JRSM Cardiovascular Disease最新文献

{"title":"Determinants of adherence to anti-hypertensive medications among adult hypertensive patients on follow-up in Hawassa Referral Hospital: A case-control study.","authors":"Atsede Getenet,&nbsp;Mulugeta Tesfa,&nbsp;Aster Ferede,&nbsp;Yalew Molla","doi":"10.1177/2048004019892758","DOIUrl":"https://doi.org/10.1177/2048004019892758","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is a global challenge which accounts for high morbidity and mortality rates in the world. The availability of effective anti-hypertensive medications does not result in a good outcome in controlling blood pressure which points towards poor adherence. Thus, this study was conducted to assess the determinants of adherence to anti-hypertensive medication among hypertensive patients on follow-up in Hawassa Referral Hospital.</p><p><strong>Methods: </strong>Institution-based case-control study was conducted on a sample of 289 clients from February to May 2018. Census was conducted on 1600 clients to select cases and controls. Then, systematic random sampling was used to select study subjects, and adherence was measured by Morisky medication adherence scale. The associations of variables were analyzed using bivariable followed by multivariable logistic regression analyses.</p><p><strong>Results: </strong>The respondent's adherence to medication was found to be 67% as measured by Morisky medication adherence scale. The multivariate logistic regression analysis showed that medication adherence was found to be better in younger age (<45) (AOR = 3.8), clients living in urban areas (AOR = 6.84), those clients who had good knowledge (AOR = 3.13), those with no co-morbidities (AOR = 3.14) and patients who controlled their blood pressure (<140/90) (AOR = 2.35).</p><p><strong>Conclusions: </strong>The rate of medication adherence was found to be low, and hence educational interventions focusing on factors promoting adherence and patients' health support should be implemented.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"8 ","pages":"2048004019892758"},"PeriodicalIF":1.6,"publicationDate":"2019-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019892758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37603462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal artery injury during inferior vena cava filter removal with endobronchial forceps.","authors":"Carlos A Padula,&nbsp;Andrew R Lewis,&nbsp;Gregory T Frey,&nbsp;J Mark McKinney,&nbsp;Ricardo Paz-Fumagalli,&nbsp;Charles A Ritchie,&nbsp;Zlatko Devcic,&nbsp;Beau B Toskich","doi":"10.1177/2048004019893513","DOIUrl":"https://doi.org/10.1177/2048004019893513","url":null,"abstract":"<p><p>Retrieval of tip-embedded inferior vena cava filters using endobronchial forceps is a well-described technique. The tip of dorsally tilted filters may be in proximity to the right renal artery, increasing the risk of arterial injury during retrieval. We present one case that illustrates renal artery injury requiring emergent stent graft repair. The three subsequent cases illustrate techniques that avoid renal artery injury using a femoral and jugular approach with the assistance of an arterial fiducial wire. Renal artery injury is a potential complication during retrieval of filters using endobronchial forceps that can be prevented with careful planning.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"8 ","pages":"2048004019893513"},"PeriodicalIF":1.6,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019893513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37459961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iliac venous stenting for outflow obstruction does not significantly change the quality of life of patients with severe chronic venous insufficiency.","authors":"Alexander Shiferson,&nbsp;Edouard Aboian,&nbsp;Michael Shih,&nbsp;Qinghua Pu,&nbsp;Theresa Jacob,&nbsp;Robert Y Rhee","doi":"10.1177/2048004019890968","DOIUrl":"https://doi.org/10.1177/2048004019890968","url":null,"abstract":"<p><strong>Purpose: </strong>Percutaneous endovenous iliac stenting has emerged as a new modality in the treatment of advanced chronic venous insufficiency with outflow obstruction. However, the effect of this intervention on the quality of life remains unclear. We examined the impact of iliac venous stenting for outflow obstruction as compared to conservative medical management on the quality of life in severe chronic venous insufficiency patients.</p><p><strong>Methods: </strong>Medical records of all patients with CEAP class 5 and 6 disease (N = 172) who underwent ilio-caval venography with intravascular ultrasonography (IVUS) at a single institution over a seven-year period, were reviewed for this case-control study. Quality of life evaluation was performed utilizing the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-20) one year after the index procedure.