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https://www.readbyqxmd.com/read/29050844/monitoring-the-corrected-qt-in-the-acute-care-setting-a-comparison-of-the-12%C3%A2-lead-electrocardiogram-and-bedside-monitor
#1
James A Chenoweth, Aaron M Hougham, Daniel K Colby, Jonathan B Ford, Jordan Sandhu, Timothy E Albertson, Mark E Sutter
INTRODUCTION: Prolongation of the QT interval is a well-recognized complication associated with many commonly used medications. Emergency Department monitoring of the corrected QT (QTc) both before and after medication administration is typically performed using the 12‑lead electrocardiogram (ECG). The purpose of this study is to compare the QTc reported on the 12‑lead ECG to that reported by single brand of bedside monitor. METHODS: A convenience sample of emergency department patients over the age of 18 undergoing bedside monitoring and who had an ECG ordered by their treating physician were enrolled...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29048771/catecholaminergic-polymorphic-ventricular-tachycardia-an-update
#2
REVIEW
Andrés R Pérez-Riera, Raimundo Barbosa-Barros, Marianne P C de Rezende Barbosa, Rodrigo Daminello-Raimundo, Augusto A de Lucca, Luiz C de Abreu
Catecholaminergic polymorphic ventricular tachycardia is a rare devastating lethal inherited disorder or sporadic cardiac ion channelopathy characterized by unexplained syncopal episodes, and/or sudden cardiac death (SCD), aborted SCD (ASCD), or sudden cardiac arrest (SCA) observed in children, adolescents, and young adults without structural heart disease, consequence of adrenergically mediated arrhythmias: exercise-induced, by acute emotional stress, atrial pacing, or β-stimulant infusion, even when the electrocardiogram is normal...
October 19, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29041910/takotsubo-cardiomyopathy-in-a-patient-with-ileus-a-case-report
#3
Chen-Yu C Guo, Nan-Sung Chou
BACKGROUND: Takotsubo cardiomyopathy (TCM) is a form of stress-induced cardiomyopathy featured by the dilatation of the apex of the left ventricle during systole. Whereas the pathogenesis of this disorder is not well understood, it usually occurs after an emotional or physical stress such as acute asthma, surgery, chemotherapy, and stroke. However, its occurrence in ileus patients is rarely reported. We hereby report probably the first case of TCM after ileus in the literature and discuss its implications...
October 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29034073/unmet-goals-in-the-treatment-of-acute-myocardial-infarction-review
#4
REVIEW
Alejandro Farah, Alejandro Barbagelata
Reperfusion therapy decreases myocardium damage during an acute coronary event and consequently mortality. However, there are unmet needs in the treatment of acute myocardial infarction, consequently mortality and heart failure continue to occur in about 10% and 20% of cases, respectively. Different strategies could improve reperfusion. These strategies, like generation of warning sign recognition and being initially assisted and transferred by an emergency service, could reduce the time to reperfusion. If the first electrocardiogram is performed en route, it can be transmitted and interpreted in a timely manner by a specialist at the receiving center, bypassing community hospitals without percutaneous coronary intervention capabilities...
2017: F1000Research
https://www.readbyqxmd.com/read/29033340/nonepileptic-seizure-provoked-by-cardiac-dysrhythmia-a-case-of-st-elevation-myocardial-infarction
#5
A Pourmand, S Davis, K Yensen
Acute seizures represent 1% of all visits to emergency departments in the United States. While many acute seizures are correctly attributable to underlying epilepsy, approximately one-third of acute seizures are provoked by underlying and potentially life-threatening acute conditions. Many clinical syndromes associated with seizure-like activity are well-established and readily identified in the acute setting. Cardiac dysrhythmias are known causes of acute seizure-like activity and, if transient and not captured by electrocardiogram tracings during acute episodes, may be incorrectly diagnosed as epileptic seizures...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29026892/prompt-diagnosis-of-st-elevation-myocardial-infarction-with-papillary-muscle-rupture-by-point-of-care-ultrasound-in-the-emergency-department
#6
Koon Ho Cheung, Colin Graham Alexander
A previously healthy 61-year-old man presented to the emergency department with chest pain and dyspnoea for 6 hours. Examination revealed distress with an apical pansystolic murmur. Initial electrocardiogram showed sinus tachycardia and ST elevation in leads II, III, and aVF compatible with an inferior ST-elevation myocardial infarction. Point-of-care echocardiography in the emergency department showed a flail anterior mitral leaflet and severe mitral regurgitation, leading to a provisional diagnosis of papillary muscle rupture...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026885/emergency-department-point-of-care-ultrasonography-improves-time-to-pericardiocentesis-for-clinically-significant-effusions
#7
Evan Avraham Alpert, Uri Amit, Larisa Guranda, Rafea Mahagna, Shamai A Grossman, Ariel Bentancur
OBJECTIVE: Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). METHODS: This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29021008/medication-review-and-transitions-of-care-a-case-report-of-a-decade-old-medication-error
#8
Rachel Comer, Mitsi Lizer
A 69-year-old Caucasian male with a 25-year history of paranoid schizophrenia was brought to the emergency department because of violence toward the staff in his nursing facility. He was diagnosed with a urinary tract infection and was admitted to the behavioral health unit for medication stabilization. History included a five-year state psychiatric hospital admission and nursing facility placement. Because of poor cognitive function, the patient was unable to corroborate medication history, so the pharmacy student on rotation performed an in-depth chart review...
