Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 62.410
Filtrar
1.
Kyobu Geka ; 73(10): 855-861, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130779

RESUMO

Recent changes in the demographics of surgical candidates, in terms of age, have increased the number of patients with surgical risk factors. In patients with preoperative cardiac diseases such as myocardial ischemia, arrhythmia, or congestive heart failure, it is important to offer any necessary preoperative medical examinations and treatments because postoperative cardiac failure is more of a concern in patients with already abnormal cardiac physiology, undergoing significant lung resection. Thoracic surgeons should be challenged by another conundrum to accurately select the best candidates for surgical treatment. Usually perioperative management of antithrombotic therapy in patients who need general thoracic operations such as lung cancer surgery after coronary artery stent placement or valve replacement have made recommendations, and heparinization is needed for patients with atrial fibrillation for prevention of thrombo-embolism. It is sometimes used in clinical practice as bridging therapy during the period of discontinuation of antiplatelet therapy for patients with cardiac complications after several cardiac surgery. As points to be aware of regarding surgical operations, minimal invasive surgery probably should be performed if possible.


Assuntos
Doença da Artéria Coronariana , Cardiopatias , Insuficiência Cardíaca , Cirurgia Torácica , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/terapia , Humanos , Assistência Perioperatória , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco
2.
BMC Cardiovasc Disord ; 20(1): 479, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33167876

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic. Studies showed COVID-19 affected not only the lung but also other organs. In this study, we aimed to explore the cardiac damage in patients with COVID-19. METHODS: We collected data of 100 patients diagnosed as severe type of COVID-19 from February 8 to April 10, 2020, including demographics, illness history, physical examination, laboratory test, and treatment. In-hospital mortality were observed. Cardiac damage was defined as plasma hypersensitive troponin I (hsTnI) over 34.2 pg/ml and/or N-terminal-pro brain natriuretic peptide (NTproBNP) above 450 pg/ml at the age < 50, above 900 pg/ml at the age < 75, or above 1800 pg/ml at the age ≥ 75. RESULTS: The median age of the patients was 62.0 years old. 69 (69.0%) had comorbidities, mainly presenting hypertension, diabetes, and cardiovascular disease. Fever (69 [69.0%]), cough (63 [63.0%]), chest distress (13 [13.0%]), and fatigue (12 [12.0%]) were the common initial symptoms. Cardiac damage occurred in 25 patients. In the subgroups, hsTnI was significantly higher in elder patients (≥ 60 years) than in the young (median [IQR], 5.2 [2.2-12.8] vs. 1.9 [1.9-6.2], p = 0.018) and was higher in men than in women (4.2 [1.9-12.8] vs. 2.9 [1.9-7.4], p = 0.018). The prevalence of increased NTproBNP was significantly higher in men than in women (32.1% vs. 9.1%, p = 0.006), but was similar between the elder and young patients (20.0% vs. 25.0%, p = 0.554). After multivariable analysis, male and hypertension were the risk factors of cardiac damage. The mortality was 4.0%. CONCLUSIONS: Cardiac damage exists in patients with the severe type of COVID-19, especially in male patients with hypertension. Clinicians should pay more attention to cardiac damage.


Assuntos
Infecções por Coronavirus/complicações , Cardiopatias/etiologia , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Pneumonia Viral/complicações , Fatores Etários , Idoso , Biomarcadores/sangue , China , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Feminino , Cardiopatias/diagnóstico , Cardiopatias/mortalidade , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Troponina I/sangue
3.
Sci Rep ; 10(1): 16384, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009426

