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Cardiovascular intensive care

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https://www.readbyqxmd.com/read/28821576/effect-of-a-behavioral-intervention-strategy-for-adoption-and-maintenance-of-a-physically-active-lifestyle-the-italian-diabetes-and-exercise-study-ides-2-a-randomized-controlled-trial
#1
Stefano Balducci, Valeria D'Errico, Jonida Haxhi, Massimo Sacchetti, Giorgio Orlando, Patrizia Cardelli, Martina Vitale, Lucilla Bollanti, Francesco Conti, Silvano Zanuso, Antonio Nicolucci, Giuseppe Pugliese
OBJECTIVE: Adherence to physical activity (PA) recommendations is hampered by the lack of effective strategies to promote behavior change. The Italian Diabetes and Exercise Study_2 is a randomized controlled trial evaluating a novel behavioral intervention strategy for increasing PA and decreasing sedentary time (SED-time) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: The study randomized 300 physically inactive and sedentary patients with type 2 diabetes 1:1 to receive theoretical and practical counseling once yearly for 3 years (intervention group [INT]) or standard care (control group [CON])...
August 18, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28816063/acute-cardiovascular-care-association-position-paper-on-intensive-cardiovascular-care-units-an-update-on-their-definition-structure-organisation-and-function
#2
Eric Bonnefoy-Cudraz, Hector Bueno, Gianni Casella, Elia De Maria, Donna Fitzsimons, Sigrun Halvorsen, Christian Hassager, Zaza Iakobishvili, Ahmed Magdy, Toomas Marandi, Jorge Mimoso, Alexander Parkhomenko, Susana Price, Richard Rokyta, Francois Roubille, Pranas Serpytis, Avi Shimony, Janina Stepinska, Diana Tint, Elina Trendafilova, Marco Tubaro, Christiaan Vrints, David Walker, Doron Zahger, Endre Zima, Robert Zuckerman, Maddalena Lettino
Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure...
August 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28814290/predicted-impact-of-lipid-lowering-therapy-on-cardiovascular-and-economic-outcomes-of-swedish-atherosclerotic-cardiovascular-disease-guideline
#3
Gunilla Journath, Kristina Hambraeus, Emil Hagström, Billie Pettersson, Mickael Löthgren
BACKGROUND: The effects on cardiovascular disease (CVD) by treatment recommendations on prevention of atherosclerotic CVD remain to be evaluated. The objectives were to assess treatment gap for low density lipoprotein cholesterol (LDL-C) according to guidelines, potential impact on CVD outcomes, and possible avoided economic costs, in post myocardial infarction (MI) patients, if target LDL-C levels of ≤1.8 mmol/L would be achieved. METHODS: All patients registered in the Swedish Secondary Prevention after Heart Intensive care Admission register, with one-year post-MI follow-up during 2013 were selected...
August 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#4
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28806965/decreased-circulating-dihomo-gamma-linolenic-acid-levels-are-associated-with-total-mortality-in-patients-with-acute-cardiovascular-disease-and-acute-decompensated-heart-failure
#5
Shohei Ouchi, Tetsuro Miyazaki, Kazunori Shimada, Yurina Sugita, Megumi Shimizu, Azusa Murata, Takao Kato, Tatsuro Aikawa, Shoko Suda, Tomoyuki Shiozawa, Masaru Hiki, Shuhei Takahashi, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Polyunsaturated fatty acids (PUFAs) have important roles in the pathogenesis of cardiovascular diseases. However, the clinical significance of omega-6 PUFAs in acute cardiovascular disease remains unknown. METHODS: We enrolled 417 consecutive patients with acute cardiovascular disease admitted to the cardiac intensive care unit at Juntendo University Hospital between April 2012 and October 2013. We investigated the association between serum PUFA levels and long-term mortality...
August 14, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28800865/contemporary-reviews-in-critical-care-medicine-anaphylaxis
#6
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or non-allergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28797537/mortality-associated-with-less-intense-risk-factor-control-among-adults-with-diabetes-in-the-united-states
#7
Sharon H Saydah, Edward W Gregg, Henry S Kahn, Mohammed K Ali
AIMS: Determine the mortality experience among adults with diabetes in meeting and not meeting less intense control for glycated hemoglobin (HbA1c), blood pressure (BP), and cholesterol. METHODS: National Health and Nutrition Examination Survey 1999-2010 participants with self-report of diagnosed diabetes (N=3335), measured HbA1c, BP and non-HDL cholesterol were linked to the National Death Index through December 31, 2011. Proportional hazards models were used to estimate hazard ratios (HR) of meeting HbA1c<9% and BP<160/110, and non-HDL cholesterol<190mg/dL...
