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Cardiovascular intensive care

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https://www.readbyqxmd.com/read/29440909/clinical-characteristics-patterns-of-lipid-lowering-medication-use-and-health-care-resource-utilization-and-costs-among-patients-with-atherosclerotic-cardiovascular-disease
#1
Thomas P Power, Xuehua Ke, Zhenxiang Zhao, Nicole Gidaya Bonine, Mark J Cziraky, Michael Grabner, John J Barron, Ralph Quimbo, Burkhard Vangerow, Peter P Toth
Purpose: The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment. Patients and methods: This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29433446/homocysteine-is-a-bystander-for-st-segment-elevation-myocardial-infarction-a-case-control-study
#2
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/29431134/smoking-cessation-support-for-regular-smokers-in-hungarian-primary-care-a-nationwide-representative-cross-sectional-study
#3
Valéria Sipos, Anita Pálinkás, Nóra Kovács, Karola Orsolya Csenteri, Ferenc Vincze, József Gergő Szőllősi, Tibor Jenei, Magor Papp, Róza Ádány, János Sándor
OBJECTIVES: Our study aimed to evaluate the effectiveness of general practitioners' (GPs') smoking cessation support (SCS). STUDY DESIGN: We carried out a cross-sectional study between February and April 2016. SETTING AND PARTICIPANT: A sample of 2904 regular smokers aged 18 years or older was selected randomly from 18 general medical practices involved in a national representative, general medical practice-based morbidity monitoring system...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29430560/epilepsy-is-associated-with-ventricular-alterations-following-convulsive-status-epilepticus-in-children
#4
Wail Ali, Beth A Bubolz, Linh Nguyen, Danny Castro, Jorge Coss-Bu, Michael M Quach, Curtis E Kennedy, Anne E Anderson, Yi-Chen Lai
Objective: Convulsive status epilepticus can exert profound cardiovascular effects in adults including ventricular depolarization-repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. Methods: We conducted a 2-year retrospective, case-control study...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29430423/mid-term-results-of-minimally-invasive-direct-coronary-artery-bypass-grafting
#5
Dong Hyun Seo, Jun Sung Kim, Kay-Hyun Park, Cheong Lim, Su Ryeun Chung, Dong Jung Kim
Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data-including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention-were collected...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29428620/postoperative-chylothorax-after-thoracoabdominal-aortic-aneurysm-repair
#6
Darrell Wu, Arina E Chesnokova, Shahab Akvan, Matt D Price, David J Sugarbaker, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Chylothorax is a potentially deadly complication that can occur after thoracoabdominal aortic aneurysm (TAAA) repair. We describe our contemporary experience (2005-2014) with this complication, our efforts to identify perioperative variables associated with it, and our attempts to assess treatment outcomes. METHODS: We reviewed the records of 1092 consecutive patients who underwent TAAA repair between 2005 and 2014. Standard bivariate analysis was used to test for between-group differences...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29427982/exercise-and-asthma
#7
Andréanne Côté, Julie Turmel, Louis-Philippe Boulet
Transient airway narrowing can occur during or following exercise, a phenomenon called exercise-induced bronchoconstriction (EIB). The main mechanism of EIB is considered to be airway dehydration, resulting from increased ventilation during exercise. In asthma, such water loss causes an increase in airway fluid osmolarity, inducing airway smooth muscle contraction following the release of mediators from airway inflammatory cells. Asthmatics frequently experience EIB, but it may also be observed in others not reporting asthma symptoms, particularly elite endurance athletes...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29426359/twenty-weeks-of-isometric-handgrip-home-training-to-lower-blood-pressure-in-hypertensive-older-adults-a-study-protocol-for-a-randomized-controlled-trial
#8
Martin Grønbech Jørgensen, Jesper Ryg, Mathias Brix Danielsen, Pascal Madeleine, Stig Andersen
BACKGROUND: Hypertension markedly increases the risk of cardiovascular diseases and overall mortality. Lifestyle modifications, such as increased levels of physical activity, are recommended as the first line of anti-hypertensive treatment. A recent systematic review showed that isometric handgrip (IHG) training was superior to traditional endurance and strength training in lowering resting systolic blood pressure (SBP). The average length of previous IHG training studies is approximately 7...
