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Emergency cardiovascular care

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https://www.readbyqxmd.com/read/29458455/impact-of-nepal-earthquake-on-patients-presenting-for-emergency-care-at-patan-hospital
#1
Mimang Tembe, Sushma Dhakal, Ashis Shrestha, Josh Mugele, Darlene R House
OBJECTIVE: Natural disasters have a significant impact on the health sector. On April 25, 2015, Nepal was struck by a 7.8 magnitude earthquake. The aim of the study was to compare patient volumes and clinical conditions presenting to the emergency department pre- and post-earthquake. METHODS: A retrospective study was done at Patan Hospital Emergency Department in Kathmandu, Nepal. Volume, demographics, and patient diagnoses were collected for 4 months post-disaster and compared with cases seen the same months the year before the disaster to control for seasonal variations...
February 20, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29453595/cardio-oncology-conflicting-priorities-of-anticancer-treatment-and-cardiovascular-outcome
#2
REVIEW
Lisa M Tilemann, Markus B Heckmann, Hugo A Katus, Lorenz H Lehmann, Oliver J Müller
BACKGROUND: This article about the emerging field of cardio-oncology highlights typical side effects of oncological therapies in the cardiovascular system, cardiovascular complications of malignancies itself, and potential preventive or therapeutic modalities. METHODS: We performed a selective literature search in PubMed until September 2016. RESULTS: Cardiovascular events in cancer patients can be frequently attributed to oncological therapies or to the underlying malignancy itself...
February 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29450524/effect-of-a-quality-improvement-intervention-on-clinical-outcomes-in-patients-in-india-with-acute-myocardial-infarction-the-acs-quik-randomized-clinical-trial
#3
Mark D Huffman, Padinhare P Mohanan, Raji Devarajan, Abigail S Baldridge, Dimple Kondal, Lihui Zhao, Mumtaj Ali, Mangalath N Krishnan, Syam Natesan, Rajesh Gopinath, Sunitha Viswanathan, Joseph Stigi, Johny Joseph, Somanathan Chozhakkat, Donald M Lloyd-Jones, Dorairaj Prabhakaran
Importance: Wide heterogeneity exists in acute myocardial infarction treatment and outcomes in India. Objective: To evaluate the effect of a locally adapted quality improvement tool kit on clinical outcomes and process measures in Kerala, a southern Indian state. Design, Setting, and Participants: Cluster randomized, stepped-wedge clinical trial conducted between November 10, 2014, and November 9, 2016, in 63 hospitals in Kerala, India, with a last date of follow-up of December 31, 2016...
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29443421/diabetes-uk-evidence-based-nutrition-guidelines-for-the-prevention-and-management-of-diabetes
#4
P A Dyson, D Twenefour, C Breen, A Duncan, E Elvin, L Goff, A Hill, P Kalsi, N Marsland, P McCardle, D Mellor, L Oliver, K Watson
A summary of the latest evidence-based nutrition guidelines for the prevention and management of diabetes is presented. These guidelines are based on existing recommendations last published in 2011, and were formulated by an expert panel of specialist dietitians after a literature review of recent evidence. Recommendations have been made in terms of foods rather than nutrients wherever possible. Guidelines for education and care delivery, prevention of Type 2 diabetes, glycaemic control for Type 1 and Type 2 diabetes, cardiovascular disease risk management, management of diabetes-related complications, other considerations including comorbidities, nutrition support, pregnancy and lactation, eating disorders, micronutrients, food supplements, functional foods, commercial diabetic foods and nutritive and non-nutritive sweeteners are included...
February 14, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29433446/homocysteine-is-a-bystander-for-st-segment-elevation-myocardial-infarction-a-case-control-study
#5
Ching-Yu Julius Chen, Tzu-Ching Yang, Christopher Chang, Shao-Chun Lu, Po-Yuan Chang
BACKGROUND: Homocysteine has been long considered a risk factor for atherosclerosis. However, cardiovascular events cannot be reduced through homocysteine lowering by B vitamin supplements. Although several association studies have reported an elevation of serum homocysteine levels in cardiovascular diseases, the relationship of homocysteine with ST-segment elevation myocardial infarction (STEMI) is not well established. METHODS: We prospectively enrolled STEMI patients who were consecutively admitted to an intensive care unit following coronary intervention in a single medical center in Taiwan...
February 13, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29428052/heart-score-and-stress-test-emergency-department-bayesian-decision-scheme-results-from-the-acute-care-diagnostic-collaboration
#6
Naureen Farook, L Cochon, A D Bode, B P Langer, A A Baez
BACKGROUND: Accurate identification of patients at risk of major adverse cardiac events (MACE) places a substantial burden on emergency physicians (EPs). Bayesian nomogram for risk stratification in low- to intermediate-risk cardiovascular patients has not been investigated previously. OBJECTIVE: The objective of this study was to develop a comparative diagnostic model using Bayesian statistics for exercise treadmill test (ETT) and stress echocardiogram (ECHO) to calculate post-test diagnostic risk of MACE using HEART (history, electrocardiogram, age, risk factors, and troponin) risk score as predictor of pretest probability...
February 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29402689/patient-provider-and-environmental-factors-associated-with-adherence-to-cardiovascular-and-cerebrovascular-clinical-practice-guidelines-in-the-emergency-department
#7
Stacy A Trent, Michael A Johnson, Erica A Morse, Edward P Havranek, Jason S Haukoos
OBJECTIVES: Myocardial infarction and stroke are two of the leading causes of death in the U.S. Both diseases have clinical practice guidelines (CPGs) specific to the emergency department (ED) that improve patient outcomes. Our primary objectives were to estimate differences in ED adherence across CPGs for these diseases and identify patient, provider, and environmental factors associated with adherence. METHODS: Design: Retrospective study at 3 hospitals in Colorado using standard medical record review...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29401740/primary-care-comprehensiveness-can-reduce-emergency-department-visits-and-hospitalization-in-people-with-hypertension-in-south-korea
#8
Nak-Jin Sung, Yong-Jun Choi, Jae-Ho Lee
Hypertension has been the leading risk factor contributing to cardiovascular morbidity and mortality, which needs comprehensive measures to manage and can be controlled effectively in primary care. In the health care context of South Korea, where specialists can see patients directly at their own community clinics and there has been no consensus on the definition of primary care, the authors used the nationally representative 2013 Korea Health Panel data, categorized adults (≥18 years) with hypertension by types of usual source of care (USC), and analyzed the association of having a comprehensive community clinic (i...
February 5, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29395178/early-post-therapy-prescription-drug-usage-among-childhood-and-adolescent-cancer-survivors
#9
Andrew B Smitherman, Danielle Mohabir, Tania M Wilkins, Julie Blatt, Hazel B Nichols, Stacie B Dusetzina
OBJECTIVE: To describe the patterns of prescription drug use among child and adolescent survivors of cancer in the early post-therapy period compared with matched peers without a cancer history. STUDY DESIGN: Using the MarketScan commercial insurance claims database, we performed a retrospective cohort study identifying survivors of pediatric (0-21 years of age at diagnosis) leukemia, lymphoma, central nervous system, bone, or gonadal cancers who completed therapy from 2000 to 2011 and remained insured for 3 years post-therapy...
January 30, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29394343/looking-behind-the-bars-emerging-health-issues-for-people-in-prison
#10
S Stürup-Toft, E J O'Moore, E H Plugge
Introduction: There are more than 10 million people imprisoned worldwide. These individuals experience a higher burden of communicable and non-communicable disease, mental health and substance misuse problems than the general population and often come from marginalized and underserved groups in the community. Prisons offer an important opportunity for tackling health problems in a way that can deliver benefits to the individual and to the community. This paper focuses specifically on emerging health issues for prisons across the world...
January 31, 2018: British Medical Bulletin
https://www.readbyqxmd.com/read/29392549/acute-fissuration-of-a-giant-splenic-artery-aneurysm-detected-by-point-of-care-ultrasound-case-report
#11
Philippe Le Conte, David Trewick, Philippe Pes, Eric Frampas, Eric Batard
BACKGROUND: Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vascular disease. Point-of-care ultrasound (POCUS) could be performed in such situation. CASE PRESENTATION: A healthy 66-year-old man with no previous medical history was admitted to the Emergency Department for a rapid onset epigastric pain. He reported taking non-steroidal anti-inflammatories for 1 week prior to admission...
February 1, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29389363/a-new-educational-framework-to-improve-lifelong-learning-for-cardiologists
#12
REVIEW
Akhil Narang, Poonam Velagapudi, Bharath Rajagopalan, Bryan LeBude, Aaron P Kithcart, David Snipelisky, Shashank S Sinha
Lifelong learning is essential for the practicing cardiologist. Present lifelong learning mechanisms are stagnant and at risk for not meeting the needs of currently practicing cardiologists. With the increasing burden of cardiovascular disease, growing complexity of patient care, and ongoing pressures of nonclinical responsibilities, educational programming must evolve to meet the demands of the contemporary cardiovascular professional. A paradigm shift, replete with modern and practical educational tools, is needed in the lifelong learning armamentarium...
January 30, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29382343/evidence-to-service-gap-cardiac-rehabilitation-and-secondary-prevention-in-rural-and-remote-western-australia
#13
Sandra Hamilton, Belynda Mills, Shelley McRae, Sandra Thompson
BACKGROUND: Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations...
