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Myocardial Infarction Stabilization

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261. Vascular imaging

, and hypoxia. Furthermore, incidence of the condition is rare relative to mimics like pneumonia, pleurisy, pericarditis, and myocardial infarction. Vascular imaging plays an important role in establishing the diagnosis of pulmonary embolism, but there is evidence that vascular imaging is overutilized in select patient populations where diagnostic yield can be less than 3%. 18-23 LOW PRE-TEST PROBABILITY OF PULMONARY EMBOLISM Consensus exists among multiple high-quality evidence-based guidelines that CTA (...) to visualize metallic stent struts. Following endovascular repair, imaging is appropriate at 1 month, 6 months, 12 months, and annually thereafter for aneurysm. Annual evaluation is appropriate following endovascular repair of aortic dissection. Following surgical repair, less-frequent imaging may be performed after 1 year of stability has been established. Atheromatous disease (Adult only) Advanced imaging is considered medically necessary for evaluation of the thoracic aorta as a source of distal emboli

2019 AIM Specialty Health

262. Lansoprazole

, lansoprazole can treat or prevent incident tuberculosis (TB) disease. METHODS AND FINDINGS: We studied a cohort (...) of new users of lansoprazole , omeprazole, or pantoprazole from the United Kingdom Clinical Practice Research Datalink to determine whether lansoprazole users have a lower incidence of TB disease than omeprazole or pantoprazole users. Negative control outcomes of myocardial infarction (MI) and herpes zoster were also studied. Multivariable Cox proportional hazards regression was used (...) . This study seeks to determine if the medication is equally distributed within the tablet to allow for accurate dosing. METHODS: Ten 15-mg Prevacid SoluTabs were divided. Each (...) ). CONCLUSIONS: There are statistically significant differences in the amount of lansoprazole -containing microgranules within each half of a divided tablet. Clinicians must determine whether this difference is clinically relevant when prescribing "divided" medication to children. 2015 16. A Novel, Validated Stability

2018 Trip Latest and Greatest

263. Nitroglycerin

ration via nasogastric tube. In 4 groups of 5 horses each, saline (0.9% NaCl) solution or ET receptor antagonist (10(5)M 2006 2. Prehospital Nitroglycerin Safety in Inferior ST Elevation Myocardial Infarction. Patients with inferior ST elevation myocardial infarction (STEMI), associated with right ventricular infarction, are thought to be at higher risk of developing hypotension when administered nitroglycerin (NTG). However, current basic life support (BLS) protocols do not differentiate location (...) (or ) are indicated as first line agents in most other cases of III. Preparation Mix 50 mg in 250 ml D5W IV. Dosing: Acute Myocardial Ischemia or Infarction Bolus: 12.5 to 25 mcg 2015 16. Nitroglycerin Nitroglycerin Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies

2018 Trip Latest and Greatest

264. Quinapril

angiotensin (...) -converting enzyme inhibition (ACE-I) (i.e., quinapril ) prevents transient ischemia (exertional and spontaneous) in patients with coronary artery disease (CAD). It is known that ACE-I reduces the risk of death, myocardial infarction (MI), and other CAD-related outcomes in high-risk patients. Numerous studies have confirmed that ACE-I improves coronary flow and endothelial function. Whether ACE-I also decreases transient ischemia is unclear, because no studies have been adequately (...) of systematic reviews, clinical guidelines 2018 12. Effects of quinapril , losartan and hydralazine on cardiac hypertrophy and β-adrenergic neuroeffector mechanisms in transgenic (mREN2)27 rats 9504380 1998 04 13 1998 04 13 2015 11 19 0007-1188 123 3 1998 Feb British journal of pharmacology Br. J. Pharmacol. Effects of quinapril , losartan and hydralazine on cardiac hypertrophy and beta-adrenergic neuroeffector mechanisms in transgenic (mREN2)27 rats. 405-12 1. Desensitization of the myocardial beta

2018 Trip Latest and Greatest

265. Diltiazem

Comparison of Diltiazem and Metoprolol in the Management of Acute Atrial Fibrillation or Atrial Flutter (DiME (...) complications such as congestive heart failure, hypotension, ventricular ectopy, respiratory failure, angina and myocardial infarction. Both beta-blocking agents and calcium channel blockers are commonly used to treat AFF in the ED. Metoprolol is the most commonly used beta-blocker; and diltiazem is the most frequently used calcium channel antagonist.[8] Diltiazem was released by the FDA (...) intravenous NTG. Both groups had similar baseline features and the endpoints of treatment were recurrence of angina, myocardial infarction 1995 11. [Intraoperative cortical PO2 measurement in kidney transplantation. the effect of the calcium antagonist diltiazem ]. 7974930 1994 12 23 1994 12 23 2013 11 21 0340-2592 33 5 1994 Sep Der Urologe. Ausg. A Urologe A [Intraoperative cortical PO2 measurement in kidney transplantation. the effect of the calcium antagonist diltiazem ]. 415-21 A local measurement

2018 Trip Latest and Greatest

266. Ezetimibe

of major adverse cardiovascular events (including cardiac death, spontaneous myocardial infarction, unplanned 2017 2. Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary Syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) 28972004 2017 12 26 2017 12 26 1524-4539 136 25 2017 Dec 19 Circulation Circulation Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary (...) of cardiovascular events, but whether the addition of ezetimibe , a nonstatin drug that reduces intestinal cholesterol absorption (...) (40 mg) and ezetimibe (10 mg) (simvastatin- ezetimibe ) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization (≥30 days after randomization), or nonfatal stroke. The median follow-up was 6

2018 Trip Latest and Greatest

267. Allopurinol

disease. Methods We conducted a multicenter, double-blind, noninferiority trial involving patients with gout (...) and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function. The trial had a prespecified noninferiority margin of 1.3 for the hazard ratio for the primary end point (a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization (...) ), allopurinol and febuxostat, are the mainstay of urate lowering treatment for gout and may have different effects on cardiovascular risk in patients with gout. Methods -Using U.S. Medicare claims data (2008-2013), we conducted a cohort study for comparative cardiovascular safety of initiating febuxostat versus allopurinol among gout patients aged ≥65 years. The primary outcome was a composite endpoint of hospitalization for myocardial infarction (MI) or stroke 2018 16. Does Allopurinol Prolong a Treated

2018 Trip Latest and Greatest

268. ESC/ESH Management of Arterial Hypertension

Rosuvastatin LDH Lactate dehydrogenase LDL-C LDL cholesterol LEAD Lower extremity artery disease LIFE Losartan Intervention For Endpoint reduction in hypertension LV Left ventricular LVH Left ventricular hypertrophy MAP Mean arterial pressure MI Myocardial infarction MR Magnetic resonance MRA Mineralocorticoid receptor antagonist MRI Magnetic resonance imaging MUCH Masked uncontrolled hypertension NORDIL Nordic Diltiazem NS Non-significant NT-proBNP N-terminal pro-B natriuretic peptide o.d. Omni die (every (...) million), and ischaemic stroke (1.5 million). Both office BP and out-of-office BP have an independent and continuous relationship with the incidence of several CV events [haemorrhagic stroke, ischaemic stroke, myocardial infarction, sudden death, heart failure, and peripheral artery disease (PAD)], as well as end-stage renal disease. Accumulating evidence is closely linking hypertension with an increased risk of developing atrial fibrillation (AF), and evidence is emerging that links early elevations

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2018 European Society of Cardiology

269. Management of Cardiovascular Diseases during Pregnancy

ratio ACS Acute coronary syndromes AF Atrial fibrillation AHF Acute heart failure AMI Acute myocardial infarction aPTT Activated partial thromboplastin time ARB Angiotensin receptor blocker ARNI Angiotensin receptor neprilysin inhibitor AS Aortic stenosis ASD Atrial septal defect ASI Aortic size index AT Atrial tachycardia AUC Area under the curve AV Atrioventricular BMI Body mass index BP Blood pressure BSA Body surface area CAD Coronary artery disease CARPREG CARdiac disease in PREGnancy CCB (...) 5-HT1A 5-hydroxytryptamine (serotonin) HTAD Heritable thoracic aortic disease ICD Implantable cardioverter-defibrillator ICU Intensive care unit IE Infective endocarditis INR International normalized ratio i.v. Intravenous KLH Keyhole limpet haemocyanin LMWH Low molecular weight heparin LQTS Long QT syndrome LV Left ventricular LVEF Left ventricular ejection fraction MCS Mechanical circulatory support mGy Milligray MI Myocardial infarction MR Mitral regurgitation MRA Mineralocorticoid receptor

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2018 European Society of Cardiology

270. Acute Mental Status Change, Delirium, and New Onset Psychosis

onset that make evaluation challenging, some of which are life threatening. These may be related to systemic disease, such as sepsis or infection, hypoxia, metabolic derangements, hypoglycemia, hyperglycemia, hyponatremia, hypoxia, hypothermia, acute myocardial infarction, neurologic disease including stroke, ICH, Wernicke encephalopathy (thiamine deficiency), central nervous system infection, seizure, surgery, trauma, drugs such as anticholinergic drugs, sedatives, narcotics, drug or alcohol (...) imaging. Procedure Appropriateness Category Relative Radiation Level CT head without IV contrast Usually Appropriate ??? MRI head without IV contrast Usually Appropriate O MRI head without and with IV contrast May Be Appropriate O CT head without and with IV contrast May Be Appropriate ??? CT head with IV contrast Usually Not Appropriate ??? Variant 2: Acute or progressively worsening mental status change in patient with a known intracranial process (mass, recent hemorrhage, recent infarct, central

2019 American College of Radiology

271. SCAI clinical expert consensus statement on the classification of cardiogenic shock

THE CLASSIFICATION SCHEMA There are five stages of shock labeled A‐E in our proposed schema (Table , Figure ). Table 1. Descriptors of shock stages: physical exam, biochemical markers and hemodynamics Stage Description Physical exam/bedside findings Biochemical markers Hemodynamics A At risk A patient who is not currently experiencing signs or symptoms of CS, but is at risk for its development. These patients may include those with large acute myocardial infarction or prior infarction acute and/or acute (...) or diastolic heart failure may fall into this classification which is quite broad. In general, anterior wall and large distribution infarcts carry a higher risk of cardiogenic shock but some patients may manifest shock with smaller infarcts in the setting of pre‐existing left ventricular dysfunction. A recent study notes the increasing incidence of shock in the ICU without myocardial infarction. Stage B: “Beginning” CS (Pre‐shock/compensated shock) describes a patient who has clinical evidence of relative

2019 Society for Cardiovascular Angiography and Interventions

273. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm

blockers, calcium channel blockers (CCBs), and thiazide diuretics are favored choices for first-line treatment ( ). The selection of medications should be based on factors such as the presence of albuminuria, ASCVD, heart failure, or post–myocardial infarction status as well as patient race/ethnicity, possible metabolic side effects, pill burden, and cost. Because ACEIs and ARBs can slow progression of nephropathy and retinopathy, they are preferred for patients with T2D ( , ). Patients with heart (...) with clinical ASCVD and diabetes. When added to maximal statin therapy, these once-or twice-monthly injectable agents reduce LDL-C by approximately 50%, raise HDL-C, and have favorable effects on other lipids ( ). In the FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) study, evolocumab significantly reduced the risk of myocardial infarction, stroke, and coronary revascularization ( ), and similar effects were seen with alirocumab in ODYSSEY Outcomes