February 9, 2018: Trials
https://www.readbyqxmd.com/read/29423967/suvorexant-is-associated-with-a-low-incidence-of-delirium-in-critically-ill-patients-a-retrospective-cohort-study
#9
Tomoyuki Masuyama, Masamitsu Sanui, Naoto Yoshida, Yusuke Iizuka, Kunio Ogi, Satoko Yagihashi, Kanae Nagatomo, Yusuke Sasabuchi, Alan K Lefor
BACKGROUND: Benzodiazepine use is a risk factor for the development of delirium in adult intensive care unit (ICU) patients. Suvorexant is an alternative to benzodiazepines to induce sleep, but the incidence of delirium in critically ill patients is unknown. We undertook this retrospective study to investigate the incidence of delirium in patients who receive suvorexant in the ICU. METHODS: This retrospective cohort study was conducted in a closed 12-bed ICU at a tertiary teaching hospital...
February 8, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29413718/postprandial-hypotension-in-older-survivors-of-critical-illness
#10
Thu Anh Ngoc Nguyen, Yasmine Ali Abdelhamid, Luke M Weinel, Seva Hatzinikolas, Palash Kar, Matthew J Summers, Liza K Phillips, Michael Horowitz, Karen L Jones, Adam M Deane
PURPOSE: In older people postprandial hypotension occurs frequently; and is an independent risk factor for falls, cardiovascular events, stroke and death. The primary aim of this pilot study was to estimate the frequency of postprandial hypotension and evaluate the mechanisms underlying this condition in older survivors of an Intensive Care Unit (ICU). MATERIALS AND METHODS: Thirty-five older (>65 years) survivors were studied 3 months after discharge. After an overnight fast, participants consumed a 300 mL drink containing 75 g glucose, labelled with 20 MBq 99mTc-calcium phytate...
January 24, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29411048/comparison-of-analgesic-interventions-for-traumatic-rib-fractures-a-systematic-review-and-meta-analysis
#11
Jesse Peek, Diederik P J Smeeing, Falco Hietbrink, Roderick M Houwert, Marije Marsman, Mirjam B de Jong
PURPOSE: Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks...
February 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29411044/second-consensus-on-the-assessment-of-sublingual-microcirculation-in-critically-ill-patients-results-from-a-task-force-of-the-european-society-of-intensive-care-medicine
#12
Can Ince, E Christiaan Boerma, Maurizio Cecconi, Daniel De Backer, Nathan I Shapiro, Jacques Duranteau, Michael R Pinsky, Antonio Artigas, Jean-Louis Teboul, Irwin K M Reiss, Cesar Aldecoa, Sam D Hutchings, Abele Donati, Marco Maggiorini, Fabio S Taccone, Glenn Hernandez, Didier Payen, Dick Tibboel, Daniel S Martin, Alexander Zarbock, Xavier Monnet, Arnaldo Dubin, Jan Bakker, Jean-Louis Vincent, Thomas W L Scheeren
PURPOSE: Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables...
February 6, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29407093/evolution-of-natriuretic-peptide-biomarkers-in-heart-failure-implications-for-clinical-care-and-clinical-trials
#13
Nicolas Vodovar, Alexandre Mebazaa, James L Januzzi, Gillian Murtagh, Wendy Gattis Stough, Kirkwood F Adams, Faiez Zannad
Natriuretic peptides (NPs) are recommended by international guidelines to exclude non-heart failure causes of acute dyspnea and to assess prognosis. NPs are commonly used as an entry criterion for clinical trials, to minimize enrollment of misdiagnosed patients, or to ensure enrollment of a sufficiently at-risk population. NP values used to select trial populations to date have been inconsistent across studies. Future trials should consider using standardized thresholds for NP levels, with protocol-specified adaptations appropriate for the specific study and patient population to account for factors that can influence the NP level...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29405503/review-an-australian-model-of-care-for-co-morbid-diabetes-and-chronic-kidney-disease
#14
REVIEW
Clement Lo, Edward Zimbudzi, Helena Teede, Alan Cass, Greg Fulcher, Martin Gallagher, Peter G Kerr, Stephen Jan, Greg Johnson, Tim Mathew, Kevan Polkinghorne, Grant Russell, Tim Usherwood, Rowan Walker, Sophia Zoungas
Diabetes and chronic kidney disease (CKD) are two of the most prevalent co-morbid chronic diseases in Australia. The increasing complexity of multi-morbidity, and current gaps in health-care delivery for people with co-morbid diabetes and CKD, emphasise the need for better models of care for this population. Previously, proposed published models of care for co-morbid diabetes and CKD have not been co-designed with stake-holders or formally evaluated. Particular components of health-care shown to be effective in this population are interventions that: are structured, intensive and multifaceted (treating diabetes and multiple cardiovascular risk factors); involve multiple medical disciplines; improve self-management by the patient; and upskill primary health-care...
