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19001. Effectiveness of implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in women with advanced heart failure

American Society of Pacing and Electrophysiology/Heart Rhythm Society were scanned between 1994 and 2008. Bibliographies of recent narrative reviews were handsearched. Study selection Randomised controlled trials (RCTs) assessing implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in patients with heart failure and reduced left ventricular ejection fraction, were eligible for inclusion. Eligible trials were required to report all-cause mortality in the female (...) Effectiveness of implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in women with advanced heart failure Effectiveness of implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in women with advanced heart failure Effectiveness of implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in women with advanced heart failure Ghanbari H, Dalloul G, Hasan R, Daccarett M, Saba S, David S

2009 DARE.

19002. Radiofrequency catheter ablation of the pulmonary veins for treatment of atrial fibrillation

or (in patients with atrial fibrillation and congestive heart failure) atrioventricular node ablation and pacing. Anticoagulation regimens varied between studies. The authors did not state how the studies were selected for review. Assessment of study quality The quality of individual RCTs was evaluated using the United States Preventative Services Task Force Framework, which categorises studies as being of good, fair or poor quality based on five criteria related to comparability of groups, interventions (...) and superior to atrioventricular nodal ablation in patients with congestive heart failure, symptomatic atrial fibrillation and uncontrolled heart rate. Though broadly reliable, these conclusions are based on a small number of studies that reported 12 months follow-up or less. Authors' objectives To determine whether radiofrequency catheter ablation improves health outcomes when used to treat patients with atrial fibrillation. Searching An earlier search of MEDLINE from 1990 to March 2006 for relevant

2009 DARE.

19003. Treatment of overactive bladder in women

electrical stimulation and caffeine reduction. Comparisons included other behavioural treatments, pharmacological treatment, placebo and control. Complementary and alternative therapies included acupuncture, foot reflexology and hypnotherapy. Two reviewers independently screened studies for inclusion. Discrepancies were resolved through referral to a third reviewer. Assessment of study quality Two reviewers independently assessed the internal and external validity of the included studies. Criteria

2009 DARE.

19004. Neuro-realism

reports? It was truly terrible journalism. A milli amp in the correct direction (poor theoretical knowledge of electricity shown by the BBC, direction of flow of electrons or the pre atomic model of + to – flow?) improves ability to perform in maths where the opposite makes you as poor as a six year old. A trial where n=15. I’m sure I’ve seen a suggest topic to Ben link somewhere once but long since forgotten where it was. Maybe that is due to a milli amp or two in the wrong directions who knows (...) the cure du jour is) also happen to be wealthy, leisured, unstressed and called Tarquin or Miranda is never mentioned. ALHolland said, November 7, 2010 at …and did the experiment take into account that sometimes, some people get turned on by visual stimulus which would involve, i’ll wager, blood flow to the brain, whereas sometimes, some people get turned on by having their gentitals stimulated (somehow) and therefore, not so much blood flow (maybe) and that sometimes, some people get turned

2010 Bad Science

19005. Is combined resynchronisation and implantable defibrillator therapy a cost-effective option for left ventricular dysfunction?

. The effectiveness and cost-effectiveness of cardiac resynchronisation therapy (biventricular pacing) for heart failure: a systematic review and economic model. Health Technology Assessment 2007; 11(47). Indexing Status Subject indexing assigned by NLM MeSH Adult; Aged; Aged, 80 and over; Cardiac Pacing, Artificial /economics; Cost-Benefit Analysis; Death, Sudden, Cardiac /epidemiology /prevention & Defibrillators, Implantable /economics; Electric Power Supplies; Female; Humans; Male; Markov Chains; Middle Aged (...) resynchronisation and implantable defibrillator therapy. The population was a hypothetical cohort of patients, with an average age of 74 years and with heart failure, defined by a New York Heart Association (NYHA) level III or IV, with left ventricular dysfunction and evidence of electrical dyssynchrony. Interventions The study assessed combined cardiac resynchronisation and implantable defibrillator therapy compared with the usual cardiac resynchronisation therapy, which was compared with best medical care

2009 NHS Economic Evaluation Database.

19006. Pseudoanteroseptal STEMI in the Setting of Paced Rhythm

" See literature below. Annotated Bibliography on STEMI in Paced Rhythm, Pseudoanteroseptal MI, and RV MI in LBBB: AMI in paced rhythms 1. Maloy KR, Bhat R, Davis J, Reed K, Morrissey R. Sgarbossa criteria are highly specific for acute myocardial infarction with pacemakers. West J Emerg Med. 2010;11(4):354-357.3. The authors assessed the Sgarbossa criteria in 57 cases of paced ECG in biomarker-diagnosed AMI (not angiographic occlusions), and compared them to 99 troponin negative paced controls who (...) . The authors analyzed data from GUSTO-1. They looked at a ll patients in the study who had a paced rhythm and were diagnosed with AMI and included in the GUSTO trial. Many physicians, however, have been reluctant to make this diagnosis and to enter a patient with chest pain and a paced rhythm into a thrombolytic trial. Consequently, only 32 patients (0.1%) with pacemakers were included in GUSTO-1, which is much lower than the percentage of patients with CP and AMI who have a ventricular pacemaker. We do

