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https://www.readbyqxmd.com/read/29657734/treatment-of-a-patient-with-acute-aortic-dissection-using-extracorporeal-cardiopulmonary-resuscitation-after-an-out-of-hospital-cardiac-arrest-a-case-report
#1
Takahiro Yukawa, Kazuhiro Sugiyama, Kazuki Miyazaki, Takahiro Tanabe, Susumu Ishikawa, Yuichi Hamabe
Case: Circulatory support using veno-arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66-year-old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance. While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657235/reduction-in-door-to-balloon-time-with-training-for-effective-and-efficient-action-in-medical-service-better-process-teams-bp-at-a-community-hospital-in-japan
#2
Hiroki Isono, Tetsuhiro Maeno, Shigeyuki Watanabe
ST-elevation myocardial infarction (STEMI) is a fatal condition. Prompt primary percutaneous coronary intervention is associated with lower mortality. However, community hospitals in Japan lack human and medical resources, and implementation of the same strategies as those used in the USA, such as an on-call cardiologist at the hospital, to achieve a door-to-balloon time of ≤ 90 min appears particularly challenging. Therefore, we used Training for Effective and Efficient Action in Medical Service-Better Process (TEAMS-BP) to develop a new process and assessed its effectiveness in reducing door-to-balloon time...
2018: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29657083/the-course-of-awake-breathing-disturbances-across-the-lifespan-in-rett-syndrome
#3
Daniel C Tarquinio, Wei Hou, Jeffrey L Neul, Gamze Kilic Berkmen, Jana Drummond, Elizabeth Aronoff, Jennifer Harris, Jane B Lane, Walter E Kaufmann, Kathleen J Motil, Daniel G Glaze, Steven A Skinner, Alan K Percy
Rett syndrome (RTT), an X-linked dominant neurodevelopmental disorder caused by mutations in MECP2, is associated with a peculiar breathing disturbance exclusively during wakefulness that is distressing, and can even prompt emergency resuscitation. Through the RTT Natural History Study, we characterized cross sectional and longitudinal characteristics of awake breathing abnormalities in RTT and identified associated clinical features. Participants were recruited from 2006 to 2015, and cumulative lifetime prevalence of breathing dysfunction was determined using the Kaplan-Meier estimator...
April 12, 2018: Brain & Development
https://www.readbyqxmd.com/read/29626346/propofol-for-implantable-cardioverter-defibrillator-implantation-in-patients-with-brugada-syndrome
#4
Hye-Mee Kw On, Sung-Hoon Kim, Se-Ung Pa Rk, Jin-Ho Rh Im, Hee-Su N Park, Wook-Jong Kim, Gi-Byou Ng Nam
AIMS: Avoiding propofol in patients with Brugada syndrome has been suggested because of the theoretical risk of provoking ventricular arrhythmias, although propofol may be selected for conscious sedation during electrophysiological procedures in catheterization laboratories. This study aimed to document peri-procedural electrocardiographic changes and adverse events in patients with Brugada syndrome undergoing implantable cardioverter defibrillator (ICD) implantation using propofol sedation...
April 6, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29614430/a-novel-wavelet-sequences-based-on-deep-bidirectional-lstm-network-model-for-ecg-signal-classification
#5
Özal Yildirim
Long-short term memory networks (LSTMs), which have recently emerged in sequential data analysis, are the most widely used type of recurrent neural networks (RNNs) architecture. Progress on the topic of deep learning includes successful adaptations of deep versions of these architectures. In this study, a new model for deep bidirectional LSTM network-based wavelet sequences called DBLSTM-WS was proposed for classifying electrocardiogram (ECG) signals. For this purpose, a new wavelet-based layer is implemented to generate ECG signal sequences...
March 28, 2018: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29607545/effectiveness-to-identify-acute-myocardial-infarction-using-the-manchester-screening-in-patients-with-chest-pain-at-the-emergency-service
#6
Simone M Gonçalves, Karina B Gomes, Maria das G Carvalho, Henrique P B Magalhães, Edna A Reis, Iêda de Fátima O Silva
BACKGROUND: Among cardiovascular diseases (CVD), acute coronary syndrome (ACS) is the main manifestation, corresponding to signs and symptoms that occur with ischemia and outcome of angina or acute myocardial infarction (AMI). The aim of this study was to investigate the performance of biochemical markers eligible in a chest pain protocol, using Point of care Test (POCT), in patients in a reference emergency room. METHODS: In this study, 1380 medical records of patients of both genders were evaluated, ranked by applying chest pain protocol using the Manchester Triage System (MTS)...