October 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28992867/early-exclusion-of-major-adverse-cardiac-events-in-emergency-department-chest-pain-patients-a-prospective-observational-study
#9
Yuk-Ki Leung, Nga-Man Cheng, Cangel Pui-Yee Chan, Anna Lee, Jeffrey Ka-Tak Wong, Bryan Ping-Yen Yan, Anil Tejbhan Ahuja, Colin Alexander Graham, Timothy Hudson Rainer
BACKGROUND: The current evaluation of patients with chest pain presenting to an emergency department (ED) with suspected acute coronary syndrome (ACS) is a lengthy process involving serial measurements of troponin. OBJECTIVE: We aimed to validate the diagnostic accuracy of a Thrombolysis in Myocardial Infarction (TIMI) score with single high-sensitive cardiac troponin T (hs-cTnT) for early rule out of 30-day major adverse cardiac events (MACE), and to compare the TIMI score with combinations of heart-type fatty acid binding protein (H-FABP) and a modified HEART (history, electrocardiogram, age, risk factors, troponin) score...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28989934/takotsubo-cardiomyopathy-with-a-rapidly-resolved-left-ventricular-thrombus
#10
Abdel Anabtawi, Paola C Roldan, Carlos A Roldan
This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28984702/current-assessment-of-heart-rate-variability-and-qtc-interval-length-in-hiv-aids
#11
Roger C McIntosh, Judith D Lobo, Barry E Hurwitz
PURPOSE OF REVIEW: The increasing prevalence of cardiovascular disease comorbidity in persons infected with the HIV has become a global concern. The electrocardiogram (ECG) is increasingly being utilized to provide clinically relevant information regarding cardiac arrhythmias and cardio-autonomic dysfunction. The purpose of this review is to summarize the latest research comparing QT and R-to-R interval length as a function of HIV+ status or antiretroviral therapy (ART) regimen. RECENT FINDINGS: Prolongation of the corrected QTc interval may be acquired in HIV+ ART-naive individuals, exacerbated by various classes of ART drugs, and is generally predictive of lethal cardiac arrhythmias, with effects observed from childhood to adulthood...
November 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28965185/safety-pharmacokinetic-and-pharmacodynamics-of-erdafitinib-a-pan-fibroblast-growth-factor-receptor-fgfr-tyrosine-kinase-inhibitor-in-patients-with-advanced-or-refractory-solid-tumors
#12
Tomohiro Nishina, Shunji Takahashi, Ryota Iwasawa, Hidehisa Noguchi, Masayuki Aoki, Toshihiko Doi
Introduction This phase 1, open-label, multicenter, single-arm, dose-escalation study aimed to evaluate safety, pharmacokinetics (PK), and pharmacodynamics of erdafitinib (JNJ-42756493), an oral selective pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, and to determine the recommended phase 2 dose in Japanese patients with advanced or refractory solid tumors. Methods Three to 6 patients were enrolled into sequentially escalating dose cohorts (erdafitinib 2, 4, or 6 mg) with a daily dosing schedule of 21-day cycles or a 7 days-on/7 days-off intermittent schedule (erdafitinib 10 mg or 12 mg) of 28-day cycles...
September 30, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28959003/st-elevation-myocardial-infarction-due-to-left-anterior-descending-artery-occlusion-presenting-primarily-with-otalgia
#13
Elhaitham K Ahmed, M Salim Alkodaymi, Mohammed Mohammed Soliman, Asaad Suliman Shujaa
BACKGROUND Myocardial infarction (MI) is one of the most serious conditions presenting to the Emergency Department. Typical/classical symptoms of MI include chest pain and tightness that is referred to the left arm. CASE REPORT We present a case of ST-elevation myocardial infarction (STEMI) with a primary atypical presentation of right ear pain. The patient was diagnosed with STEMI based on electrocardiogram (ECG) and cardiac markers. As a result, the patient underwent percutaneous intervention (PCI), which showed an occluded left anterior descending artery (LAD) compared to the previous reported studies with similar presentation in which the right coronary artery (RCA) was affected...
