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2.
Artigo em Inglês | MEDLINE | ID: mdl-34444292

RESUMO

BACKGROUND: Cardiovascular diseases (CVDs) are the number one cause of death globally. Most can be prevented by addressing behavioral risk factors, where advanced practice nurses- clinical specialists in cardiovascular nursing play a fundamental role. This modern and effective role is based on advanced activities, knowledge, skills, and experience in a specialized field, which can make a significant contribution to solving the problems of these civilization diseases. The aim of this work is to explore the self-perception of advanced-practice nurses (APNs) working in cardiology and vascular medicine departments within the context of advanced-practice nursing. METHODS: This quantitative exploratory study included 103 APNs working in cardiology and vascular diseases departments of specialized hospitals in Slovakia. A validated instrument was used. RESULTS: The overall perception was at the level of 68.01%. The highest-rated domain was the outcomes for patients/clients, and subdomains were meeting the needs, education of healthcare workers, and quality in relation to management. There was a significant difference found among hospitals with a better scoring of specialized institutions. CONCLUSION: There have been promising advances due to the current legislation in Slovakia defining APNs and specialists' competencies. However, the practice in nursing for CVD patients remains fragmented, uncategorized and less valued by stakeholders and the public. According to the results, nurses have the potential and preparedness for this role in the context of their knowledge and skills in general. The Authors conclude that there is a need of such specialization of APNs in Slovakia.


Assuntos
Prática Avançada de Enfermagem , Cardiologia , Hospitais , Humanos , Eslováquia
3.
AMIA Annu Symp Proc ; 2021: 267-275, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457141

RESUMO

Errors and incompleteness in electronic health record (EHR) medication lists can result in medical errors. To reduce errors in these medication lists, clinicians use patient self-reported data to reconcile EHR data. We assessed the agreement between patient self-reported medications and medications recorded in the EHR for six medication classes related to cardiovascular care and used logistic regression models to determine which patient-related factors were associated with the disagreement between these two information sources. From our 297 patients, we found self-reported medications had an overall above-average agreement with the EHR (? = .727). We observed the highest agreement level for statins (? = .831) and the lowest for other antihypertensives (? = .465). Agreement was less likely for Hispanic and male patients. We also performed an in-depth error analysis of different types of disagreement beyond medication names, which revealed that the most frequent type of disagreement was mismatched dosages.


Assuntos
Cardiologia , Registros Eletrônicos de Saúde , Anti-Hipertensivos , Humanos , Masculino
4.
Curr Cardiol Rep ; 23(10): 136, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34410520

RESUMO

PURPOSE OF REVIEW: To describe the INTERASPIRE scientific protocol-an international survey of secondary prevention of coronary heart disease (CHD). RECENT FINDINGS: This international survey is being conducted through National Societies of Cardiology in selected countries from each of the six WHO regions and has the following overall aims: (i) describe prevalence of cardiometabolic and renal risk factors together with biomarkers in CHD patients; (ii) describe current risk factor management through lifestyle changes and cardioprotective drug therapies; (iii) provide an objective assessment of clinical implementation of preventive care by comparison with the lifestyle and risk factor targets defined in international and national guidelines; (iv) investigate the reasons for variation in preventive cardiology practice between regions and countries; and (v) promote the principles of best preventive cardiology practice. This international survey will provide a unique picture of CHD patients; their cardiometabolic, renal and biomarker status; lifestyle and therapeutic management; and the quality of preventive care provided in all WHO regions.


Assuntos
Cardiologia , Doença das Coronárias , Doença das Coronárias/prevenção & controle , Humanos , Fatores de Risco , Inquéritos e Questionários , Organização Mundial da Saúde
5.
Artigo em Inglês | MEDLINE | ID: mdl-34399567

RESUMO

PURPOSE: During medical residency programs, physicians develop their professional identities as specialists and encounter high expectations in terms of achieving competencies. The responsibilities of medical trainees include caring for patients, balancing work with personal life, and weathering stress, depression, and burnout. Formal academic mentoring programs strive to ease these burdens. The coronavirus disease 2019 (COVID-19) pandemic has altered the trainee­academic mentor relationship, and solutions are needed to address these challenges. The present study aimed to evaluate the formal academic mentoring process through trainees' perceptions and expectations of formal mentoring programs during COVID-19 in Indonesian cardiology residency programs. METHODS: This cross-sectional study used a self-administered online questionnaire to capture trainees' perceptions and expectations regarding academic mentoring programs in 3 cardiology residency programs in Indonesia from October to November 2020. The questionnaire was developed before data collection. Perceptions of the existing mentoring programs were compared with expectations. RESULTS: Responses were gathered from 169 out of 174 residents (response rate, 97.3%). Most trainees reported having direct contact with COVID-19 patients (88.82%). They stated that changes had taken place in the mode and frequency of communication with their academic advisors during the pandemic. Significant differences were found between trainees' perceptions of the existing mentoring programs and their expectations for academic mentoring programs (P<0.001). CONCLUSION: Despite the challenges of interacting with their academic mentors, trainees still perceived academic mentors as a vital resource. Study programs need to consider trainees' expectations when designing academic mentoring programs.


