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J Trauma Acute Care Surg 2019 Feb 13. Epub 2019 Feb 13.

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, College of Medicine, Tucson, Arizona.

Introduction: Frailty is a geriatric syndrome characterized by decreased physiological reserves, increased inflammation, and decreased anabolic-endocrine response. The biomarkers associated with frailty are poorly understood in trauma. The aim of this study was to analyze the association between frailty and immune: IL-1β, IL-6, IL-2Rα, TNF-α and endocrine biomarkers: Insulin-like growth factor-1(IGF-1), and growth hormone(GH) in trauma patients. Read More

Crit Pathw Cardiol 2019 Mar;18(1):5-9

Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.

Background: Patients from racial and ethnic minority groups presenting to the Emergency Department (ED) with chest pain experience lower odds of receiving stress testing compared with nonminorities. Studies have demonstrated that care pathways administered within the ED can reduce health disparities, but this has yet to be studied as a strategy to increase stress testing equity.

Methods: A secondary analysis from 3 randomized clinical trials involving ED patients with acute chest pain was performed to determine whether a care pathway, ACES (Accelerated Chest pain Evaluation with Stress imaging), reduces the racial disparity in index visit cardiac testing between African American (AA) and White patients. Read More

Medicine (Baltimore) 2019 Feb;98(6):e14496

Department of Traumatology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.

This study aimed to determine whether the combination of procalcitonin (PCT) and S100B improves prognostic performance compared to either alone in cardiac arrest (CA) patients treated with targeted temperature management (TTM).We performed a prospective cohort study of CA patients treated with TTM. PCT and S100B levels were obtained at 0, 24, 48, and 72 hours after return of spontaneous circulation. Read More

Medicine (Baltimore) 2019 Feb;98(6):e14371

Department of Emergency, The Second People's Hospital of Lianyungang, Lianyungang 222006, China.

This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP).The clinical data of 98 patients, who were treated in our hospital due to oral AOPP from April 2013 to April 2017, were retrospectively analyzed. These patients were divided into two groups: AMI group and control group. Read More

J BUON 2018 Dec;23(7):122-131

Emergency County Hospital for Children, Pediatric Clinic no 2, Department of Pediatric Cardiology, Cluj-Napoca, Romania.

Purpose: To describe the high-risk profile group, susceptible to develop anthracycline-induced cardiomyopathy in children with acute leukemia.

Methods: The study involved 35 pediatric patients diagnosed with acute lymphoblastic (ALL) or acute myeloblastic leukemia (AML), from March 2014 to December 2016. Serologic markers used for the analysis of cardiac dysfunction were troponin T, NT-proBNP and PCRhs. Read More

BMC Cardiovasc Disord 2019 Jan 24;19(1):26. Epub 2019 Jan 24.

Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany.

Background: The aim of our study was the identification of genetic variants associated with postoperative complications after cardiac surgery.

Methods: We conducted a prospective, double-blind, multicenter, randomized trial (RIPHeart). We performed a genome-wide association study (GWAS) in 1170 patients of both genders (871 males, 299 females) from the RIPHeart-Study cohort. Read More

PLoS One 2019 16;14(1):e0210666. Epub 2019 Jan 16.

Department of Anesthesia and Intensive Care I, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.

Aim: The aim of our study was to evaluate the potential role of resistin in estimating the 30 days prognosis in patients with hypoxic-ischemic organ injury who survived after a cardiac arrest (CA).

Materials And Methods: The study included 40 patients resuscitated after a non-traumatic out-of-hospital CA admitted in Emergency Department (ED). All patients were followed for 30 days after CA or until death. Read More

Int J Cardiol 2019 Mar 2;279:155-161. Epub 2019 Jan 2.

Department of Internal Medicine (Section of Nephrology), New Haven, CT, United States of America.

Aims: We explored the relationship between inflammation, renalase an anti-inflammatory protein, and acute chest pain with coronary microvascular dysfunction (CMD).

Methods And Results: We used cardiac Rb-82 PET/CT imaging to diagnose coronary artery disease (CAD/CALC) (defect or coronary calcification) and CMD (depressed coronary flow reserve without CAD) in patients with chest pain in an emergency department (ED). Blood samples were collected pre-imaging within 24 h of ED presentation and were analyzed for renalase and inflammatory markers including C-reactive protein, interleukins, interferon gamma, tumor necrosis factor, vascular endothelial growth factor, and metalloproteinases. Read More

Front Physiol 2018 14;9:1794. Epub 2018 Dec 14.

