Cancer and acute cardiovascular diseases: team work to transform the clinical practice

2021 ◽  
Author(s):  
Teresa López-Fernández ◽  
Javier de Castro Carpeño
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Team Work

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Economic Growth ◽  
Developing Countries ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Secondary Prevention ◽  
Health Authorities ◽  
Overwhelming Evidence ◽  
Core Components ◽  
Interventional Therapies ◽  
Limited Period

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major healthcare and socio-economic burden both in western and developing countries, in which this burden is increasing in closecorrelation to economic growth. Health authorities and the general population have started to recognize that the fightagainst these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestylechanges and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives includingcardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorlyimplemented in clinical practice, often only on selected populations and over a limited period of time. The developmentof systematic and full comprehensive preventive programmes is warranted, integrated in the organization ofnational health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity.

scholarly journals Systematic review of international clinical guidelines for the promotion of physical activity for the primary prevention of cardiovascular diseases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. Aerts ◽  
D. Le Goff ◽  
M. Odorico ◽  
J. Y. Le Reste ◽  
P. Van Bogaert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Prevention Programs ◽  
Prevention Of Cardiovascular Disease

Abstract Background Cardiovascular diseases are the world’s leading cause of morbidity and mortality. An active lifestyle is one of the cornerstones in the primary prevention of cardiovascular disease. An initial step in guiding primary prevention programs is to refer to clinical guidelines. We aimed to systematically review clinical practice guidelines on primary prevention of cardiovascular disease and their recommendations regarding physical activity. Methods We systematically searched Trip Medical Database, PubMed and Guidelines International Network from January 2012 up to December 2020 using the following search strings: ‘cardiovascular disease’, ‘prevention’, combined with specific cardiovascular disease risk factors. The identified records were screened for relevance and content. We methodologically assessed the selected guidelines using the AGREE II tool. Recommendations were summarized using a consensus-developed extraction form. Results After screening, 27 clinical practice guidelines were included, all of which were developed in Western countries and showed consistent rigor of development. Guidelines were consistent about the benefit of regular, moderate-intensity, aerobic physical activity. However, recommendations on strategies to achieve and sustain behavior change varied. Multicomponent interventions, comprising education, counseling and self-management support, are recommended to be delivered by various providers in primary health care or community settings. Guidelines advise to embed patient-centered care and behavioral change techniques in prevention programs. Conclusions Current clinical practice guidelines recommend similar PA lifestyle advice and propose various delivery models to be considered in the design of such interventions. Guidelines identify a gap in evidence on the implementation of these recommendations into practice.

scholarly journals Kardia Mobile and ISTEL HR applicability in clinical practice: A comparison of Kardia Mobile, ISTEL HR and standard 12-lead electrocardiogram records in 98 consecutive patients of a tertiary cardiovascular care centre

2021 ◽  
Author(s):  
Bartosz Krzowski ◽  
Kamila Skoczylas ◽  
Gabriela Osak ◽  
Natalia Żurawska ◽  
Michał Peller ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Sinus Rhythm ◽  
Sensitivity And Specificity ◽  
Heart Rhythm ◽  
Everyday Practice ◽  
Portable Devices ◽  
Care Centre ◽  
Cardiovascular Care

Abstract Aims Mobile, portable ECG-recorders allow the assessment of heart rhythm in out-of-hospital conditions and may prove useful for monitoring patients with cardiovascular diseases. However, the effectiveness of these portable devices has not been tested in everyday practice. Methods and results A group of 98 consecutive cardiology patients (62 males [63%], mean age 69 ± 12.9 years) were included in an academic care centre. For each patient, a standard 12-lead electrocardiogram (SE), as well as a Kardia Mobile 6L (KM) and Istel (IS) HR-2000 ECG were performed. Two groups of experienced physycians analyzed obtained recordings. After analyzing ECG tracings from SE, KM, and IS, quality was marked as good in 82%, 80%, and 72% of patients, respectively (p < 0.001). There were no significant differences between devices in terms of detecting sinus rhythm (SE [60%, n = 59], KM [58%, n = 56], and IS [61%, n = 60]; SE vs KM p = 0.53; SE vs IS p = 0.76) and atrial fibrillation (SE [22%, n = 22], KM [22%, n = 21], and IS [18%, n = 18]; (SE vs KM p = 0.65; SE vs IS = 0.1). KM had a sensitivity of 88.1% and a specificity of 89.7% for diagnosing sinus rhythm. IS showed 91.5% and 84.6% sensitivity and specificity, respectively. The sensitivity of KM in detecting atrial fibrillation was higher than IS (86.4% vs. 77.3%), but their specificity was comparable (97.4% vs. 98.7%). Conclusion Novel, portable devices are useful in showing sinus rhythm and detecting atrial fibrillation in clinical practice. However, ECG measurements concerning conduction and repolarisation should be clarified with a standard 12-lead electrocardiogram.