RESUMO

The COVID-19 outbreak is becoming a public health emergency. Data are limited on the clinical characteristics and causes of death. A retrospective analysis of COVID-19 deaths were performed for patients' clinical characteristics, laboratory results, and causes of death. In total, 56 patients (72.7%) of the decedents (male-female ratio 51:26, mean age 71 ± 13, mean survival time 17.4 ± 8.4 days) had comorbidities. Acute respiratory failure (ARF) and sepsis were the main causes of death. Increases in C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer and lactic acid and decreases in lymphocytes were common laboratory results. Intergroup analysis showed that (1) most female decedents had cough and diabetes. (2) The proportion of young- and middle-aged deaths was higher than elderly deaths for males, while elderly decedents were more prone to myocardial injury and elevated CRP. (3) CRP and LDH increased and cluster of differentiation (CD) 4+ and CD8+ cells decreased significantly in patients with hypertension. The majority of COVID-19 decedents are male, especially elderly people with comorbidities. The main causes of death are ARF and sepsis. Most female decedents have cough and diabetes. Myocardial injury is common in elderly decedents. Patients with hypertension are prone to an increased inflammatory index, tissue hypoxia and cellular immune injury.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Sepse/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Causas de Morte , China , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Diabetes Mellitus/epidemiologia , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Cardiopatias/epidemiologia , Humanos , L-Lactato Desidrogenase/sangue , Ácido Láctico/sangue , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Sepse/etiologia , Síndrome Respiratória Aguda Grave/etiologia
5.
Rev Prat ; 70(5): 555-560, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-33058647

RESUMO

How to reduce the sudden nontraumatic death related to sport risk? Sport's related sudden cardiac death (SCD) is still dramatically perceived and often widely publicized. In case of SCD sport's practice reveals a heart disease that is mainly overlooked. In a society under the influence of the precautionary principle, preventing SCD seems essential. However, implementing effective SCD prevention is not easy. Among the three most often preventive actions proposed, the pre-participation screening evaluation, the athlete's education, and the population education for resuscitation maneuvers, the pre-participation evaluation currently seems to have the most difficulty in proving its effectiveness.


Assuntos
Cardiopatias , Esportes , Atletas , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/prevenção & controle , Humanos , Programas de Rastreamento
7.
Vasc Health Risk Manag ; 16: 379-387, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061399

RESUMO

Background: Currently, cardiovascular diseases (CVDs) are rising in the world and require great concern because the consequences are not only morbidity and mortality, but also a high economic burden. However, the pattern of CVDs in Ethiopia is not well known. Therefore, this study aimed to describe CVD and co-existing morbidities among newly registered cardiac patients in Hawassa University Comprehensive Specialized Hospital. Methods: A retrospective cross-sectional study was conducted from January 1 to December 31, 2016 among newly registered cardiac patients in an adult cardiac referral clinic. Records and cardiac referral clinic logbooks were used to collect relevant information using structured checklists. Results: Of the total 310 records of cardiac patients, 236 were explored and included in the study, while the records of 74 patients were absent in the cards room when tracing and/or incomplete to assess cardiac pattern. Rheumatic heart disease (RHD) was the leading cardiac problem and diagnosed in 70 (29.7%) cases followed by non-ischemic cardiomyopathy (55, 23.3%), ischemic heart disease (41, 17.4%), hypertensive heart disease (29, 12.3%), and cor pulmonale (14, 5.9%). The mean age of RHD patients was 28.7 (±13.1) years. Eighty-two (35%) females and 23 (19.8%) males had RHD, while 69 (29.2%) females and 23 (19.8%) males had non-ischemic cardiomyopathy. The overall rate of mitral stenosis, mitral regurgitation, and aortic regurgitation among patients with RHD were 39 (55.7%), 48 (68.6%), and 26 (37.1%), respectively. Moreover, the overall coexisted morbidity was 81 (34.3%), with a high rate of hypertension alone at 44 (18.6%) followed by hypertension with diabetes at 11 (4.7%). Conclusion: This study indicated that more than one-third of cardiac patients had at least one of the co-existing morbidities like hypertension, diabetes mellitus, asthma and other diseases. Therefore, careful diagnosis and management of cardiac patients plays an important role to minimize comorbidity-linked complications. Moreover, population-based studies are recommended for better representing and generalization.


Assuntos
Cardiopatias/epidemiologia , Hospitais Universitários , Adolescente , Adulto , Idoso , Comorbidade , Estudos Transversais , Etiópia/epidemiologia , Feminino , Cardiopatias/diagnóstico , Cardiopatias/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto Jovem
8.
BMC Infect Dis ; 20(1): 769, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33076855

