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PAD guideline

Ehud J Schmidt, Ronald D Watkins, Menekhem M Zviman, Michael A Guttman, Wei Wang, Henry A Halperin
BACKGROUND: Subjects undergoing cardiac arrest within a magnetic resonance imaging (MRI) scanner are currently removed from the bore and then from the MRI suite, before the delivery of cardiopulmonary resuscitation and defibrillation, potentially increasing the risk of mortality. This precludes many higher-risk (acute ischemic and acute stroke) patients from undergoing MRI and MRI-guided intervention. An MRI-conditional cardiac defibrillator should enable scanning with defibrillation pads attached and the generator ON, enabling application of defibrillation within the seconds of MRI after a cardiac event...
October 2016: Circulation. Cardiovascular Imaging
J Bremer, R Böthig, B Domurath, J Kutzenberger, A Kaufmann, J Pretzer, J P Klask, V Geng, W Vance, I Kurze
BACKGROUND: The provision of urological appliances for patients with neurogenic lower urinary tract dysfunction (NLUTD) is essential. Hitherto existing standard guidelines for the estimation of monthly material requirements are based solely on estimates. OBJECTIVE: The goal of this work was to define the objective and subsequently subjective requirements for urological appliances on a scientifically validated basis. MATERIALS AND METHODS: Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD were collected through a standardized survey at six different centers in Germany during the period of October to December 2014 and statistically evaluated...
October 10, 2016: Der Urologe. Ausg. A
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
A Vahl, B Elsman, A van Enst
- Revision of the 2005 guideline 'Diagnostics and treatment of lower extremity peripheral arterial disease' and the development of an audit have instigated a degree of efficiency and transparency for the treatment of patients with peripheral arterial disease (PAD). - The key recommendations are that first-line treatment of patients, who - preferably by means of a consultation in a vascular laboratory - are diagnosed with intermittent claudication, is supervised exercise therapy and secondary prevention. Referral for second-line treatment only needs to occur when invasive therapy is considered, for example when there is insufficient improvement in symptoms or in patients who have or are developing critical ischemia...
2016: Nederlands Tijdschrift Voor Geneeskunde
Sandeep Aggarwal, Randy D Moore, Ross Arena, Brenda Marra, Amanda McBride, Brea Lamb, Billie-Jean Martin, James Stone
Peripheral arterial disease (PAD) is the result of atherosclerosis in the lower limb arteries, which can give rise to intermittent claudication (IC), limb ulceration, infections, and, in some circumstances, amputation. As a result of PAD, patients are frequently limited in both walking duration and speed. These ambulatory deficits impact both functional capacity and quality of life. The prevalence of PAD is increasing, and patients with this diagnosis have high cardiovascular morbidity and mortality. A comprehensive approach is required to improve outcomes in patients with PAD and include tobacco cessation, pharmacologic management of metabolic fitness, risk-factor modification, and exercise training...
October 2016: Canadian Journal of Cardiology
Robert C Sibley, Stephen P Reis, Jarrod J MacFarlane, Mark A Reddick, Sanjeeva P Kalva, Patrick D Sutphin
Noninvasive physiologic vascular studies play an important role in the diagnosis and characterization in peripheral arterial disease (PAD) of the lower extremity. These studies evaluate the physiologic parameters of blood flow through segmental arterial pressures, Doppler waveforms, and pulse volume recordings. Collectively, they comprise a powerful toolset for defining the functionality of the arterial system, localizing the site of disease, and providing prognostic data. This technology has been widely adopted by diverse medical specialty practitioners, including radiologists, surgeons, cardiologists, and primary care providers...
September 30, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Chang Guk Yoon, Jinwoo Jeong, In Ho Kwon, Jae Hoon Lee
Out-of-hospital cardiac arrest (OHCA) is considered an important health issue worldwide, and early defibrillation is a key element for a favourable prognosis. In South Korea, public access defibrillation (PAD) programmes were initiated in 2007. However, the impact of PAD programmes on OHCA survival rates remains unclear. This study evaluated the deployment and maintenance status of public automatic external defibrillators (AED), including how frequently they were used, in Busan Metropolitan City, South Korea...
2016: SpringerPlus
Susan Prendeville, Theodorus H van der Kwast
Pelvic lymph node dissection (PLND) currently represents the gold standard method for nodal staging in the setting of localised prostate cancer and may also have a therapeutic benefit in certain patients. The histopathological evaluation of PLND specimens plays a critical role in accurate lymph node staging, however there is currently a lack of consensus regarding the optimum approach and no quality parameters are in place. In addition, there are no guidelines as to the handling of less commonly encountered nodal specimens such as those identified within the anterior fat pad...