scholarly journals Rational pharmacotherapy in real clinical practice through the prism of multimorbidity and drug safety

2020 ◽  
Vol 1 (2) ◽  
pp. 29-39
Author(s):  
Dmitry I. Trukhan ◽  
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Drug Safety ◽  
Adult Population ◽  
Premature Death ◽  
Review Article ◽  
Rational Pharmacotherapy ◽  
Real Clinical Practice

Currently, multimorbidity/comorbidity and drug safety are important components of rational pharmacotherapy in real clinical practice. Cardiovascular diseases occupy a leading place in the structure of non-infectious pathology of the adult population, being the main cause of early disability and premature death. In a review article, using clinical examples, the issues of rational pharmacotherapy in patients with cardiovascular diseases and concomitant comorbid/multimorbid pathology are considered.

scholarly journals Modern biomarkers in cardiology

2018 ◽  
pp. 118-123 ◽  
Author(s):  
O. V. Dymova
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Natriuretic Peptides ◽  
International Experience ◽  
Diagnostic Efficiency ◽  
Medical Decisions ◽  
Level Of Evidence ◽  
Neurohumoral Regulation ◽  
Myocardial Stress

Modern clinical practice requires obligatory use of results of laboratory researches, international experience demonstrates the need of the clinic in laboratory information for making up to 70% of medical decisions. Described a large number of biomarkers of cardiovascular diseases, high diagnostic efficiency with sufficient level of evidence is shown not for all. In article the possibilities of a modern laboratory in determining markers of myocardium damage (troponins, hFABP), myocardial stress (natriuretic peptides) and neurohumoral regulation (copeptin), the diagnostic and predictive importance of these researches are considered.

Interdisciplinary Approach to Cardiovascular Diseases for Research and Everyday Clinical Practice Purposes

2019 ◽  
pp. 139-171
Author(s):  
Aleksander Goch ◽  
Anna Rosiek ◽  
Krzysztof Leksowski ◽  
Emilia Mikołajewska
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Interdisciplinary Approach ◽  
Social Awareness ◽  
Modifiable Risk Factors ◽  
Cvd Prevention ◽  
Interdisciplinary Effort ◽  
Professional Resources ◽  
Prevention And Therapy

Cardiovascular Diseases (CVD) are perceived a leading cause of death globally. Scientists and clinicians still search for more efficient prevention, treatment, rehabilitation and care programs suitable for patients with CVD. Common social awareness and interdisciplinary effort may significantly improve current situation, but the problem is more complex. This chapter, based on research and own experiences of authors, tries to answer the question: how maximize professional resources and optimize outcomes in clinical practice. Aim of this chapter is discuss current issues which may potentially influence efficiency of CVD prevention and therapy, including prevention, modifiable and non-modifiable risk factors, ways of cardiac rehabilitation (CR) and cardiac telerehabilitation (CTR), influence of researcher-subject relationship and patient-therapist relationship as far as placebo effect.

scholarly journals Immunovirological parameters and cytokines in HIV infection

2012 ◽  
Vol 45 (6) ◽  
pp. 663-669 ◽  
Author(s):  
Karen Ingrid Tasca ◽  
Sueli Aparecida Calvi ◽  
Lenice do Rosário de Souza
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Hiv Infection ◽  
Immune Activation ◽  
Healthy Individuals ◽  
Antiretroviral Therapies ◽  
The Many ◽  
Lower Morbidity

Although modern combined antiretroviral therapies (cART) result in lower morbidity and mortality and a visible improvement of clinical and laboratory parameters in HIV-infected, it is known that their long-term use contributes to appearance of the many events unrelated to AIDS such as cardiovascular diseases, cancer and osteoporosis, comorbidities which have been proposed as some of the most important that deprive the majority of infected to present an even better prognosis. This is because even with a decrease in inflammation and immune activation after drug intervention to the patient, these parameters remain higher than those shown by healthy individuals and the imbalance of cytokine profiles also persists. Therefore, evaluations of other biomarkers in clinical practice are needed to complement the exams already carried out routinely and allow more effective monitoring of HIV patients. This review aims to investigate the role of cytokines as potential markers showing studies on their behavior in various stages of HIV infection, with or without cART.