April 2, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29602277/suspected-coronary-fat-embolism-after-liposuction
#7
Alisa Thamwiwat, Deepthi Sudhakar, David Paniagua, Ali E Denktas
A 38-year-old female presented with chest pain and ST elevation on electrocardiogram after an outpatient liposuction procedure. Emergent coronary angiography revealed complete occlusion of multiple coronary arteries, with fat embolism as the suspected etiology. Attempts to restore distal coronary flow with balloon dilatation, aspiration with Pronto catheter, and distal adenosine administration resulted in minimal improvement in flow. The material aspirated was consistent with fat. With supportive therapy, including Impella CP support, the patient's clinical condition improved...
March 30, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29582518/long-term-safety-and-effectiveness-of-brexpiprazole-in-japanese-patients-with-schizophrenia-a-52-week-open-label-study
#8
Jun Ishigooka, Shuichi Iwashita, Yoshihiro Tadori
AIMS: This study assessed the long-term safety, tolerability and maintenance of the therapeutic effect of brexpiprazole in Japanese patients with schizophrenia. METHODS: This 52-week, open-label, flexible-dose (1-4 mg/day) study included patients with schizophrenia who continued treatment from a short-term randomized placebo-controlled fixed-dose (1, 2, or 4 mg/day) trial and de novo patients who switched from other antipsychotics. RESULTS: A total of 282 patients (184 de novo and 98 rolled over from short-term trial) entered the 52-week treatment with brexpiprazole, and 150 (53...
March 26, 2018: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29581813/atypical-presentation-of-acute-myeloid-leukemia
#9
Kavita Agrawal, Levin Miles, Nirav Agrawal, Asim Khan
We present a case of a 48-year-old male who presented with worsening pleuritic chest pain for 2 h. He also complained of fever, malaise, headache and severe neck pain. Electrocardiogram (ECG) showed ST segment elevation in leads I, II, aVL and V5 with PR elevation and ST depression in aVR. On admission, troponin-I was 14.8 ng/mL. Based on ECG changes, elevated troponin and family history of early coronary artery disease, the patient was emergently taken to cardiac catheterization lab. Angiography showed non-obstructive coronaries, mild hypokinesis of mid inferior and anterolateral wall with ejection fraction (EF) of 40-45%...
February 2018: World Journal of Oncology
https://www.readbyqxmd.com/read/29576872/pfo-closure-in-high-risk-patient-with-paradoxical-arterial-embolism-deep-vein-thrombosis-pulmonary-embolism-and-factor-v-leiden-genetic-mutation
#10
A Parikh, T P Vacek
Occurrence of paradoxical arterial embolism may cause the first symptoms in patients with a coexisting hypercoagulable state and patent foramen ovale (PFO). This can result in significant morbidity and mortality depending on the location of the embolism. The risks and benefits of closure of small PFOs have not been well elucidated in prior studies. We describe a patient with a history of Factor V Leiden heterozygosity who presented with left arm pain secondary to arterial embolism. The patient was a 51-year-old male who initially presented to the emergency department after awaking from sleep with progressive, severe, burning left arm pain...
March 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29562910/left-ventricular-hypertrophy-diagnosed-after-a-stroke-a-case-report
#11
Wilfred Ifeanyi Umeojiako, Ritesh Kanyal
BACKGROUND: Stroke is a recognized clinical course of hypertrophic cardiomyopathy. This interesting case showed notable difference on the electrocardiogram of a patient 4 months prior to suffering a stroke and 10 days after suffering a stroke. The pre-stroke electrocardiogram showed atrial fibrillation with a narrow QRS complex, while the post-stroke electrocardiogram showed marked left ventricular hypertrophy. Left ventricular hypertrophy was diagnosed using the Sokolow-Lyon indices...
March 22, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29561964/mid-term-results-of-surgical-treatment-of-atrial-fibrillation-in-valvular-heart-disease-assesed-by-speckle-tracking-echocardiography
#12
Natalia Lorenzo, Irene Mendez, Mikel Taibo, Gianfranco Martinis, Sara Badia, Guillermo Reyes, Rio Aguilar
BACKGROUND: Atrial fibrillation frequently affects patients with valvular heart disease. Ablation of atrial fibrillation during valvular surgery is an alternative for restoring sinus rhythm. OBJECTIVES: This study aimed to evaluate mid-term results of successful atrial fibrillation surgical ablation during valvular heart disease surgery, to explore left atrium post-ablation mechanics and to identify predictors of recurrence. METHODS: Fifty-three consecutive candidates were included...