Dorothy M. Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, United States.

Although cell survival post-transplantation is very low, emerging evidence using stem cell therapy for myocardial repair points toward a primary role of paracrine signaling mechanisms as the basis for improved cardiac function, decreased fibrosis, and increased angiogenesis. Recent studies have demonstrated that extracellular vesicles (EVs) such as exosomes secreted by stem cells stimulate angiogenesis, provide cytoprotection, and modulate apoptosis. However, the angiogenic potential of EVs secreted from human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM), a terminally differentiated cell type, has not been elucidated yet. Read More

Pediatr Crit Care Med 2019 Jan;20(1):38-46

Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health and Science University, Portland, OR.

Objectives: Heart rate variability is controlled by the autonomic nervous system. After brain death, this autonomic control stops, and heart rate variability is significantly decreased. However, it is unknown if early changes in heart rate variability are predictive of progression to brain death. Read More

J Am Heart Assoc 2018 Nov;7(21):e010283

1 Department of Emergency Medicine Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou China.

Background After cardiopulmonary resuscitation, the protective effects of therapeutic hypothermia induced by conventional cooling are limited. Recently, esophageal cooling ( EC ) has been shown to be an effective, easily performed approach to induce therapeutic hypothermia. In this study we investigated the efficacy of EC and its effects on early markers of postresuscitation cardiac and neurological injury in a porcine model of cardiac arrest. Read More

Dis Markers 2018 22;2018:5607932. Epub 2018 Nov 22.

Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.

Objective: To investigate the characteristics of early catheter-related bloodstream infection (CRBSI) in severe burn injury patients induced by a massive aluminum dust explosion.

Methods: Sixty-eight severe burn injury patients experienced a massive dust explosion in Kunshan were included in this study. Patients received central venous catheter placement, arterial catheterization to monitor blood pressure and PiCCO cardiac monitoring, tracheostomy, mechanical ventilation, analgesics and sedation treatment, and fluid resuscitation. Read More

J Adv Pract Oncol 2018 Mar 1;9(2):216-221. Epub 2018 Mar 1.

The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

RS, a 36-year-old female, presented to the emergency department (ED) of a large academic medical center upon the advice of her primary care provider because of 3 weeks of progressive mental status changes, weakness, and decreased oral intake. According to her husband, RS was diagnosed with stage IIIA large cell lung cancer 8 months earlier and was treated with concurrent chemotherapy (carboplatin, pemetrexed, and bevacizumab) and radiation therapy that was completed 4 months prior to admission. No other specific information about her treatment or outside health records was available. Read More

Clin Cardiol 2019 Feb 7;42(2):277-284. Epub 2019 Jan 7.

Department of Medicine, Ronald Reagan-UCLA Medical Center, Los Angeles, California.

Background: Real-world data on the clinical outcomes of heart failure (HF) across the spectrum of ejection fraction (EF) and the prognostic value of B-type natriuretic peptide (BNP) have not been well examined.

Hypothesis: The real-world association between the clinical outcomes of HF and EF or BNP levels may differ across different EF or BNP values.

Methods: The Optum Integrated Claims-Clinical data (07/2009-09/2016) was used to identify adult patients with ≥1 HF diagnosis during hospitalization or emergency room visit. Read More

Clin Exp Pharmacol Physiol 2018 Dec 21. Epub 2018 Dec 21.

Harbor-UCLA, Department of Emergency Medicine Torrance, CA, 90502.

Early, non-clinical studies support the use of hydroxocobalamin to treat sepsis-induced hypotension, but there is no translational, large animal model. The objective of this study was to compare survival in a sepsis model where large swine had endotoxaemia induced with lipopolysaccharide (LPS) and were treated with intravenous hydroxocobalamin (HOC), norepinephrine (NE), or saline. Thirty swine (45-55 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. Read More

Dis Markers 2018 12;2018:9136971. Epub 2018 Nov 12.

2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.

Background: Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms. The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain.

Methods: This cohort study included patients with chest pain with onset maximum of 6 h before admission and no persistent ST-segment elevation on electrocardiogram. Read More

J Cell Biochem 2018 Dec 9. Epub 2018 Dec 9.

Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Experimenter Center, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.