</p><p><strong>Results: </strong>Of the 172 severe chronic venous insufficiency patients, 109 were stented and 63 patients were treated medically based on their venography and IVUS results. The indication for stenting was confirmation of IVUS determined surface area or diameter outflow stenosis of greater than 50% within the common or external iliac venous systems. Eighty patients (47%) responded with completed CIVIQ-20 questionnaires for analysis. Of these, 47 were from the stented group and 33 from the non-stented group. At least moderate persistent pain or discomfort post-procedure was reported by 20 (43%) stented group patients and 19 (58%) non-stented group patients. Scores for all the other criteria in the CIVIQ-20 were similar between the groups. The mean total CIVIQ-20 score was 45.23 and 47.13, respectively, in stented group and non-stented group patients. (<i>p</i> = 0.678).</p><p><strong>Conclusion: </strong>There was no significant difference in the quality of life reported by CEAP 5 and 6 patients who underwent iliac venous stenting versus those who were treated medically for presumed iliac outflow obstruction. Prospective studies are needed to determine the true value of iliac venous stenting based on IVUS criteria in the management advanced chronic venous insufficiency.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"8 ","pages":"2048004019890968"},"PeriodicalIF":1.6,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019890968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37459960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traits and characteristics of highly successful medical leaders","authors":"Shyam S Sharma","doi":"10.1177/2048004019880630","DOIUrl":"https://doi.org/10.1177/2048004019880630","url":null,"abstract":"Background Medicine attracts a broad range of personality traits but the inner thoughts of its leaders have rarely been studied. The BMJ has been asking perceived leaders in the field a set of structured questions on a weekly basis. Those responses have proved insightful into the characteristic traits of high profile doctors. Methods We analysed the responses of each medically qualified doctor interviewed weekly by BMJ Confidential following the use of a set of structured questions about their likes and dislikes. These structured questions allowed us to cross analyse responses. Results From 2013 to 2017, 134 medically qualified doctors were identified by the BMJ to be suitable for inclusion in their weekly BMJ Confidential series. These individuals were selected because they were deemed by the BMJ to be leaders in their clinical, medico-political or academic fields. Of the cohort, 91% were white and 69% male. Clinical mistakes by these individuals were not uncommon (28%) over the course of their careers. Conceit and arrogance were despised most (16%) whereas politics was of interest but not political correctness. The founder of the NHS Aneurin Bevan was identified as the best Secretary of State for Health while the worst was Andrew Lansley (26%) followed by the former health secretary Jeremy Hunt. Conclusion Medicine attracts a broad range of personalities, but the characteristics of its perceived leaders seem less diverse.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019880630","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44332900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical lessons from a historical case: The disappearance of King Charles IV","authors":"A. Sharma","doi":"10.1177/2048004019872371","DOIUrl":"https://doi.org/10.1177/2048004019872371","url":null,"abstract":"Traumatic injury to the brain and its vessels is a major part of medical practice across the world. Its management however has long historical origins, but those beginnings can still teach clinical practitioners about the basic care of an injured patient. We present a little known historical medical case that to this day provides an example of best practice management resulting in successful clinical outcome. Charles IV (1316–1378) was Holy Roman Emperor between 1347 and 1378. During his reign, he disappeared for four months and returned a disfigured hunchback. There has been considerable controversy as to the cause of both his physical change and disappearance. We propose the most likely cause is from an unfortunate consequence of his love of jousting. Despite the damage and management of the traumatic injury endured by Charles IV occurring over 600 years ago, there are still lessons of his clinical management relevant to this day.