September 29, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28944001/recurrent-graves-hyperthyroidism-after-prolonged-radioiodine-induced-hypothyroidism
#14
REVIEW
Fariha Salman, Hooman Oktaei, Solomon Solomon, Ebenezer Nyenwe
BACKGROUND: Radioactive iodine (RAI) is the most cost effective therapy for Graves' disease (GD). Patients with GD who have become hypothyroid after therapeutic RAI, rarely develop recurrence of disease. Herein we describe a case of recurrence of thyrotoxicosis after 2 years of hypothyroidism. METHODS: We present the clinical features, laboratory findings, imaging and management of an unusual case of recurrent hyperthyroidism. RESULTS: A 48-year-old male presented to the emergency room with a 2-day history of palpitation, chest discomfort and 30 pounds of weight loss...
July 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28932163/preparedness-of-dammam-primary-health-care-centers-to-deal-with-emergency-cases
#15
Sanaa S M Alsaad, Salma H S Abu-Grain, Dalia Y M El-Kheir
OBJECTIVES: The objective of the study was to assess the availability of human and nonhuman resources for emergency medical services (EMSs) at the primary health care (PHC) level. MATERIALS AND METHODS: A cross-sectional study with mixed research methods (quantitative and qualitative) was carried out in governmental PHC centers in Dammam, Eastern Province of Saudi Arabia, between September 2014 and January 2015. Using systematic random sampling technique, 13 out of 26 PHC centers were included in the study...
September 2017: Journal of Family & Community Medicine
https://www.readbyqxmd.com/read/28930184/use-of-wavelet-transform-to-detect-compensated-and-decompensated-stages-in-the-congestive-heart-failure-patient
#16
Pratibha Sharma, Kimberly Newman, Carlin S Long, A J Gasiewski, Frank Barnes
This research work is aimed at improving health care, reducing cost, and the occurrence of emergency hospitalization in patients with Congestive Heart Failure (CHF) by analyzing heart and lung sounds to distinguish between the compensated and decompensated states. Compensated state defines stable state of the patient but with lack of retention of fluids in lungs, whereas decompensated state leads to unstable state of the patient with lots of fluid retention in the lungs, where the patient needs medication. Acoustic signals from the heart and the lung were analyzed using wavelet transforms to measure changes in the CHF patient's status from the decompensated to compensated and vice versa...
September 20, 2017: Biosensors
https://www.readbyqxmd.com/read/28920131/reversible-causes-in-cardiovascular-collapse-at-the-emergency-department-using-ultrasonography-revive-us
#17
Mui Teng Chua, Gene Wh Chan, Win Sen Kuan
INTRODUCTION: Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality...
August 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28895038/a-retrospective-external-validation-study-of-the-heart-score-among-patients-presenting-to-the-emergency-department-with-chest-pain
#18
Matthew Jay Streitz, Joshua James Oliver, Jessica Marie Hyams, Richard Michael Wood, Yevgeniy Mikhaylovich Maksimenko, Brit Long, Robert Michael Barnwell, Michael David April
Emergency physicians must be able to effectively prognosticate outcomes for patients presenting to the Emergency Department (ED) with chest pain. The HEART score offers a prognostication tool, but external validation studies are limited. We conducted an external retrospective validation study of the HEART score among ED patients presenting to our ED with chest pain from 1 January 2014 to 9 June 2014. We utilized chart review methodology to abstract data from each patient's electronic medical record. We collected data relevant to each of the five elements of the HEART score: history, electrocardiogram (ECG) interpretation, patient age, patient risk factors, and troponin levels...
September 11, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28893184/the-canadian-hiv-and-aging-cohort-study-determinants-of-increased-risk-of-cardio-vascular-diseases-in-hiv-infected-individuals-rationale-and-study-protocol
#19
Madeleine Durand, Carl Chartrand-Lefebvre, Jean-Guy Baril, Sylvie Trottier, Benoit Trottier, Marianne Harris, Sharon Walmsley, Brian Conway, Alexander Wong, Jean-Pierre Routy, Colin Kovacs, Paul A MacPherson, Kenneth Marc Monteith, Samer Mansour, George Thanassoulis, Michal Abrahamowicz, Zhitong Zhu, Christos Tsoukas, Petronela Ancuta, Nicole Bernard, Cécile L Tremblay
BACKGROUND: With potent antiretroviral drugs, HIV infection is becoming a chronic disease. Emergence of comorbidities, particularly cardiovascular disease (CVD) has become a leading concern for patients living with the infection. We hypothesized that the chronic and persistent inflammation and immune activation associated with HIV disease leads to accelerated aging, characterized by CVD. This will translate into higher incidence rates of CVD in HIV infected participants, when compared to HIV negative participants, after adjustment for traditional CVD risk factors...
September 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#20
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
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