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Coronary Risk Stratification of Chest Pain


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781. Perioperative Early Tiredness (Acute Fatigue) in Patients With Epithelial Ovarian Cancer

is a method of bioimpedance Heart rate variability, cardiorespiratory coupling, pulse wave velocity and new markers calculated from raw biosignals [ Time Frame: Up to the fifth postoperative day, at hospital discharge (an average of two weeks) and before, during and after the first cycle of chemotherapy (an average of four to six weeks) ] Bioelectrical signals to assess the interaction of the cardiac and pulmonary rhythms Metabolomics/Proteomics [ Time Frame: Up to the first postoperative day (...) an important clinical challenge whereas appropriate risk predictors are still missing. In this regard, fatigue is a complex phenomenon, is affected by many factors and has been shown to be associated with delayed return to normal activity after surgery. The investigators hypothesize that early tiredness (acute fatigue) assessed shortly after surgery is associated to postoperative complications and organ dysfunctions and might be used for risk stratification. Therefore, in this prospective, observational

2017 Clinical Trials

782. COOL-AMI EU Pivotal Trial

]). The patient is presenting with resuscitated cardiac arrest, atrial fibrillation, or Killip risk stratification class II through IV. The patient has an aortic dissection or requires an immediate surgical or procedural intervention other than PCI. The patient has known history of Congestive Heart Failure (CHF), hepatic failure, end-stage kidney disease or severe renal failure (clearance < 30ml/min/1.73m²). The patient is febrile (temperature > 37.5 °C) or has experienced an infection with fever in the last (...) as an adjunct to PCI Cooling with ZOLL Proteus IVTM System before and after Percutaneous Coronary Intervention (PCI) -or- Standard of Care for PCI Outcome Measures Go to Primary Outcome Measures : Relative reduction of in mean anterior myocardial infarct size as determined by Cardiac Magnetic Resonance (cMR) imaging at 4-6 days post infarct in the Test Arm (cooling + PCI) relative to the Control Arm (PCI only). [ Time Frame: 4-6 Days ] Eligibility Criteria Go to Information from the National Library

2017 Clinical Trials

783. Prostate Cancer Survivors and Exercise and Behavioral Counseling

Exclusion Criteria: Severe coronary artery disease (Canadian Cardiovascular Society class III or greater) Significant congestive heart failure (New York Heart Association class III or greater) Uncontrolled pain Neurological or musculoskeletal co-morbidity inhibiting exercise Diagnosed psychotic, addictive or major cognitive disorders Absent for more than 3 consecutive days during the 12-week intervention High risk individuals (i.e., men who have symptomatic and known cardiovascular, pulmonary (...) and/or metabolic disease) as determined by the risk stratification questionnaire Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its identifier (NCT number): NCT03191968 Contacts Layout table for location contacts Contact: Linda Trinh, PhD (217) 333-2461 Locations Layout table for location

2017 Clinical Trials

784. Downstream Molecular Signals of P2Y12 Receptors in Hyporeactive Patients Under Clopidogrel Treatment A Possible Mechanism of HOTPR(High On-Treatment Platelet Reactivity)

Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases Chest Pain Pain Neurologic Manifestations Signs and Symptoms Clopidogrel Platelet Aggregation Inhibitors Purinergic P2Y Receptor Antagonists Purinergic P2 Receptor Antagonists Purinergic Antagonists Purinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs (...) as an indicator of the reaction of the P2Y12 inhibitor during treatment, currently, the existing evidence to support the post-treatment platelet activity can be used to distinguish the potential risk among patients who received percutaneous transluminal coronary angioplasty after ischemic / thrombotic events. The risks of stent thrombosis, of which, by analysis of the PRU (P2Y12 reaction units) value level of VerifyNow System has been considered an international standard tools. PRU value by VerifyNow system

