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https://www.readbyqxmd.com/read/28830124/postmortem-fluid-and-tissue-concentrations-of-thc-11-oh-thc-and-thc-cooh
#1
Sunday R Saenz, Russell J Lewis, Mike K Angier, Jarrad R Wagner
Marijuana is the most commonly abused illicit drug worldwide. Marijuana is used for its euphoric and relaxing properties. However, marijuana use has been shown to result in impaired memory, cognitive skills and psychomotor function. The Federal Aviation Administration's Civil Aerospace Medical Institute conducts toxicological analysis on aviation fatalities. Due to severe trauma associated with aviation accidents, blood is not always available; therefore, the laboratory must rely on specimens other than blood for toxicological analysis in ~30-40% of cases...
July 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28829876/effect-of-natriuretic-peptide-guided-therapy-on-hospitalization-or-cardiovascular-mortality-in-high-risk-patients-with-heart-failure-and-reduced-ejection-fraction-a-randomized-clinical-trial
#2
G Michael Felker, Kevin J Anstrom, Kirkwood F Adams, Justin A Ezekowitz, Mona Fiuzat, Nancy Houston-Miller, James L Januzzi, Daniel B Mark, Ileana L Piña, Gayle Passmore, David J Whellan, Hongqiu Yang, Lawton S Cooper, Eric S Leifer, Patrice Desvigne-Nickens, Christopher M O'Connor
Importance: The natriuretic peptides are biochemical markers of heart failure (HF) severity and predictors of adverse outcomes. Smaller studies have evaluated adjusting HF therapy based on natriuretic peptide levels ("guided therapy") with inconsistent results. Objective: To determine whether an amino-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided treatment strategy improves clinical outcomes vs usual care in high-risk patients with HF and reduced ejection fraction (HFrEF)...
August 22, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28829853/biomarker-guided-vs-guideline-directed-titration-of-medical-therapy-for-heart-failure
#3
Gregg C Fonarow
No abstract text is available yet for this article.
August 22, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28828233/atrial-fibrillation-and-psychological-factors-a-systematic-review
#4
Federica Galli, Lidia Borghi, Stefano Carugo, Marco Cavicchioli, Elena Maria Faioni, Maria Silvia Negroni, Elena Vegni
BACKGROUND: Psychological factors have been suggested to have an influence in Atrial Fibrillation (AF) onset, progression, severity and outcomes, but their role is unclear and mainly focused on anxiety and depression. METHODS: A systematic electronic search had been conducted to identify studies exploring different psychological factors in AF. The search retrieved 832 articles that were reviewed according to inclusion criteria: observational study with a control/comparison group; use of standardized and validated instruments for psychological assessment...
2017: PeerJ
https://www.readbyqxmd.com/read/28828196/use-of-proton-pump-inhibitors-in-general-practice
#5
Cesare Tosetti, Ilaria Nanni
AIM: To evaluate the characteristics of the prescription of the proton pump inhibitor drugs (PPI) and the adherence to the indications of the guidelines regulating the reimbursement limitations set forth by the Italian Drug Agency. METHODS: Thirty general practitioners (GP) participated in the study, providing data on more than 40000 patients in total. The population was divided into non occasional users of PPI drugs (PPI users) and non-users (PPI non-users) based on evidence of a prescription of at least 3 packs of PPIs in the last 90 d before analysis...
August 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28828019/chronic-pain-in-chronic-heart-failure-a-review-article
#6
REVIEW
Mohammad Javad Alemzadeh-Ansari, Mohammad Mostafa Ansari-Ramandi, Nasim Naderi
Heart failure (HF) is one of the main causes of death and disability in the world. The prevalence of HF in developed countries is between 1% and 2% of the adult population and approximately between 6% and 10% in the elderly, giving rise to high costs of care and treatment. Indeed, in the United States, the direct and indirect costs exceeded 23 billion dollars in 2002. HF is typically characterized by periods of acute symptoms followed by returns to nearly asymptomatic periods. As dyspnea and fatigue are considered the signature symptoms of HF, other symptoms such as pain go unnoticed...
