Practices and Attitudes of Canadian Cardiologists Caring for Patients with Trisomy 18 (85 characters, max 97)

Publication date: Available online 17 November 2016 Source:Canadian Journal of Cardiology Author(s): Aisling A. Young, Christy Simpson, Andrew E. Warren Trisomy 18 (T18) is a genetic disorder with cardiac lesions in up to 90% of patients. Cardiac surgery is not frequently offered because of the overall poor prognosis, though this has recently been challenged. Our study aimed to explore the practices and attitudes of Canadian Pediatric Cardiologists managing T18 patients. We administered a survey to Pediatric Cardiologists attending the Canadian Cardiovascular Congress, Canadian Pediatric Cardiology Association Business Meeting. There were thirty respondents. The majority (67%) supported comfort care for affected patients with a heart lesion. None supported palliative surgery for those with complex heart lesions. 16/30 (53%) counsel families prenatally, and none would present the option of a single ventricle surgical track for complex heart disease. In a hypothetical situation where their own child was born with T18, 67% would choose comfort care with medical treatment of heart failure, and none would choose palliative surgery. Being a parent was associated with a higher likelihood of choosing termination (14/20 v 6/9, p=0.046) or comfort care (14/20 v 6/9, p=0.036). Qualitative data suggest support for comfort care, while recognizing the need for individualization and shared decision-making, within the context of institution-specific policies. Canadian Pediatric Cardiologist...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
By KIP SULLIVAN, JD The Medicare Payment Advisory Commission (MedPAC) and other proponents of the Hospital Readmissions Reduction Program (HRRP) justified their support for the HRRP with the claim that research had already demonstrated how hospitals could reduce readmissions for all Medicare fee-for-service patients, not just for groups of carefully selected patients. In this three-part series, I am reviewing the evidence for that claim. We saw in Part I and Part II that the research MedPAC cited in its 2007 report to Congress (the report Congress relied on in authorizing the HRRP) contained no studies supporting tha...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Medicare health reform Hospital Readmissions Reduction Program HRRP Kip Sullivan MedPAC Source Type: blogs
Conclusions Workers with low job control are at increased risk of all-cause and CHD mortality compared to workers with high job control. Policy and practi ce interventions to improve job control could contribute to reductions in all-cause and CHD mortality.byTaouk Y, Spittal MJ, LaMontagne AD, Milner AJ. doi:10.5271/sjweh.3853
Source: Scandinavian Journal of Work, Environment and Health - Category: Occupational Health Tags: Review Source Type: research
Publication date: Available online 12 October 2019Source: Social Science &MedicineAuthor(s): Kristin Bindley, Joanne Lewis, Joanne Travaglia, Michelle DiGiacomoAbstractAn emphasis on individual intervention and psychological complexity has characterised research on bereavement following an experience of life-limiting illness. Exploration of “structural vulnerability” as a positionality produced by social and structural inequity could provide insights into areas of practice and policy in need of development. This scoping review sought to summarise published research on experiences of social and structural in...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research
Journal of Perinatology, Published online: 14 October 2019; doi:10.1038/s41372-019-0528-1Neonatal and maternal outcomes of pregnancies with a fetal diagnosis of congenital heart disease using a standardized delivery room management protocol
Source: Journal of Perinatology - Category: Perinatology & Neonatology Authors: Source Type: research
ConclusionLower apparent density of axonal packing, but not altered axonal orientation, is a key microstructural factor in the white matter abnormalities observed in youth born with CHD. These impairments in axonal packing may be an enduring consequence of early life brain injury and dysmaturation and may explain some of the long-term neuropsychological difficulties experienced by this at-risk group.
Source: NeuroImage - Category: Neuroscience Source Type: research
Authors: Bhullar SK, Shah AK, Dhalla NS Abstract Effective therapy of hypertension represents a key strategy for reducing the burden of cardiovascular disease and its associated mortality. The significance of voltage dependent L-type Ca²⁺ channels to Ca²⁺ influx, and of their regulatory mechanisms in the development of heart disease, is well established. A wide variety of L-type Ca²⁺ channel inhibitors and Ca²⁺ antagonists have been found to be beneficial not only in the treatment of hypertension, but also in myocardial infarction and heart failure. Over the past two decades, another cla...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
Authors: Singhania G, Ejaz AA, McCullough PA, Kluger AY, Balamuthusamy S, Dass B, Singhania N, Agarwal A Abstract Randomized controlled trials have demonstrated the benefits of guideline-directed medical therapy in the outpatient setting for treatment of chronic heart failure. However, the benefits of continuation (or discontinuation) of major chronic heart failure therapies when treating acute heart failure during hospitalization are less clear. Real and anticipated worsening renal function, hyperkalemia and hypotension are the three major reasons for discontinuation of renin-angiotensin-aldosterone system inhibit...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
These diets can reduce the risk of coronary heart disease and the risk of diabetes as well as keeping you in shape. → Support PsyBlog for just $4 per month. Enables access to articles marked (M) and removes ads. → Explore PsyBlog's ebooks, all written by Dr Jeremy Dean: Accept Yourself: How to feel a profound sense of warmth and self-compassion The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic Spark: 17 Steps That Will Boost Your Motivation For Anything Activate: How To Find Joy Again By Changing What You Do
Source: PsyBlog | Psychology Blog - Category: Psychiatry & Psychology Authors: Tags: Heart Disease Source Type: blogs
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Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
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