August 23, 2016: Journal of Clinical Pathology
Ravi S Hira, Jennifer B Cowart, Julia M Akeroyd, David J Ramsey, Yashashwi Pokharel, Vijay Nambi, Hani Jneid, Anita Deswal, Ali Denktas, Addison Taylor, Khurram Nasir, Christie M Ballantyne, Laura A Petersen, Salim S Virani
Cardiovascular disease (CVD) is a systemic process involving multiple vascular beds and includes coronary heart disease (CHD), ischemic cerebrovascular disease (ICVD), and peripheral arterial disease (PAD). All these manifestations are associated with an increased risk of subsequent myocardial infarction, stroke, and death. Guideline-directed medical therapy is recommended for all patients with CVD. In a cohort of US veterans, we identified 1,242,015 patients with CVD receiving care in 130 Veterans Affairs facilities from October 1, 2013 to September 30, 2014...
October 15, 2016: American Journal of Cardiology
F Daniel Ramirez, Sandra L Fiset, Mark J Cleland, Timothy J Zakutney, Pablo B Nery, Girish M Nair, Calum J Redpath, Mouhannad M Sadek, David H Birnie
BACKGROUND: Current guidelines disagree on the role for applying force to electrodes during electrical cardioversion (ECV) for atrial fibrillation, particularly when using self-adhesive pads. We evaluated the impact of this practice on transthoracic impedance (TTI) with varying force and in individuals with differing body mass indices (BMI). We additionally assessed whether specific prompts could improve physicians' ECV technique. METHODS: The study comprised three parts: (1) TTI was measured in 11 participants throughout the respiratory cycle and with variable force applied to self-adhesive electrodes in anteroposterior (AP) and anterolateral (AL) configurations...
October 2016: Pacing and Clinical Electrophysiology: PACE
Kjell Hansson Mild, Stefan Friberg, Jennifer Frankel, Jonna Wilén
As a case study we have measured the magnetic field from an induction loop pad designed for hearing aid assistance. The magnitude of the field was high, although well below international guidelines. We recorded values up to 70% of recommended standard in some instances. However, in view of the many reports indicating health effects of low-level exposure we recommend that the precautionary principle is applied when such pads are given to people that might be especially vulnerable. This is relevant for children, pregnant women and women on breast cancer medication...
August 19, 2016: International Journal of Occupational Safety and Ergonomics: JOSE
Matjaž Špan, Gregor Geršak, Sandrine C Millasseau, Marko Meža, Andrej Košir
In occidental countries, peripheral arterial disease (PAD) is an important health issue; however, most subjects are asymptomatic (~50%) and therefore undiagnosed and untreated. Current guidelines recommend screening for PAD in primary care setting using ankle brachial index (ABI) in all patients with cardiovascular risks. This is, however, not performed strictly because the standard Doppler method is cumbersome and time-consuming. Here, we evaluate the accuracy and reproducibility of ABI measurements obtained by an improved automated oscillometric device, the MESI ABPI MD(®) device, and the standard Doppler method...
2016: Vascular Health and Risk Management
Tamio Teramoto, Kiyoko Uno, Izuru Miyoshi, Irfan Khan, Katherine Gorcyca, Robert J Sanchez, Shigeto Yoshida, Kazuhiro Mawatari, Tomoya Masaki, Hidenori Arai, Shizuya Yamashita
BACKGROUND AND AIMS: Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in the development of cardiovascular (CV) disease. In 2012, the Japan Atherosclerosis Society (JAS) issued guidelines recommending statins as first-line pharmacotherapy for lowering LDL-C in patients at high risk for CV events. This study assessed achievement of recommended LDL-C goals and lipid-modifying therapy (LMT) use in a high CV risk population in Japan. METHODS: Patients from the Medical Data Vision (MDV) database, an electronic hospital-based claims database in Japan, who met the following inclusion criteria were included in this study: LDL-C measurement in 2013; ≥20 years of age; ≥2 years representation in the database; and a high CV risk condition (recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) or diabetes)...
August 2016: Atherosclerosis
Blinc Ales Blinc, Matija Kozak, Miso Sabovic, Mojca Bozic Mijovski, Mojca Stegnar, Pavel Poredos, Andrej Kravos, Breda Barbic-Zagar, Janez Stare, Maja Pohar Perme
BACKGROUND: Patients with peripheral arterial disease (PAD) are at very high risk for cardiovascular events. How do patients with PAD differ from age- and sex-matched controls in survival, major ischemic events and revascularization procedures when both groups were managed according to the European guidelines on cardiovascular disease prevention? METHODS: 742 patients with PAD and 713 age and sex-matched control subjects without PAD, both groups aged 65±9 years at inclusion, were managed for 5 years according to the European guidelines on cardiovascular disease prevention and evaluated yearly for occurrence of death, non-fatal major ischemic events and revascularization procedures (minor events)...