2017 Clinical Trials

785. Stress Tests Part 3: Stress test accuracy

pretest probability of coronary artery disease and stress test utilization and outcomes in a chest pain observation unit. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2014; 21(4):401-7. PMID: Poldermans D, Bax JJ, Schouten O, et al. Should major vascular surgery be delayed because of preoperative cardiac testing in intermediate-risk patients receiving beta-blocker therapy with tight heart rate control? Journal of the American College of Cardiology (...) detect MI or death? (Can stress testing be used for risk stratification?) When we discharge chest pain patients home from the emergency department, we are worried about missing MIs, with the potential consequence of the patient dying. We order stress tests because we don’t want to miss an MI. This data can get very confusing because so many other outcomes are studied, but it makes sense to start with the outcomes that we (and out patients) care about. The quick summary of these papers is that stress

2019 First10EM

786. Transient loss of consciousness ('blackouts') in over 16s

guidance 88). [4] Arrhythmias and heart failure – implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (NICE technology appraisal guidance 314). [5] National service framework for coronary heart disease. [6] European Society of Cardiology guidelines on syncope. Transient loss of consciousness ('blackouts') in over 16s (CG109) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 6 of 32K Ke ey (...) %. The Framingham study [10] identified people with cardiac syncope to have a poorer prognosis than those with neurally mediated syncope or those in whom the cause of TLoC was uncertain. Risk-stratification studies undertaken in Emergency Departments in patients with TLoC have identified that an abnormal resting 12-lead ECG at presentation is a marker of high risk of death. A 12-lead ECG is cheap, widely available and can be performed quickly at the patient's bedside. In the past, all recorded ECGs were

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

787. Diagnosis and management of colorectal cancer

cancer and hip fractures, but this risk reduction was outweighed by increased risk for coronary heart disease events, strokes, pulmonary embolism and invasive breast cancer. 9 The relative risks appear to be lower for current than for past users. The protective effect reduces several years after stopping hormone use, 11 and there appears to be no association with rectal cancer. 13 Fewer data are available on OC use, although recent, rather than long term, intake appears to be related to some risk (...) in patients with inflammatory bowel disease increases with the duration and extent of disease; other risk factors include severity of inflammation, primary sclerosing cholangitis (PSC), a family history of colorectal cancer (especially with a first degree relative 1 cm) at the first colonoscopy or if the index adenoma has a villous or high-grade dysplastic component. 27 Surveillance intervals should be determined by risk stratification. 22 Patients with one or two adenomas 1 cm in size confers

2011 SIGN

788. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®): Health Professional Version

and other conditions have been grouped into overgrowth and non-overgrowth categories (refer to ). Overgrowth syndromes and conditions are the result of excessive prenatal and postnatal somatic growth.[ , ] It is important to recognize that the absolute risk of Wilms tumor varies with the underlying condition or anomaly (e.g., most patients with hemihypertrophy will not develop Wilms tumor). Table 1. Syndromes and Conditions Associated With Wilms Tumor Syndrome/Condition Gene Overgrowth Phenotype Non (...) mutations in the WT1 gene are responsible for most cases of Wilms tumor that occur as part of Denys-Drash syndrome.[ , ] The risk of Wilms tumor is about 90% for children with Denys-Drash syndrome.[ ] WT2 -related syndromes include the following: Beckwith-Wiedemann syndrome. Beckwith-Wiedemann syndrome is an overgrowth syndrome characterized by asymmetric growth of one or more parts of the body, large tongue, omphalocele or umbilical hernia at birth, creases or pits in the skin near the ears, kidney

2016 PDQ - NCI's Comprehensive Cancer Database

789. Childhood Vascular Tumors Treatment (PDQ®): Health Professional Version

cardiac and pulmonary assessment and measurement of heart rate and blood pressure. - Consensus was not reached regarding the need for pretreatment electrocardiogram; however, two studies found no contraindication to beta-blocker therapy in 6.5% to 25% of patients who had electrocardiogram abnormalities.[ , ] Electrocardiogram should be considered in children with heart rate lower than normal for age and history of arrhythmia or arrhythmia detected during examination. - Family history of congenital (...) high-flow lesions that are completely formed at birth but rapidly involute by 12 to 15 months. They can ulcerate and bleed and can cause transient heart failure and mild coagulopathy. After involution, usually some residual changes in the skin are present (refer to ).[ - ] In a retrospective case series of congenital hemangiomas, several high-risk ultrasound findings were noted for RICH. Venous lakes were associated with cardiac failure, and an increased risk of bleeding was noted with venous lakes