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019872371","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48924690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular diseases risk factors among adult diabetic patients in eastern Ethiopia","authors":"Tekabe Abdosh, Fitsum Weldegebreal, Z. Teklemariam, H. Mitiku","doi":"10.1177/2048004019874989","DOIUrl":"https://doi.org/10.1177/2048004019874989","url":null,"abstract":"Objective The aim of this study was to determine the magnitude of cardiovascular disease risk factors among adult diabetic patients at Hiwot Fana Specialized University Hospital and Jugal Hospital, eastern Ethiopia. Methods An institutional based cross sectional study was conducted on a total of 416 study participants (age ≥18 years) from February to March 2017. Data were collected using: structured questionnaires, measurements of weight, height, and blood pressure, and laboratory examination of blood lipids (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein cholesterol) and fasting blood glucose. Data were analyzed using SPSS version 16.0 software packages. The association of cardiovascular disease risk factors with diabetes type, age, and sex was assessed by chi-square test. Result The mean age of study participants was 52 years and 44% were male. Dyslipidemia (90.6%), physical inactivity (76%), and hypertension (62.7%) were the most common cardiovascular disease risks factors identified among diabetic patients. It was also observed that 68.5% of the study participants had uncontrolled blood glucose level. Hypertension was significant in patients over 65 compared to those ≤65 years of age (p < 0.023). Females were considered to be significantly physically inactive compared to males (p < 0.001). Conclusion Dyslipidemia is the most common risk factor of CVD in individuals with Types 1 and 2 diabetes mellitus. Identification and treatment of lipid abnormalities is very important. Controlling hypertension among older patients and lifestyle modification among female diabetic patients are also recommended.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"734 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019874989","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41274044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic disparities persist despite decline in mortality from IHD in California's Central Valley 1999-2014.","authors":"Ralph Spada,&nbsp;Nicholas Spada,&nbsp;Hyosim Seon-Spada","doi":"10.1177/2048004019866320","DOIUrl":"https://doi.org/10.1177/2048004019866320","url":null,"abstract":"<p><strong>Background: </strong>Nationally, ischemic heart disease mortality has declined significantly due to advancements in managing traditional risk factors of hypertension, diabetes, hyperlipidemia, smoking, and obesity and acute intervention. However geographic disparities persist that may, in part, be attributed to environmental effects.</p><p><strong>Methods: </strong>Ischemic heart disease age-adjusted mortality were obtained from the CDC database for years 1999 through 2014 by county, gender, race, and Hispanic origin for the Central Valley of California.</p><p><strong>Results: </strong>There was an increase in mortality from north to south of 14.9 (95% CI: 8.0-21.9, p value <0.0001) in time period 1, 7.9 (95% CI: 0.8-15, p value <0.05) in time period 2, and 9.2 (95% CI: 4.0-14.3, p value <0.001) in time period 3. In time period 1, the ambient particulate matter ≤2.5 micrometers (PM_2.5) level increased from north to south by 0.84 µg/m³ (95% CI: 0.71-0.96), in time period 2 there was a 0.87 µg/m³ increase (95% CI: 0.74-1.0), and a 1.0 µg/m³ increase in time period 3 (95% CI: 0.87-1.1). PM_2.5 level was correlated to IHD mortality in all time periods (Period 1 r² = 0.46, p = 0.0001; Period 2, r² = 0.34, p = 0.008; Period 3 r² = 0.51, p value <0.0001).</p><p><strong>Conclusion: </strong>Continued declines in ischemic heart disease mortality will depend on the concerted efforts of clinicians in continuing management of the traditional risk factors with appropriate medication use, acute interventions for coronary syndromes, the necessity of patient self-management of high risk behaviors associated with smoking and obesity, and the development of coordinated actions with policy makers to reduce environmental exposure in their respective communities.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"8 ","pages":"2048004019866320"},"PeriodicalIF":1.6,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019866320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41214682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of EuroSCORE II and logistic EuroSCORE in Bangladeshi population undergoing off-pump coronary artery bypass surgery: A prospective cohort study","authors":"R. Ranjan, D. Adhikary, S. Mandal, S. Saha, K. Hasan, A. B. Adhikary","doi":"10.1177/2048004019862125","DOIUrl":"https://doi.org/10.1177/2048004019862125","url":null,"abstract":"Introduction European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to identify patients who may have a greater postoperative risk