Introduction: Sepsis can result in acute lung injury. LL-37 is a small cationic host defense peptide involved in anti-inflammatory. In the current study, it was hypothesized that antimicrobial peptide LL-37 could play a protective role in attenuating the progression of sepsis-induced acute lung injury. Read More

ESC Heart Fail 2019 02 26;6(1):202-207. Epub 2018 Nov 26.

Harvard Medical School, Boston, MA, USA.

Aims: Dyspnoea is common in heart failure (HF) but non-specific. Lung ultrasound (LUS) could represent a non-invasive tool to detect subclinical pulmonary congestion in patients with undifferentiated dyspnoea.

Methods And Results: We assessed the feasibility of an abbreviated LUS protocol (eight and two zones) in a prospective pilot study of 25 ambulatory patients with undifferentiated dyspnoea undergoing clinically indicated invasive cardiopulmonary exercise testing (iCPET) at rest (LUS 1) and after peak exercise (LUS 2). Read More

ESC Heart Fail 2019 02 24;6(1):98-102. Epub 2018 Nov 24.

Division of Emergency Medicine, University of Helsinki and Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland.

Aims: The role of microRNAs has not been studied in cardiogenic shock. We examined the potential role of miR-423-5p level to predict mortality and associations of miR-423-5p with prognostic markers in cardiogenic shock.

Methods And Results: We conducted a prospective multinational observational study enrolling consecutive cardiogenic shock patients. Read More

Heart Lung 2018 Nov 20. Epub 2018 Nov 20.

Department of Emergency Medicine, UMPC University of Pittsburgh, USA.

Objective: Ischemia and reperfusion injury (IRI) in cardiac arrest patients after return to spontaneous circulation causes dysfunctions in multiple organs. Kidney injury is generally transient but in some patients persists and contributes both to mortality and increased resource utilisation. Ongoing shock may compound renal injury from IRI, resulting in persistent dysfunction. Read More

Intensive Care Med 2018 Dec 15;44(12):2091-2101. Epub 2018 Nov 15.

Department of Intensive Care, North Karelia Central Hospital, Joensuu, Finland.

Purpose: We aimed to determine the feasibility of targeting low-normal or high-normal mean arterial pressure (MAP) after out-of-hospital cardiac arrest (OHCA) and its effect on markers of neurological injury.

Methods: In the Carbon dioxide, Oxygen and Mean arterial pressure After Cardiac Arrest and REsuscitation (COMACARE) trial, we used a 2 factorial design to randomly assign patients after OHCA and resuscitation to low-normal or high-normal levels of arterial carbon dioxide tension, to normoxia or moderate hyperoxia, and to low-normal or high-normal MAP. In this paper we report the results of the low-normal (65-75 mmHg) vs. Read More

Intensive Care Med 2018 Dec 14;44(12):2112-2121. Epub 2018 Nov 14.

Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Purpose: We assessed the effects of targeting low-normal or high-normal arterial carbon dioxide tension (PaCO) and normoxia or moderate hyperoxia after out-of-hospital cardiac arrest (OHCA) on markers of cerebral and cardiac injury.

Methods: Using a 2 factorial design, we randomly assigned 123 patients resuscitated from OHCA to low-normal (4.5-4. Read More

Clin Cardiol 2019 Jan 17;42(1):5-12. Epub 2018 Dec 17.

The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK.

Background: In ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI), current oral P2Y12 platelet inhibitors do not provide maximal platelet inhibition at the time of reperfusion. Furthermore, administration of cangrelor prior to reperfusion has been shown in pre-clinical studies to reduce myocardial infarct (MI) size. Therefore, we hypothesize that cangrelor administered prior to reperfusion in STEMI patients will reduce the incidence of microvascular obstruction (MVO) and limit MI size in STEMI patients treated with PPCI. Read More

Dis Markers 2018 10;2018:3406028. Epub 2018 Oct 10.

Internal Medicine Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Cardiovascular disease is the leading cause of death among both women and men, but there is still a great percentage of misdiagnosis and lack of clearly defined criteria. Advances in biomolecular science have proven the crucial role of inflammation and, more importantly, the role of adipokines in mediating all stages of coronary artery disease. It has also been suggested that regional fat deposits, more precisely from thoracic region, have a major influence on the development of coronary artery disease by creating a local proatherogenic environment. Read More

Adv Exp Med Biol 2018 ;1088:73-92

Division of Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Muscle atrophy typically is a direct effect of protein degradation induced by a diversity of pathophysiologic states such as disuse, immobilization, denervation, aging, sepsis, cachexia, glucocorticoid treatment, hereditary muscular disorders, cancer, diabetes and obesity, kidney and heart failure, and others. Muscle atrophy is defined by changes in the muscles, consisting in shrinkage of myofibers, changes in the types of fiber and myosin isoforms, and a net loss of cytoplasm, organelles and overall a protein loss. Although in the literature there are extensive studies in a range of animal models, the paucity of human data is a reality. Read More

Am J Cardiol 2018 Dec 14;122(12):2086-2094. Epub 2018 Sep 14.

Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon. Electronic address:

Failure to achieve euvolemia before discharge in patients admitted with acute heart failure (HF) syndromes has gained attention as a marker for increased readmission risk. This study assessed whether variations in discharge documentation practices reflected the readmission risk of patients admitted for decompensated HF. This was a retrospective cohort study of 100 adult patients discharged from an admission for an acute HF syndrome from May 2014 to June 2015. Read More

J Am Heart Assoc 2018 Sep;7(18):e009111

1 Department of Emergency Qilu Hospital Shandong University Jinan China.

Background Stress-induced cell premature senescence participates in a variety of tissue and organ remodeling by secreting such proteins as proinflammatory cytokines, chemokines, and growth factors. However, the role of cardiomyocyte senescence in heart remodeling after acute myocardial infarction has not been thoroughly elucidated to date. Therefore, we sought to clarify the impact of premature myocardial senescence on postinfarction heart function. Read More

In Vivo 2018 Nov-Dec;32(6):1599-1607

Neurology, Department of Neuroscience - Municipal Emergency Hospital, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.

Aim To assess the onset of early left ventricular (LV) systolic and diastolic function impairment and the subclinical atherosclerosis following chemotherapy in patients diagnosed with acute myeloid leukemia (AML).

Materials And Methods: Thirty patients diagnosed with AML with no cardiac history, having LV ejection fraction (LVEF) >50%, were evaluated at baseline and 6 months after starting four cycles of chemotherapy. We measured LV function, global longitudinal strain and subclinical atherosclerosis markers: intima-media thickness (IMT), arterial stiffness aortic pulse wave velocity (PWVAo) and ankle-brachial index (ABI). Read More

Pediatr Emerg Care 2018 Oct 17. Epub 2018 Oct 17.

From the Division of Emergency Medicine, Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey.

Objective: Children are presented with an unknown intoxication at emergency department (ED) after carbon monoxide (CO) poisoning. Although CO poisoning is well defined in the adult literature, little information exists regarding CO poisoning in childhood, especially in infants. The only diagnostic test for CO poisoning is elevation of the carboxyhemoglobin level in the blood. Read More

Acta Clin Belg 2018 Oct 16:1-3. Epub 2018 Oct 16.

a Department of Cardiology, Faculty of Medicine , Mugla Sitki Kocman University , Muğla , Turkey.

Objectives: Allergic myocardial infarction, known as Kounis syndrome, is an acute myocardial infarction after an allergic reaction to food, drugs, or insect stings, etc. Kounis syndrome can also be caused by all kinds of seafood, such as finned fish, molluscan shellfish, cephalopods, and crustacean shellfish.

Methods: Herein, we report a case of a 67-year-old man, with hypertension, referred for itchiness, facial rash, chest pain, and palpitations developed after consumption of blue crab. Read More

Acad Emerg Med 2018 Oct 12. Epub 2018 Oct 12.

Department of Critical Care, Department of Anesthesia, Northern Ontario School of Medicine, Sudbury, Ontario.

Background: Acute aortic syndrome (AAS) is a time-sensitive and difficult-to-diagnose aortic emergency. The American Heart Association (AHA) proposed the acute aortic dissection detection risk score (ADD-RS) as a means to reduce miss rate and improve time to diagnosis. Previous validation studies were performed in a high prevalence population of patients. Read More

Trauma Surg Acute Care Open 2018 1;3(1):e000165. Epub 2018 Oct 1.

Department of Surgery, University of Texas Health Science Center at Houston, Memorial Hermann Hospital Red Duke Trauma Institute, Houston, Texas, USA.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. Read More

Crit Care Med 2019 Jan;47(1):e8-e13

Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Diego, San Diego, CA.

Objectives: A recently published simulation study suggested that women are inferior leaders of cardiopulmonary resuscitation efforts. The aim of this study was to compare female and male code leaders in regard to cardiopulmonary resuscitation outcomes in a real-world clinical setting.