RESUMO

BACKGROUND: Norwegian children are more frequently hospitalized with influenza than adults. Little is known about the characteristics of these children. Our aim was to investigate the presence of pre-existing risk conditions and to determine the duration of influenza hospitalizations in children during two influenza seasons. METHODS: The Norwegian Patient Registry holds data on all hospitalized patients in Norway. We included all patients younger than 18 years hospitalized with a diagnosis of influenza during the influenza seasons 2017-18 and 2018-19. Pre-existing risk conditions for influenza were identified by ICD-10 diagnoses in the Norwegian Patient Registry. In addition, information on asthma diagnoses were also retrieved from the Norwegian Registry for Primary Health Care. To estimate the prevalence of risk conditions in the child population, we obtained diagnoses on all Norwegian children in a two-year period prior to each influenza season. We calculated age-specific rates for hospitalization and risk for being hospitalized with influenza in children with risk conditions. RESULTS: In total, 1013 children were hospitalized with influenza during the two influenza seasons. Children younger than 6 months had the highest rate of hospitalization, accounting for 13.5% of all admissions (137 children). Hospitalization rates decreased with increasing age. Among children hospitalized with influenza, 25% had one or more pre-existing risk conditions for severe influenza, compared to 5% in the general population under 18 years. Having one or more risk conditions significantly increased the risk of hospitalization, (Odds Ratio (OR) 6.1, 95% confidence interval (CI) 5.0-7.4 in the 2017-18 season, and OR 6.8, 95% CI 5.4-8.4 in the 2018-19 season). Immunocompromised children and children with epilepsy had the highest risk of hospitalization with influenza, followed by children with heart disease and lung disease. The average length of stay in hospital were 4.6 days, and this did not differ with age. CONCLUSION: Children with pre-existing risk conditions for influenza had a higher risk of hospitalization for influenza. However, most children (75%) admitted to hospital with influenza in Norway during 2017-2019 did not have pre-existing risk conditions. Influenza vaccination should be promoted in particular for children with risk conditions and pregnant women to protect new-borns.


Assuntos
Hospitalização , Influenza Humana/complicações , Adolescente , Criança , Pré-Escolar , Feminino , Cardiopatias/complicações , Hospitalização/estatística & dados numéricos , Humanos , Hospedeiro Imunocomprometido , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Pneumopatias/complicações , Masculino , Noruega/epidemiologia , Razão de Chances , Cobertura de Condição Pré-Existente , Medição de Risco , Estações do Ano
9.
Eur J Endocrinol ; 183(6): R185-R196, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33077688

RESUMO

Primary aldosteronism is common and contributes to adverse cardiovascular, kidney, and metabolic outcomes. When instituted early and effectively, targeted therapies can mitigate these adverse outcomes. Surgical adrenalectomy is among the most effective treatments because it has the potential to cure, or attenuate the severity of, pathologic aldosterone excess, resulting in a host of biochemical and clinical changes that improve health outcomes. Herein, we review the role of surgical adrenalectomy in primary aldosteronism while emphasizing the physiologic ramifications of surgical intervention, and compare these to other targeted medical therapies for primary aldosteronism. We specifically review the role of curative adrenalectomy for unilateral primary aldosteronism, the role of non-curative adrenalectomy for bilateral primary aldosteronism, and how these interventions influence biochemical and clinical outcomes in relation to medical therapies for primary aldosteronism.


Assuntos
Adrenalectomia/tendências , Aldosterona/sangue , Hiperaldosteronismo/sangue , Hiperaldosteronismo/cirurgia , Adrenalectomia/métodos , Doenças do Sistema Endócrino/sangue , Doenças do Sistema Endócrino/cirurgia , Cardiopatias/sangue , Cardiopatias/prevenção & controle , Humanos , Nefropatias/sangue , Nefropatias/prevenção & controle
12.
J Pharm Pharm Sci ; 23: 396-405, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33086028