2014 Dr Smith's ECG Blog

19007. Several Wide Complex Rhythms in One Patient. Test yoursefl: Will You See What I Did Not See?

: A patient with a history of diabetes and renal failure, on dialysis, was found with a very rapid heart rate. He was awake and responsive. Here is the rhythm on the monitor: There is a wide complex tachycardia. It is difficult to diagnose without a 12-lead ECG. A 12-lead was obtained rapidly: There are no P-waves. There is a wide complex very similar to LBBB, but quite wide at 161 milliseconds. However, the initial part of the QRS is rapid - the onset of the R-wave in right precordial leads to the nadir (...) by nebulization. FYI-- . --0.5 mg of IV albuterol reduces K by about 1.2 mEq/L. -- A 20 mg neb (most are 2.5 mg) lowers it by about 1.0 mEq/L. --A 10 mg neb lowers it by about 0.6 mEq/L. -- I give 0.25 mg of IM terbutaline to an adult, but only if it is critical, and add nebulized albuterol also. I've never given it IV, as I'm a bit reluctant to risk the cardiac irritability. K returned at 7.5 mEq/L, repeat was 6.7 mEq/L He seemed to stabilize in this rhythm with a much narrower QRS: Initially I saw

2014 Dr Smith's ECG Blog

19008. Terbutaline and Albuterol for Lowering of Plasma Postassium

terbutaline to an adult, but only if it is critical, and add nebulized albuterol also. I've never given it IV, as I'm a bit reluctant to risk the cardiac irritability. 1 TI Treatment of hyperkalaemia in renal failure: salbutamol v. insulin. AU Lens XM, Montoliu J, Cases A, Campistol JM, Revert L SO Nephrol Dial Transplant. 1989;4(3):228. Three groups of patients with acute or chronic renal failure (GFR less than 5 ml/min) and hyperkalaemia (K+ greater than or equal to 6 mEq/l), similar in age, serum (...) sparing diuretics, angiotensin converting enzyme inhibitors), hyperglycaemia, rhabdomyolysis and adrenal insufficiency. Hyperkalaemia affects the cardiac conducting tissue and can cause serious arrhythmias including ventricular fibrillation and asystolic arrest. Therefore it is important to treat hyperkalaemia promptly in the emergency department. This paper evaluates the therapeutic options available for treatment of hyperkalaemia. AD Department of Accident and Emergency Medicine, City Hospital

2014 Dr Smith's ECG Blog

19009. Incessant Regular Wide Complex Tachycardia

Incessant Regular Wide Complex Tachycardia Dr. Smith's ECG Blog: Incessant Regular Wide Complex Tachycardia Tuesday, March 11, 2014 A male in his 50's presented after a witnessed syncopal episode. He reported multiple syncopal events over the last 1-2 months with increasing frequency, as well as recent fatigue. He had a remote history of in-hospital cardiac arrest during surgery. He had no anginal symptoms, no CP or SOB. Prehospital tracings were concerning for monomorphic sustained regular (...) ectopy with 30 beat runs of VT which were well tolerated. In the morning, he had a 30 beat run of monomorphic VT and then had an episode of severe bradycardia down to the 20's, with loss of pulses and need for brief CPR. The patient was given 2 mg of atropine and was then transcutaneously paced for 5 minutes during which time he woke up and was alert. He was sedated and intubated. Etiology was not entirely clear, but amiodarone was suspected as partly to blame and it was stopped. A transvenous pacer

2014 Dr Smith's ECG Blog

19010. Ventricular Fibrillation During Echocardiogram, Then Spontaneous Reversion Without Defibrillation

Ventricular Fibrillation During Echocardiogram, Then Spontaneous Reversion Without Defibrillation Dr. Smith's ECG Blog: Ventricular Fibrillation During Echocardiogram, Then Spontaneous Reversion Without Defibrillation Tuesday, March 18, 2014 A 47 yo male presented to the Echo Lab one day after being seen in the ED for syncope. During the echocardiogram, the tech noted that the heart stopped. The monitor showed ventricular fibrillation. Before the patient could be defibrillated, he spontaneously (...) to run ads here. All ad revenue will go to my ECG research projects. We need funding. Up until now, my wife and I have funded the PERFECT (Paced ECG Requiring Fast Emergent Coronary Therapy) study by making her the full time coordinator without pay. Dr. Smith's Book Recommended Resources More basic books for the less advanced learner: Comments not appropriate for general posting, or interesting ECGs, may be sent here (do this judiciously!) Always send ECGs in the correct orientation, not sideways