April 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28827377/clinical-practice-guideline-for-screening-and-management-of-high-blood-pressure-in-children-and-adolescents
#7
Joseph T Flynn, David C Kaelber, Carissa M Baker-Smith, Douglas Blowey, Aaron E Carroll, Stephen R Daniels, Sarah D de Ferranti, Janis M Dionne, Bonita Falkner, Susan K Flinn, Samuel S Gidding, Celeste Goodwin, Michael G Leu, Makia E Powers, Corinna Rea, Joshua Samuels, Madeline Simasek, Vidhu V Thaker, Elaine M Urbina
These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy...
August 21, 2017: Pediatrics
https://www.readbyqxmd.com/read/28826846/2016-american-college-of-cardiology-american-heart-association-guideline-on-the-management-of-patients-with-lower-extremity-peripheral-artery-disease-perioperative-implications
#8
REVIEW
Elizabeth A Valentine, E Andrew Ochroch
No abstract text is available yet for this article.
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28826683/perioperative-management-of-dual-antiplatelet-therapy-in-patients-with-new-generation-drug-eluting-metallic-stents-and-bioresorbable-vascular-scaffolds-undergoing-elective-noncardiac-surgery
#9
REVIEW
Michael Essandoh, Adam A Dalia, Mazen Albaghdadi, Barry George, Nicoleta Stoicea, Muhammad Shabsigh, Sunil V Rao
Dual-antiplatelet therapy (DAPT) is considered mandatory after new-generation drug-eluting coronary stent implantation to reduce ischemic complications such as stent thrombosis, but the need for DAPT makes the timing of elective surgery difficult. Interrupting DAPT places patients at risk for stent thrombosis, and surgery in the setting of DAPT may lead to bleeding. The 2016 American College of Cardiology/American Heart Association guideline recommends delaying elective noncardiac surgery for a minimum 6-month period to reduce ischemic risks after the implantation of a second-generation metallic drug-eluting stent (DES)...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28826671/a-blueprint-for-the-post-discharge-clinic-visit-after-an-admission-for-heart-failure
#10
REVIEW
Aaron Soufer, Ralph J Riello, Nihar R Desai, Jeffrey M Testani, Tariq Ahmad
The immense symptom burden and healthcare expenditure associated with heart failure (HF) has resulted in hospital systems, insurance companies, and federal agencies playing close attention to systems of care delivery. In particular, there has been a large extent of focus on decreasing the frequency of HF readmissions through the development of hospital quality measures and the expansion of post discharge services to improve transitions of care from the inpatient to the outpatient setting. The post discharge clinic visit (PDV) serves an important role in this process as it acts as a fulcrum for the multi-disciplinary services available to HF patients, as well as an opportunity to fill any gaps that might have occurred in evidence based care of the patient...
August 18, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28823072/prevalence-and-predictors-of-digoxin-utilization-among-heart-failure-patients-with-reduced-ejection-fraction-in-qatar
#11
Alaa Abdullah Rahhal, Ahmed Awaisu, Kawthar M Tawengi, Safae AbuYousef, Lylia Mekideche
Background Digoxin is a cardiac glycoside that is recommended by clinical practice guidelines to be used in patients with heart failure with reduced ejection fraction (HFrEF) who still have persistent symptoms despite optimal medical therapy. However, this recommendation is based on limited and old trial data. Moreover, pharmacoepidemiologic studies are important in determining the prevalence of digoxin use and factors influencing this. Objective This study aimed to determine the prevalence and the predictors of digoxin utilization among patients with HFrEF with or without atrial fibrillation (AF) in Qatar...
August 19, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28823011/guidelines-versus-reality-is-coronary-stent-application-in-three-vessel-disease-standard-or-the-exception
#12
Roland Linder, J Zeidler, F Verheyen, J-M Graf von der Schulenburg, A Haverich, T Schilling
The national guidelines for treatment of chronic coronary heart disease (CHD) recommend surgical coronary aortic bypass grafting (CABG) rather than percutaneous coronary intervention (PCI) for patients with a coronary three-vessel disease. The epidemiology of three-vessel CHD and data about the application of different revascularisation strategies raise suspicion of deviation from the guidelines in the treatment of those patients. Claims data containing records of almost 10 million patients of the largest German statutory health insurance fund (Techniker Krankenkasse) were utilised to measure adherence to the guidelines for treatment of groups of patients with one-, two-, and three-vessel CHD, respectively...
August 19, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28822701/clinical-applications-of-biomarkers-in-atrial-fibrillation
#13
REVIEW
Kay-Won Chang, Jonathan C Hsu, Avinash Toomu, Sutton Fox, Alan S Maisel
While biomarkers have greatly impacted the diagnosis and management of myocardial infarction and heart failure, the use of biomarkers has been slow to permeate management of atrial fibrillation. Guideline recommendations on the use of biomarkers in atrial fibrillation were virtually non-existent until the 2016 European Society of Cardiology guidelines on atrial fibrillation offered a class IIb recommendation to consider using biomarkers such as high sensitivity troponin and natriuretic peptide to further refine stroke and bleeding risk in atrial fibrillation patients...
August 16, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28822512/implications-of-the-2013-acc-aha-cholesterol-guidelines-on-contemporary-clinical-practice-for-patients-with-atherosclerotic-coronary-and-peripheral-arterial-disease
#14
Prasad Gunasekaran, Vinodh Jeevanantham, Suresh Sharma, Rashmi Thapa, Kamal Gupta
BACKGROUND: Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. METHODS: We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n=9563), peripheral arterial disease (PAD) (n=596) and CAD+PAD (n=975) by applying both guidelines...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28822511/comparison-of-different-cardiovascular-risk-score-calculators-for-cardiovascular-risk-prediction-and-guideline-recommended-statin-uses
#15
Naveen Garg, Subrat K Muduli, Aditya Kapoor, Satyendra Tewari, Sudeep Kumar, Roopali Khanna, Pravin Kumar Goel
OBJECTIVE: The accuracy of various 10-year cardiovascular disease (CVD) risk calculators in Indians may not be the same as in other populations. Present study was conducted to compare the various calculators for CVD risk assessment and statin eligibility according to different guidelines. METHODS: Consecutive 1110 patients who presented after their first myocardial infarction were included. Their CVD risk was calculated using Framingham Risk score- Coronary heart disease (FRS-CHD), Framingham Risk Score- Cardiovascular Disease (FRS-CVD), QRISK2, Joint British Society risk calculator 3 (JBS3), American College of Cardiology/American Heart Association (ACC/AHA), atherosclerotic cardiovascular disease (ASCVD) and WHO risk charts, assuming that they had presented one day before cardiac event for risk assessment...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821397/cardiac-metabolism-a-promising-therapeutic-target-for-heart-failure
#16
REVIEW
Hannah Noordali, Brodie L Loudon, Michael P Frenneaux, Melanie Madhani
Heart failure, with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF), is associated with high morbidity and mortality. Although many established pharmacological interventions exist for those patients with HFrEF, hospitalization and death rates remain high, and in those with HFpEF (over half of all heart failure patients), there are no effective therapies. Recently, the role of impaired cardiac energetic status in heart failure has gained increasing recognition with the identification of reduced metabolic capacity for carbohydrates and fatty acids, impaired function of the electron transport chain, reduced capacity to transfer ATP to the cytosol, and inefficient utilization of the energy produced...
August 15, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28819824/-update-pulmonary-arterial-hypertension-definitions-diagnosis-therapy
#17
N Sommer, M J Richter, K Tello, F Grimminger, W Seeger, H A Ghofrani, H Gall
The term pulmonary arterial hypertension comprises a group of pulmonary vascular diseases of different etiologies that are characterized by similar precapillary vascular remodeling processes and result in exertional dyspnea and right heart insufficiency. The specific pharmacological treatment approach considers the risk of mortality and phenotypical properties and includes treatment with phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostanoids, as well as with more novel substances, such as a soluble guanylyl cyclase stimulator and an oral prostacyclin receptor agonist...
August 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#18
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28818058/evaluation-of-therapy-management-and-outcome-in-takotsubo-syndrome
#19
Nadine Abanador-Kamper, Lars Kamper, Judith Wolfertz, Witali Pomjanski, Anamaria Wolf-Pütz, Melchior Seyfarth
BACKGROUND: To date there is no validated evidence for standardized treatment of patients with Takotsubo syndrome (TTS). Medication therapy after final TTS diagnosis remains unclear. Previous data on patient outcome is ambivalent. Aim of this study was to evaluate medication therapy in TTS and to analyze patient outcome. METHODS: Within an observational retrospective cohort study we analyzed our medical records and included 72 patients with TTS that underwent cardiovascular magnetic resonance imaging (CMR) after a median of 2 days interquartile range (IQR 1-3...
August 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#20
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
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