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Total 34927 results found since Jan 2013.

Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson
ConclusionRegadenoson might be a safe and feasible pharmacologic stress agent for use in cardiac MR in older pediatric patients with congenital heart disease and acquired heart disease. The ease of use as a bolus and the advantage of a prolonged hyperemia make its use appealing in pediatrics. In a limited number of cases, regadenoson stress perfusion showed excellent agreement with cardiac catheterization. Regadenoson might be a viable pharmacologic stress agent in this population.
Source: Pediatric Radiology - December 28, 2016 Category: Radiology Source Type: research

Intravascular ultrasound versus digital subtraction angiography: direct comparison of intraluminal diameter measurements in pediatric and adolescent imaging
ConclusionOverall, IVUS measurements were slightly larger than DSA measurements in all data subsets. Absolute vessel diameter measurements obtained with IVUS in the pediatric and adolescent population are statistically significantly larger than those obtained using DSA when excluding venous compression syndromes. In venous compression syndromes, IVUS might provide a more accurate representation of vessel compression and diameter than DSA.
Source: Pediatric Radiology - January 18, 2017 Category: Radiology Source Type: research

A retrievable rescue stent graft and radiofrequency positioning for rapid control of noncompressible hemorrhage
CONCLUSION: This study demonstrates the rapid deployment and retrieval of a RESCUE stent graft as well as the ability to tamponade injuries of the aorta and cava. In addition, this study demonstrates the feasibility of RF tags to guide stent placement through tissue. More rigorous models are needed to define the effectiveness of this approach in the setting of vascular injury and shock.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - July 22, 2017 Category: Orthopaedics Tags: Original Articles Source Type: research

CMS Releases Final Rule for Second Year of QPP
Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes in the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including the Merit-based Incentive Program (MIPS) and Advanced Payment Models (APMs). The second year of the QPP continues to build on transitional year 1 policies, noting that a “second year to ramp-up the program will continue to help build upon the iterative learning and development of year 1 in preparation for a robust program in year 3.” In addition to the final rule, CMS als...
Source: Policy and Medicine - November 6, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

CMS Releases Final Rule for Second Year of QPP - Includes PI-QI CME Improvement Activity
Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes in the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including the Merit-based Incentive Program (MIPS) and Advanced Payment Models (APMs). The second year of the QPP continues to build on transitional year 1 policies, noting that a “second year to ramp-up the program will continue to help build upon the iterative learning and development of year 1 in preparation for a robust program in year 3.” In addition to the final rule, CMS als...
Source: Policy and Medicine - November 6, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Looking beyond the indication: Bone scan for trauma providing unsuspected initial diagnosis of acute critical lower limb arterial compromise.
We report a case of rare incidental initial detection of unsuspected arterial supply compromise to the right lower extremity on a bone scan done to rule out fracture in a patient with right hip pain following a fall. Follow up CT angiogram confirmed near complete occlusion of right lower extremity arteries for which patient underwent above knee amputation. PMID: 29127251 [PubMed - as supplied by publisher]
Source: Journal of Nuclear Medicine Technology - November 12, 2017 Category: Nuclear Medicine Tags: J Nucl Med Technol Source Type: research

Delineate, yet not dread: Anomalous vertebral artery in pediatric congenital atlantoaxial dislocation and basilar invagination
Conclusion: It is important to delineate the anomalous VA. However, the presence of such an artery is not a deterrent to the manipulation of C1–C2 joint, essential for best results. Special attention needs to be paid to the extent of distraction, medial C2 transverse foramen, and dissection/drilling of the area superior to the anomalous VA in the pediatric age group.
Source: Journal of Pediatric Neurosciences - November 14, 2017 Category: Neuroscience Authors: Pravin Salunke Source Type: research

Portable CT Pulmonary Angiogram in an Infant on Veno-Arterial Extracorporeal Membrane Oxygenation in the Pediatric Intensive Care Unit
Computed tomography (CT) has been shown to change management in children on extracorporeal membrane oxygenation (ECMO). Although techniques have been described to transport these critically ill patients to the CT suite in the radiology department, transport out of the intensive care setting is not without risk, and using portable CT is a practical alternative. However, obtaining a CT pulmonary angiogram (CTPA) in a patient on veno-arterial (VA) ECMO presents unique challenges due to bypass of the cardiopulmonary system, which may lead to suboptimal opacification of the pulmonary arteries.
Source: Current Problems in Diagnostic Radiology - November 21, 2017 Category: Radiology Authors: Simon S. Ho, Meral M. Patel, Renee M. Mansour, Atul Vats, Nikhil K. Chanani, Bradley S. Rostad Source Type: research

