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https://www.readbyqxmd.com/read/28331489/reversible-atrial-fibrillation-following-crotalinae-envenomation
#1
Dan Quan, Kenneth Zurcher
BACKGROUND: Cardiotoxicity is a documented complication of Crotalinae envenomation. Reported cardiac complications following snake envenomation have included acute myocardial infarction, electrocardiogram abnormalities and arrhythmias. Few reports exist describing arrhythmia induced by viper envenomation and to our knowledge none describe arrhythmia induced by Crotalinae envenomation. This report concerns the first known case of atrial fibrillation precipitated by rattlesnake bite. CASE PRESENTATION: A 73-year-old Caucasian man with a past medical history of hypertension, hyperlipidemia, type 1 diabetes mellitus, and a baseline first-degree atrioventricular block presented to the emergency department following a rattlesnake bite to his left lower leg...
2017: Journal of Venomous Animals and Toxins Including Tropical Diseases
https://www.readbyqxmd.com/read/28328711/management-of-atrial-fibrillation-with-rapid-ventricular-response-in-the-intensive-care-unit-a-secondary-analysis-of-electronic-health-record-data
#2
Ari Moskowitz, Kenneth P Chen, Avraham Z Cooper, Abdullah Chahin, Mohammad M Ghassemi, Leo Anthony Celi
PURPOSE: Atrial fibrillation with rapid ventricular response (RVR) is common during critical illness. In this study, we explore the comparative effectiveness of three commonly used drugs (metoprolol, diltiazem, and amiodarone) in the management of atrial fibrillation with RVR in the intensive care unit (ICU). METHODS: Data pertaining to the first ICU admission were extracted from the Medical Information Mart for Intensive Care (MIMIC) III database. Patients who received one of the above pharmacologic agents while their heart rate was > 110bpm and had atrial fibrillation documented in the clinical chart were included...
March 21, 2017: Shock
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#3
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#4
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28299212/hemorrhagic-shock-as-complication-of-intramural-intestinal-bleeding
#5
Asma Ben Ali, Mohamed Ali Cherif, Walid Mhajba, Hamdi Hamdène Doghri, Malek Hassouna, Youssef Zied El Hechmi, Zouheir Jerbi, Ines Ben Hassen, Mohamed Habib Daghfous
Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#6
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes. SETTING: Tertiary care academic center...
March 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28292220/impact-of-low-dose-hydrocortisone-on-the-incidence-of-atrial-fibrillation-in-patients-with-septic-shock
#7
Yoann Launey, Sigismond Lasocki, Karim Asehnoune, Baptiste Gaudriot, Claire Chassier, Raphael Cinotti, Pascale Le Maguet, Leila Laksiri, Olivier Mimoz, Audrey Tawa, Nicolas Nesseler, Yannick Malledant, Bastien Perrot, Philippe Seguin
PURPOSE: Atrial fibrillation (AF) is common in the intensive care unit (ICU), notably in patients with septic shock for whom inflammation is an already identified risk factor. The aim of this study was to evaluate the effect of low-dose hydrocortisone on AF occurrence in patients with septic shock. METHODS: We performed a prospective nonrandomized observational study in 5 academic ICUs in France. From November 2012 to June 2014, all patients ≥16 years having septic shock were included, except those who had a history of AF, had a pacemaker, and/or experienced AF during hospitalization before the onset of shock or in whom the onset of shock occurred prior to admission to the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28243434/spontaneous-thyroid-hemorrhage-on-chronic-anticoagulation-therapy
#8
Kulothungan Gunasekaran, Kelly M Rudd, Swetha Murthi, Scott Kaatz, Nazir Lone
Even though highly vascularized, the thyroid gland rarely has spontaneous bleeding. Bleeding into the thyroid gland can result in potentially lethal acute airway compromise. This case report describes an elderly patient on warfarin for atrial fibrillation, who presented with swelling on the right side of her neck causing acute airway obstruction. An urgent computed tomography of the neck showed an enlarging hemorrhage into the right lobe of the thyroid gland. She was initially intubated for airway protection and her anticoagulation was reversed to stop the bleeding...
January 11, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28226202/predictors-of-acute-myocarditis-in-complicated-scrub-typhus-an-endemic-province-in-the-republic-of-korea
#9
Jung Yeon Chin, Ki-Woon Kang, Kyung Min Moon, Jongwoo Kim, Yu Jeong Choi
Background/Aims: Scrub typhus is known as a self-limited infectious disease. Cardiac complication is uncommon and usually not life-threatening. Until now, few cases of fulminant myocarditis by scrub typhus have been reported. So, we investigated incidence and predictors of acute myocarditis in severe scrub typhus. Methods: We retrospectively reviewed 89 patients among 91 scrub typhus confirmed patients who examined an echocardiogram and cardiac biomarkers from 2005 to 2015 in the intensive care unit at our hospital...
February 23, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28215423/chads2-score-predicts-postoperative-atrial-fibrillation-in-patients-undergoing-elective-pulmonary-lobectomy
#10
Svetlana Kotova, Mansen Wang, Katie Lothrop, Gary Grunkemeier, Heather E Merry, John R Handy
BACKGROUND: Postoperative atrial fibrillation (PAF) affects 12% to 17% of patients undergoing lobectomy and is associated with increased morbidity. CHADS2 (congestive heart failure history, hypertension history, age ≥75 years, diabetes mellitus history, and stroke or transient ischemic attack symptoms previously) is used to predict stroke risk in patients with existing AF. It also has been shown also to predict new-onset PAF. Our objective was to determine whether CHADS2 can predict PAF in patients undergoing lobectomy...