2016 PDQ - NCI's Comprehensive Cancer Database

790. Breast Cancer Prevention (PDQ®): Health Professional Version

of Breast Cancer Hormone therapy Based on a 1997 reanalysis of 51 epidemiological studies encompassing more than 150,000 women, hormone therapy (HT) after menopause was shown to be associated with increased breast cancer risk.[ ] The Heart and Estrogen/Progestin Replacement Study supported this finding in 2002.[ ] In this study, 2,763 women with coronary heart disease at a mean age of 67 years were randomly assigned to receive either estrogen and progestin therapy or placebo. After a mean follow-up (...) ). The trial was terminated early because combined HT did not decrease coronary heart disease risk but did increase the risk of stroke and breast cancer. An increased rate of invasive breast cancer risk (hazard ratio [HR], 1.24; 95% CI, 1.02–1.50), but not for in situ breast cancer, was observed in all subgroups of women. The combined HT-related cancers had similar grade, histology, and expression of estrogen receptor (ER), progesterone receptor, and HER2 /neu, with a trend toward larger size and higher

2016 PDQ - NCI's Comprehensive Cancer Database

791. Melanoma Treatment (PDQ®): Health Professional Version

diagnosed in the United States, with 5.4 million cancers diagnosed among 3.3 million people in 2012.[ ] Invasive melanoma represents about 1% of skin cancers but results in most deaths.[ , ] The incidence has been increasing over the past 30 years.[ ] Elderly men are at highest risk; however, melanoma is the most common cancer in young adults aged 25 to 29 years and the second most common cancer in those aged 15 to 29 years.[ ] Ocular melanoma is the most common cancer of the eye, with approximately (...) 2,000 cases diagnosed annually. Risk Factors Risk factors for melanoma include both intrinsic (genetic and phenotype) and extrinsic (environmental or exposure) factors: Sun exposure. Pigmentary characteristics. Multiple nevi. Family and personal history of melanoma. Immunosuppression. Environmental exposures. (Refer to the PDQ summaries on and the for more information about risk factors.) Anatomy Schematic representation of normal skin. Melanocytes are also present in normal skin and serve

2016 PDQ - NCI's Comprehensive Cancer Database

792. Childhood Hematopoietic Cell Transplantation (PDQ®): Health Professional Version

comparison.[ , ] However, for very high-risk patients such as those with early relapse of acute lymphoblastic leukemia (ALL), randomized trials have not been feasible because of investigator bias.[ , ] In general, HCT typically offers benefit only to children at high risk of relapse with standard chemotherapy approaches. Accordingly, treatment schemas that accurately identify these high-risk patients and offer HCT if reasonably HLA-matched donors are available have come to be the preferred approach (...) for many diseases.[ ] Less well-established, higher-risk approaches to HCT are generally reserved for only the very highest-risk patients. However, higher-risk approaches such as haploidentical transplantation are becoming safer and more efficacious and are increasingly being used interchangeably with fully matched allogeneic approaches.[ - ] (Refer to the section of this summary for more information.) When comparisons of similar patients treated with HCT or chemotherapy are made in the setting where

2016 PDQ - NCI's Comprehensive Cancer Database

793. Genetics of Endocrine and Neuroendocrine Neoplasias (PDQ®): Health Professional Version

in the following: Constipation. Nausea and vomiting. Dehydration. Decreased appetite and abdominal pain. Anorexia. Diuresis. Kidney stones. Increased bone resorption with resultant increased risk of bone fracture. Lethargy. Depression. Confusion. Hypertension. Shortened QT interval. Since MEN1-associated hypercalcemia is directly related to the presence of parathyroid tumors, surgical removal of these tumors may result in normalization of calcium and PTH levels and relief of symptoms; however, high recurrence (...) in this PDQ summary on the genetics of endocrine and neuroendocrine neoplasias, with hyperlinks to detailed sections below that describe the evidence on each topic. Inheritance and Risk Several hereditary syndromes involve the endocrine or neuroendocrine glands. (MEN1), (MEN2), (MEN4), (FPPL), (CSS), and (FNMTC) are covered in this summary. Autosomal dominantly inherited pathogenic variants have been identified as the cause of most of these syndromes. PHEOs and PGLs may also be found in individuals