RESUMO

- Purpose: Since December 2019, coronavirus disease 2019 infection has become a global pandemic. The cases of Coronavirus Disease 2019 (COVID-19)-related acute cardiac injury with unknown pathophysiologic mechanism has become increasingly prevalent. However, it is not yet understood how the extent of cardiac injury differs with the intensity of viral infection.  In the current study, we aimed to assess the association between elevated cardiac biomarkers and the severity of COVID-19 infection. METHODS: A systematic literature search was performed across PubMed and Embase databases from December 1, 2019 to July 10, 2020, to identify studies that reported cardiac biomarkers of troponin (TnI) and creatine kinase-myocardial band (CK-MB) in patients with COVID-19. These studies compared non-severe patients with severe patients, or survivors with non-survivors or medical patients with critically ill patients. The data were extracted for TnI, CK-MB, N-terminal-brain natriuretic peptide (NT-BNP), D-dimer, and lactate dehydrogenase (LDH), C-reactive protein (CRP), and interleukin 6 (IL-6). Wherever possible, the data were pooled for meta-analysis (Review Manager, RevMan. version 5.3) with standard or weighted mean or median difference and corresponding 95% confidence intervals (95% CI). RESULTS: A total of 25 studies involving 5,626 patients were included in the present analysis. More severe COVID-19 infection was found to be associated with higher mean values of TnI (-0.54 [-0.72, -0.36]) (ng/mL), CK-MB (-1.55 [-2.23, -0.88]) (ng/mL) and (-4.75 [-13.31, 3.82]) (units/L), NT-BNP (-815.7 [-1073.97, -557.42]) (pg/mL), D-dimer (-1.4 [-2.04, -0.77]) (mcg/mL), and LDH (-176.59 [-224.11, -129.06]) (units/L), as well as CRP (-64.03 [-68.88, -59.19]) (mg/L) and IL-6 (-22.59 [-29.39, -15.79]) (pg/mL). CONCLUSIONS: There is significant association between elevated cardiac biomarkers and the severity of COVID-19, which underlines the increased risk of acute cardiac injury with more severe viral infection. This highlights the need to understand the cardiac history among the COVID-19 patients during initial assessment and for monitoring.


Assuntos
Biomarcadores/análise , Infecções por Coronavirus/complicações , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Pneumonia Viral/complicações , Humanos , Pandemias
13.
Internist (Berl) ; 61(11): 1132-1139, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33034675

RESUMO

BACKGROUND: Oncological therapies show a number of undesired adverse effects on the cardiovascular system. In particular, the side effects of recently established oncological therapies are incompletely understood and clinical data are lacking in the interpretation of novel cardiac complications. OBJECTIVE: This article provides a short overview of the mechanisms of cardiac side effects of certain oncological therapies. MATERIAL AND METHODS: The review is mainly based on data from preclinical studies. RESULTS: Numerous toxic side effects have already been described and investigated in preclinical models. For certain groups of drugs (e.g. anthracyclines, tyrosine kinase inhibitors and immune checkpoint inhibitors) the underlying molecular mechanisms are still not fully understood. CONCLUSION: An improved understanding of the molecular mechanism involved in cardiotoxicity might help improve the quality of clinical decisions. Additionally, it will provide new insights into the pathophysiology of cardiac diseases. The aim is to use the results of translational research and to clinically implement them in suitable cardio-oncology units.


Assuntos
Antineoplásicos/efeitos adversos , Cardiotoxicidade , Cardiopatias/induzido quimicamente , Neoplasias/tratamento farmacológico , Humanos , Oncologia
14.
Internist (Berl) ; 61(11): 1120-1124, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33052455

RESUMO

As a result of the continuous development of modern cancer treatment, more cancer patients can be cured every year. However, since many patients experience cardiovascular problems before, during and after their cancer treatment, cardio-oncology is becoming increasingly important. Numerous therapies can cause cardiotoxicity, such as chemotherapy, immunotherapy, antibody therapy and radiotherapy. If these remain undetected, the patient may develop, e.g. heart failure or severe heart valve damage. The broad spectrum of cardiovascular comorbidities has become an immense challenge for cardiologists and oncologists. Cardio-oncology also deals with the effects that cancer has on the cardiovascular system. New research indicates that the tumor itself also has direct negative effects on the heart, mediated by messenger substances. Therefore, it is important to understand which cancer patients are at increased cardiovascular risk, thereby enabling the development of new therapeutic approaches in the long term to maintain mobility and improve patient prognosis.


Assuntos
Antineoplásicos/efeitos adversos , Cardiotoxicidade , Sistema Cardiovascular/efeitos dos fármacos , Cardiopatias/induzido quimicamente , Coração/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Antineoplásicos/uso terapêutico , Humanos , Oncologia
15.
Internist (Berl) ; 61(11): 1125-1131, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33025122

RESUMO

This article provides an overview of current prevention and treatment options for typical cardiovascular side effects of oncological therapies as well as cardiovascular complications of malignant disease. Focus is put on the prevention and treatment of heart failure under potentially cardiotoxic cancer therapies. In addition, current options for the treatment of common venous thromboembolism in cancer patients will be discussed.