2014 Dr Smith's ECG Blog

19011. Cost-effectiveness of sacral neuromodulation versus intravesical botulinum A toxin for treatment of refractory urge incontinence

-2804 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Administration, Intravesical; Botulinum Toxins, Type A /economics /therapeutic use; Cost-Benefit Analysis; Electric Stimulation Therapy; Humans; Lumbosacral Plexus; Markov Chains; Neuromuscular Agents /economics /therapeutic use; Urinary Incontinence, Urge /economics /therapy AccessionNumber 22010000139 Date bibliographic record published 02/06/2010 Date abstract record published 17/11/2010 NHS Economic (...) evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The aim was to examine the cost-effectiveness of sacral nerve stimulation versus botulinum toxin A for the treatment of refractory idiopathic detrusor overactivity. The authors concluded that botulinum toxin A was cost-effective compared with sacral

2009 NHS Economic Evaluation Database.

19012. Modelling the relative cost-effectiveness of amelogenin in non-healing venous leg ulcers Full Text available with Trip Pro

of amelogenin in non-healing venous leg ulcers. Journal of Wound Care 2009; 18(5): 216, 218-224 PubMedID DOI Original Paper URL Other publications of related interest Vowden P, Romanelli M, Peter R, et al. The effect of amelogenin (Xelma) on hard-to-heal venous leg ulcers. Wound Repair and Regeneration 2006; 14(3): 240-246. Clegg JP, Guest JF. Modelling the cost-utility of bio-electric stimulation therapy (Posifect) compared to standard care in the treatment of elderly patients with chronic non-healing

2009 NHS Economic Evaluation Database.

19013. Functional magnetic stimulation using a parabolic coil for dysphagia after stroke. (Abstract)

Functional magnetic stimulation using a parabolic coil for dysphagia after stroke. Recently, the usefulness of neuromuscular electrical stimulation and repetitive transcranial magnetic stimulation for poststroke dysphagia has been reported. However, there is no report that describes the effectiveness of functional magnetic stimulation (FMS) for dysphagia. The purpose of this study is to clarify the effectiveness of FMS for poststroke dysphagia.Twenty poststroke dysphagic patients (age (...) at treatment: 51-80 years; interval between onset of stroke and treatment: 6 to 36 months) were randomly assigned to a real group or a sham group. In the real group, FMS of 30 Hz was applied for suprahyoid muscles in a 20-sec train using a parabolic coil for 10 min (total 1200 pulses). In the sham group, sham stimulation was applied for 10 min at the same site. Swallowing function was evaluated by the timed water swallow test, interswallow interval (ISI), swallowing volume velocity (speed), and volume per

2014 Neuromodulation : journal of the International Neuromodulation Society Controlled trial quality: uncertain

19014. Managing Acute Dysrhythmias

electrical therapy (cardioversion) to reset the normal activity of the heart. They may also respond to drug therapy. Unsynchronised electrical therapy (defibrillation) is the mainstay of treatment of fast rhythms of the heart when the patient is in cardiac arrest. Slow rhythms of the heart may be treated with drugs to increase the heart rate such as atropine (anti-cholinergic) or adrenergic agents. Alternately, an electrical impulse may be applied to the heart either internally (internal pacemaker (...) ) by cardiac pacing wires or externally (external pacemaker) by pads. All anti-arrhythmic treatments (physical maneuvers, drugs, cardioversion, pacing) have the potential to make the rhythm worse rather than better, causing clinical deterioration. Furthermore most anti-arrhythmic drugs cause myocardial depression, which may worsen heart failure or hypotension. It is important to recognise patients who are stable and have no adverse signs from an arrhythmia. If there is no immediate urgency for treatment

2009 Australian Resuscitation Council

19015. Sensitivity of quantitative sensory models to morphine analgesia in humans. Full Text available with Trip Pro

pressure (F=3.98, P=0.05), rectal pressure (F=4.25, P=0.04), and the cold pressor test (F=25.3, P<0.001). Compared to placebo, morphine increased tolerance to muscle stimulation by 14.07%; bone stimulation by 9.72%; rectal mechanical stimulation by 20.40%, and reduced pain reported during the cold pressor test by 9.14%. In contrast, the more phasic experimental pain models were not sensitive to morphine analgesia: skin heat, rectal electrical stimulation, or rectal heat stimulation (all P>0.05).Pain (...) and compare various pain models to morphine analgesia in healthy volunteers.The study was a double-blind, randomized, two-way crossover study. Thirty-nine healthy participants were included and received morphine 30 mg (2 mg/mL) as oral solution or placebo. To cover both tonic and phasic stimulations, a comprehensive multi-modal, multi-tissue pain-testing program was performed.Tonic experimental pain models were sensitive to morphine analgesia compared to placebo: muscle pressure (F=4.87, P=0.03), bone