Design: Retrospective cohort review. Read More

Cardiol Clin 2018 Aug;36(3):375-386

Department of Emergency Medicine, University of Washington, Harborview Medical Center, Box 359727, 325 9th Avenue, Seattle, WA 98122, USA. Electronic address:

Cardiopulmonary resuscitation (CPR) quality, including chest compression rate, depth, and fraction of hands-on time, is integral to cardiac arrest survival. Introducing mechanized devices to target these measures of quality in the challenging prehospital environment holds great promise. Comparing mechanical to manual CPR, animal models deliver favorable results on markers of perfusion and manikin studies demonstrate improved consistency of high-quality CPR performance with device use. Read More

PLoS One 2018 27;13(9):e0203756. Epub 2018 Sep 27.

Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.

Aims: Left atrial (LA) structural remodelling develops in rheumatic heart disease (RHD) according to the disease severity of the mitral valve and the presence of atrial fibrillation. Sustained active inflammation has been previously reported in the LA of patients with RHD, suggesting a direct role of cell-mediated immunity in the pathogenesis of LA remodelling. Dendritic cells (DCs) have a major antigen-presenting role, and are known as crucial modulators of innate and adaptive immunity. Read More

Wilderness Environ Med 2018 Dec 23;29(4):471-478. Epub 2018 Sep 23.

Department of Pediatric Emergency, School of Medicine, Çukurova University, Adana, Turkey (Drs Gökay, Kendir, Nalbant, and Prof Ylmaz).

Introduction: A clinical course ranging from mild local findings to life-threatening systemic findings may occur after scorpion stings. The purpose of this study was to identify priority markers indicating scorpion sting-related cardiac involvement.

Methods: Our study was performed between July 2014, and September 2015 in the Çukurova University medical faculty pediatric emergency department, in Adana, Turkey. Read More

Cell Physiol Biochem 2018 26;49(6):2254-2263. Epub 2018 Sep 26.

Department of Basic Medicine Sciences, Zhejiang University School of Medicine, Hangzhou, China.

Background/aims: Hyperglycemia is an important risk factor for the most severe cardiovascular diseases in patients with diabetes. It has been demonstrated that cardiac stem cells (CSCs) play a pivotal role in the maintenance of cardiac homeostasis and regeneration. However, the mechanism underlying the influence of diabetes on CSCs remains unclear. Read More

J Occup Environ Med 2019 Jan;61(1):35-40

Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque (Dr Beverly, Dr Zuhl, Dr McCormick, Dr Mermier); Department of Emergency Medicine, University of New Mexico Health Science Center, Albuquerque (Dr White, Ms Beverly, Dr Williams); School of Fitness Education, Santa Fe Community College, Santa Fe (Dr Beam), New Mexico; and Department of Exercise Science and Sports Management, Kennesaw State University, Kennesaw, Georgia (Dr VanDusseldorp).

: Hanging motionless in a full body harness may result in unwanted events, such as acute hypotension and syncope, which has been termed harness suspension stress (HSS). The etiology of HSS has not been explored, and it is unknown if the type of harness influences the HSS response.

Objectives: Evaluate hemodynamics, subjective discomfort, and biological markers of muscle damage during 30-minutes suspension; and evaluate differences between harness attachment (frontal or dorsal). Read More

Case Rep Infect Dis 2018 27;2018:2179097. Epub 2018 Aug 27.

Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia.

A 23-year-old male presented to the emergency department with one-day history of right-sided pleuritic chest pain, haemoptysis, and fever. In the emergency department, the blood pressure was 140/60 mmHg, heart rate 89/min, body temperature 40°C, respiratory rates 20 breaths/min, and oxygen saturation 98% in room air. Physical examination revealed rales and bronchial breathing in the right infrascapular region. Read More

Int J Cardiol 2018 Oct 21;269:114-121. Epub 2018 Jun 21.

Cardiovascular Research Institute Basel (CRIB), Department of Cardiology, University Hospital Basel, University of Basel, Switzerland.

Background: Various scores have been derived for the assessment of syncope patients in the emergency department (ED) but stay inconsistently validated. We aim to compare their performance to the one of a common, easy-to-use CHADS score.

Methods: We prospectively enrolled patients ≥ 40 years old presenting with syncope to the ED in a multicenter study. Read More

J Int Med Res 2018 Sep 17:300060518798257. Epub 2018 Sep 17.