Assuntos
COVID-19 , Cardiologia , Internato e Residência , Tutoria , Estudos Transversais , Humanos , Indonésia , Mentores , Motivação , Pandemias , Percepção , SARS-CoV-2 , Inquéritos e Questionários
8.
Front Public Health ; 9: 701878, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34368064

RESUMO

The effect of the reportedly low ionizing radiation doses, such as those very often delivered to patients in interventional cardiology, remains ambiguous. As interventional cardiac procedures may have a significant impact on total collective effective dose, there are radiation protection concerns for patients and physicians regarding potential late health effects. Given that very low doses (<100 mSv) are expected to be delivered during these procedures, the purpose of this study was to assess the potency and suitability of current genotoxicity biomarkers to detect and quantitate biological effects essential for risk estimation in interventional cardiology. Specifically, the biomarkers γ-H2AX foci, dicentric chromosomes, and micronuclei, which underpin radiation-induced DNA damage, were studied in blood lymphocytes of 25 adult patients before and after interventional cardiac procedures. Even though the mean values of all patients as a group for all three endpoints tested show increased yields relative to baseline following medical exposure, our results demonstrate that only the γ-H2AX biomarker enables detection of statistically significant differences at the individual level (p < 0.001) for almost all patients (91%). Furthermore, 24 h after exposure, residual γ-H2AX foci were still detectable in irradiated lymphocytes. Their decline was found to vary significantly among the individuals and the repair kinetics of γ-H2AX foci was found to range from 25 to 95.6% of their maximum values obtained.


Assuntos
Cardiologia , Lesões por Radiação , Adulto , Biomarcadores , Dano ao DNA , Relação Dose-Resposta à Radiação , Histonas/genética , Humanos
9.
J Assoc Physicians India ; 69(7): 11-12, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34431279
10.
Arch. argent. pediatr ; 119(4): 273-: I-276, VI, agosto 2021. Tab, graf
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1280991

RESUMO

La incidencia del paro cardíaco pediátrico es desconocida; sus principales etiologías son cardiopatías congénitas, miocardiopatías y arritmias ventriculares. El electrocardiograma es un método diagnóstico que podría detectarlas precozmente y disminuir la morbimortalidad. El objetivo del estudio fue describir las habilidades de residentes de Pediatría para reconocer si un electrocardiograma era normal o anormal y realizar un diagnóstico electrocardiográfico preciso, antes y después de una intervención educativa. Participaron médicos residentes de primer año de Pediatría. Se tomó una evaluación con 12 trazados de electrocardiogramas, antes y después de un módulo educativo, y se compararon los puntajes mediante la prueba de "t" para datos pareados. No se halló diferencia entre ambas evaluaciones para la interpretación de electrocardiogramas como normales o anormales (p: 0,42). Sin embargo, hubo una diferencia estadísticamente significativa en cuanto a los diagnósticos de certeza (p < 0,002). Los diagnósticos de certeza electrocardiográficos mejoraron luego de implementar un módulo educacional


The incidence of pediatric cardiac arrest is unknown; its main etiologies are congenital heart diseases, cardiomyopathies, and ventricular arrhythmias. An electrocardiogram (ECG) is a diagnostic method that may allow to detect them in an early manner and reduce morbidity and mortality.The objective of this study was to describe pediatric residents' skills to determine if an ECG was normal or abnormal and make an accurate electrocardiographic diagnosis before and after an educational intervention. First-year pediatric residents participated in this study. An assessment including 12 ECG tracings was done before and after an educational module, and scores were compared using the t-test for paired data. No differences were observed between both assessments regarding the interpretation of ECG as normal or abnormal (p: 0.42). However, a statistically significant difference was observed in definitive diagnoses (p < 0.002). Definitive electrocardiographic diagnoses improved after the implementation of an educational module.


Assuntos
Humanos , Cardiologia/educação , Educação Médica , Eletrocardiografia , Competência Clínica , Ensaios Clínicos Controlados não Aleatórios como Assunto , Internato e Residência
11.
Cardiol Young ; 31(7): 1205-1206, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34236020
12.
Artigo em Inglês | MEDLINE | ID: mdl-34300069

RESUMO

Intravenous therapy administration through peripheral venous catheters is one of the most common nursing procedures performed in clinical contexts. However, peripherally inserted central catheters (PICC) remain insufficiently used by nurses and can be considered a potential alternative for patients who need aggressive intravenous therapy and/or therapy for extended periods. The purpose of this study was to understand nurses' perspectives about PICC implementation in their clinical practice. As part of an action-research project, three focus groups were developed in June 2019 with nineteen nurses of a cardiology ward from a Portuguese tertiary hospital. From the content analysis, two main categories emerged: 'nursing practices' and 'patients'. Nurses considered PICC beneficial for their clinical practice because it facilitates maintenance care and catheter replacement rates. Moreover, nurses suggested that, since there is a need for specific skills, the constitution of vascular access teams, as recommended by international guidelines, could be an advantage. Regarding patient benefits, nurses highlighted a decrease in the number of venipunctures and also of patient discomfort, which was associated with the number of peripheral venous catheters. Infection prevention was also indicated. As an emerging medical device used among clinicians, peripherally inserted central catheters seem to be essential to clinical practice.


Assuntos
Cardiologia , Cateterismo Venoso Central , Enfermeiras e Enfermeiros , Cateterismo Venoso Central/efeitos adversos , Cateteres , Grupos Focais , Humanos
13.
Epilepsy Behav ; 122: 108188, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34252834

RESUMO

OBJECTIVE: To determine cardiologist knowledge of and experience with seizure-related bradyarrhythmias and sudden unexpected death in epilepsy (SUDEP). BACKGROUND: Autonomic changes related to acute seizures are common and can occur during the ictal or postictal period. Two concerning changes in these periods are significant bradycardia and asystole. Postictal asystole has been investigated as a potential mechanism for SUDEP. METHODS: A 27-question survey delivered to cardiologists and cardiology fellows assessed demographics, personal experience, and training involving SUDEP and seizure-related bradycardia and asystole. Following IRB approval, a list of US cardiology fellowships was constructed using the AAMC public website. Surveys were distributed by email to all programs whose program director or coordinator's email was readily available on their website. They were asked to forward the survey to both cardiology fellows and practicing cardiologists. RESULTS: Fifty one surveys were completed: 23 from fellows and 28 from practicing cardiologists. Forty nine were from academic centers. Twenty four respondents (47%) reported being consulted for ictal bradycardia or asystole. Nine and 13 recommended treatment for ictal bradycardia or ictal asystole, respectively. Nineteen respondents (37%) reported being consulted for postictal bradycardia or asystole. Eight recommended treatment for postictal bradycardia or asystole, respectively. Treatment recommendations included medical management and/or pacemaker. None reported a substantial knowledge of SUDEP. The most common response interrogating SUDEP awareness (63%) was "no knowledge of SUDEP". Formal SUDEP education was not reported by any participant with only one reporting formal didactics regarding seizure-related arrhythmias. DISCUSSION: Our results suggest ictal bradyarrhythmias are less commonly known to cardiologists, with SUDEP awareness being far less. Formal education to cardiologists on these two topics could prove beneficial at the intersection of cardiology and care for patients with epilepsy.


Assuntos
Cardiologia , Morte Súbita Inesperada na Epilepsia , Bradicardia/complicações , Bradicardia/terapia , Eletroencefalografia , Humanos , Convulsões/complicações , Convulsões/terapia , Inquéritos e Questionários
14.
Nicolau, José Carlos; Filho, Gilson Soares Feitosa; Petriz, João Luiz; Furtado, Remo Holanda de Mendonça; Précoma, Dalton Bertolim; Lemke, Walmor; Lopes, Renato Delascio; Timerman, Ari; Marin-Neto, José A; Neto, Luiz Bezerra; Gomes, Bruno Ferraz de Oliveira; Santos, Eduardo Cavalcanti Lapa; Piegas, Leopoldo Soares; Soeiro, Alexandre de Matos; Negri, Alexandre Jorge de Andrade; Franci, Andre; Filho, Brivaldo Markman; Baccaro, Bruno Mendonça; Montenegro, Carlos Eduardo Lucena; Rochitte, Carlos Eduardo; Barbosa, Carlos José Dornas Gonçalves; Virgens, Cláudio Marcelo Bittencourt das; Stefanini, Edson; Manenti, Euler Roberto Fernandes; Lima, Felipe Gallego; Monteiro Jr, Francisco das Chagas; Filho, Harry Correa; Pena, Henrique Patrus Mundim; Pinto, Ibraim Masciarelli Francisco; Falcão, João Luiz de Alencar Araripe; Sena, Joberto Pinheiro; Peixoto, José Maria; Souza, Juliana Ascenção de; Silva, Leonardo Sara da; Maia, Lilia Nigro; Ohe, Louis Nakayama; Baracioli, Luciano Moreira; Dallan, Luís Alberto de Oliveira; Dallan, Luis Augusto Palma; Mattos, Luiz Alberto Piva e; Bodanese, Luiz Carlos; Ritt, Luiz Eduardo Fonteles; Canesin, Manoel Fernandes; Rivas, Marcelo Bueno da Silva; Franken, Marcelo; Magalhães, Marcos José Gomes; Júnior, Múcio Tavares de Oliveira; Filho, Nivaldo Menezes Filgueiras; Dutra, Oscar Pereira; Coelho, Otávio Rizzi; Leães, Paulo Ernesto; Rossi, Paulo Roberto Ferreira; Soares, Paulo Rogério; Neto, Pedro Alves Lemos; Farsky, Pedro Silvio; Cavalcanti, Rafael Rebêlo C; Alves, Renato Jorge; Kalil, Renato Abdala Karam; Esporcatte, Roberto; Marino, Roberto Luiz; Giraldez, Roberto Rocha Corrêa Veiga; Meneghelo, Romeu Sérgio; Lima, Ronaldo de Souza Leão; Ramos, Rui Fernando; Falcão, Sandra Nivea dos Reis Saraiva; Dalçóquio, Talia Falcão; Lemke, Viviana de Mello Guzzo; Chalela, William Azem; Júnior, Wilson Mathias.
Arq. bras. cardiol ; 117(1): 181-264, July. 2021. graf, ilus, tab
Artigo em Português | Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1283725
15.
Intern Med J ; 51(8): 1229-1235, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34227713

RESUMO

BACKGROUND: The use of telehealth has increased dramatically in Australia in 2020 as a pragmatic response to the COVID-19 pandemic; however, differences between telehealth modalities have not been established. AIM: To identify characteristics contributing to choosing telephone (TP) versus video consultation (VC) and assess patient outcomes between telehealth modalities. METHODS: We conducted an observational study of cardiology outpatients at a tertiary hospital with appointments from 17 March 2020 to 12 August 2020. Demographic variables and appointment modality were compared between each group. Outcomes assessed were mortality, emergency department (ED) presentations and cross over between appointment modalities. RESULTS: There were 1754 telemedicine encounters with 1188 patients seen by TP and 327 patients by VC. Consulting volume increased from previous years. Cardiac mortality was low (0.3%). There were no differences in mortality or ED presentations between telehealth modalities. Patients choosing TP over VC were older (P < 0.001), more likely to be female (P = 0.005), non-English-speaking (P = 0.041), living in metropolitan Melbourne (P < 0.0001), undertaking a first appointment (P = 0.002) and seeing particular cardiologists (P < 0.001). VC patients were more likely to have early review (P = 0.015), and this was likely to be TP (P < 0.0001). TP patients were more likely to follow up in person (P < 0.0001). CONCLUSION: During COVID-19, we increased consultation volumes without adverse patient outcomes. We identified factors influencing the choice of telemedicine modality which did not translate into differences in mortality or ED presentations. Telemedicine is a growing platform with an important role of facilitating access to healthcare for diverse patient groups.


Assuntos
COVID-19 , Cardiologia , Telemedicina , Austrália/epidemiologia , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2 , Telefone
17.
Rev Port Cardiol (Engl Ed) ; 40(7): 501-504, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34274097

RESUMO

gA ender gap is apparent in several professional areas, including in Medicine and particularly in the Cardiovascular field. We present a brief review of the subject and we analyse data from the Portuguese Journal of Cardiology regarding women authorship.


Assuntos
Autoria , Cardiologia , Grupos Étnicos , Feminino , Humanos , Portugal , Fatores Sexuais
20.
Herzschrittmacherther Elektrophysiol ; 32(3): 335-340, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34251502

RESUMO

Patients with primary neurogenic disorders such as pure autonomic failure or multiple system atrophy may initially present with cardiocirculatory symptoms such as orthostatic intolerance or fluctuations in heart rate with symptomatic tachycardia. It is therefore clinically important to identify such patients since circulatory manifestations are only one of a series of symptoms resulting from autonomic dysfunction in various organ systems. These patients require a multimodal diagnostic and therapeutic approach and should undergo extensive evaluation in a specialized autonomic nervous system (ANS) outpatient unit. Based on a clinical case presentation, the current review summarizes the diagnostic and therapeutic approach to key cardiovascular symptoms of primary autonomic disorders and their neurological work-up in a specialized autonomic function laboratory.


Assuntos
Doenças do Sistema Nervoso Autônomo , Cardiologia , Hipotensão Ortostática , Neurologia , Intolerância Ortostática , Doenças do Sistema Nervoso Autônomo/diagnóstico , Doenças do Sistema Nervoso Autônomo/terapia , Humanos
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