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2019 American Association of Clinical Endocrinologists

275. Iron Deficiency and Anaemia in Adults

is a 75-year-old gentleman with known chronic heart failure, aetiology ischaemic heart disease having had two previous myocardial infarctions. He has been well for some time (NYHA I) but has found he has been able to do less, with his wife taking on more in the home. His deteriorating symptoms include increasing shortness of breath and fatigue and he is now NYHA II/ III. He is unable to play nine holes of golf as he once did and is feeling isolated at home, unable to get out like previously and meet (...) >500 to 1000mg 250ml 15 minutes Note: For stability reasons, dilutions to concentrations less than 2mg iron/ml are not permissible. Ferinject must not be administered by the subcutaneous or intramuscular route. Minimum observation is required (pulse and blood pressure should be checked before and after infusion). Facilities for cardiorespiratory resuscitation and equipment for handling acute anaphylactic/anaphylactoid reactions should be available, including an injectable 1:1000 adrenaline solution

2018 Royal College of Nursing

277. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations.

) ( x 13 Lane, D.A. and Lip, G.Y. Use of the CHADS-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation . 2012 ; 126 : 860–865 ) (13) . The acryonm represents underlying cardiovascular risk factors used to calculate the score: congestive hear failiure (C), hypertension (H), age (A), diabetes (D), stroke/transient ischemic attack (S), and vascular diseases (VASc) such as peripheral arterial disease, previous myocardial infarction (...) of thrombotic risk, especially when newly implanted ( x 18 Dangas, G.D., Weitz, J.I., Giustino, G., Makkar, R., and Mehran, R. Prosthetic heart valve thrombosis. J Am Coll Cardiol . 2016 ; 68 : 2670–2689 ) (18) . Coronary Artery Disease As discussed in part I of these guidelines, significant morbidity and potential for thromboembolic complications exist if such patients are mismanaged ( x 20 Windecker, S., Kolh, P., Alfonso, F. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force

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2019 Society of Interventional Radiology

278. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part I: Review of Anticoagulation Agents and Clinical Considerations

of thrombosis. It is used in patients without verified vascular disease and to reduce the risk of vascular events in patients at high risk or those with a history of myocardial infarction or stroke. Aspirin irreversibly inhibits cyclooxygenase (COX)-1, resulting in reduced thromboxane A2 production, which subsequently decreases platelet aggregation and activation. Aspirin has a mild antiplatelet effect, acts within 15–30 minutes, and is rapidly metabolized into its nonactive metabolite. The lifespan (...) P2Y12 inhibitor that has a rapid onset of action with a short half-life of 3–6 minutes. It is used in acute coronary care for the prevention of periprocedural myocardial infarction or stent thrombosis, with patients being transitioned to an oral thienopyridine agent postprocedurally. Cangrelor can also be used as a “bridge” therapy option for patients receiving oral thienopyridines before surgery ( x 38 Angiolillo, D.J., Firstenberg, M.S., Price, M.J , and BRIDGE Investigators. Bridging antiplatelet

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2019 Society of Interventional Radiology

279. Male Sexual Dysfunction

-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur Urol, 2009. 55: 121. 147. Khera, M., et al. A new era of testosterone and prostate cancer: from physiology to clinical implications. Eur Urol, 2014. 65: 115. 148. Corona, G., et al. Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis. Expert Opin Drug Saf, 2014. 13: 1327. 149. Baillargeon, J., et al. Risk of Myocardial Infarction in Older Men Receiving Testosterone (...) and meta-analysis. J Clin Endocrinol Metab, 2010. 95: 2560. 153. Haddad, R.M., et al. Testosterone and cardiovascular risk in men: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc, 2007. 82: 29. 154. Vigen, R., et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA, 2013. 310: 1829. 155. Sohn, M., et al. Standard operating procedures for vascular surgery in erectile dysfunction

2019 European Association of Urology

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