2016 PDQ - NCI's Comprehensive Cancer Database

794. Genetics of Skin Cancer (PDQ®): Health Professional Version

by BCNS.[ , , ] BCNS-associated ovarian fibromas are more likely to be bilateral and calcified than sporadic ovarian fibromas.[ ] Ameloblastomas, aggressive tumors of the odontogenic epithelium, have also been proposed as a diagnostic criterion for BCNS, but most groups do not include it at this time.[ ] Other associated benign neoplasms include gastric hamartomatous polyps,[ ] pulmonary cysts,[ ] cardiac fibromas,[ ] meningiomas,[ - ] craniopharyngiomas,[ ] fetal rhabdomyomas,[ ] leiomyomas (...) that describe the evidence on each topic. Inheritance and Risk More than 100 types of tumors are clinically apparent on the skin; many are known to have familial and/or inherited components, either in isolation or as part of a syndrome with other features. and , which are known collectively as nonmelanoma skin cancer, are two of the most common malignancies in the United States and are often caused by sun exposure, although several hereditary syndromes and genes are also associated with an increased risk

2016 PDQ - NCI's Comprehensive Cancer Database

795. Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Health Professional Version

mediastinal masses are at risk of tracheal compression, superior vena caval compression, large pleural and pericardial effusions, and right and left ventricular outflow compression. Thus, cardiac or respiratory arrest is a significant risk, particularly if the patient is placed in a supine position for procedures such as computed tomography (CT) scans or echocardiograms.[ ] Because of the risk of complications from general anesthesia or heavy sedation, a careful physiologic and radiographic evaluation (...) ALCL = anaplastic large cell lymphoma; DLBCL = diffuse large B-cell lymphoma; NHL = non-Hodgkin lymphoma. a Adapted from Percy et al.[ ] b Indolent and aggressive histologies (more commonly seen in adult patients) are mostly found in older adolescents. Risk Factors Relatively little data on the epidemiology of childhood NHL have been published. However, known risk factors include the following: EBV: EBV is associated with most cases of NHL seen in the immunodeficient population.[ ] Almost all

2016 PDQ - NCI's Comprehensive Cancer Database

796. Prostate Cancer Treatment (PDQ®): Health Professional Version

Information for Prostate Cancer Staging Tests Most men are diagnosed with prostate cancer at an early clinical stage and do not have detectable metastases. Therefore, they generally do not have to undergo staging tests, such as a bone scan, computed tomography (CT), or magnetic resonance imaging (MRI). However, staging studies are done if there is clinical suspicion of metastasis, such as bone pain; local tumor spread beyond the prostate capsule; or a substantial risk of metastasis (prostate-specific (...) . Randomized trials have yielded conflicting results.[ - ] Systematic literature reviews and meta-analyses have reported no clear evidence that screening for prostate cancer decreases the risk of death from prostate cancer, or that the benefits outweigh the harms of screening.[ , ] (Refer to the PDQ summary on for a detailed summary of evidence regarding the benefits and harms of screening for prostate cancer.) Pathology More than 95% of primary prostate cancers are adenocarcinomas. Prostate