February 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#11
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28207554/isolated-cardiac-troponin-rise-does-not-modify-the-prognosis-in-elderly-patients-with-hip-fracture
#12
Hélène Vallet, Alice Breining, Yannick Le Manach, Judith Cohen-Bittan, Anthony Mézière, Mathieu Raux, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203538/robotic-mitral-valve-repair-for-degenerative-posterior-leaflet-prolapse
#13
Hoda Javadikasgari, Rakesh M Suri, Bassman Tappuni, Ashley M Lowry, Tomislav Mihaljevic, Stephanie Mick, A Marc Gillinov
BACKGROUND: Robotic mitral valve (MV) repair is the least invasive surgical approach to the MV and provides unparalleled access to the valve. We sought to assess technical aspects and clinical outcomes of robotic MV repair for isolated posterior leaflet prolapse by examining the first 623 such cases performed in a tertiary care center. METHODS: We reviewed the first 623 patients (mean age 56±9.7 years) with isolated posterior leaflet prolapse who underwent robotic primary MV repair from 01/2006 to 11/2013...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203537/robotic-cardiac-surgery-in-brazil
#14
Robinson Poffo, Alisson P Toschi, Renato B Pope, Paola K Montanhesi, Ricardo S Santos, Alexandre Teruya, Dina M Hatanaka, Gabriel F Rusca, Claudio H Fischer, Marcelo C Vieira, Marcia R Makdisse
BACKGROUND: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci(®) robotic system was performed in Latin America. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil. METHODS: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28179605/the-effects-of-different-bmi-on-blood-loss-and-transfusions-in-chinese-patients-undergoing-coronary-artery-bypass-grafting
#15
Mingya Wang, Ming Chen, Hushan Ao, Sipeng Chen, Zhifa Wang
OBJECTIVE: Blood loss is a predictor of outcomes after coronary artery bypass grafting (CABG). This study investigated the effects of body mass index (BMI) on blood loss, blood transfusion rate, and the variations in coagulation parameters of Chinese patients undergoing CABG. METHODS: A total of 1007 Chinese patients who consecutively underwent isolated, primary CABG at Fuwai Hospital from January 1, 2013 to December 31, 2013 were included in this study. They were categorized by BMI into <24 kg/m(2) (low and normal weight group), 24≤ BMI <28 kg/m(2) (overweight group), and BMI ≥28 kg/m(2) (obese group)...
February 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28147435/developing-models-to-predict-early-postoperative-patient-deterioration-and-adverse-events
#16
Mitchell K Petersen Tym, Guy L Ludbrook, Arthas Flabouris, Richard Seglenieks, Thomas W Painter
BACKGROUND: Accurate identification of patients at risk of early postoperative deterioration allows needs-based allocation of patients to appropriate levels of care. This study aimed to record the incidence of early postoperative deterioration and identify factors predictive of at-risk patients. Doing so may assist future evidence-based perioperative planning and allocation of patients to high-acuity facilities. METHODS: With ethical approval, data from elective non-cardiac surgical patients were collected between May and August 2013...
February 1, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#17
D C Gulba, L Broscaru
Since first used in 2009, non-vitamin K oral anticoagulants (NOAC) have gained world-wide acceptance. Two groups of NOAC are currently used: the direct thrombin antagonist dabigatran and three direct factor  Xa antagonists apixaban, edoxaban, and ricaroxaban. With their increasing use for prevention of thromboembolism, the probability increases that NOAC-pretreated patients are admitted to emergency departments or intensive care units.The clinical challenge in NOAC preanticoagulated patients is to adequately cope with the given anticoagulated status of such patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28143406/vitamin-c-for-preventing-atrial-fibrillation-in-high-risk-patients-a-systematic-review-and-meta-analysis
#18
Harri Hemilä, Timo Suonsyrjä
BACKGROUND: Atrial fibrillation (AF), a common arrhythmia contributing substantially to cardiac morbidity, is associated with oxidative stress and, being an antioxidant, vitamin C might influence it. METHODS: We searched the Cochrane CENTRAL Register, MEDLINE, and Scopus databases for randomised trials on vitamin C that measured AF as an outcome in high risk patients. The two authors independently assessed the trials for inclusion, assessed the risk of bias, and extracted data...
February 1, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28143401/acute-kidney-injury-induces-high-sensitivity-troponin-measurement-changes-after-cardiac-surgery
#19
Amr S Omar, Khaled Mahmoud, Samy Hanoura, Hany Osman, Praveen Sivadasan, Suraj Sudarsanan, Yasser Shouman, Rajvir Singh, Abdulaziz AlKhulaifi
BACKGROUND: The value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. METHODS: Single center observational retrospective study...
January 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28129319/mini-bentall-an-interesting-approach-for-selected-patients
#20
Elisa Mikus, Antonio Micari, Simone Calvi, Maria Salomone, Marco Panzavolta, Marco Paris, Mauro Del Giglio
OBJECTIVE: Minimally invasive surgery through an upper hemisternotomy for aortic valve replacement has become the routine approach with excellent results. Actually, the same minimally invasive access is used for complex ascending aorta procedures only in few centers. We report our experience with minimally invasive approach for aortic valve and ascending aorta replacement using Bentall technique. METHODS: From January 2010 to November 2015, a total of 238 patients received ascending aorta and aortic valve replacement using Bentall De Bono procedure at our institution...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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