Metabolomics and Heart Diseases: From Basic to Clinical Approach

2019 ◽  
Vol 26 (1) ◽  
pp. 46-59 ◽  
Author(s):  
Ignasi Barba ◽  
Mireia Andrés ◽  
David Garcia-Dorado
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Heart Diseases ◽  
Medium Size ◽  
Clinical Approach ◽  
Full Spectrum ◽  
Main Research ◽  
Clinical Environments ◽  
The Many ◽  
Work Done

Background:The field of metabolomics has been steadily increasing in size for the last 15 years. Advances in analytical and statistical methods have allowed metabolomics to flourish in various areas of medicine. Cardiovascular diseases are some of the main research targets in metabolomics, due to their social and medical relevance, and also to the important role metabolic alterations play in their pathogenesis and evolution. </P><P> Metabolomics has been applied to the full spectrum of cardiovascular diseases: from patient risk stratification to myocardial infarction and heart failure. However - despite the many proof-ofconcept studies describing the applicability of metabolomics in the diagnosis, prognosis and treatment evaluation in cardiovascular diseases - it is not yet used in routine clinical practice. </P><P> Recently, large phenome centers have been established in clinical environments, and it is expected that they will provide definitive proof of the applicability of metabolomics in clinical practice. But there is also room for small and medium size centers to work on uncommon pathologies or to resolve specific but relevant clinical questions. </P><P> Objectives: In this review, we will introduce metabolomics, cover the metabolomic work done so far in the area of cardiovascular diseases.Conclusion:The cardiovascular field has been at the forefront of metabolomics application and it should lead the transfer to the clinic in the not so distant future.

scholarly journals The effectiveness of training in emergency obstetric care: a systematic literature review

2019 ◽  
Vol 34 (4) ◽  
pp. 257-270 ◽  
Author(s):  
Charles A Ameh ◽  
Mselenge Mdegela ◽  
Sarah White ◽  
Nynke van den Broek
Keyword(s):  
Clinical Practice ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Emergency Obstetric Care ◽  
Case Fatality ◽  
Obstetric Care ◽  
Team Work ◽  
Knowledge And Skills ◽  
Effectiveness Of Training ◽  
Four Levels

Abstract Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of training in EmOC. Eleven databases and websites were searched for publications describing EmOC training evaluations between 1997 and 2017. Effectiveness was assessed at four levels: (1) participant reaction, (2) knowledge and skills, (3) change in behaviour and clinical practice and (4) availability of EmOC and health outcomes. Weighted means for change in knowledge and skills obtained, narrative synthesis of results for other levels. One hundred and one studies including before–after studies (n = 44) and randomized controlled trials (RCTs) (n = 15). Level 1 and/or 2 was assessed in 68 studies; Level 3 in 51, Level 4 in 21 studies. Only three studies assessed effectiveness at all four levels. Weighted mean scores pre-training, and change after training were 67.0% and 10.6% for knowledge (7750 participants) and 53.1% and 29.8% for skills (6054 participants; 13 studies). There is strong evidence for improved clinical practice (adherence to protocols, resuscitation technique, communication and team work) and improved neonatal outcomes (reduced trauma after shoulder dystocia, reduced number of babies with hypothermia and hypoxia). Evidence for a reduction in the number of cases of post-partum haemorrhage, case fatality rates, stillbirths and institutional maternal mortality is less strong. Short competency-based training in EmOC results in significant improvements in healthcare provider knowledge/skills and change in clinical practice. There is emerging evidence that this results in improved health outcomes.

The significance of serum γ-glutamyltransferase in cardiovascular diseases

2004 ◽  
Vol 42 (10) ◽  
Author(s):  
Alfonso Pompella ◽  
Michele Emdin ◽  
Claudio Passino ◽  
Aldo Paolicchi
Keyword(s):  
Myocardial Infarction ◽  
Reactive Oxygen Species ◽  
Clinical Practice ◽  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Laboratory Test ◽  
Prognostic Value ◽  
Cerebral Arteries ◽  
Atherosclerotic Plaques ◽  
Oxygen Species

AbstractSince early after the introduction of serum γ-glutamyltransferase (GGT) in clinical practice as a reliable and widely employed laboratory test, epidemiological and prospective studies have repeatedly shown that this activity possesses a prognostic value for morbidity and mortality. The association is independent of possibly concomitant conditions of liver disease, and notably, a significant independent correlation of serum GGT exists with the occurrence of cardiovascular diseases (myocardial infarction, stroke). Experimental work has documented that active GGT is present in atherosclerotic plaques of coronary as well as in cerebral arteries. These findings, and the recently recognized functions of GGT in the generation of reactive oxygen species, indicate that serum GGT represents a true marker of cardiovascular diseases and underlying atherosclerosis. Further insights into potential therapeutic interest will probably be derived from studies investigating the origin of GGT activity in plaque tissue.

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