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Total 87 results found since Jan 2013.

Telestroke, tele-oncology and teledialysis: a systematic review to analyse the outcomes of active therapies delivered with telemedicine support
We conducted a systematic review of studies involving telemedicine supervision of active treatment for rural patients in the fields of stroke, medical oncology and nephrology. Searches were performed on the MEDLINE, CINAHL and INFORMIT databases. A total of 521 articles were found, and an additional 42 articles were identified by searching the reference lists. After removing duplicates, screening the abstracts and assessing the full text of the articles, 14 articles remained. Nine concerned telestroke, two concerned tele-oncology and three concerned teledialysis. Most studies did not undertake randomisation, allocation con...
Source: Journal of Telemedicine and Telecare - June 3, 2015 Category: Information Technology Authors: Jhaveri, D., Larkins, S., Sabesan, S. Tags: RESEARCH/Systematic Reviews Source Type: research

Management of Bleeding Complications in Patients Taking Direct Oral Anticoagulants at a Large Tertiary Academic Medical Center
Abstract Direct oral anticoagulants (DOACs) offer a fixed-dose alternative to warfarin for stroke prevention in patients with atrial fibrillation. However, there is minimal evidence to guide the management of bleeding in patients taking a DOAC. We retrospectively evaluated the acute management of major bleeding in this patient population at a large, tertiary academic medical center. We evaluated various strategies of management including dialysis, transfusions, pharmacologic agents, surgical intervention, and reinitiation of anticoagulation. We also assessed length of intensive care unit and hospital stay, mor...
Source: Current Emergency and Hospital Medicine Reports - June 13, 2015 Category: Emergency Medicine Source Type: research

Cardiac risk stratification in patients undergoing endovascular aortic repair.
Authors: Biagi P, de Donato G, Setacci C Abstract Endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAA) is the preferred first treatment option in case of patients with advanced age and/or fit anatomy owing to shorter length of in hospital staying, less complications or laparotomy-related re- interventions, and lower initial costs. Although it is a less-invasive intervention, EVAR entails a risk similar to that of open aortic procedures for medical comorbidities, and a perioperative clinical evaluation is mandatory to minimize the early and late cardiovascular risk. In this brief review the determi...
Source: Minerva Cardioangiologica - November 18, 2015 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research

Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus
We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's...
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

Pregnancy Is Scary Enough Without Having To Worry That a Catholic Hospital Might Turn You Away
Maybe I'm just more attuned to it these days -- your 30s will do that to you -- but lately it feels like everyone I know has a scary story about pregnancy. After the adorable photographs have been posted, the celebratory texts sent, the welcome-back-to-the-world-of-sushi-and-beer meals eaten, they tell you about the darker parts of the experience. The nightmarishly long labor. The NICU. The miscarriages that sometimes came before. The last thing any of these women should have to worry about -- the last thing anyone who is pregnant, or their family, should have to worry about -- is being denied appropriate medical care be...
Source: Healthy Living - The Huffington Post - May 9, 2016 Category: Consumer Health News Source Type: news

Mp200 * the impact of acute kidney injury on in-hospital mortality in acute ischemic stroke patients undergoing intravenous thrombolysis
Source: Nephrology Dialysis Transplantation - May 13, 2016 Category: Urology & Nephrology Authors: Gadalean, F., Simu, M., Joikits, R., Parv, F., Marc, L., Petrica, L., Timar, R., Bob, F., Mihaescu, A., Timar, B., Schiller, A. Tags: ACUTE KIDNEY INJURY. CLINICAL - 2 Source Type: research

Discharge Destination after Elective Femoropopliteal Bypass in Patients without Critical Ischemia.
This study examined the disposition at initial discharge of such patients. Data from the 2012 National Surgical Quality Improvement Program registry was queried for all elective FPB performed in patients without CLI. Analysis was limited to patients surviving to initial discharge who were living independently at home before surgery. Initial disposition was defined as to HOME or to a FACILITY (either rehabilitation or skilled nursing); these constituting the study groups. Univariate analysis and multivariable logistic regression were performed to identify patient risk factors for failure to discharge to home. In-hospital an...
Source: The American Surgeon - April 30, 2016 Category: Surgery Authors: Kauvar DS, Osborne CL Tags: Am Surg Source Type: research

Is moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion superior to deep hypothermic circulatory arrest in elective aortic arch surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion (SACP) is more beneficial than deep hypothermic circulatory arrest in elective aortic arch surgery. Altogether, 1028 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. There were four retrospective obser...
Source: Interactive CardioVascular and Thoracic Surgery - August 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Poon, S. S., Estrera, A., Oo, A., Field, M. Tags: Extracorporeal circulation Adult Cardiac Source Type: research