2014 Journal of pain research Controlled trial quality: uncertain

19016. Design and Usage of the HeartCycle Education and Coaching Program for Patients With Heart Failure. Full Text available with Trip Pro

education and coaching program.The online automated program was developed using a well-established, face-to-face, home-based cardiac rehabilitation approach. Education is tailored to the behaviors and knowledge of the individual patient, and the system supports patients in adopting self-care behaviors. Patients are guided through a goal-setting process that they conduct at their own pace through the support of the system, and they record their progress in an electronic diary such that the system can (...) Design and Usage of the HeartCycle Education and Coaching Program for Patients With Heart Failure. Heart failure (HF) is common, and it is associated with high rates of hospital readmission and mortality. It is generally assumed that appropriate self-care can improve outcomes in patients with HF, but patient adherence to many self-care behaviors is poor.The objective of our study was to develop and test an intervention to increase self-care in patients with HF using a novel, online, automated

2014 JMIR Research Protocols Controlled trial quality: uncertain

19017. Potentiation and electrical stimulus frequency during self-paced exercise and recovery. Full Text available with Trip Pro

Potentiation and electrical stimulus frequency during self-paced exercise and recovery. The aim of this study was to investigate the effect of potentiation on stimulation-induced muscle function during and after an intense bout of self-paced dynamic exercise. Ten active subjects performed a time trial involving repetitive concentric extension-flexion of the right knee using a Biodex dynamometer. Electrical stimulation before and after a 5 s maximal isometric voluntary contraction was performed

2014 Journal of human kinetics Controlled trial quality: uncertain

19018. Pain Elimination during Injection with Newer Electronic Devices: A Comparative Evaluation in Children. Full Text available with Trip Pro

Pain Elimination during Injection with Newer Electronic Devices: A Comparative Evaluation in Children. The present study was taken up to clinically evaluate and compare effectiveness of transcutaneous electrical nerve stimulator (TENS) and comfort control syringe (CCS) in various pediatric dental procedures as an alternative to the conventional method of local anesthesia (LA) administration.Ninety healthy children having at least one deciduous molar tooth indicated for extraction in either (...) maxillary right or left quadrant in age group of 6 to 10 years were randomly divided into three equal groups having 30 subjects each. Group I: LA administration using conventional syringe, group II: LA administration using TENS along with the conventional syringe, group III: LA administration using CCS. After LA by the three techniques, pain, anxiety and heart rate were measured.The observations, thus, obtained were subjected to statistical analysis using analysis of variance (ANOVA), student t-test

2014 International journal of clinical pediatric dentistry Controlled trial quality: uncertain

19019. Does mental exertion alter maximal muscle activation? Full Text available with Trip Pro

(incongruent Stroop task), (ii) moderate mental exertion (congruent Stroop task), (iii) low mental exertion (watching a movie). In each condition, mental exertion was combined with 10 intermittent maximal voluntary contractions of the knee extensor muscles (one maximal voluntary contraction every 3 min). Neuromuscular function was assessed using electrical nerve stimulation. Maximal voluntary torque, maximal muscle activation and other neuromuscular parameters were similar across mental exertion conditions

2014 Frontiers in human neuroscience Controlled trial quality: uncertain

19020. Outcomes of ultrasound-guided extracorporeal shock wave therapy for painful stump neuroma. Full Text available with Trip Pro

Outcomes of ultrasound-guided extracorporeal shock wave therapy for painful stump neuroma. To investigate the effect of extracorporeal shock wave therapy (ESWT) on painful stump neuroma.Thirty patients with stump neuroma at the distal end of an amputation site were assigned randomly to the ESWT group (n=15) and the transcutaneous electrical nerve stimulation (TENS)+desensitization+pharmacological treatment group (n=15). For 3 weeks, the ESWT group received a weekly session involving 1,500 (...) pulses at 0.10 mJ/mm(2), while the control group was treated 10 times each, 40 minutes per day with TENS and desensitization treatment, and daily medication for 3 weeks. ESWT stimulation was given by focusing on the area at the neuroma site clearly identified by ultrasound.The changes in the McGill pain questionnaire were 38.8±9.0 prior to treatment and 11.8±3.1 following the treatment. The corresponding values for the control group were 37.2±7.7 and 28.5±10.3. The changes between groups were

2014 Annals of rehabilitation medicine Controlled trial quality: uncertain

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