August 7, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28797281/the-efficacy-of-transcutaneous-electrical-nerve-stimulation-on-the-improvement-of-walking-distance-in-patients-with-peripheral-arterial-disease-with-intermittent-claudication-study-protocol-for-a-randomised-controlled-trial-the-tens-pad-study
#8
Florent Besnier, Jean-Michel Sénard, Vincent Grémeaux, Mélanie Riédel, Damien Garrigues, Thibaut Guiraud, Marc Labrunée
BACKGROUND: In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking...
August 10, 2017: Trials
https://www.readbyqxmd.com/read/28794121/changes-in-primary-noncardiac-diagnoses-over-time-among-elderly-cardiac-intensive-care-unit-patients-in-the-united-states
#9
Shashank S Sinha, Michael W Sjoding, Devraj Sukul, Hallie C Prescott, Theodore J Iwashyna, Hitinder S Gurm, Colin R Cooke, Brahmajee K Nallamothu
BACKGROUND: Early reports suggest the number of cardiac intensive care unit (CICU) patients with primary noncardiac diagnoses is rising in the United States, but no national data currently exist. We examined changes in primary noncardiac diagnoses among elderly patients admitted to a CICU during the past decade. METHODS AND RESULTS: Using 2003 to 2013 Medicare data, we grouped elderly patients admitted to CICUs into 2 categories based on principal diagnosis at discharge: (1) primary noncardiac diagnoses and (2) primary cardiac diagnoses...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28793300/the-burden-of-malignancy-in-a-tertiary-hospital-intensive-cardiovascular-care-unit
#10
Israel Mazin, Shlomi Matetzky, Linor Shemer, Dana Fourey, Paul Fefer, Amit Segev, Arsalan Abu-Much, Roy Beigel, Elad Asher
OBJECTIVES: During the past decade, the most common causes of mortality and morbidity were cardiovascular diseases and malignancies. The aim of the current study was to describe the incidence, course of admission, and short-term (30-day) prognosis of patients with and without malignancy, admitted to a tertiary center intensive cardiovascular care unit (ICCU). METHODS: A prospective observational study of 2,259 patients admitted to the ICCU was conducted between January 2014 and December 2015...
August 10, 2017: Cardiology
https://www.readbyqxmd.com/read/28790791/mortality-audit-of-medical-patients-at-armed-forces-hospitals
#11
K V S Hari Kumar, N S Ajai Chandra
The mortality statistics of the medical patients at our tertiary care hospitals are sparse and lacking. We studied the mortality characteristics of the patients admitted to medical wards and intensive care unit at two hospitals based on the available fatal documents. Our objectives include analysis of the cause of death, duration of stay and presence of sepsis. The deceased (103 males, 47 females) had a mean age of 64.6 ± 15.5 yrs and mean duration of stay 7.1 ± 12.3 days. Infections and sepsis syndrome (33%), respiratory (17%), neurological (15%) and cardiovascular disorders (10%) were the top four causes of the mortality...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28790272/-respiratory-rehabilitation-to-reduce-respiratory-complications-after-cardiovascular-surgery
#12
Yusuke Suzuki, Yoshikatsu Saiki
The number of cardiovascular surgical operations has been increasing, accompanied by an increase in the number of patients with an aging patient and various comorbidities. For this reason, the risk of respiratory complications after cardiovascular surgery is high, and ingenuity to alleviate this is necessary. We evaluated preoperative respiratory function and examined whether there is a difference in the onset of postoperative respiratory complications with or without respiratory rehabilitation from preoperative...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28783810/adaptation-and-validation-of-a-pediatric-sequential-organ-failure-assessment-score-and-evaluation-of-the-sepsis-3-definitions-in-critically-ill-children
#13
Travis J Matics, L Nelson Sanchez-Pinto
Importance: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objectives: To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28776550/blood-pressure-targets-in-the-hypertensive-elderly
#14
REVIEW
Peng Liu, Jin-Gang Zheng
OBJECTIVE: Hypertension is an important risk factor of cardiovascular disease and increases mortality in the elderly. However, the available medical evidences are both inconsistent and insufficient regarding establishing credible and useful blood pressure (BP) targets in the hypertensive elderly. This review summarizes the existing evidences used for establishing optimal BP targets for this patient population and points out some data inconsistencies which have added to the uncertainty...
August 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28767690/a-simplified-prevention-bundle-with-dual-hand-hygiene-audit-reduces-early-onset-ventilator-associated-pneumonia-in-cardiovascular-surgery-units-an-interrupted-time-series-analysis
#15
Kang-Cheng Su, Yu Ru Kou, Fang-Chi Lin, Chieh-Hung Wu, Jia-Yih Feng, Shiang-Fen Huang, Tao-Fen Shiung, Kwei-Chun Chung, Yu-Hsiu Tung, Kuang-Yao Yang, Shi-Chuan Chang
BACKGROUND: To investigate the effect of a simplified prevention bundle with alcohol-based, dual hand hygiene (HH) audit on the incidence of early-onset ventilation-associated pneumonia (VAP). METHODS: This 3-year, quasi-experimental study with interrupted time-series analysis was conducted in two cardiovascular surgery intensive care units in a medical center. Unaware external HH audit (eHH) performed by non-unit-based observers was a routine task before and after bundle implementation...