Assuntos
Antineoplásicos/efeitos adversos , Cardiotoxicidade , Cardiopatias/induzido quimicamente , Neoplasias/tratamento farmacológico , Cardiotoxicidade/prevenção & controle , Humanos , Oncologia/tendências , Neoplasias/complicações
16.
Internist (Berl) ; 61(11): 1114-1119, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33025124

RESUMO

In recent decades, major advances in the treatment of malignant diseases have significantly improved long-term survival. However, this has increased the spectrum of side effects of these treatment methods, particularly for the cardiovascular system. Cardiotoxicity can be acute and chronic, including hypertension, heart failure, arrhythmias, acute myocardial infarction, venous thromboembolism, stroke, and valvular heart disease. While the occurrence of cardiotoxicity is known for many older cancer therapies, it needs to be largely evaluated for newer forms of therapy. Diagnosing possible cardiotoxic side effects is essential for optimal treatment, but remains a challenge. Troponin and the natriuretic peptides play an essential role as cardiac biomarkers in the diagnosis of conventional heart diseases. However, they also appear to play an important role in the detection of cardiotoxicity, as well as in the treatment of cardio-oncology patients. Elevated troponin or B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels are associated with increased overall mortality and were associated with the development of heart failure in selected cohorts. Troponin can also be used to identify myocarditis associated with immune checkpoint inhibitor therapy. This overview summarizes the current knowledge about biomarkers for the detection of cardiotoxicity due to tumor therapy. Possible clinical recommendations for the detection of cardiotoxic effects using biomarkers are also outlined.


Assuntos
Antineoplásicos/efeitos adversos , Insuficiência Cardíaca/induzido quimicamente , Peptídeos Natriuréticos/análise , Neoplasias/patologia , Antineoplásicos/uso terapêutico , Biomarcadores/sangue , Cardiopatias , Insuficiência Cardíaca/diagnóstico , Humanos , Neoplasias/complicações , Neoplasias/tratamento farmacológico
17.
Am J Physiol Heart Circ Physiol ; 319(5): H1059-H1068, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-33036546

RESUMO

The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) quickly reached pandemic proportions, and knowledge about this virus and coronavirus disease 2019 (COVID-19) has expanded rapidly. This review focuses primarily on mechanisms that contribute to acute cardiac injury and dysfunction, which are common in patients with severe disease. The etiology of cardiac injury is multifactorial, and the extent is likely enhanced by preexisting cardiovascular disease. Disruption of homeostatic mechanisms secondary to pulmonary pathology ranks high on the list, and there is growing evidence that direct infection of cardiac cells can occur. Angiotensin-converting enzyme 2 (ACE2) plays a central role in COVID-19 and is a necessary receptor for viral entry into human cells. ACE2 normally not only eliminates angiotensin II (Ang II) by converting it to Ang-(1-7) but also elicits a beneficial response profile counteracting that of Ang II. Molecular analyses of single nuclei from human hearts have shown that ACE2 is most highly expressed by pericytes. Given the important roles that pericytes have in the microvasculature, infection of these cells could compromise myocardial supply to meet metabolic demand. Furthermore, ACE2 activity is crucial for opposing adverse effects of locally generated Ang II, so virus-mediated internalization of ACE2 could exacerbate pathology by this mechanism. While the role of cardiac pericytes in acute heart injury by SARS-CoV-2 requires investigation, expression of ACE2 by these cells has broader implications for cardiac pathophysiology.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/enzimologia , Cardiopatias/enzimologia , Peptidil Dipeptidase A/metabolismo , Pericitos/enzimologia , Pneumonia Viral/enzimologia , Internalização do Vírus , Animais , Infecções por Coronavirus/virologia , Cardiopatias/fisiopatologia , Cardiopatias/virologia , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pericitos/virologia , Pneumonia Viral/virologia
18.
Cardiovasc Ther ; 2020: 1494506, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072188