March 19, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29560287/management-of-a-rare-variant-of-hypertrophic-cardiomyopathy
#13
Sidra Khalid, Murtaza Sundhu, Alinda Sarma, Bicky Thapa, Praful Maroo
Apical hypertrophic cardiomyopathy (HCM) is a rare variant of HCM. We present the case of a 26-years-old female who was diagnosed with apical HCM. Her electrocardiogram showed the characteristic T-wave inversions in V2-V5 and her echocardiogram portrayed apical left ventricular hypertrophy. The diagnosis was confirmed with a cardiac magnetic resonance imaging (MRI) scan. She was treated with beta blockers. Our case emphasizes that apical HCM is a relatively benign disease. However, due to the emerging evidence of sudden cardiac deaths in these patients, the risk for sudden death needs to be evaluated...
January 16, 2018: Curēus
https://www.readbyqxmd.com/read/29559356/alpha-lipoic-acid-intoxicat%C3%A4-on-an-adult-case-report-and-l%C3%A4-terature-rev%C3%A4-ew
#14
Duygu Ferek Emir, Ibrahim Ulas Ozturan, Serkan Yilmaz
INTRODUCTION: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT: A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention...
March 13, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29558433/an-energy-efficient-algorithm-for-wearable-electrocardiogram-signal-processing-in-ubiquitous-healthcare-applications
#15
Ali Hassan Sodhro, Arun Kumar Sangaiah, Gul Hassan Sodhro, Sonia Lohano, Sandeep Pirbhulal
Rapid progress and emerging trends in miniaturized medical devices have enabled the un-obtrusive monitoring of physiological signals and daily activities of everyone's life in a prominent and pervasive manner. Due to the power-constrained nature of conventional wearable sensor devices during ubiquitous sensing (US), energy-efficiency has become one of the highly demanding and debatable issues in healthcare. This paper develops a single chip-based wearable wireless electrocardiogram (ECG) monitoring system by adopting analog front end (AFE) chip model ADS1292R from Texas Instruments...
March 20, 2018: Sensors
https://www.readbyqxmd.com/read/29557905/heritability-and-genetic-correlations-of-heart-rate-variability-at-rest-and-during-stress-in-the-oman-family-study
#16
M Loretto Muñoz, Deepali Jaju, Saroja Voruganti, Sulayma Albarwani, Afshin Aslani, Riad Bayoumi, Said Al-Yahyaee, Anthony G Comuzzie, Philip J Millar, Peter Picton, John S Floras, Ilja Nolte, Mohammed O Hassan, Harold Snieder
INTRODUCTION: Individual differences in heart rate variability (HRV) can be partly attributed to genetic factors that may be more pronounced during stress. Using data from the Oman Family Study (OFS), we aimed to estimate and quantify the relative contribution of genes and environment to the variance of HRV at rest and during stress; calculate the overlap in genetic and environmental influences on HRV at rest and under stress using bivariate analyses of HRV parameters and heart rate (HR)...
March 19, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29548521/the-utility-of-the-triage-electrocardiogram-for-the-detection-of-st-segment-elevation-myocardial-infarction
#17
Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29535268/atrial-cardiopathy-and-the-risk-of-ischemic-stroke-in-the-chs-cardiovascular-health-study
#18
Hooman Kamel, Traci M Bartz, Mitchell S V Elkind, Peter M Okin, Evan L Thacker, Kristen K Patton, Phyllis K Stein, Christopher R deFilippi, Rebecca F Gottesman, Susan R Heckbert, Richard A Kronmal, Elsayed Z Soliman, W T Longstreth
BACKGROUND AND PURPOSE: Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke. METHODS: The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29525246/evaluation-and-management-of-aortic-stenosis-for-the-emergency-clinician-an-evidence-based-review-of-the-literature
#19
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29523389/postural-tachycardia-syndrome-diagnosis-physiology-and-prognosis
#20
REVIEW
Amy C Arnold, Jessica Ng, Satish R Raj
Postural tachycardia syndrome (POTS) is a heterogeneous clinical syndrome that has gained increasing interest over the past few decades due to its increasing prevalence and clinical impact on health-related quality of life. POTS is clinically characterized by sustained excessive tachycardia upon standing that occurs in the absence of significant orthostatic hypotension and other medical conditions and or medications, and with chronic symptoms of orthostatic intolerance. POTS represents one of the most common presentations of syncope and presyncope secondary to autonomic dysfunction in emergency rooms and in cardiology, neurology, and primary care clinics...
February 28, 2018: Autonomic Neuroscience: Basic & Clinical
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