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Showing 1 - 124 of 124 Journals sorted alphabetically
AACN Advanced Critical Care     Full-text available via subscription   (Followers: 36)
Academic Emergency Medicine     Hybrid Journal   (Followers: 90)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 9)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 8)
Advances in Emergency Medicine     Open Access   (Followers: 16)
Advances in Neonatal Care     Hybrid Journal   (Followers: 43)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 7)
African Journal of Emergency Medicine     Open Access   (Followers: 7)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 5)
American Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Annals of Emergency Medicine     Hybrid Journal   (Followers: 126)
Annals of Intensive Care     Open Access   (Followers: 37)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 15)
Archives of Academic Emergency Medicine     Open Access   (Followers: 6)
Archives of Trauma Research     Open Access   (Followers: 4)
ASAIO Journal     Hybrid Journal   (Followers: 2)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Critical Care     Full-text available via subscription   (Followers: 21)
Bangladesh Critical Care Journal     Open Access   (Followers: 1)
BMC Emergency Medicine     Open Access   (Followers: 25)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65)
Burns Open     Open Access  
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 2)
Case Reports in Acute Medicine     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 13)
Case Reports in Emergency Medicine     Open Access   (Followers: 19)
Chronic Wound Care Management and Research     Open Access   (Followers: 7)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32)
Clinical Intensive Care     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 3)
Clinical Risk     Hybrid Journal   (Followers: 5)
Crisis: The Journal of Crisis Intervention and Suicide Prevention     Hybrid Journal   (Followers: 15)
Critical Care     Open Access   (Followers: 74)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 29)
Critical Care Clinics     Full-text available via subscription   (Followers: 34)
Critical Care Explorations     Open Access   (Followers: 3)
Critical Care Medicine     Hybrid Journal   (Followers: 279)
Critical Care Research and Practice     Open Access   (Followers: 13)
Current Emergency and Hospital Medicine Reports     Hybrid Journal   (Followers: 5)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 73)
Disaster and Emergency Medicine Journal     Open Access   (Followers: 12)
Egyptian Journal of Critical Care Medicine     Open Access   (Followers: 2)
EMC - Urgenze     Full-text available via subscription  
Emergency Care Journal     Open Access   (Followers: 7)
Emergency Medicine (Medicina neotložnyh sostoânij)     Open Access  
Emergency Medicine Australasia     Hybrid Journal   (Followers: 17)
Emergency Medicine Clinics of North America     Full-text available via subscription   (Followers: 19)
Emergency Medicine International     Open Access   (Followers: 8)
Emergency Medicine Journal     Hybrid Journal   (Followers: 53)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Emergency Nurse     Full-text available via subscription   (Followers: 17)
Enfermería Intensiva (English ed.)     Full-text available via subscription  
European Burn Journal     Open Access   (Followers: 10)
European Journal of Emergency Medicine     Hybrid Journal   (Followers: 23)
Frontiers in Emergency Medicine     Open Access   (Followers: 8)
Global Journal of Transfusion Medicine     Open Access   (Followers: 1)
Hong Kong Journal of Emergency Medicine     Full-text available via subscription   (Followers: 5)
Indian Journal of Burns     Open Access   (Followers: 2)
Injury     Hybrid Journal   (Followers: 20)
Intensive Care Medicine     Hybrid Journal   (Followers: 82)
Intensive Care Medicine Experimental     Open Access   (Followers: 2)
Intensivmedizin up2date     Hybrid Journal   (Followers: 4)
International Journal of Critical Illness and Injury Science     Open Access   (Followers: 1)
International Journal of Emergency Medicine     Open Access   (Followers: 9)
International Journal of Emergency Mental Health and Human Resilience     Open Access   (Followers: 2)
International Paramedic Practice     Full-text available via subscription   (Followers: 14)
Iranian Journal of Emergency Medicine     Open Access  
Irish Journal of Paramedicine     Open Access   (Followers: 2)
Journal Européen des Urgences et de Réanimation     Hybrid Journal   (Followers: 1)
Journal of Acute Care Physical Therapy     Hybrid Journal   (Followers: 3)
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal Of Cardiovascular Emergencies     Open Access  
Journal of Concussion     Open Access  
Journal of Critical Care     Hybrid Journal   (Followers: 48)
Journal of Critical Care Medicine     Open Access   (Followers: 18)
Journal of Education and Teaching in Emergency Medicine     Open Access   (Followers: 1)
Journal of Emergencies, Trauma and Shock     Open Access   (Followers: 13)
Journal of Emergency Medical Services     Full-text available via subscription   (Followers: 12)
Journal of Emergency Medicine     Hybrid Journal   (Followers: 53)
Journal of Emergency Medicine, Trauma and Acute Care     Open Access   (Followers: 25)
Journal of Emergency Practice and Trauma     Open Access   (Followers: 6)
Journal of Intensive Care     Open Access   (Followers: 9)
Journal of Intensive Care Medicine     Hybrid Journal   (Followers: 22)
Journal of Intensive Medicine     Open Access  
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Stroke Medicine     Hybrid Journal  
Journal of the American College of Emergency Physicians Open     Open Access   (Followers: 1)
Journal of the Intensive Care Society     Hybrid Journal   (Followers: 4)
Journal of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6)
Journal of Thrombosis and Haemostasis     Hybrid Journal   (Followers: 81)
Journal of Translational Critical Care Medicine     Open Access   (Followers: 5)
Journal of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 34)
La Presse Médicale Open     Open Access  
Médecine de Catastrophe - Urgences Collectives     Hybrid Journal  
Medicina Intensiva     Open Access   (Followers: 3)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Mediterranean Journal of Emergency Medicine & Acute Care : MedJEM     Open Access  
Notfall + Rettungsmedizin     Hybrid Journal   (Followers: 3)
OA Critical Care     Open Access   (Followers: 3)
OA Emergency Medicine     Open Access   (Followers: 2)
Open Access Emergency Medicine     Open Access   (Followers: 6)
Open Journal of Emergency Medicine     Open Access   (Followers: 2)
Palliative Care : Research and Treatment     Open Access   (Followers: 19)
Palliative Medicine     Hybrid Journal   (Followers: 54)
Prehospital Emergency Care     Hybrid Journal   (Followers: 19)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 41)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Resuscitation     Hybrid Journal   (Followers: 54)
Resuscitation Plus     Open Access   (Followers: 2)
Saudi Critical Care Journal     Open Access   (Followers: 2)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine     Open Access   (Followers: 11)
Seminars in Thrombosis and Hemostasis     Hybrid Journal   (Followers: 46)
Shock : Injury, Inflammation, and Sepsis : Laboratory and Clinical Approaches     Hybrid Journal   (Followers: 10)
Sklifosovsky Journal Emergency Medical Care     Open Access  
The Journal of Trauma Injury Infection and Critical Care     Full-text available via subscription   (Followers: 24)
Therapeutics and Clinical Risk Management     Open Access   (Followers: 2)
Transplant Research and Risk Management     Open Access  
Trauma Case Reports     Open Access   (Followers: 1)
Trauma Monthly     Open Access   (Followers: 3)
Visual Journal of Emergency Medicine     Full-text available via subscription   (Followers: 1)
Western Journal of Emergency Medicine     Open Access   (Followers: 11)
 AEM Education and Training : A Global Journal of Emergency Care     Open Access   (Followers: 1)

           

Similar Journals
Journal Cover
Journal Of Cardiovascular Emergencies
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2457-550X - ISSN (Online) 2457-5518
Published by Sciendo Homepage  [370 journals]
  • Do WBC, NLR, and WMR predict MACE in NSTEMI patients'

    • PubDate: Tue, 14 Jun 2022 00:00:00 GMT
       
  • Coronary Angioplasty and Stenting in Acute Coronary Syndromes Using Very
           Low Contrast Volume and Radiation Dosage Improves Renal and Cardiovascular
           Outcomes

    • Abstract: Aim: To demonstrate that in patients with acute coronary syndrome (ACS), using Cordis 6F Infiniti diagnostic catheters for angioplasty may represent a safe alternative associated with lower contrast volume and radiation dosage, improving cardiovascular and renal outcomes.Material and Methods: In 1,800 patients with ACS (2,331 lesions/2,603 stents), angioplasty was performed with Cordis 6F Infiniti Thrulumen diagnostic catheters. Primary angioplasty was performed in 545 cases, and only balloon angioplasty in 67 patients. All procedures were performed through the femoral route, and switch-over to the radial route was made in 5 cases due to associated aortic/iliac obstructive lesions. Iodixanol was used in 76% of cases, and tirofiban in 99% of cases with adjusted dosages based on creatinine values. The mean contrast volume used per patient was 28 mL (± 6 mL) including the angiogram prior to the angioplasty.Results: The median fluoroscopy time was 4.4 min (IQR 3–6.8), the mean fluoroscopy time was 5.59 min (± 0.28), the median dose-area product or kerma-area product was 1,507 µGym2 (IQR 918–2,611), median total or cumulative dose including backscatter was 2,702 µGym2 (IQR 1,805–4,217), and the median cumulative skin dose was 468 mGy (IQR 296–722). Groin hematoma was seen in 7 cases, proximal mild edge dissection in the deployed stent in 3 cases, and acute in-hospital stent thrombosis in 7 cases. In total, 33 deaths were registered and 19 of these patients had cardiogenic shock, of which 11 subjects were late presenters. Three patients died after discharge due to possible acute stent thrombosis.Conclusions: Angioplasty and stenting can be performed safely in patients with acute coronary syndromes using Cordis 6F diagnostic catheters. The procedure was associated with a very low volume of contrast and radiation dose, leading to improved clinical outcomes..
      PubDate: Tue, 14 Jun 2022 00:00:00 GMT
       
  • Brachial Artery Embolectomy in a Polytrauma Patient: A Case Report

    • Abstract: Introduction: The upper extremity is a frequent site of injury. Upper limb arterial thromboembolism, a rare complication of such injuries, may be missed if typical signs, such as pain, pulselessness, and sensory loss, cannot be ascertained or are overlooked by physicians, especially in the case of polytrauma or comatose patients.Case presentation: In this report, we present the case of a left brachial artery thromboembolism in a polytrauma patient for which brachial artery embolectomy was performed. Before surgery, the diagnosis was established with doppler ultrasonography of the upper limb vessels, performed upon suspicion of thrombus formation. Brachial artery arteriotomy and thrombo-embolectomy were performed using a size 6 Fr Fogarty catheter, after which 500 IU heparin was flushed to ensure adequate back and forward flow. Limb function and blood flow were restored immediately after the procedure.Conclusion: A high index of suspicion, timely assessment, and a prompt intervention can significantly reduce the rate of limb ischemia and/or amputations in polytrauma patients, especially in resource-limited settings.
      PubDate: Tue, 14 Jun 2022 00:00:00 GMT
       
  • Safety and Efficacy of Magnet Use to Temporarily Inhibit Inappropriate
           Subcutaneous Implantable Cardioverter Defibrillator Therapy in Emergency
           Situations: A Case Report

    • Abstract: Introduction: The subcutaneous implantable cardioverter defibrillator (S-ICD) represents a major advancement in ICD technology. Inappropriate shocks (IAS) occur in more than 3.1% of the population with S-ICD each year and are usually followed by admission to the emergency department (ED). In this setting, the disabling of IAS is mandatory during a pseudo-electrical storm (ES). This report describes the strategies that can be followed in order to temporarily inhibit IAS in critical care settings with the use of magnets.Case presentation: An S-ICD was implanted more than 6 weeks prior to presentation in a 68-year-old man with hypertrophic cardiomyopathy. In the ED, the patient experienced 3 IAS in the last hour. A Medtronic magnet was applied to stop IAS, as the specific programmer was not available. The maneuver interrupted the IAS. In order to verify the universal magnetic response of the S-ICD, six different magnets and one smartphone with MagSafe technology were tested. All magnet models suspended arrhythmia detection and IAS, while the smartphone did not cause magnet interferences.Conclusions: This report demonstrates the safety and efficacy of all clinical magnet models in inhibiting IAS. In case of pseudo-ES, any type of magnet allows ED providers to easily and rapidly disable the functionality of the devices when appropriate.
      PubDate: Tue, 14 Jun 2022 00:00:00 GMT
       
  • New Perspectives in the Treatment of Acute and Chronic Heart Failure with
           Reduced Ejection Fraction

    • Abstract: ABSTRACTAcute and chronic heart failure with reduced ejection fraction (HFrEF) is a major public health problem, studies showing a 25% survival rate at 5 years after hospitalization. If left untreated, it is a common and potentially fatal disease. In recent years, the medical and device therapies of patients with HFrEF have significantly improved. The aim of our review is to provide an evidence-based update on new therapeutic strategies in acute and chronic settings, to prevent hospitalization and death in patients with HFrEF. We performed a systematic literature search on PubMed, EMBASE, and the Cochrane Database of Systemic Reviews, and we included a number of 23 randomized controlled trials published in the last 30 years. The benefit of beta-blockers and renin-angiotensin-aldosterone system inhibitors in patients with HFrEF is well known. Recent developments, such as sodium-glucose cotransporter 2 inhibitors, vericiguat, transcatheter mitral valve repair, wireless pulmonary artery pressure monitor and cardiac contractility modulation, have also proven effective in improving prognosis. In addition, other new therapeutic agents showed encouraging results, but they are currently being studied. The implementation of personalized disease management programs that directly target the cause of HFrEF is crucial in order to improve prognosis and quality of life for these patients.
      PubDate: Thu, 30 Dec 2021 00:00:00 GMT
       
  • Epicardial Adipose Tissue Thickness is Higher in Right Ventricular Outflow
           Tract Tachycardia

    • Abstract: ABSTRACTIntroduction: Idiopathic ventricular arrhythmias, which occur in the absence of structural heart disease, are commonly originating from the outflow tract, and 80% of the them arise from the right ventricle. Epicardial adipose tissue (EAT), which originates from the splanchnopleuric mesoderm, has been shown to be an important source of inflammatory mediators and plays an important role in cardiac autonomic function by epicardial ganglionated plexuses. EAT may potentially contribute to the pathophysiology of idiopathic right ventricular outflow tract (RVOT) tachycardia by different mechanisms. In this study, we aimed to investigate the relationship between EAT thickness and RVOT tachycardia. Methods: This study included 55 patients (32 male, 23 female) with RVOT tachycardia and 60 control subjects (38 male, 22 female). Patients who had more than three consecutive ventricular beats over 100 bpm with specific morphological features on the electrocardiogram (ECG) were diagnosed with RVOT tachycardia. EAT thickness was measured by transthoracic echocardiography. Results: EAT thickness was significantly higher in the RVOT tachycardia group (p <0.05). Ejection fraction (EF), and the thickness of the posterior wall of the left ventricle and of the interventricular septum were significantly lower, and left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left atrial diameter were significantly higher in patients who had RVOT tachycardia compared to normal subjects (p <0.05). Conclusion: Patients who were diagnosed with RVOT tachycardia had increased EAT thickness compared to normal subjects. The underlying mechanism of the condition could be mechanical, metabolic, infiltrative, or autonomic effects of the EAT.
      PubDate: Thu, 30 Dec 2021 00:00:00 GMT
       
  • Magnitude of ST-segment Elevation Is Associated with Increased Acute
           Inflammatory Response and Myocardial Scar in Patients with Acute
           Myocardial Infarction Undergoing pPCI

    • Abstract: ABSTRACTBackground: The integrated ST segment elevation score (ISSTE) score objectively quantifies the ECG changes before and after primary percutaneous coronary intervention (pPCI) for ST segment elevation myocardial infarction (STEMI). The inflammatory response is a major component in scar formation and remodeling process of the myocardial tissue following myocardial infarction (MI). Cardiac magnetic resonance imaging (CMR) precisely quantifies the cardiac function and assesses the pattern of the myocardial scar tissue. The aim of the study was to evaluate the relations between the ISSTE score and: (1) acute inflammatory biomarkers and (2) extent of the myocardial scar determined by CMR in STEMI treated with pPCI. Material and methods: One hundred thirty STEMI patients were included in the study, who underwent pPCI in the first 12 hours from symptom debut. ISSTE-1 was calculated at presentation and 2 hours following pPCI (ISSTE-2). Inflammatory biomarkers were determined at admission and day 5, followed by LGE-CMR at 4 weeks, with quantification of cardiac function and extent of infarct size (IS) and transmurality. Patients were divided in low and high ISSTE groups based on the median values. Results: No significant differences were noted in terms of CMR parameters or inflammatory biomarkers and between the groups with low or high ISSTE-1. Significantly higher levels of day-5 hs-CRP (p = 0.03) and day-1 IL-6 (p = 0.02), MMP-9 (p = 0.05) were recorded in high ISSTE-2 groups. LV IS mass (23.11 ± 5.31 vs. 57.94 ± 8.33, p = 0.001), percentage (13.55 ± 6.22 vs. 27.15 ± 7.12, p = 0.001) and transmurality (p = 0.001) was significantly higher in ISSTE-2 group. ISSTE-2 significantly correlated with LV IS mass (r = 0.391, p <0.0001), percentage (r = 0.541, p <0.0001) high transmurality (r = 0.449, p <0.0001) and LV EF (r = -0.397, p <0.0001). Conclusions: A high ISSTE-2 score is associated with increased inflammatory response exhibited by elevated serum IL-6 and MMP-9 levels determined on the day of admission, and with persistently increased serum hs-CRP levels on day 5 of the acute event. A higher ISSTE-2 score is associated with larger myocardial scar extent expressed by IS, higher transmurality and reduced LV EF at 1-month LGE CMR follow-up.
      PubDate: Thu, 30 Dec 2021 00:00:00 GMT
       
  • Possible Option for Treatment of Severe Congestive Heart Failure Under
           Mechanical Ventilation Using Tolvaptan via Nasogastric Tube: A
           Single-Center Analysis

    • Abstract: ABSTRACTBackground: The oral vasopressin-2 receptor antagonist tolvaptan causes aquaresis, and its effect on heart failure is proven. However, it is not recommended in patients who are unable to appropriately respond to thirst because of possible severe hypernatremia. Aim: To assess the safety and efficacy of tolvaptan treatment via nasogastric tube in patients who are unable to respond to thirst by fluid ingestion. Methods: We analyzed 70 consecutive patients with severe congestive heart failure (CHF) who were resistant to loop diuretics and treated with tolvaptan. From the 70 patients, 12 required endotracheal intubation under sedation (Group Tube; GT) and 58 did not (Group Oral; GO). We administered tolvaptan orally in GO; however, in GT, we had to administer tolvaptan via nasogastric tube to achieve pulmonary decongestion quickly. In GT, serum sodium level was monitored closely, and intravenous fluid infusion volume was controlled in the intensive care unit (ICU). Outcomes, including safety and efficacy parameters, were evaluated. Results: In both groups, tolvaptan treatment did not develop a significant rise in serum sodium level compared with baseline, and the incidence of worsening renal failure was comparable, despite greater net fluid loss and higher doses of loop diuretics used in patients of GT compared to GO. In GT, all patients achieved pulmonary decongestion and were weaned from mechanical ventilation. Conclusions: In sedated patients with severe CHF who are unable to respond to thirst by fluid ingestion, tolvaptan can be used without clinically significant hypernatremia under close monitoring in the ICU.
      PubDate: Thu, 30 Dec 2021 00:00:00 GMT
       
  • Predictive Value of Hematological Parameters in Non-ST Segment Elevation
           Myocardial Infarction and Their Relationship with the TIMI Risk Score

    • Abstract: ABSTRACTBackground: Hematological parameters, such as white blood cell count (WBC), mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and WBC to MPV ratio (WMR), could provide data in prognosis, risk stratification, and optimal management in patients with acute coronary syndromes. Aim: We aimed to investigate the prognostic value of hematological parameters and their relationship with the TIMI risk score in non-ST elevation myocardial infarction (NSTEMI) patients. Material and Methods: A total of 259 adult patients with NSTEMI were included in this retrospective and observational cohort study. During a 1-year follow-up period, the efficacy of the main hematological parameters in predicting major adverse cardiovascular events (MACE) and their correlation with the TIMI risk score was analyzed. Results: Among the 259 patients, 188 (72.6%) were male, and the mean age was 60.4 ± 11.9 years. MACE was observed in 60 patients (23.2%). Elevated baseline levels of WBC, neutrophils, NLR, PLR, and WMR were associated with MACE development throughout the 1-year follow-up. Moreover, WBC, WMR, and NLR were correlated with the TIMI risk score. When the predictive power of these parameters for MACE was evaluated by ROC analysis, the AUC values for WBC, WMR, and NLR were 0.670 (95% CI 0.590–0.750), 0.666 (95% CI 0.582–0.746), and 0.689 (95% CI 0.610–0.767), respectively. Conclusion: WBC, NLR, and WMR predicted MACE in NSTEMI patients and were consistent with the TIMI risk score. On this basis, they could provide supportive data for early risk stratification and optimized therapeutic approach, particularly in high-risk patients.
      PubDate: Thu, 30 Dec 2021 00:00:00 GMT
       
  • Fatal Aortoduodenal Fistula Caused by a Ruptured Abdominal Aortic Aneurysm
           - a Case Report

    • Abstract: ABSTRACTIntroduction: Ruptured abdominal aortic aneurysm (AAA) has a high mortality, even when the patients reach the hospital in time and the intervention is expeditious. Case presentation: We present the case of a 66-year-old male patient, with a known history of AAA, presenting to the emergency room in a state of hypovolemic shock due to massive bleeding in the upper and lower gastrointestinal tract and acute abdominal pain, which presented an abrupt onset one hour before presentation. The computed tomography angiography identified an aortoduodenal fistula with a trajectory toward the D3 segment of the duodenum, as well as a common iliac artery occlusion and extensive atherosclerotic stigmas. The patient was rushed to the operation room where he was resuscitated with intravenous fluids, two units of packed red blood cells, and hemostatic agents. The bleeding was stopped by clamping the aorta above the aneurysm. The duodenum was sutured, and the aorta was reconstructed with an aortobifemoral graft. Unfortunately, even though intensive care procedures continued for a few hours after surgery, all therapeutic efforts failed and the patient had succumbed.
      PubDate: Thu, 30 Dec 2021 00:00:00 GMT
       
  • Late Rupture of a Thrombosed Aortic Abdominal Aneurysm – a Case
           Report

    • Abstract: Introduction: Severe back pain caused by a thrombosed and ruptured aortic abdominal aneurysm can imitate a lumbar disc herniation.Case presentation: We present the case of a 72-year-old diabetic patient with chronic atrial fibrillation, who had been experiencing high-intensity low back pain and claudication in the last year prior to his presentation. After experiencing a minor trauma, a lumbar MRI examination was performed, which revealed a retroperitoneal tumoral mass compressing and eroding the L2–L4 vertebral bodies. Computed tomography angiography showed an infrarenal aortic aneurysm (3.374 × 3.765 cm) which appeared to have ruptured and thrombosed. The question arising was when did the rupture occur, how massive was the damage, and how suitable for reconstruction was the aortic wall below the origin of the renal arteries. An open repair was scheduled and performed. The intraoperative finding was ruptured aneurysm of the thrombosed infra-abdominal aorta. The thrombosis extended along the common iliac and external iliac branches. We performed an aortobifemoral bypass using a 16 × 8 mm Dacron graft, clamping the aorta above the origin of the renal arteries.Conclusion: The unintentional diagnosis, due to a minor fall, was overall a fortunate event for this patient. Aortic aneurysms may present with lumbar pain that can be mistakenly interpreted as a spinal issue.
      PubDate: Thu, 14 Oct 2021 00:00:00 GMT
       
  • Biomarkers of Systemic Versus Local Inflammation During the Acute Phase of
           Myocardial Infarction, as Predictors of Post-infarction Heart Failure

    • Abstract: Background: The aim of this study was to investigate the correlation between serum biomarkers of left ventricular dysfunction and systemic inflammation in the first days after the acute episode, and to investigate their role for early identification of patients at high risk for post-infarction heart failure.Materials and methods: In total, 123 subjects admitted to the Intensive Cardiovascular Care Unit of the Cardiology Clinic of the Târgu Mureș County Clinical Emergency Hospital, Romania, with acute myocardial infarction were retrospectively analyzed in this study. Based on the level of NT-proBNP, the study population was divided into 2 groups: Group 1 (n = 92), with NT-proBNP <3,000 pg/mL, and Group 2 (n = 31), with NT-proBNP >3,000 pg/mL.Results: Biomarkers reflecting systemic inflammation presented significantly higher values in patients with elevated NT-proBNP (hs-CRP – 12.3 ± 8.9 mg/L vs. 3.6 ± 6.7 mg/L, p <0.0001, and interleukin 6 – 27.6 ± 30.7 pg/mL vs. 8.6 ± 6.2 pg/mL, p <0.0001). However, cell adhesion molecules VCAM and ICAM were not significantly different between the groups. Patients in Group 2 presented significantly higher rates of major cardiovascular events and rehospitalizations in the first year after the acute coronary event, with 13.33% event rate for patients in Group 2 compared to 8.7% in Group 1 (p <0.05).Conclusions: Serum biomarkers of ventricular dysfunction are strongly associated with systemic inflammation and ventricular impairment in the immediate phase after an acute myocardial infarction. Systemic inflammation has a higher impact on the clinical outcomes and progression to heart failure than the local coronary inflammation expressed by cell adhesion molecules.
      PubDate: Thu, 14 Oct 2021 00:00:00 GMT
       
  • Increased QT Dispersion and High Risk of Ventricular Arrhythmias is
           Associated with Hyperuricemia in Individuals with Normal Renal Function

    • Abstract: Background and aim: Uric acid elevation has been shown to be an important risk factor for cardiovascular and cerebrobascular disease. QT dispersion (QTd) is a parameter that shows the heterogeneity of ventricular repolarization and can be calculated noninvasively from surface electrocardiography. Increased QTd has been associated with severe arrhythmia and risk of sudden death in many patients and disease groups. In this context, we aimed to investigate the effect of uric acid levels on QTd and the effects of decrease in uric acid levels on QTd.Methods: A total of 225 patients with normal renal function were included in the study; 133 of these patients were hyperuricemic (>7 mg/dL), and the remaining 72 patients were normouricemic (Group 1). The hyperuricemic patients were randomly divided into 2 groups, one group (n = 67) was given placebo (Group 2) for 4 months, and the remaining 66 patients were given allopurinol 300 mg/day (Group 3).Results: Hyperuricemic patients had higher hsCRP and QTd and lower eGFR values compared to the normouricemic control group. After 4 months of treatment, 66 patients treated with allopurinol showed a significant decrease in serum uric acid, systolic and diastolic blood pressure, and hsCRP levels, and a significant increase in eGFR. Although the QTd values in the treatment group did not decrease to the same levels as in the normouricemic control group, a statistically significant decrease was found compared to their baseline values. In hyperuricemic control and normouricemic control patients, there were no differences in the levels of uric acid, hsCRP, eGFR, systolic and diastolic blood pressure, and QTd values compared to baseline values.Conclusions: There was a significant association between elevated serum uric acid and QTd, as well as with inflammatory biomarkers. Also, patients who had received hypouricemic therapy during the follow-up period presented a significant decrease in inflammatory markers as well as QTd. This indicates the beneficial effects of decreasing uric acid levels in decreasing the risk for future major adverse events related to ventricular arrhythmias.
      PubDate: Thu, 14 Oct 2021 00:00:00 GMT
       
  • Relationship between ECG Findings and Serum Biomarkers in COVID-19
           Patients

    • Abstract: Background and aim: The aim of this study was to evaluate the relationship between ECG findings and blood parameters indicative of inflammation and myocardial injury in COVID-19 patients.Methods: The study included 159 females and 194 males. Demographics, ECG findings (axis, rhythm, branch block, ST- and T-wave changes, premature ventricular contractions, early repolarization, S1Q3T3, fragmented QRS [fQRS], rate, PR, QRS, QT interval, QTc, P-wave dispersion) and albumin, D-dimer, ferritin, pro-BNP, procalcitonin, protein, troponin T, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR) were recorded.Results: In the study, 45% of the cases were female and 55% were male. The mean age of the included patients was 45.7 ± 24.4 years. The most frequent comorbidities were chronic obstructive pulmonary disease (COPD) and hypertension (HT) in both groups. The incidence of fQRS on the 1st day was significantly higher in patients with negative COVID-19 test (23% for positive RT-PCR versus 35.6% for negative RT-PCR, p = 0.016). QTc values on the 3rd and 5th day were significantly higher in patients with negative RT-PCR (p = 0.045 and p = 0.042, respectively). Albumin and procalcitonin were significantly higher in patients with positive COVID-19 test results (p = 0.018 and p <0.001, respectively). Patients with fragmented QRS presented significantly lower serum albumin (40.62 ± 4.73 g/L vs. 42.92 ± 3.72 g/L, p = 0.01), and protein levels (p = 0.02), as well as lower lymphocyte count, and significantly higher levels of C-reactive protein (47.01 ± 65.01 mg/L vs. 24.55 ± 44.17 mg/L, p = 0.001), D-dimer (p = 0.009), neutrophil count, pro-BNP (p = 0.004), troponin T (p <0.001), NRL and CAR (1.28 ± 1.83 versus 0.6 ± 1.11, p <0.001).Conclusion: Patients with COVID-19 infection presented significantly higher levels of C-reactive protein, D-dimer, neutrophil, pro-BNP, procalcitonin, troponin T, NLR, and CAR, and significantly lower levels of albumin, lymphocyte count, and serum proteins, indicating the level of inflammation and its relationship with myocardial injury. Further follow-up studies are required, on larger patient sets, for the development of risk prediction tools in COVID-19 patients.
      PubDate: Thu, 14 Oct 2021 00:00:00 GMT
       
  • Endovascular Aortic Aneurysm Repair during the Early Days of the COVID-19
           Outbreak

    • Abstract: Introduction: We report the results of endovascular aortic repair (EVAR) in three patients during the COVID-19 pandemic. Materials and Methods: Three patients were diagnosed with abdominal aortic aneurysm. All three patients were male and aged 68 years. The diameter of the aneurysm was larger than 65 mm and was considered suitable for EVAR. Thorax tomography was performed to exclude SARS-CoV-2 infection before the procedure. Results: We performed EVAR under general anesthesia. “Priority Level” was based on the guideline of the American College of Surgeons. The procedure was conducted in the angiography laboratory by taking advanced precautions. Intensive care admission was avoided. The postoperative period was uneventful, and all patients were discharged without any condition associated with COVID-19. There were no mortality, rupture, secondary intervention, major adverse event, limb occlusion, and 60-day read-mission. Conclusions: During the pandemic, EVAR can be performed for symptomatic abdominal aortic aneurysm with a diameter of more than 65 mm. Thorax tomography is safe to exclude SARS-CoV-2 infection. However, tomographic angiography to monitor patients may be difficult during the pandemic.
      PubDate: Sat, 17 Jul 2021 00:00:00 GMT
       
  • Vitamin D Supplementation Replaced Catheter Ablation in a Patient with
           Frequent Premature Ventricular Contractions

    • Abstract: A high premature ventricular contractions (PVC) burden can disturb the patient’s condition through fatigue during exercise or palpitations. Hence, researchers started to look for treatment options that decrease PVC burden without the side effects of antiarrhythmic drugs, and vitamin D could be a valuable solution and safe alternative to drugs or catheter ablation for high-burden PVCs. We present the case of a 24-year-old patient with high-burden PVC of >25,500/24 hours referred for urgent catheter ablation. Treatment with beta-blockers and calcium blockers did not reduce PVC burden. Under propafenone, there was a slight reduction in the number of PVCs to 21,200/24 hours, therefore the patient was referred for catheter ablation. As there was a vitamin D deficiency of 10.1 ng/mL, an attempt of vitamin D supplementation was done, with increase of vitamin D to 32.1 ng/mL and decrease of PVC burden to 9,600/24 hours. Further dietary supplementation increased 25-OH vitamin D to 50.2 ng/mL and decreased the PVC burden to 119/24 hours. Consequently, catheter ablation was canceled, and the patient remained free of antiarrhythmic drugs.
      PubDate: Sat, 17 Jul 2021 00:00:00 GMT
       
  • Prolonged QT Interval Associated with Multiple Entities

    • PubDate: Sat, 17 Jul 2021 00:00:00 GMT
       
  • Can Inferior Vena Cava Diameter and Collapsibility Index Be a Predictor in
           Detecting Preoperative Intravascular Volume Change in Pediatric
           Patients'

    • Abstract: Background: Inferior vena cava (IVC) ultrasound measurement is a reliable indicator used in the assessment of intravascular volume status. The aim of this study was to evaluate intravascular volume changes in pediatric patients by measuring the IVC diameter and collapsibility index (CI) in children whose oral feeding was restricted preoperatively. Material and Methods: From May 2018 to October 2018, a total of 55 pediatric patients who were scheduled for surgery were included in this prospective, observational, cohort study. Fasting and satiety IVC diameters and CIs of patients were determined by ultrasonographic evaluation twice: in the preoperative preliminary evaluation, when the patients were satiated, and before surgery, during a fasting period of 6–8 hours. Ultra-sonographic data were recorded and compared between fasting and satiety periods. Results: In the grey scale (B-mode), mean IVC diameter was significantly higher when the patients were satiated, compared to the measurements made just before surgery during the fasting period. In the M-mode, the mean IVC diameter was significantly higher only during the inspiratory phase when the patients were satiated, while during the expiratory phase it was detected to be statistically similar. Mean CI was significantly higher in the immediate preoperative period, compared to the assessment made when satiated. Conclusion: Preoperative ultrasound IVC diameter and CI measurement can be a practical and useful method for evaluating preoperative intravascular volume in children.
      PubDate: Sat, 17 Jul 2021 00:00:00 GMT
       
  • Current Recommendations for the Management of Cancer-Associated Venous
           Thromboembolism

    • Abstract: Cancer-associated thrombosis (CAT) is a major cause of death in oncological patients. The mechanisms of thrombogenesis in cancer patients are not fully established, and it seems to be multifactorial in origin. Also, several risk factors for venous thromboembolism (VTE) are present in these patients such as tumor site, stage, histology of cancer, chemotherapy, surgery, and immobilization. Anticoagulant treatment in CAT is challenging because of high bleeding risk during treatment and recurrence of VTE. Current major guidelines recommend low molecular weight heparins (LMWHs) for early and long-term treatment of VTE in cancer patients. In the past years, direct oral anticoagulants (DOACs) are recommended as potential treatment option for VTE and have recently been proposed as a new option for treating CAT. This manuscript will give a short overview of risk factors involved in the development of CAT and a summary on the recent recommendations and guidelines for treatment of VTE in patients with malignancies, discussing also some special clinical situations (e.g. renal impairment, catheter-related thrombosis, and thrombocytopenia).
      PubDate: Sat, 17 Jul 2021 00:00:00 GMT
       
  • Site-specific Phenotype of Atherosclerotic Lesions According to Their
           Location Within the Coronary Tree – a CCTA-based Study of Vulnerable
           Plaques

    • Abstract: Background: The evaluation of site-specific phenotype according to the topographic location of atherosclerotic lesions within the coronary tree has not been studied so far. The present study is based on the premise that the location of coronary plaques can influence their composition and degree of vulnerability. Aim: To evaluate different phenotypes of vulnerable coronary plaques across the three major coronary arteries in terms of composition, morphology, and degree of vulnerability, in patients with chest pain and low-to-intermediate probability of coronary artery disease, using coronary computed tomography angiography (CCTA) and a complex plaque analysis. Material and methods: This was a cross-sectional study on 75 subjects undergoing CCTA for chest pain, who presented at least one vulnerable coronary plaque (VP), defined as the presence of ≥1 CT vulnerability marker (low attenuation plaque, napkin-ring sign, spotty calcifications, positive remodeling). The study included per plaque analysis of 90 vulnerable coronary lesions identified in various locations within the coronary tree as follows: n = 30 VPs in the left anterior descending artery (LAD), n = 30 VPs in the circumflex artery (CXA), and n = 30 VPs in the right coronary artery (RCA). Results: The RCA exhibited significantly longer VPs (p = 0.001), with the largest volume (p = 0.0007) compared to those arising from the LAD and CXA. Vulnerable plaques located in the LAD exhibited a significantly more calcified phenotype (calcified volume: LAD – 44.07 ± 63.90 mm3 vs. CXA – 12.40 ± 19.65 mm3 vs. RCA – 33.69 ± 34.38 mm3, p = 0.002). Plaques from the RCA presented a more non-calcified phenotype, with the largest non-calcified (p = 0.002), lipid rich (p = 0.0005), and fibrotic volumes (p = 0.003). Low-attenuation plaques were most frequent in the RCA (p = 0.0009), while the highest vulnerability degree was present in lesions located in the LAD, which presented the highest number of vulnerability markers per plaque (p = 0.01). Conclusions: Vulnerable plaques arising from the right coronary artery are longer, more vo-luminous and with larger lipid and non-calcified content, whereas those located in the left anterior descending artery present a higher volume of calcium, but also a higher degree of vulnerability. The least vulnerable lesions were present in the circumflex artery.
      PubDate: Sat, 17 Jul 2021 00:00:00 GMT
       
 
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