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Outstanding Clinical Review

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269 papers 100 to 500 followers ASE LVAD Echo Recs
Michael Auerbach, John W Adamson
It is estimated that one-third of the world's population is anemic, the majority being due to iron deficiency (ID). In adults, ID is associated with fatigue in the absence of anemia, restless legs syndrome, pica and, in neonates, delayed growth and development. In adolescents, ID is associated with decrements in learning and behavioral abnormalities. In the absence of a clear cause, search for a source of bleeding is indicated. No single test is diagnostic of ID unless the serum ferritin is low or the percent transferrin saturation is low with an elevated total iron binding capacity...
January 2016: American Journal of Hematology
Emily J MacKay, Prakash A Patel, Jacob T Gutsche, Stuart J Weiss, John G Augoustides
No abstract text is available yet for this article.
July 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Maude St-Onge, Kurt Anseeuw, Frank Lee Cantrell, Ian C Gilchrist, Philippe Hantson, Benoit Bailey, Valéry Lavergne, Sophie Gosselin, William Kerns, Martin Laliberté, Eric J Lavonas, David N Juurlink, John Muscedere, Chen-Chang Yang, Tasnim Sinuff, Michael Rieder, Bruno Mégarbane
OBJECTIVE: To provide a management approach for adults with calcium channel blocker poisoning. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Following the Appraisal of Guidelines for Research & Evaluation II instrument, initial voting statements were constructed based on summaries outlining the evidence, risks, and benefits. DATA SYNTHESIS: We recommend 1) for asymptomatic patients, observation and consideration of decontamination following a potentially toxic calcium channel blocker ingestion (1D); 2) as first-line therapies (prioritized based on desired effect), IV calcium (1D), high-dose insulin therapy (1D-2D), and norepinephrine and/or epinephrine (1D)...
October 3, 2016: Critical Care Medicine
Christina J Hayhurst, Pratik P Pandharipande, Christopher G Hughes
No abstract text is available yet for this article.
September 30, 2016: Anesthesiology
Walter R Wilson, Thomas C Bower, Mark A Creager, Sepideh Amin-Hanjani, Patrick T O'Gara, Peter B Lockhart, Rabih O Darouiche, Basel Ramlawi, Colin P Derdeyn, Ann F Bolger, Matthew E Levison, Kathryn A Taubert, Robert S Baltimore, Larry M Baddour
No abstract text is available yet for this article.
October 13, 2016: Circulation
Julia Wallenborn, Sebastian Herrmann, Marc Hansen, Kai Hu, Wolfram Voelker, Stefan Störk, Georg Ertl, Frank Weidemann
In patients with relevant mitral regurgitation (MR), transcatheter edge-to-edge repair (also called MitraClip) provides an alternative treatment option especially for inoperable or high-risk patients. In preparation for the procedure, echocardiography is the method of choice for assessment of mitral valve (MV) morphology and function and thus provides important information if successful treatment of MR can be accomplished by MitraClip. This review article provides structured and detailed guidance how to systematically assess functional and degenerative MR and MV pathology by echocardiography in order to select eligible patients for this procedure...
July 2016: Echocardiography
Karen S Brown, Hamim Zahir, Michael A Grosso, Hans J Lanz, Michele F Mercuri, Jerrold H Levy
BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) are approved for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of venous thromboembolism. These include the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban. Bleeding is a complication for all anticoagulants and concerns regarding bleeding risk and the suitability of effective reversal strategies may be a barrier to their prescription...
September 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
Jay V Doshi, Sahil Agrawal, Jalaj Garg, Rajiv Paudel, Chandrasekar Palaniswamy, Tina V Doshi, William Gotsis, William H Frishman
Mitral regurgitation (MR) is the most common cardiac valvular disease in the United States. Approximately 4 million people have severe MR and roughly 250,000 new diagnoses of MR are made each year. Mitral valve surgery is the only treatment that prevents progression of heart failure and provides sustained symptomatic relief. Mitral valve repair is preferred over replacement for the treatment of MR because of freedom from anticoagulation, reduced long-term morbidity, reduced perioperative mortality, improved survival, and better preservation of left ventricular function compared with valve replacement...
November 2014: Cardiology in Review
John Arthur McClung
Native valvular emergencies are nearly always regurgitant in nature, whereas acute prosthetic valve dysfunction can be either regurgitant or stenotic. Regardless of the etiology, the presentation of acute valvular pathology differs significantly from chronic disease in both clinical presentation and in its appearance on diagnostic modalities, and appropriate recognition is critical to the choice of the appropriate therapeutic modality. Intrinsic to the recognition of a valvular emergency is a knowledge of those conditions for which a high index of suspicion must be maintained...
January 2016: Cardiology in Review
Daniel Mangels, William H Frishman
The subcutaneous implantable cardioverter defibrillator (S-ICD) is a subcutaneous alternative to conventional transvenous ICD (TV-ICD) systems, which have previously been shown to treat life-threatening ventricular tachyarrhythmias in cardiac disease patients. A review of the literature reveals that S-ICDs have similar shock efficacy rates for both induced and spontaneous ventricular tachyarrhythmias when compared with TV-ICDs. Furthermore, S-ICDs seem to have a higher specificity for withholding therapy when supraventricular tachycardia is present compared with TV-ICDs...
September 2016: Cardiology in Review
Parveen K Garg
Vascular surgery is associated with a higher incidence of perioperative cardiovascular morbidity and mortality compared with other noncardiac surgeries. Patients undergoing vascular surgery represent a higher-risk population, usually because of the presence of generalized arterial disease and multiple comorbidities. The overwhelming perioperative cardiac event is myocardial infarction. This article offers a tailored approach to preoperative cardiovascular management for patients undergoing vascular surgery...
February 2015: Cardiology Clinics
Jason F Deen, Thomas K Jones
Intracardiac shunts are among the most common cardiac lesions seen in adult patients with congenital heart disease. Shunt lesions comprise much of the de novo congenital heart disease diagnosed in adults and engender a wide range of pathophysiologic consequences with a variety of treatment options. This article discusses the pathophysiology, clinical presentation, indications for intervention, late management issues, and pregnancy in adults with atrial septal defects, ventricular septal defects, and patent ductus arteriosus...
November 2015: Cardiology Clinics
Nick H Kim
Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious but treatable complication of pulmonary embolism. Proper diagnosis and referral are critical, as pulmonary thromboendarterectomy offers the possibility of a cure. For patients with CTEPH deemed inoperable, new and effective treatments have emerged to help fill this unmet need.
August 2016: Cardiology Clinics
Elvera L Baron, Daniel I Fremed, Rami O Tadros, Pedro A Villablanca, Adam S Evans, Menachem M Weiner, Eric H Yang, John T Augoustides, Farouk Mookadam, Harish Ramakrishna
No abstract text is available yet for this article.
July 18, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Marlies Ostermann, Michael Joannidis
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this review, we outline the current definition of AKI and the potential pitfalls, and summarise the existing and future tools to investigate AKI in critically ill patients.
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
Mehdi H Shishehbor, Christopher J White, Bruce H Gray, Matthew T Menard, Robert Lookstein, Kenneth Rosenfield, Michael R Jaff
Critical limb ischemia (CLI), the most advanced form of peripheral artery disease, is associated with significant morbidity, mortality, and health care resource utilization. It is also associated with physical, as well as psychosocial, consequences such as amputation and depression. Importantly, after a major amputation, patients are at heightened risk of amputation on the contralateral leg. However, despite the technological advances to manage CLI with minimally invasive technologies, this condition often remains untreated, with significant disparities in revascularization and amputation rates according to race, socioeconomic status, and geographic region...
September 22, 2016: Journal of the American College of Cardiology
Srijita Sen-Chowdhry, Daniel Jacoby, James C Moon, William J McKenna
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment...
November 2016: Nature Reviews. Cardiology
Vladimir V Lomivorotov, Sergey M Efremov, Mikhail Y Kirov, Evgeny V Fominskiy, Alexander M Karaskov
No abstract text is available yet for this article.
July 29, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Vincent Chan, Olivier Levac-Martinho, Benjamin Sohmer, Elsayed Elmistekawy, Marc Ruel, Thierry G Mesana
BACKGROUND: Data comparing outcomes after repair versus replacement of chronic ischemic mitral regurgitation (MR) is evolving. Recent data suggest that repair is associated with recurrent MR, but not survival, when compared with replacement. However, it remains unclear when either surgical strategy should be applied based on preoperative mitral valve anatomy. METHODS: Between 2001 and 2013, 161 patients underwent repair or replacement of chronic ischemic MR. The mean age of these patients was 68...
September 22, 2016: Annals of Thoracic Surgery
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
2016: Critical Care: the Official Journal of the Critical Care Forum
2016-09-26 18:40:11
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