Articles Tagged With:
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Left Atrial vs. Left Ventricular Parameters for Intervention Decisions
A one-institution study of serial echocardiograms in patients with moderate to severe or severe aortic regurgitation demonstrated that changes in left atrial size and strain changed over time in a similar fashion regardless of sex and age, and were of incremental prognostic value compared to left ventricular size and function.
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Screening Relatives of Hypertrophic Cardiomyopathy Patients
A retrospective cohort study of the first-degree relatives of patients with hypertrophic cardiomyopathy (HCM) seen in screening clinics in Denmark has shown that the diagnostic yield of the first visit is 26% and subsequent visits add 4%. The best predictor of the development of HCM in relatives of families with negative genetic findings was maximal left ventricular wall thickness of ≥ 10 mm.
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Benefits of Early, Aggressive Cholesterol-Lowering After Myocardial Infarction
A large national registry study of myocardial infarction patients has shown that achieving target levels of non-high-density lipoprotein cholesterol by one month and maintaining them for at least one year reduces subsequent major adverse cardiac events and argues for aggressive early cholesterol management rather than the usual stepwise approach.
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Validation of the New American Heart Association’s PREVENT Equations
An analysis of the accuracy of the new American Heart Association PREVENT Equations for predicting 10-year cardiovascular disease mortality in the National Health and Nutrition Examination Survey population has shown excellent discrimination with only modest underprediction and supports its use vs. the pooled cohort equation, which is the current standard.
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Benefit of TAVR in Patients with Moderate Aortic Stenosis and Systolic Dysfunction
In this multicenter randomized trial of early transcatheter aortic valve replacement (TAVR) in patients with moderate aortic stenosis, TAVR was not superior to medical surveillance, with TAVR triggered by progression to severe aortic stenosis.
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Ethicists Can Ensure Goals of Care Discussions Happen Earlier
Goals of care discussions are known to reduce invasive interventions and align patient care with patient values, but conversations often occur shortly before death.
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Ethical Considerations with DNR Orders and Anesthesia Care
Because many elements of anesthesia care constitute “resuscitation” in other settings, patients presenting for surgery with do-not-resuscitate orders or other directives limiting treatment pose some unique ethical challenges.
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Gap in End-of-Life Care in Rural Areas Is an Ethical Concern
Rural hospices have limited resources and lower Medicare reimbursement rates compared to their urban counterparts. These challenges result in disparities in end-of-life care.
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Ethical Concerns with Data Sharing Practices of Healthcare Organizations
It is not uncommon for hospitals to share patient data with technology companies, either to spur research and product development or to train artificial intelligence models designed to improve clinical decision making. Researchers interviewed and surveyed 24 informatics leaders about current data sharing practices at their institutions.
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Facilitated Ethics Conversations Are Tools to Address Moral Distress
Ethicists often help nurses and other clinicians to identify and address moral distress during ethics consults. However, ethicists struggle to identify the most effective approaches. Lucia Wocial, PhD, FAAN, RN, HEC-C, and colleagues conducted a study to determine the effect of a two-phased moral stress intervention.