January 30, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29379321/digital-stethoscope-technology-update
#14
REVIEW
Supreeya Swarup, Amgad N Makaryus
Cardiovascular disease (CVD) is recognized as the leading cause of mortality throughout the world. About one-third of global mortality is attributable to CVD. In addition to clinical presentation, specific clinical exam findings can assist in treating and preventing CVD. CVD may initially manifest as pulmonary pathology, and thus, accurate cardiopulmonary auscultation is paramount to establishing accurate diagnosis. One of the most powerful tools available to physicians is the stethoscope. The stethoscope first emerged in the year 1818, invented by a French physician, René Laennec...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29362891/post-operative-complications-following-emergency-operations-performed-by-trainee-surgeons-a-retrospective-analysis-of-surgical-deaths
#15
Noha Ferrah, Karen Stephan, Janaka Lovell, Joseph Ibrahim, Barry Beiles
BACKGROUND: Adequate surgical care of patients and concurrent training of residents is achieved in elective procedures through careful case selection and adequate supervision. Whether this applies when trainees are involved in emergency operations remains equivocal. The aim of this study was therefore to compare the risk of post-operative complications following emergency procedures performed by senior operators compared with supervised trainees. METHODS: This is a retrospective cohort study examining in-hospital deaths of patients across all surgical specialties who underwent emergency surgery in Australian public hospitals reported to the national surgical mortality audit between 2009 and 2015...
January 23, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29346836/emergency-demand-repeat-and-frequent-presentations-by-older-patients-in-metropolitan-melbourne-a-retrospective-cohort-study-using-routinely-collected-hospital-data
#16
Judy Lowthian, Lyle Turner, Angela Joe, Christopher Pearce, Bianca Brijnath, Colette Browning, Marianne Shearer, Danielle Mazza
OBJECTIVE: To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. METHODS: Retrospective analysis of ED presentations by patients ≥70 years for 2008 and 2012. Metropolitan Melbourne public hospital data were obtained from the Victorian Emergency Minimum Dataset. Outcomes were characteristics of PAGP-type and non-PAGP-type presentations as defined by the Australian Institute of Health and Welfare; numbers and rates per 1000 population ≥70 years of repeat (×2-3/year) and frequent (≥ ×4/year) PAGP-type and non-PAGP-type presentations...
January 18, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29346558/thoraco-abdominal-aortic-aneurysm-rupture-in-a-patient-with-shprintzen-goldberg-syndrome
#17
Naritaka Kimura, Yu Inaba, Kaori Kameyama, Hideyuki Shimizu
Shprintzen-Goldberg syndrome is a rare systemic connective tissue disorder characterized by craniosynostosis, skeletal abnormalities, infantile hypotonia, mild-to-moderate intellectual disability and cardiovascular anomalies. To our knowledge, this is the first report of a Shprintzen-Goldberg syndrome patient who developed a thoraco-abdominal aortic aneurysm. The aneurysm grew rapidly necessitating emergent thoraco-abdominal aortic replacement. The postoperative course was uneventful, and a careful lifetime follow-up was planned...
January 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29322358/anti-hypotensive-drug-induced-cardiotoxicity-an-in-vitro-study
#18
Aditi Jain, Vibha Rani
Cardiotoxic side effects of broad range of drugs have emerged as an important cause of developing cardiovascular complications, as patients recover from one disease but develop another. Both cardiovascular and non-cardiovascular drugs may lead to the toxicity in the heart. Many drugs were initially not screened for cardiotoxicity, which is now an essential concern for drug discovery. Levophed is used for treating hypotension in critical care patients. Being a neurotransmitter, its concentration increases significantly in stress conditions and administration of this drug to patients' results in developing acute as well as persistent cardiac complications...
February 2018: In Vitro Cellular & Developmental Biology. Animal
https://www.readbyqxmd.com/read/29321113/top-cited-publications-on-point-of-care-ultrasound-the-evolution-of-research-trends
#19
Shao-Feng Liao, Pai-Jung Chen, Chung-Hsien Chaou, Ching-Hsing Lee
STUDY OBJECTIVES: Point-of-care ultrasound (POCUS) has been a rapidly growing and broadly used modality in recent decades. The purpose of this study was to determine how POCUS is incorporated into clinical medicine by analyzing trends of use in the published literature. METHODS: POCUS-related publications were retrieved from the Web of Science (WoS) database. The search results were ranked according to the number of times an article was cited during three time frames and average annual number of citations...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29319376/the-effect-of-physical-activity-on-ptsd
#20
Lauren M Oppizzi, Reba Umberger
Although physical activity (PA) is known to reduce anxiety and depression, less is known about the effects of PA on post-traumatic stress disorder (PTSD). The author examined the state of the science regarding the effect of PA on PTSD. Three themes emerged: PA characteristics, added benefits of PA as a PTSD intervention, and theories on the method of action. Physical activity seems to be an effective adjunct therapy to reduce PTSD symptom severity. Findings are inconsistent between observational and controlled studies...
January 10, 2018: Issues in Mental Health Nursing
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