February 5, 2018: Nephrology
https://www.readbyqxmd.com/read/29403316/validation-of-modified-world-health-organization-classification-for-pregnant-women-with-heart-disease-in-a-tertiary-care-center-in-southern-thailand
#15
Chitkasaem Suwanrath, Putthaporn Thongphanang, Sutham Pinjaroen, Saranyou Suwanugsorn
Purpose: To validate the modified World Health Organization (WHO) classification in pregnant women with congenital and acquired heart diseases. Patients and methods: The database of pregnant women with heart disease, who delivered at Songklanagarind Hospital between January 1995 and December 2016, was retrieved from the Statistical Unit, Department of Obstetrics and Gynecology, along with the Hospital Information System of Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29393584/complications-and-risk-factors-in-pediatric-bronchoscopy-in-a-tertiary-pediatric-respiratory-center
#16
Julia Carlens, Jan Fuge, Timothy Price, David S DeLuca, Mareike Price, Gesine Hansen, Nicolaus Schwerk
Bronchoscopy is an established procedure routinely used by pediatric pulmonologists. Despite its frequent application, data on complications and specific risk factors are scarce and sometimes conflicting. AIM: The aim of this study was to evaluate frequency and severity of clearly defined complications of bronchoscopy in children that occur both during and after the procedure, and to identify potential risk factors. METHOD: A retrospective single-center analysis of 670 elective bronchoscopies in 522 children aged 0-17 years during the time period of 2008-2012 was performed...
February 2, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29393126/significance-of-hyperuricemia-among-community-based-screening-participants
#17
Kunitoshi Iseki
BACKGROUND: Chronic kidney disease (CKD) is a risk factor of cardiovascular disease (CVD) and end-stage renal disease (ESRD). Early detection and management of risk factors of incidence and progression of CKD are necessary. We have been studying these risk factors among community-based screening participants in Okinawa, Japan. Okinawa was one of the longevity areas in the world; however, the incidence and prevalence of ESRD increased. In Japan, the incidence of ESRD is 2 times higher in men compared to that in women...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29392967/sedation-in-the-coronary-intensive-care-unit-an-adapted-algorithm-for-critically-ill-cardiovascular-patient
#18
A L Schenone, K Chen, K Andress, M Militello, L Cho
In the current era, cardiovascular intensive care units care for more complex patients who are far sicker than historical post-myocardial infarction patients, and sedation has become a common intervention in these units. Current sedation best practices derive mainly from non-cardiac units which limits their generalization to the critically ill cardiac patient. Thus, a great variability in sedation protocols, especially the selection of sedative agents, is commonly seen in daily practice across cardiac units...
February 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29390106/does-provider-advice-to-increase-physical-activity-differ-by-activity-level-among-us-adults-with-cardiovascular-disease-risk-factors
#19
Meera Sreedhara, Valerie J Silfee, Milagros C Rosal, Molly E Waring, Stephenie C Lemon
Background: Regular physical activity (PA) lowers the risk of cardiovascular disease (CVD), but few US adults meet PA guidelines. The United States Preventive Services Task Force (USPSTF) recommends primary care providers offer PA counselling for CVD prevention. We examined the association between adherence to PA guidelines and reported provider advice to increase PA among US adults with overweight/obesity and ≥1 additional CVD risk factor. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) on PA and provider advice to increase PA were analysed for 4158 adults (≥20 years old) with overweight/obesity who reported ≥1 of hypertension, high cholesterol or impaired fasting glucose...
January 30, 2018: Family Practice
https://www.readbyqxmd.com/read/29386542/development-and-validation-of-risk-prediction-models-for-cardiovascular-mortality-in-chinese-people-initialising-peritoneal-dialysis-a-cohort-study
#20
Dahai Yu, Yamei Cai, Ying Chen, Tao Chen, Rui Qin, David Simmons, Zhanzheng Zhao
Cardiovascular disease is the leading cause of death among patients receiving peritoneal dialysis. We aimed to develop and validate a risk prediction model for cardiovascular death within 2 years after the initiation of peritoneal dialysis (PD). A cohort including all patients registered with the Henan Peritoneal Dialysis Registry (HPDR) between 2007 and 2014. Multivariate logistic regression analysis was used to develop the risk prediction model. The HPDR data was randomly divided into two cohorts with 60% (1,835 patients) for model derivation, and 40% (1,219 patients) for model validation...
January 31, 2018: Scientific Reports
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