June 22, 2016: International Angiology: a Journal of the International Union of Angiology
Thomas Cayton, Amy Harwood, George E Smith, Ian Chetter
BACKGROUND: Extracorporeal shockwave therapy (ESWT) is emerging as a potential new treatment option for a variety of clinical scenarios including promotion of wound healing and symptom control in end-stage ischemic heart disease. A number of small trials have investigated ESWT in the management of peripheral arterial disease (PAD). A systematic review of the literature was performed investigating the efficacy and potential mechanism of action of ESWT for PAD. METHODS: A systematic review was conducted using MEDLINE and PubMed databases in keeping with the standard reporting guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis group to identify any publications relating to the use of ESWT in PAD...
August 2016: Annals of Vascular Surgery
Mehmet Akif Sargın, Murat Yassa, Bilge Dogan Taymur, Emrah Ergun, Gizem Akca, Niyazi Tug
OBJECTIVE: To translate and validate the Michigan Incontinence Severity Index (M-ISI) for its use in Turkish-speaking women with urinary incontinence. METHODS: The translation and cross-cultural adaptation were based on international guidelines. Content validity by content validity ratio/content validity index, internal consistency by Cronbach's alpha, test-retest reliability by Pearson's correlation, and construct validity by using Spearman rank correlations to show the relationship between individual items and the relevant domains and subdomains were analyzed in 100 female participants with a chief complaint of urinary incontinence...
2016: Patient Preference and Adherence
Pier Alberto Testoni, Alberto Mariani, Lars Aabakken, Marianna Arvanitakis, Erwan Bories, Guido Costamagna, Jacques Devière, Mario Dinis-Ribeiro, Jean-Marc Dumonceau, Marc Giovannini, Tibor Gyokeres, Michael Hafner, Jorma Halttunen, Cesare Hassan, Luis Lopes, Ioannis S Papanikolaou, Tony C Tham, Andrea Tringali, Jeanin van Hooft, Earl J Williams
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting to cannulate; more than 5 minutes spent attempting to cannulate following visualization of the papilla; more than one unintended pancreatic duct cannulation or opacification (low quality evidence, weak recommendation)...
July 2016: Endoscopy
Ukachukwu Okoroafor Abaraogu, Philippa Margaret Dall, Christopher Andrew Seenan
INTRODUCTION: Peripheral arterial disease (PAD) and intermittent claudication (IC) decrease an individual's capacity to engage in physical activity (PA) with potentially negative effects on PA behaviour. Strategies to improve PA among this population may provide a range of positive health benefits. We present a protocol to assess the components of patient education interventions that improve PA capacity and PA behaviour in patients with PAD and IC. METHODS AND ANALYSIS: Published peer-reviewed studies will be searched in the following databases: CINAHL, the Cochrane Library, OVID, ProQuest, AMED, MEDLINE, PsycINFO, Web of Science Core Collection and PEDro, to identify literature investigating the effect of patient education on PA of patients with PAD and IC, or studies that investigated patients' perceptions or experience with these interventions...
2016: BMJ Open
T Raymond Foley, Stephen W Waldo, Ehrin J Armstrong
Peripheral artery disease (PAD) comprises atherosclerosis of the aorta and lower extremities. Many patients with PAD are asymptomatic, while others present with intermittent claudication (IC) or critical limb ischemia (CLI). Defined as rest pain or tissue loss that persists for >2 weeks, CLI represents the most severe clinical manifestation of PAD and is associated with an increased risk of limb loss and death. Patients with PAD, including those with CLI, are underdiagnosed and undertreated. In addition to smoking cessation, medical therapy with an antiplatelet agent and statin is recommended for all patients with PAD...
July 2016: Current Treatment Options in Cardiovascular Medicine
Agessandro Abrahao, James Downar, Hanika Pinto, Nicolas Dupré, Aaron Izenberg, William Kingston, Lawrence Korngut, Colleen O'Connell, Nicolae Petrescu, Christen Shoesmith, Anu Tandon, Ana Beatriz Vargas-Santos, Lorne Zinman
OBJECTIVE: To survey amyotrophic lateral sclerosis (ALS) health care providers to determine attitudes regarding physician-assisted death (PAD) after the Supreme Court of Canada (SCC) invalidated the Criminal Code provisions that prohibit PAD in February 2015. METHODS: We conducted a Canada-wide survey of physicians and allied health professionals (AHP) involved in the care of patients with ALS on their opinions regarding (1) the SCC ruling, (2) their willingness to participate in PAD, and (3) the PAD implementation process for patients with ALS...
September 13, 2016: Neurology
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