Cardiac Imaging Modalities and Appropriate Use.
Abstract Cardiovascular imaging with calcium scoring computed tomography (CT), coronary CT angiography (CCTA), and cardiac MRI (CMR) have advanced rapidly over recent years. These imaging modalities have increased in availability, accessibility, and clinical practicality due to technological advances allowing for significant radiation dose reduction for high-quality CCTA and for rapid and reliable imaging techniques in CMR. Hardware and software developments are continually increasing efficiency and accuracy of postprocessing. In the context of these rapidly developing imaging modalities, it is critical for orderi...
Source: Primary Care - February 8, 2018 Category: Primary Care Authors: Peterson PG, Berge M, Lichtenberger JP, Hood MN, Ho VB Tags: Prim Care Source Type: research

Portable CT Pulmonary Angiogram in an Infant on Veno-Arterial Extracorporeal Membrane Oxygenation in the Pediatric Intensive Care Unit
Computed tomography (CT) has been shown to change management in children on extracorporeal membrane oxygenation (ECMO). Although techniques have been described to transport these critically ill patients to the CT suite in the radiology department, transport out of the intensive care setting is not without risk, and using portable CT is a practical alternative. However, obtaining a CT pulmonary angiogram (CTPA) in a patient on veno-arterial (VA) ECMO presents unique challenges due to bypass of the cardiopulmonary system, which may lead to suboptimal opacification of the pulmonary arteries.
Source: Current Problems in Diagnostic Radiology - November 21, 2017 Category: Radiology Authors: Simon S. Ho, Meral M. Patel, Renee M. Mansour, Atul Vats, Nikhil K. Chanani, Bradley S. Rostad Source Type: research

American College of Surgeons Committee on Trauma verification level affects trauma center management of pelvic ring injuries and patient mortality
CONCLUSION Admission with a partially stable or unstable pelvic ring injury to a Level I trauma center is associated with decreased mortality. Level II trauma centers had significantly less utilization of advanced treatment modalities. This variation in clinical practice highlights potential processes to emphasize in the appropriate treatment of these critically ill patients. LEVEL OF EVIDENCE Economic/Decision, Level II.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - December 25, 2018 Category: Orthopaedics Tags: AAST 2018 PODIUM PAPER Source Type: research

Clinical outcomes and need for intensive care after non-ST-segment-elevation myocardial infarction.
CONCLUSIONS: Complications requiring ICU care were infrequent in a cohort of NSTEMI patients who were routinely admitted to the ICU over a 4-year period. The ACTION risk score had low accuracy in the prediction of complications requiring ICU care in our population. PMID: 32089424 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - February 19, 2020 Category: Internal Medicine Authors: Guimarães PO, Sampaio MC, Malafaia FL, Lopes RD, Fanaroff AC, de Barros E Silva PGM, Dos Santos TM, Okada MY, Mouallem ARE, Diniz MDS, Custódio JV, Garcia JCT, Furlan V Tags: Eur J Intern Med Source Type: research

How to assess the severity of heart failure?
Purpose of review Mortality rates for acute decompensated heart failure and cardiogenic shock remain unacceptably high despite advances in medical therapy and mechanical circulatory support. Systems designed to quickly and accurately identify and risk stratify these patients are needed in order to improve survival. Recent findings The Society for Cardiovascular Angiography and Interventions developed an expert consensus statement aimed at early identification and assessment of patients with advanced heart failure and cardiogenic shock. Recent studies have validated this novel classification system within several large...
Source: Current Opinion in Critical Care - July 30, 2020 Category: Nursing Tags: CARDIOGENIC SHOCK: Edited by Alexandre Mebazaa Source Type: research

Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure
ConclusionsAge is an independent risk factor for mortality that modifies the relationship between the SCAI shock stage and mortality risk in CICU patients, providing robust risk stratification for in ‐hospital and 1 year mortality. Although patients with HF had a higher risk of dying, age was more strongly associated with mortality among patients with ACS.
Source: ESC Heart Failure - September 9, 2020 Category: Cardiology Authors: Mitchell Padkins, Thomas Breen, Nandan Anavekar, Sean Diepen, Timothy D. Henry, David A. Baran, Gregory W. Barsness, Kianoush Kashani, David R. Holmes, Jacob C. Jentzer Tags: Original Research Article Source Type: research

Primary care physicians comprehensively manage acute pulmonary embolism without higher-level-of-care transfer: A report of two cases
This report sets the stage for investigating the public health implications of comprehensive primary care-based PE management, including cost-savings as well as enhanced patient follow-up and patient satisfaction.
Source: Medicine - November 6, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research