2017: PloS One
https://www.readbyqxmd.com/read/28763361/dexmedetomidine-associated-hyperthermia-a-series-of-9-cases-and-a-review-of-the-literature
#16
Bernard D Krüger, Judith Kurmann, Natascia Corti, Donat R Spahn, Dominique Bettex, Alain Rudiger
Dexmedetomidine, an α2-adrenergic agonist, can be used to perform mild to moderate sedation in critically ill patients. In this case series, 9 cardiovascular intensive care unit patients with hyperthermia during dexmedetomidine administration, suggestive of drug fever, are presented. Hyperthermia (>38.5°C) occurred 6 (4-10) hours (median [interquartile range]) after dexmedetomidine initiation at a dose of 1.0 (0.8-1.3) μg/kg/h and was resolved 3 (1-8) hours after discontinuation of dexmedetomidine. All patients were screened for infectious and noninfectious causes of hyperthermia, and the findings were analyzed by 2 adverse drug reaction (ADR) assessment methods-the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) Causality Assessment and the Naranjo ADR scale...
July 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28761026/utilization-and-adherence-to-guideline-recommended-lipid-lowering-therapy-at-an-academic-medical-center
#17
Khalid A Alburikan, Rayah M Asiri, Abduallah M Alhammad, Amer A Abuelizz, Ghada A Bawazeer, Mohammed H Aljawadi
BACKGROUND: Clinical guidelines for managing blood cholesterol were updated in November 2013. OBJECTIVE: To evaluate the adherence to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline recommendations for statin therapy in the treatment of elevated blood cholesterol in high-risk patients. DESIGN: A single-center, retrospective, observational study. SETTING: A tertiary care academic medical center in Riyadh, Saudi Arabia...
July 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28760204/effects-of-serelaxin-on-the-outcome-of-patients-with-or-without-substantial-peripheral-edema-a-subgroup-analysis-from-the-relax-ahf-trial
#18
RANDOMIZED CONTROLLED TRIAL
Claudio Gimpelewicz, Marco Metra, John G F Cleland, Peter Szecsödy, Chuan-Chuan Chang Wun, Leandro Boer-Martins, Gad Cotter, Beth A Davison, Gary Michael Felker, Gerasimos Filippatos, Barry H Greenberg, Peter Pang, Piotr Ponikowski, Thomas Severin, Adrian A Voors, John R Teerlink
BACKGROUND: Acute heart failure (AHF) is a heterogeneous disorder, with most of the patients presenting with breathlessness along with varying degrees of peripheral edema. The presence of peripheral edema suggests that volume overload is the cause of decompensation leading to AHF, whereas breathlessness in the absence of edema may reflect a "vascular phenotype." This analysis investigated the characteristics, therapeutic response, and outcome of patients with AHF, with and without overt peripheral edema in the RELAX-AHF trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28757746/characteristics-and-outcomes-of-patients-with-emergency-department-revisits-within-72-hours-and-subsequent-admission-to-the-intensive-care-unit
#19
I-Ting Tsai, Cheuk-Kwan Sun, Chao-Sung Chang, Kuo-Hsin Lee, Chih-Yu Liang, Chih-Wei Hsu
OBJECTIVE: This study aimed to investigate the characteristics and outcomes of patients with emergency department (ED) revisits within 72 hours and subsequent admission to the intensive care unit (ICU). MATERIALS AND METHODS: The medical records of all adult patients revisiting the ED of a single tertiary referral medical center with ICU admissions between January 2012 and September 2014 were reviewed in terms of patient characteristics, clinical manifestations, diagnoses, triage according to the Taiwan Triage and Acuity Scale, causes of revisits, and mortality...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28756695/cardiometabolic-risks-lifestyle-health-behaviors-and-heart-disease-in-filipino-americans
#20
Maria Lg Bayog, Catherine M Waters
BACKGROUND: Cardiovascular disease is the leading cause of death among all racial and ethnic populations in the USA. Cardiovascular risks and cardioprotective factors have been disparately estimated among Asian American subpopulations. AIMS: The study's purpose was to describe the cardiometabolic risks and lifestyle health behaviors associated with cardiovascular disease, considering age and gender, in Filipinos, the second largest Asian American population. METHODS: Secondary analysis was conducted of behavioral (smoking, walking, body mass index and soda, fast food and fruit/vegetable consumption), cardiometabolic (hypertension and diabetes) and heart disease variables in the 2011-2012 California Health Interview Survey...
August 2017: European Journal of Cardiovascular Nursing
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