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By Aswathnarayan Manandhi Internist working in Division of Cardiology, Hartford Hospital having interest in Cardiology.
Oscar Peñuelas, Alfonso Muriel, Fernando Frutos-Vivar, Eddy Fan, Konstantinos Raymondos, Fernando Rios, Nicolás Nin, Arnaud W Thille, Marco González, Asisclo J Villagomez, Andrew R Davies, Bin Du, Salvatore M Maggiore, Dimitrios Matamis, Fekri Abroug, Rui P Moreno, Michael A Kuiper, Antonio Anzueto, Niall D Ferguson, Andrés Esteban
BACKGROUND: Intensive care unit-acquired paresis (ICUAP) is associated with poor outcomes. Our objective was to evaluate predictors for ICUAP and the short-term outcomes associated with this condition. METHODS: A secondary analysis of a prospective study including 4157 mechanically ventilated adults in 494 intensive care units from 39 countries. After sedative interruption, patients were screened for ICUAP daily, which was defined as the presence of symmetric and flaccid quadriparesis associated with decreased or absent deep tendon reflexes...
April 13, 2016: Journal of Intensive Care Medicine
Sripal Bangalore, Robert Fakheri, Bora Toklu, Franz H Messerli
OBJECTIVE: To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. DESIGN: Meta-analysis. DATA SOURCES AND STUDY SELECTION: PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, and end stage renal disease...
February 11, 2016: BMJ: British Medical Journal
Courtney E Bennett, Ronald Freudenberger
Isolated left ventricular noncompaction (LVNC) is a genetic cardiomyopathy characterized by prominent ventricular trabeculations and deep intertrabecular recesses, or sinusoids, in communication with the left ventricular cavity. The low prevalence of patients with this cardiomyopathy presents a unique challenge for large, prospective trials to assess its pathogenesis, management, and outcomes. In this paper we review the embryology and genetics of LVNC, the diagnostic approach, and propose a management approach based on the current literature available...
2016: Cardiology Research and Practice
Maureen A Smythe, Jennifer Priziola, Paul P Dobesh, Diane Wirth, Adam Cuker, Ann K Wittkowsky
Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. Despite the changing landscape of VTE treatment with the introduction of the new direct oral anticoagulants many uncertainties remain regarding the optimal use of traditional parenteral agents. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. This specific chapter addresses the practical management of heparins including low molecular weight heparins and fondaparinux...
January 2016: Journal of Thrombosis and Thrombolysis
Abhishek Singh, Saïd Laribi, John R Teerlink, Alexandre Mebazaa
Millions of patients worldwide are admitted for acute heart failure (AHF) each year and physicians caring for these patients are confronted with the short-term challenges of reducing symptoms while preventing end organ dysfunction without causing additional harm, and the intermediate-term challenges of improving clinical outcomes such as hospital readmission and survival. There are limited data demonstrating the efficacy of any currently available therapies for AHF to meet these goals. After diuretics, vasodilators are the most common intravenous therapy for AHF, but neither nitrates, nitroprusside, nor nesiritide have robust evidence supporting their ability to provide meaningful effects on clinical outcomes, except perhaps early symptom improvement...
February 4, 2016: European Heart Journal
Sakiko Honda, Tatsuya Kawasaki, Hirokazu Shiraishi, Michiyo Yamano, Tadaaki Kamitani, Satoaki Matoba
No abstract text is available yet for this article.
February 9, 2016: Circulation
Roger Rear, Robert M Bell, Derek J Hausenloy
No abstract text is available yet for this article.
April 2016: Heart: Official Journal of the British Cardiac Society
Anjali Tiku Owens, Susan C Brozena, Mariell Jessup
Despite >100 clinical trials, only 2 new drugs had been approved by the US Food and Drug Administration for the treatment of chronic heart failure in more than a decade: the aldosterone antagonist eplerenone in 2003 and a fixed dose combination of hydralazine-isosorbide dinitrate in 2005. In contrast, 2015 has witnessed the Food and Drug Administration approval of 2 new drugs, both for the treatment of chronic heart failure with reduced ejection fraction: ivabradine and another combination drug, sacubitril/valsartan or LCZ696...
February 5, 2016: Circulation Research
Vikas Thondapu, Christos V Bourantas, Nicolas Foin, Ik-Kyung Jang, Patrick W Serruys, Peter Barlis
Coronary plaque rupture is the most common cause of vessel thrombosis and acute coronary syndrome. The accurate early detection of plaques prone to rupture may allow prospective, preventative treatment; however, current diagnostic methods remain inadequate to detect these lesions. Established imaging features indicating vulnerability do not confer adequate specificity for symptomatic rupture. Similarly, even though experimental and computational studies have underscored the importance of endothelial shear stress in progressive atherosclerosis, the ability of shear stress to predict plaque progression remains incremental...
February 22, 2016: European Heart Journal
J David Spence, A Ross Naylor
No abstract text is available yet for this article.
March 17, 2016: New England Journal of Medicine
Gregory W Hosier, Stephen J Phillips, Steve P Doucette, Kirk D Magee, Gordon J Gubitz
OBJECTIVES: 1) To evaluate whether transient ischemic attack (TIA) management in emergency departments (EDs) of the Nova Scotia Capital District Health Authority followed Canadian Best Practice Recommendations, and 2) to assess the impact of being followed up in a dedicated outpatient neurovascular clinic. METHODS: Retrospective chart review of all patients discharged from EDs in our district from January 1, 2011 to December 31, 2012 with a diagnosis of TIA. Cox proportional hazards models, Kaplan-Meier survival curve, and propensity matched analyses were used to evaluate 90-day mortality and readmission...
September 2016: CJEM
Mahesh Anantha Narayanan, Toufik Mahfood Haddad, Andre C Kalil, Arun Kanmanthareddy, Rakesh M Suri, George Mansour, Christopher J Destache, Janani Baskaran, Aryan N Mooss, Tammy Wichman, Lee Morrow, Renuga Vivekanandan
OBJECTIVE: Infective endocarditis is associated with high morbidity and mortality and optimal timing for surgical intervention is unclear. We performed a systematic review and meta-analysis to compare early surgical intervention with conservative therapy in patients with infective endocarditis. METHODS: PubMed, Cochrane, EMBASE, CINAHL and Google-scholar databases were searched from January 1960 to April 2015. Randomised controlled trials, retrospective cohorts and prospective observational studies comparing outcomes between early surgery at 20 days or less and conservative management for infective endocarditis were analysed...
June 15, 2016: Heart: Official Journal of the British Cardiac Society
Emily Y Cheng, Melissa H Kong
Atrial fibrillation (AF) is the most common clinically relevant arrhythmia and increases the risk of thromboembolism and stroke; however, these risks are not the same for women and men. This review examines the evidence and clinical significance of increased thromboembolic risk in women with AF. The balance of results from over 30 recent studies suggests that female gender is an independent stroke risk factor in AF, and the inclusion of female gender in stroke risk stratification models, such as CHA2DS2-VASc, has improved risk assessment...
March 15, 2016: American Journal of Cardiology
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