for adverse effects following adult cardiac surgery. This study evaluated the discriminatory potential of using the EuroSCORE system in predicting the early, as well as late, postoperative outcomes following coronary artery bypass graft surgery in Bangladesh. Methods A total of 865 patients who underwent isolated coronary artery bypass graft surgery were evaluated with the EuroSCORE risk scoring system. Moreover, we also compared the discriminatory potentials between the EuroSCORE II and the original logistic EuroSCORE. Results Operative mortality was best predicted by EuroSCORE II (area under the curve (AUC) 0.863, Brier score 0.030) compared to the original logistic EuroSCORE (AUC 0.849, Brier score 0.033). However, the overall expected-to-observed mortality ratio for EuroSCORE II was 1.1, whereas the observed ratio for the original logistic EuroSCORE was 1.7. EuroSCORE II was predictive of an intensive care unit stay of five days or more (AUC 0.786), prolonged inotropes use (AUC 0.746), stroke (AUC 0.646), de novo dialysis (AUC 0.810), and low output syndrome (AUC 0.715). Moreover, a high EuroSCORE II quintile significantly predicted the risk for late mortality (p < 0.0001). Conclusions EuroSCORE has an important role in predicting the early, as well as late, postoperative outcomes following coronary artery bypass surgery. However, the performance of EuroSCORE II is significantly better than the original logistic EuroSCORE in predicting postoperative morbidity and mortality after isolated coronary artery bypass graft surgery among Bangladeshi patients.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019862125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42035765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of gout with an increased risk of hypertension and diabetes mellitus among stroke survivors in New Zealand: A cross-sectional study using routinely collected electronic health data","authors":"Dina Eufemia D San Gabriel, J. Slark","doi":"10.1177/2048004019863239","DOIUrl":"https://doi.org/10.1177/2048004019863239","url":null,"abstract":"Background There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, Aotearoa New Zealand. Methods A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using Statistical Package for Social Science version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results The age-, gender-, and ethnicity-adjusted odds ratio for having hypertension and diabetes mellitus among stroke survivors with gout history were 3.25 (95% confidence interval 1.32–8.03) and 1.94 (95% confidence interval 1.12–3.36), respectively. Māori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted odds ratio of 5.10 (95% confidence interval 1.90–18.93). Conclusion The findings from this study suggest gout may be independently associated with an increased risk of hypertension and diabetes mellitus in patients with stroke. Māori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout diagnosis compared to other populations. This finding highlights the importance of the need for further research with Māori stroke survivors and other indigenous populations.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019863239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44119541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A coronary cameral fistula treated with coil embolization.","authors":"Ethan D Hinds,&nbsp;Manuel J Marin,&nbsp;Joggy George,&nbsp;Reynolds Delgado","doi":"10.1177/2048004019856801","DOIUrl":"https://doi.org/10.1177/2048004019856801","url":null,"abstract":"<p><p>A 56-year-old man who had twice previously undergone orthotopic heart transplantation was admitted with dyspnea and heart failure symptoms. A biopsy excluded rejection. Left heart catheterization revealed a coronary cameral fistula. After the patient was given mild diuretics, his condition improved. No significant fistula flow was detected, and he was discharged. Several months later, the patient was readmitted with worsening chest pain and dyspnea. Left ventricular end-diastolic pressure and flow through the fistula were increased. To correct the coronary cameral fistula, we performed a coil embolization without complications. Several months later at follow-up, the patient's symptoms had resolved, and his left ventricular end-diastolic pressure had normalized. We conclude that coronary fistulas may be caused by trauma to the heart during the de-airing process, which may be prevented in the future with the development of safer and more effective de-airing techniques.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"8 ","pages":"2048004019856801"},"PeriodicalIF":1.6,"publicationDate":"2019-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2048004019856801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37397557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}