1 Gr. T. Popa University of Medicine and Pharmacy, Iași, Romania.

Objective This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays. Methods This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. Read More

Medicine (Baltimore) 2018 Sep;97(37):e12269

MPA Healthcare Solutions.

It is important that actual outcomes of care and not surrogate markers, such as process measures, be used to evaluate the quality of inpatient care. Because of the heterogenous composition of patients, risk-adjustment is essential for the objective evaluation of outcomes following inpatient care. Comparative evaluation of risk-adjusted outcomes can be used to identify suboptimal performance and can provide direction for care improvement initiatives. Read More

Front Cardiovasc Med 2018 28;5:114. Epub 2018 Aug 28.

Departments of Radiology and Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States.

Myocardial infarction (MI), which occurs often due to acute ischemia followed by reflow, is associated with irreversible loss (death) of cardiomyocytes. If left untreated, MI will lead to progressive loss of viable cardiomyocytes, deterioration of cardiac function, and congestive heart failure. While supplemental oxygen therapy has long been in practice to treat acute MI, there has not been a clear scientific basis for the observed beneficial effects. Read More

Sci Rep 2018 Aug 24;8(1):12811. Epub 2018 Aug 24.

Institute of Legal Medicine, Medical Faculty University of Leipzig, Leipzig, Germany.

Post-mortem biochemistry of serum markers has been the subject of numerous studies, but in-situ marker stability after death has not been sufficiently evaluated yet. Such laboratory analyses are especially necessary in the cases of functional deaths without morphological evidence of the death causes and also in cardiac death cases with only very short survival times. The aim of the study was to determine the post-mortem stability of commonly-used serum markers at predefined time points. Read More

Can J Kidney Health Dis 2018 8;5:2054358118776326. Epub 2018 Jun 8.

Dascena, Inc, Hayward, CA, USA.

Background: A major problem in treating acute kidney injury (AKI) is that clinical criteria for recognition are markers of established kidney damage or impaired function; treatment before such damage manifests is desirable. Clinicians could intervene during what may be a crucial stage for preventing permanent kidney injury if patients with incipient AKI and those at high risk of developing AKI could be identified.

Objective: In this study, we evaluate a machine learning algorithm for early detection and prediction of AKI. Read More

Eur J Vasc Endovasc Surg 2018 Aug 4. Epub 2018 Aug 4.

Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China; Department of Vascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China. Electronic address:

Objectives: Acute aortic dissection (AAD) is a severe clinical emergency with a high mortality, and is easily misdiagnosed in its early stage. This study aimed at discovering serum metabolomic markers with the potential to diagnose AAD and distinguish between two subtypes of AAD.

Materials And Methods: Thirty-five patients with AAD, including 20 with Stanford type A and 15 with Stanford type B were enrolled in this study, together with 20 healthy controls. Read More

Medicine (Baltimore) 2018 Aug;97(31):e11516

Department of Emergency, Tianjin First Central Hospital, Tianjin, China.

Peripartum cardiomyopathy (PPCM) is life-threatening and its diagnosis is a challenge. We highlight the clinical characteristics and bio-markers of PPCM and the proper differential diagnosis of peripartum dyspnea to aim to make an early diagnosis available.We analyzed 262 peripartum patients with dyspnea, and summed up the final diagnosis. Read More

Clin Toxicol (Phila) 2018 Aug 3:1-8. Epub 2018 Aug 3.

a Department of Emergency Medicine and Trauma , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry , India.

Background: Consumption of yellow oleander (Cascabela thevetia) is a popular method of intentional self-harm in South India.

Objectives: The objectives of this study were to identify the cardiac arrhythmias and electrolyte abnormalities in yellow oleander poisoning and to identify the association between electrolyte abnormalities, cardiac glycoside concentrations at admission and the severity of cardiotoxicity. This study was also designed to identify clinical and biochemical parameters at presentation which predict serious arrhythmias and determinants of mortality. Read More

J Emerg Med 2018 10 26;55(4):472-480. Epub 2018 Jul 26.

Department of Cardiology, University Hospital Tuebingen, Tuebingen, Germany.

Background: Community-acquired pneumonia (CAP) causes appreciable morbidity and mortality in adults, especially in those ≥65 years of age. At hospital admission, an immediate and reliable risk assessment is necessary to detect patients with possible fatal outcome.

Objective: We aimed to evaluate markers of the autonomic nervous system based on an electrocardiogram to predict mortality in patients with CAP. Read More