Factors Associated With Initial Prasugrel Versus Clopidogrel Selection for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From the Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Coronary Heart Disease
We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE‐ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection. Prasugrel use rates and associated 1‐year risk‐adjusted major adverse cardiovascular events and Global Utilization of Streptokinase and t‐PA for Occluded Coronary Arteries (GUSTO) moderate/severe bleeding outcomes were also examined in relation to predicted mortality and bleeding using the validated Ac...
Source: JAHA:Journal of the American Heart Association - September 22, 2016 Category: Cardiology Authors: Vora, A. N., Peterson, E. D., McCoy, L. A., Effron, M. B., Anstrom, K. J., Faries, D. E., Zettler, M. E., Fonarow, G. C., Baker, B. A., Stone, G. W., Wang, T. Y. Tags: Acute Coronary Syndromes, Coronary Artery Disease Original Research Source Type: research

Trends and outcomes of infective endocarditis in patients on dialysis
We examined outcomes of 44 816 patients with IE on dialysis and 202 547 patients with IE not on dialysis from the Nationwide Inpatient Sample database from 2006 thorough 2011. Dialysis patients were younger (59 ± 15 years vs 62 ± 18 years) and more likely to be female (47% vs 40%) and African‐American (47% vs 40%; all P < 0.001). Hospitalizations for IE in the dialysis group increased from 175 to 222 per 10 000 patients (P trend = 0.04). Staphylococcus aureus was the most common microorganism isolated in both dialysis (61%) and nondialysis (45%) groups. IE due to S aureus (adjusted odds ratio [aOR]...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Nirmanmoh Bhatia, Sahil Agrawal, Aakash Garg, Divyanshu Mohananey, Abhishek Sharma, Manyoo Agarwal, Lohit Garg, Nikhil Agrawal, Amitoj Singh, Sudip Nanda, Jamshid Shirani Tags: QUALITY AND OUTCOMES Source Type: research

Risk analysis of dialysis-dependent patients who underwent coronary artery bypass grafting: Effects of dialysis modes on outcomes
This study aimed to stratify the risk factors and effects of dialysis modes in relation to coronary artery bypass grafting (CABG) surgery among dialysis-dependent patients. This retrospective study enrolled dialysis-dependent patients who underwent CABG from October 2005 to January 2015. All data of demographics, medical history, surgical details, postoperative complications, and in-hospital mortality were analyzed, and patients were categorized as those with or without in-hospital mortality and those with preoperative hemodialysis (HD) or peritoneal dialysis (PD). Of 134 enrolled patients, 25 (18.7%) had in-hospital mor...
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Comparison of Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Chronic Kidney Disease
There are few data comparing outcomes of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) in patients with chronic kidney disease (CKD). In this retrospective cohort study using the National Inpatient Sample 2011 – 2014, we included a total of 2820 TAVI and 4054 SAVR procedures, representative of 14,039 TAVI and 19,835 SAVR procedures nationally. Co-primary outcomes were in-hospital mortality, acute kidney injury (AKI), dialysis-requiring AKI, and post-operative stroke.
Source: The American Journal of Cardiology - October 31, 2017 Category: Cardiology Authors: Nilay Kumar, Rohan Khera, Neetika Garg, Justin B. Echouffo-Tcheugui, Anand Venkatraman, Ambarish Pandey, Deepak L. Bhatt Source Type: research

10 Global Health Issues to Watch in 2018
January 19, 2018It ’s notallbad news.When we set out to compile our annual list of global health issues to watch this year, it seemed like all bad news. And true, that ’s often what we deal with in global health—the problems that need tackling, the suffering we can help alleviate.But then stories and columns likethis one cheer us up. They remind us that no matter how complicated and frustrating our work may get, fighting back against poverty and inequality works.There are and always will be global health challenges to face. But there ’s boundless hope, too. And a field full of determined health workers and other hu...
Source: IntraHealth International - January 19, 2018 Category: International Medicine & Public Health Authors: mnathe Source Type: news

Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.
We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Impact of Indoxyl Sulfate on Coronary Plaques in Patients on Hemodialysis.
This study aimed to interpret the association between serum IS levels and coronary plaque burden (CPB) or CAC.A total of 30 consecutive patients on hemodialysis, who underwent 320-row coronary multidetector computed tomography (MDCT) angiography for suspected coronary artery disease, were enrolled in this prospective study. Coronary artery percent atheroma volume (a CPB marker) and percent calcium volume (a CAC marker) assessed using MDCT were evaluated. Furthermore, various oxidative and inflammatory markers typified by serum IS levels at a dialysis-free day were measured. Using these data, we investigated correlation bet...
Source: International Heart Journal - May 11, 2018 Category: Cardiology Tags: Int Heart J Source Type: research