共查询到20条相似文献,搜索用时 15 毫秒
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《Clinical gastroenterology and hepatology》2019,17(13):2648-2650
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Brandon Lane Phillips MD Allison K. Cabalka MD Donald J. Hagler MD Kent R. Bailey PhD Frank Cetta MD 《Congenital heart disease》2010,5(2):118-123
Objective. We sought to identify complications that occurred during congenital cardiac catheterization (CCC) and determine factors that could improve the quality of care provided to patients with congenital heart disease during this procedure. Design. We reviewed the electronic medical record for 903 CCC cases, (455 female; mean age = 29 ± 22 years, range = birth to 91 years) performed in our catheterization laboratory from 2005 to 2007. Included in this cohort are 342 cases performed on patients less than 18 years of age. Clinical follow-up data were reviewed for 3 months postcatheterization. Complications were assigned a grade from 1 to 4 based on severity. Results. The indication for catheterization was diagnostic in 459 (51%) patients, interventional in 386 (43%) patients, and endomyocardial biopsy in 58 (6%) patients. Mean intravenous contrast dose = 1.9 ± 1.8 mL/kg. Mean fluoroscopy exposure = 22 ± 13 minutes. Mean procedure duration = 122 ± 42 minutes. Although 806 cases (89%) were performed without complication, 102 complications were observed in 97 cases. There were no deaths. Emergent surgery was performed in four patients. One patient notified us 16 days after catheterization that she was pregnant. The result of that pregnancy was normal. Thirty complications occurred during the CCC procedure and a first year fellow was involved in 17. Patient age, weight, gender, attending physician, or type of procedure (diagnostic vs. intervention) did not impact risk of complications. Conclusions. Patients of all ages with congenital heart disease can expect a safe procedure with minimal risk of serious complications. Procedural changes that have been implemented include pregnancy testing on all menstruating females prior to CCC regardless of history of sexual activity, and first-year fellows are now directly supervised by the attending physician rather than a more senior fellow throughout the procedure. 相似文献
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Mori J. Krantz Robert B. Palmer Mark C.P. Haigney 《Journal of the American College of Cardiology》2021,77(2):205-223
Opioids are the most potent of all analgesics. Although traditionally used solely for acute self-limited conditions and palliation of severe cancer-associated pain, a movement to promote subjective pain (scale, 0 to 10) to the status of a “fifth vital sign” bolstered widespread prescribing for chronic, noncancer pain. This, coupled with rising misuse, initiated a surge in unintentional deaths, increased drug-associated acute coronary syndrome, and endocarditis. In response, the American College of Cardiology issued a call to action for cardiovascular care teams. Opioid toxicity is primarily mediated via potent μ-receptor agonism resulting in ventilatory depression. However, both overdose and opioid withdrawal can trigger major adverse cardiovascular events resulting from hemodynamic, vascular, and proarrhythmic/electrophysiological consequences. Although natural opioid analogues are devoid of repolarization effects, synthetic agents may be proarrhythmic. This perspective explores cardiovascular consequences of opioids, the contributions of off-target electrophysiologic properties to mortality, and provides practical safety recommendations. 相似文献
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Matthew J. Feinstein Milana Bogorodskaya Gerald S. Bloomfield Rajesh Vedanthan Mark J. Siedner Gene F. Kwan Christopher T. Longenecker 《Current cardiology reports》2016,18(11):113
Effective combination antiretroviral therapy (ART) has enabled human immunodeficiency virus (HIV) infection to evolve from a generally fatal condition to a manageable chronic disease. This transition began two decades ago in high-income countries and has more recently begun in lower income, HIV endemic countries (HIV-ECs). With this transition, there has been a concurrent shift in clinical and public health burden from AIDS-related complications and opportunistic infections to those associated with well-controlled HIV disease, including cardiovascular disease (CVD). In the current treatment era, traditional CVD risk factors and HIV-related factors both contribute to an elevated risk of myocardial infarction, stroke, heart failure, and arrhythmias. In HIV-ECs, the high prevalence of persons living with HIV and growing prevalence of CVD risk factors will contribute to a growing epidemic of HIV-associated CVD. In this review, we discuss the epidemiology and pathophysiology of cardiovascular complications of HIV and the resultant implications for public health efforts in HIV-ECs. 相似文献
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Kathleen M. McTigue Rachel H. Mackey Lewis H. Kuller 《Current cardiovascular risk reports》2011,5(3):246-252
Severe obesity (body mass index ≥35 kg/m2) is occurring at younger ages in US women and is relatively common among women of certain racial/ethnic backgrounds. It is
associated with a high incidence of cardiovascular risk factors and cardiovascular outcomes and may represent an increasingly
important facet of cardiovascular risk for US women. Bariatric surgery has the strongest literature base for producing substantial
and sustained weight loss among the severely obese but carries the risk for potentially severe complications. An emerging
literature shows that lifestyle intervention may lead to clinically meaningful weight loss in the severely obese, but that
maintenance of such loss may be problematic. 相似文献
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Luciana Andrea Avena Smeili Paulo Andrade Lotufo 《Arquivos brasileiros de cardiologia》2015,105(5):510-518