RESUMO

Background: Cardiac adverse events are common among patients presenting with acute stroke and contribute to overall morbidity and mortality. Prophylactic measures for the reduction of cardiac adverse events in hospitalized stroke patients have not been well understood. We sought to investigate the effect of early initiation of high-dose intravenous magnesium sulfate on cardiac adverse events in stroke patients. Methods: This is a secondary analysis of the prehospital Field Administration of Stroke Therapy-Magnesium (FAST-MAG) randomized phase-3 clinical trial, conducted from 2005-2013. Consecutive patients with suspected acute stroke and a serum magnesium level within 72 hours of enrollment were selected. Twenty grams of magnesium sulfate or placebo was administered in the ambulance starting with a 15-minute loading dose intravenous infusion followed by a 24-hour maintenance infusion in the hospital. Results: Among 1126 patients included in the analysis of this study, 809 (71.8%) patients had ischemic stroke, 277 (24.6%) had hemorrhagic stroke, and 39 (3.5%) with stroke mimics. The mean age was 69.5 (SD13.4) and 42% were female. 565 (50.2%) received magnesium treatment, and 561 (49.8%) received placebo. 254 (22.6%) patients achieved the target, and 872 (77.4%) did not achieve the target, regardless of their treatment group. Among 1126 patients, 159 (14.1%) had at least one CAE. Treatment with magnesium was not associated with fewer cardiac adverse events. A multivariate binary logistic regression for predictors of CAEs showed a positive association of older age and frequency of CAEs (R = 1.04, 95% CI 1.03-1.06, p < 0.0001). Measures of early and 90-day outcomes did not differ significantly between the magnesium and placebo groups among patients who had CAEs. Conclusion: Treatment of acute stroke patients with magnesium did not result in a reduction in the number or severity of cardiac serious adverse events.


Assuntos
Cardiopatias/prevenção & controle , Hospitalização , Sulfato de Magnésio/administração & dosagem , Acidente Vascular Cerebral/tratamento farmacológico , Administração Intravenosa , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Esquema de Medicação , Feminino , Cardiopatias/diagnóstico , Cardiopatias/epidemiologia , Humanos , Incidência , Los Angeles/epidemiologia , Sulfato de Magnésio/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Fatores de Tempo , Resultado do Tratamento
19.
Vasc Health Risk Manag ; 16: 429-435, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116553

RESUMO

Background: Cardiology fellows, in particular, are in a unique position to mold the new cardiovascular workforce, especially in terms of risk prevention. There is a growing need for the cardiovascular workforce. In the United States, one person dies every forty-two seconds due to a cardiovascular adverse event. Methods: A PRISMA systematic review included comprehensive search of the MED-LINE database (PubMed) from 1927 to 2020 - the oldest to newest available literature on the subject available through PubMed. Results: Fifty-seven cardiology fellows together interpreted a total of 1719 EKGs with a correct rate of 52%. Sixty-four fellows completed a total of 1363 echocardiography interpretations with an accuracy rate of nearly 75%. Conclusion: Based on the studies discussed, it is evident that a cardiology fellow, particularly in their early years of training, may be limited due to a lack of experience. With continued EKG and echocardiogram interpretation, as well as other clinical skills practice, fellows can improve their diagnostic accuracy and procedural efficiency.


Assuntos
Cardiologistas/educação , Cardiologia/educação , Competência Clínica , Ecocardiografia , Educação de Pós-Graduação em Medicina , Eletrocardiografia , Cardiopatias/diagnóstico , Cardiologistas/psicologia , Humanos , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
20.
J Biol Regul Homeost Agents ; 34(4 Suppl. 2): 121-125, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000610

RESUMO

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first described in a cluster of patients in Wuhan, China, in December of 2019. Over the past few months, COVID-19 has rapidly spread worldwide becoming the first pandemic of the 21st century. COVID-19 results in mild symptoms in most infected children but can cause acute cardiac injury and death. In comparison to younger children, teenagers and infants are at higher risk for morbidity and mortality, with particular risk factors including pre-existing conditions like cardiovascular disease. Since this is an emerging infectious disease, there are limited data about the effects of this infection on patients especially in the pediatric population. We summarize here with the data on cardiovascular involvement in children and adolescents.


Assuntos
Infecções por Coronavirus/complicações , Cardiopatias/virologia , Pneumonia Viral/complicações , Adolescente , Betacoronavirus , Criança , Infecções por Coronavirus/fisiopatologia , Humanos , Lactente , Pandemias , Pneumonia Viral/fisiopatologia , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA