data-from-the-european-anaphylaxis-registry
#6
Margitta Worm, Wojciech Francuzik, Jean-Marie Renaudin, Maria Beatrice Bilo, Victòria Cardona, Kathrin Scherer Hofmeier, Alice Köhli, Andrea Bauer, George Christoff, Ewa Cichocka-Jarosz, Thomas Hawranek, Jonathan O'B Hourihane, Lars Lange, Vera Mahler, Antonella Muraro, Nikolaos G Papadopoulos, Claudia Pföhler, Iwona Poziomkowska-Gęsicka, Franziska Ruëff, Thomas Spindler, Regina Treudler, Montserrat Fernandez-Rivas, Sabine Dölle
BACKGROUND: Preventive measures to decrease the frequency and intensity of anaphylactic events are essential to provide optimal care for allergic patients. Aggravating factors may trigger or increase the severity of anaphylaxis and therefore need to be recognized and avoided. OBJECTIVE: To identify and prioritize factors associated with an increased risk of developing severe anaphylaxis. METHODS: Data from the Anaphylaxis Registry (122 centers in 11 European countries) was used in logistic regression models considering existing severity grading systems, elicitors, and symptoms to identify the relative risk of factors on the severity of anaphylaxis...
January 10, 2018: Allergy
https://www.readbyqxmd.com/read/29318439/mind-the-gap-mismatches-between-clinicians-and-patients-in-heart-failure-medication-management
#7
Ken Lee Chin, Marina Skiba, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Justin A Mariani, Danny Liew
PURPOSE: Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use. METHODS: A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia...
January 9, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29316267/elderly-patients-with-suspected-chronic-digoxin-toxicity-a-comparison-of-clinical-characteristics-of-patients-receiving-and-not-receiving-digoxin-fab
#8
Hooman Arbabian, Hwee Min Lee, Andis Graudins
OBJECTIVE: The aim of the present study was to compare clinical features of patients with elevated serum digoxin concentrations who were treated with digoxin-Fab with those where the immunotherapy was not given by a tertiary hospital toxicology service. METHODS: This was a retrospective series of patients with supratherapeutic serum digoxin concentrations referred to the toxicology service from August 2013 to October 2015. Data collected included demographics, presenting complaint, digoxin dose, other medications taken, serum digoxin, potassium and creatinine concentration on presentation and initial and post-digoxin-Fab heart rate...
January 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29315692/comprehensive-review-of-cardiovascular-toxicity-of-drugs-and-related-agents
#9
REVIEW
Přemysl Mladěnka, Lenka Applová, Jiří Patočka, Vera Marisa Costa, Fernando Remiao, Jana Pourová, Aleš Mladěnka, Jana Karlíčková, Luděk Jahodář, Marie Vopršalová, Kurt J Varner, Martin Štěrba
Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases...
January 5, 2018: Medicinal Research Reviews
https://www.readbyqxmd.com/read/29313593/a-patient-with-dilated-cardiomyopathy-and-portal-hypertension-which-beta-blocker-to-use
#10
Rathindranath Sarkar, Rudrajit Paul, Debaditya Roy, Asim Saha, Tanmay Jyoti Sau, Jayati Mondal
No abstract text is available yet for this article.
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29312724/long-term-results-of-radiofrequency-maze-procedure-for-persistent-atrial-fibrillation-with-concomitant-mitral-surgery
#11
Chia-Chen Wu, Jen-Ping Chang, Mien-Cheng Chen, Cheng-I Cheng, Wen-Jung Chung
Background: The radiofrequency (RF) maze procedure can effectively restore sinus rhythm in most patients with persistent atrial fibrillation (AF) and mitral disease. However, long-term results and predictors for late AF recurrence are still under investigation. Methods: From December 1995 to November 2011, 207 consecutive patients with persistent AF and mitral disease underwent RF maze procedure and concomitant mitral surgery. The mean age was 54±12.4 year-old...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310230/effect-of-salinity-and-ph-on-the-calibration-of-the-extraction-of-pharmaceuticals-from-water-by-passil
#12
Hanna Męczykowska, Piotr Stepnowski, Magda Caban
High salinity and a relatively high pH are two factors characterizing the marine water environment, which is one of the main final reservoirs receiving pharmaceutical residues. The same factors have an undeniable impact on the extraction efficiency and kinetics of uptakes of polar analytes from water by sorbent-based passive sampling techniques. Recently, we presented a novel passive sampling technique, in which ionic liquids are applied as receiving phases for pharmaceutical monitoring in water (the Passive Sampling with Ionic Liquids technique)...
March 1, 2018: Talanta
https://www.readbyqxmd.com/read/29309742/abnormal-repolarization-duration-during-everyday-emotional-arousal-in-long-qt-syndrome-and-coronary-artery-disease
#13
Richard D Lane, Harry T Reis, Chiu-Hsieh Hsu, Karl B Kern, Jean Philippe Couderc, Arthur J Moss, Wojciech Zareba
BACKGROUND: Rare high arousal negative emotions are known triggers of sudden death in individuals with preexisting heart disease. Whether everyday fluctuations in emotional arousal influence arrhythmia risk is unknown. METHODS: We studied 160 patients with the congenital Long QT Syndrome (LQTS), 199 patients with coronary artery disease, and two groups of matched healthy volunteers (n=53 and 50, respectively). Three-day home visits including a 12-hour Holter recording each day were completed...
January 5, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29308931/age-dependent-sympathetic-neural-responses-to-%C3%AE-1-selective-beta-blockade-in-untreated-hypertension-related-tachycardia
#14
Dagmara Hering, Wiesława Kucharska, Marzena Chrostowska, Krzysztof Narkiewicz
BACKGROUND: Elevated heart rate (HR) increases cardiovascular morbidity and mortality in hypertension. The impact of beta-blockers on patient prognosis in hypertension is controversial. This study examined the age-related effects of betaxolol on HR, muscle sympathetic nerve activity (MSNA), blood pressure (BP) and sympathovagal balance in untreated males with hypertension and tachycardia. METHODS: Ten young (age 26 ± 1 years) and seven older (age 50 ± 4 years) males underwent measurement of BP, HR, HR variability (Poincare plot) and MSNA before and after 8 weeks treatment with betaxolol at the initial starting dose of 10 mg/day, which was increased to 20 mg/day once daily after 4 weeks in all subjects...
January 8, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29308681/therapeutic-considerations-of-sarcopenia-in-heart-failure-patients
#15
Masakazu Saitoh, Nicole Ebner, Stephan von Haehling, Stefan D Anker, Jochen Springer
Sarcopenia is a common feature, and affects 20-47% of patients with heart failure (HF). Sarcopenia is also an independent predictor of impaired functional capacity, even after adjusting for clinical relevant variables, which is associated with adverse outcome in patients with HF. Areas covered: Several different pathophysiological pathways are involved in sarcopenic processes including altered nutrient intake and absorption, hormonal factor, inflammatory processes, oxidative stress, cellular proteolysis, and unhealthy lifestyle...
January 7, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29306478/fibroblast-growth-factor-23-is-related-to-profiles-indicating-volume-overload-poor-therapy-optimization-and-prognosis-in-patients-with-new-onset-and-worsening-heart-failure
#16
Jozine M Ter Maaten, Adriaan A Voors, Kevin Damman, Peter van der Meer, Stefan D Anker, John G Cleland, Kenneth Dickstein, Gerasimos Filippatos, Pim van der Harst, Hans L Hillege, Chim C Lang, Marco Metra, Gerjan Navis, Leong Ng, Wouter Ouwerkerk, Piotr Ponikowski, Nilesh J Samani, Dirk J van Veldhuisen, Faiez Zannad, Aeilko H Zwinderman, Martin H de Borst
BACKGROUND: Fibroblast growth factor (FGF) 23 is a hormone that increases urinary phosphate excretion and regulates renal sodium reabsorption and plasma volume. We studied the role of plasma FGF23 in therapy optimization and outcomes in patients with new-onset and worsening heart failure (HF). METHODS: We measured plasma C-terminal FGF23 levels at baseline in 2399 of the 2516 patients included in the BIOlogy Study to Tailored Treatment in Chronic HF (BIOSTAT-CHF) trial...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29305104/heart-failure-with-mid-range-ejection-fraction-in-patients-admitted-to-internal-medicine-departments-findings-from-the-rica-registry
#17
María Esther Guisado-Espartero, Prado Salamanca-Bautista, Óscar Aramburu-Bodas, Alicia Conde-Martel, José Luis Arias-Jiménez, Pau Llàcer-Iborra, Melitón Francisco Dávila-Ramos, Yolanda Cabanes-Hernández, Luis Manzano, Manuel Montero-Pérez-Barquero
AIM: To improve the knowledge on characteristics, treatment and prognosis in patients with heart failure (HF) and mid-range ejection fraction discharged after an acute HF episode. METHODS: We prospectively included and followed 2753 patients admitted with HF to Internal Medicine units. Patients were classified according to ejection fraction (EF) into three strata: reduced, EF <40% (HFrEF); mid-range EF 40-49% (HFmrEF); and preserved EF ≥50% (HFpEF). Clinical, echocardiographic, laboratory data and treatment at discharge were recorded and the groups were compared...
January 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29303829/sex-differences-in-antihypertensive-treatment-in-france-among-17%C3%A2-856-patients-in-a-tertiary-hypertension-unit
#18
Thérèse Deborde, Laurence Amar, Guillaume Bobrie, Nicolas Postel-Vinay, Christiane Battaglia, Amokrane Tache, Antoine Chedid, Mohamed-Malek Dhib, Gilles Chatellier, Pierre-François Plouin, Anita Burgun, Michel Azizi, Anne-Sophie Jannot
BACKGROUND: Sex differences in antihypertensive treatment have often been highlighted, but whether there is truly a difference or whether this difference is mediated by confounding factors has yet to be deciphered. PATIENTS AND METHODS: We performed a cross-sectional study on the first consultation in the Georges Pompidou Hospital Tertiary Hypertension Unit between July 2000 and June 2015 to explore sex differences in both patient and treatment characteristics over this period...
January 4, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29303037/placebo-effects-in-spider-phobia-an-eye-tracking-experiment
#19
Andreas Gremsl, Daniela Schwab, Carina Höfler, Anne Schienle
Several eye-tracking studies have revealed that spider phobic patients show a typical hypervigilance-avoidance pattern when confronted with images of spiders. The present experiment investigated if this pattern can be changed via placebo treatment. We conducted an eye-tracking experiment with 37 women with spider phobia. They looked at picture pairs (a spider paired with a neutral picture) for 7 s each in a retest design: once with and once without a placebo pill presented along with the verbal suggestion that it can reduce phobic symptoms...
January 5, 2018: Cognition & Emotion
https://www.readbyqxmd.com/read/29302263/radiofrequency-catheter-ablation-of-atrioventricular-nodal-reentry-tachycardia-in-children-and-adolescents-a-single-center-experience
#20
Myung Chul Hyun
Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center...
December 2017: Korean Journal of Pediatrics
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