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The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?
CONCLUSION: Hospitals in medium-sized metro counties are associated with unfavorable Medicare mortality ratings, but current methods to assign mortality ratings may hinder fair comparisons. Patient transfers from rural locations to regional medical centers may contribute to these results, a potential factor that future research should examine. PMID: 29616911 [PubMed - in process]
Source: The Permanente journal - April 6, 2018 Category: General Medicine Tags: Perm J Source Type: research

Left Atrial Appendage Occlusion for Prevention of Thromboembolic Events
More than 600  000 patients in the United States undergo cardiac operations each year, including coronary artery bypass graft operations, valve repair or replacement procedures, or other more complex operations. Patients with atrial fibrillation (AF) who undergo these procedures are at risk for postoperative th romboembolic complications, with the left atrial appendage being a common site of thrombus formation. Occlusion of the left atrial appendage may reduce the risk of thromboembolic stroke and can be performed intraoperatively at the time of cardiac operations. The most common surgical approaches to ac hieve left atr...
Source: JAMA - January 23, 2018 Category: General Medicine Source Type: research

Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients und...
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Yu Y, Zhang K, Zhang L, Zong H, Meng L, Han R Tags: Cochrane Database Syst Rev Source Type: research

Comparison of Long-term Outcomes in Patients with Premature Triple-vessel Coronary Disease Undergoing Three Different Treatment Strategies: A Prospective Cohort Study.
CONCLUSIONS: PCI and CABG provided equal long-term benefits for all-cause death and cardiac death for PTVD patients. Patients undergoing MT alone had the worst long-term clinical outcomes. TRIAL REGISTRATION: ClinicalTrials.gov; Identifier: NCT02634086. https://www.clinicaltrials.gov/ct2/show/record/NCT02634086?term=NCT02634086&rank=1. PMID: 29271373 [PubMed - in process]
Source: Chinese Medical Journal - December 24, 2017 Category: General Medicine Authors: Xu JJ, Zhang Y, Jiang L, Tian J, Song L, Gao Z, Feng XX, Zhao XY, Zhao YY, Wang D, Sun K, Xu LJ, Liu R, Gao RL, Xu B, Song L, Yuan JQ Tags: Chin Med J (Engl) Source Type: research

Outcomes of Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention in Patients Aged 18-45 Years with Diabetes Mellitus.
CONCLUSIONS: In DM patients aged 18-45 years, the cumulative survival rate, and freedom from MI and repeat revascularization for CABG were superior to those of PCI. However, a better trend to avoid stroke was observed with PCI. PMID: 29237922 [PubMed - in process]
Source: Chinese Medical Journal - December 15, 2017 Category: General Medicine Authors: Li Y, Dong R, Hua K, Liu TS, Zhou SY, Zhou N, Zhang HJ Tags: Chin Med J (Engl) Source Type: research

Comparison of tidal volume and deep breath preoxygenation techniquesundergoing coronary artery bypass graft surgery: effects of hemodynamicresponse and arterial oxygenation
Conclusion: In patients with normal ejection fraction scheduled for CABG, 8DBs can be an alternative to TVB preoxygenation. Our results should be compared with those of other studies. PMID: 29151335 [PubMed]
Source: Turkish Journal of Medical Sciences - November 22, 2017 Category: General Medicine Tags: Turk J Med Sci Source Type: research

Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial
Publication date: Available online 10 November 2017 Source:The Lancet Author(s): Stuart J Connolly, John W Eikelboom, Jackie Bosch, Gilles Dagenais, Leanne Dyal, Fernando Lanas, Kaj Metsarinne, Martin O'Donnell, Anthony L Dans, Jong-Won Ha, Alexandr N Parkhomenko, Alvaro A Avezum, Eva Lonn, Liu Lisheng, Christian Torp-Pedersen, Petr Widimsky, Aldo P Maggioni, Camilo Felix, Katalin Keltai, Masatsugu Hori, Khalid Yusoff, Tomasz J Guzik, Deepak L Bhatt, Kelley R H Branch, Nancy Cook Bruns, Scott D Berkowitz, Sonia S Anand, John D Varigos, Keith A A Fox, Salim Yusuf Background Coronary artery disease is a major cause of morbi...
Source: The Lancet - November 11, 2017 Category: General Medicine Source Type: research

Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Publication date: Available online 1 November 2017 Source:The Lancet Author(s): Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve Background Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The ai...
Source: The Lancet - November 2, 2017 Category: General Medicine Source Type: research

Use of cardiopulmonary pump support during coronary artery bypass grafting in the high-risk: a meta-analysis
ConclusionsOn-pump is associated with a decreased risk of additional revascularization by 1  year. However, this appears to be a cost of longer hospitalization.
Source: Irish Journal of Medical Science - September 21, 2017 Category: General Medicine Source Type: research

Management and clinical outcome of stable coronary artery disease in Austria : Results from 5  years of the CLARIFY registry.
CONCLUSION: Characteristics of Austrian outpatients with stable CAD corresponded to those of patients with CAD in other developed countries. Medical treatments following the recommendations of the European guidelines were prescribed in the majority of patients; however, recommended goals of life style interventions including a heart rate less than 60 bpm and general risk factor management were not achieved by a high proportion of patients. Heart rate control and life style changes remain unmet needs of cardiovascular care in Austria. PMID: 28913755 [PubMed - as supplied by publisher]
Source: Wiener Klinische Wochenschrift - September 14, 2017 Category: General Medicine Authors: Lang IM, Badr-Eslam R, Greenlaw N, Young R, Steg PG Tags: Wien Klin Wochenschr Source Type: research

Whole grain cereals for the primary or secondary prevention of cardiovascular disease.
CONCLUSIONS: There is insufficient evidence from RCTs of an effect of whole grain diets on cardiovascular outcomes or on major CVD risk factors such as blood lipids and blood pressure. Trials were at unclear or high risk of bias with small sample sizes and relatively short-term interventions, and the overall quality of the evidence was low. There is a need for well-designed, adequately powered RCTs with longer durations assessing cardiovascular events as well as cardiovascular risk factors. PMID: 28836672 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Kelly SA, Hartley L, Loveman E, Colquitt JL, Jones HM, Al-Khudairy L, Clar C, Germanò R, Lunn HR, Frost G, Rees K Tags: Cochrane Database Syst Rev Source Type: research

Low glycaemic index diets for the prevention of cardiovascular disease.
CONCLUSIONS: There is currently no evidence available regarding the effect of low GI diets on cardiovascular disease events. Moreover, there is currently no convincing evidence that low GI diets have a clear beneficial effect on blood lipids or blood pressure parameters. PMID: 28759107 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 31, 2017 Category: General Medicine Authors: Clar C, Al-Khudairy L, Loveman E, Kelly SA, Hartley L, Flowers N, Germanò R, Frost G, Rees K Tags: Cochrane Database Syst Rev Source Type: research

Deriving literature-based benchmarks for surgical complications in high-income countries: a protocol for a systematic review and meta-analysis
This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature. Results will inform a future quality improvement tool and provide benchmarks of surgical complication rates within HICs. Trial registration International Prospective Register of Systematic Reviews (PROSPERO). Registration number CRD42016037519.
Source: BMJ Open - May 9, 2017 Category: General Medicine Authors: Brindle, M. E., Roberts, D. J., Daodu, O., Haynes, A. B., Cauley, C., Dixon, E., La Flamme, C., Bain, P., Berry, W. Tags: Open access, Health policy Protocol Source Type: research

Postoperative Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery Predicts Long-Term Atrial Fibrillation and Stroke.
CONCLUSIONS: POAF is a common complication of CABG surgery, which is correlated with late AF and stroke. Patients with POAF should be closely monitored to facilitate early administration of anticoagulant therapy in a high risk population upon recurrence of AF. PMID: 28457078 [PubMed - in process]
Source: The Israel Medical Association Journal - May 1, 2017 Category: Journals (General) Tags: Isr Med Assoc J Source Type: research

Vitamin C supplementation for the primary prevention of cardiovascular disease.
CONCLUSIONS: Currently, there is no evidence to suggest that vitamin C supplementation reduces the risk of CVD in healthy participants and those at increased risk of CVD, but current evidence is limited to one trial of middle-aged and older male physicians from the USA. There is limited low- and very low-quality evidence currently on the effect of vitamin C supplementation and risk of CVD risk factors. PMID: 28301692 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 15, 2017 Category: Journals (General) Authors: Al-Khudairy L, Flowers N, Wheelhouse R, Ghannam O, Hartley L, Stranges S, Rees K Tags: Cochrane Database Syst Rev Source Type: research

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