2016 PDQ - NCI's Comprehensive Cancer Database

797. Testicular Cancer Treatment (PDQ®): Health Professional Version

of coronary heart disease (i.e., myocardial infarction and/or angina pectoris) was increased 1.17 times (95% confidence interval [CI], 1.04–1.31) compared with the general population.[ ] Patients who received radiation therapy to the mediastinum had a 2.5-fold (95% CI, 1.8–3.4) increased risk of coronary heart disease, and those who also received chemotherapy had an almost threefold (95% CI, 1.7–4.8) increased risk. Patients who were treated with infradiaphragmatic radiation therapy alone had (...) no significantly increased risk of coronary heart disease. In multivariate Cox regression analyses, the older chemotherapy regimen of cisplatin, vinblastine, and bleomycin (PVB), used until the mid-1980s, was associated with a significant 1.9-fold (95% CI, 1.2–2.9) increased risk of cardiovascular disease (i.e., myocardial infarction, angina pectoris, and heart failure combined). The newer regimen of bleomycin, etoposide, and cisplatin (BEP) was associated with a borderline significant 1.5-fold (95% CI, 1.0

2016 PDQ - NCI's Comprehensive Cancer Database

798. Childhood Soft Tissue Sarcoma Treatment (PDQ®): Health Professional Version

to treatment on the basis of their risk group (defined by the presence of metastasis, tumor resectability and margins, and tumor size and grade; refer to ).[ ][ ] Figure 4. Risk stratification and treatment assignment for the Children's Oncology Group ARST0332 trial. Credit: Sheri L. Spunt, M.D., M.B.A. Arm A (grossly excised low-grade tumor and ≤5 cm widely excised high-grade tumor): Surgery only. Arm B (≤5 cm marginally resected high-grade tumor): 55.8 Gy of radiation therapy. Arm C (>5 cm grossly (...) tissue sarcoma (with central pathology review).[ ] A review of children with non-rhabdomyosarcoma soft tissue sarcomas was performed with data from the Surveillance, Epidemiology, and End Results (SEER) program and identified 941 patients between 1988 and 2007.[ ] The COG risk stratification was validated in this cohort. Intergroup Rhabdomyosarcoma Study Staging System Nonmetastatic disease Group I: Localized tumor completely resected with histologically negative margins. Group II: Grossly resected

2016 PDQ - NCI's Comprehensive Cancer Database

799. Unusual Cancers of Childhood Treatment (PDQ®): Health Professional Version

ethnic groups, such as inhabitants of some areas in North Africa and the Mediterranean basin, and, particularly, Southeast Asia. In the United States, the incidence of nasopharyngeal carcinoma is higher in black children and adolescents younger than 20 years.[ , ] Risk Factors Nasopharyngeal carcinoma is strongly associated with Epstein-Barr virus (EBV) infection. In addition to the serological evidence of infection in more than 98% of patients, EBV DNA is present as a monoclonal episome (...) in the nasopharyngeal carcinoma cells, and tumor cells can have EBV antigens on their cell surface.[ ] The circulating levels of EBV DNA and serologic documentation of EBV infection may aid in the diagnosis.[ ] Specific HLA subtypes, such as the HLA A2Bsin2 haplotype, are associated with a higher risk of nasopharyngeal carcinoma.[ ] Histology Three histologic subtypes of nasopharyngeal carcinoma are recognized by the World Health Organization (WHO): Type I—keratinizing squamous cell carcinoma. Type II

2016 PDQ - NCI's Comprehensive Cancer Database

800. Childhood Cancer Genomics (PDQ®): Health Professional Version

of CDKN2A , CDKN2B , PAX5 , or PAR1 (in the absence of ERG deletion) were identified.[ ] There are few published results of changing therapy on the basis of IKZF1 gene status. The Malaysia-Singapore group published results of two consecutive trials. In the first trial (MS2003), IKZF1 status was not considered in risk stratification, while in the subsequent trial (MS2010), IKZF1 -deleted patients were excluded from the standard-risk group. Thus, more IKZF1 -deleted patients in the MS2010 trial received (...) intensified therapy. Patients with IKZF1 -deleted ALL had improved outcomes in MS2010 compared with patients in MS2003, but interpretation of this observation is limited by other changes in risk stratification and therapeutic differences between the two trials.[ ][ ] T-cell ALL cytogenetics/genomics Multiple chromosomal translocations have been identified in T-cell ALL that lead to deregulated expression of the target genes. These chromosome rearrangements fuse genes encoding transcription factors (e.g

2016 PDQ - NCI's Comprehensive Cancer Database

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