Role of Clinical Pharmacist in a Heart Failure Clinic

2005 ◽  
Vol 40 (10) ◽  
pp. 890-896 ◽  
Author(s):  
Devada Singh-Franco ◽  
Leanne Li ◽  
Stan Hannah ◽  
Morton Diamond
Keyword(s):  
Heart Failure ◽  
Clinical Pharmacist ◽  
Hospital Admissions ◽  
Care Service ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Medical Insurance ◽  
Post Intervention ◽  
Clinical Signs And Symptoms ◽  
The Impact

Purpose To determine if the inclusion of a clinical pharmacist (CP) in a heart failure (HF) multidisciplinary team could lead to a reduction in the number of hospital admissions and additionally decrease the clinical signs and symptoms of HF patients with either Medicaid or no medical insurance. Methods Longitudinal study to determine the impact of a pharmaceutical-care service program to HF patients by comparing the 9-month period before (pre-intervention) and the 9-month period after (post-intervention) implementation of the program. The intervention of the CP was directed in two complementary functions. The first was direct patient contact and the second was to provide drug information to the medical clinicians. Results Twenty-nine outpatients completed the study. Over 9 months, the CP made a total of 216 interventions and had three in-person, follow-up contacts and three telephone contacts per patient. At post-intervention, there was a statistically significant reduction in the total number of hospitalizations (50 vs 23; P < 0.018) and length of stay (LOS) (263 days vs 108 days; P < 0.03). However, there was an insignificant reduction in HF hospitalizations, LOS, and total number of HF signs and symptoms. Conclusions Addition of a CP to an outpatient HF clinic can lead to fewer hospital admissions and a reduction in the LOS in patients with either Medicaid or no medical insurance.

scholarly journals Congestive Heart Failure versus Inflammatory Carcinoma in Breast

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
A. Alikhassi ◽  
R. Omranipour ◽  
Z. Alikhassy
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Breast Carcinoma ◽  
Inflammatory Breast Cancer ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Inflammatory Breast Carcinoma ◽  
Inflammatory Carcinoma ◽  
Clinical Signs And Symptoms

Inflammatory breast cancer is a rare highly malignant form of breast cancer. Clinical signs and symptoms with histologic examination usually confirm the diagnosis. There are rare reports of breast edema of congestive heart failure which were difficult to differentiate from inflammatory carcinoma. The differential becomes more difficult when congestive heart failure is associated with unilateral breast edema. We present a case of a 70-year-old woman with congestive heart failure associated with unilateral breast edema and skin thickening simulating inflammatory breast carcinoma on mammography.

scholarly journals The impact of isolated lesser saphenous vein system incompetence on clinical signs and symptoms of chronic venous disease

2000 ◽  
Vol 32 (5) ◽  
pp. 954-960 ◽  
Author(s):  
Nicos Labropoulos ◽  
Athanasios D. Giannoukas ◽  
Kostas Delis ◽  
Steven S. Kang ◽  
M.Ashraf Mansour ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Vein System ◽  
Clinical Signs And Symptoms ◽  
The Impact

scholarly journals How long before hospital admission do the symptoms of heart failure decompensation arise?

2019 ◽  
Vol 27 ◽  
Author(s):  
Maraísa Carine Born ◽  
Karina de Oliveira Azzolin ◽  
Emiliane Nogueira de Souza
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Clinical Signs ◽  
Emergency Admission ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Heart Failure Decompensation

ABSTRACT Objective: to identify the signs and symptoms of decompensation of heart failure (HF) and the duration of time to hospital admission. Method: this is a cross-sectional study with adult patients hospitalized for decompensated HF in a teaching hospital located in southern Brazil from July to October 2017. Data collection was performed through a structured questionnaire that included sociodemographic, clinical signs and symptoms of HF. In the data analysis, the following tests were applied: t-Student, Mann Whitney U-Test, Chi-Square Tests. Results: 94 patients, aged between 42 and 98 years old (mean of 71.2 years old) were included. The most prevalent signs and symptoms before emergency admission were dyspnea (79.8%), cough (29.8%), orthopnea (27.7%), edema (23.4%), and fatigue (22.3%). The median time from onset of signs and symptoms to arrival in the emergency room is fatigue and edema 7 days, orthopnea 5 days, cough 4 days and dyspnea 3 days. Conclusion: the set of classic signs and symptoms of decompensation of HF occurs around seven days before the emergency search and dyspnea is the worsening that leads the patient to a hospital emergency.

Chronic heart failure management and remote haemodynamic monitoring

Heart ◽  
2018 ◽  
Vol 104 (23) ◽  
pp. 1910-1919 ◽  
Author(s):  
Aaron M Wolfson ◽  
Michael Fong ◽  
Luanda Grazette ◽  
Joseph E Rahman ◽  
David M Shavelle
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Haemodynamic Monitoring ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Clinical Signs And Symptoms

Heart failure (HF) has a large societal and economic burden and is expected to increase in magnitude and complexity over the ensuing years. A number of telemonitoring strategies exploring remote monitoring and management of clinical signs and symptoms of congestion in HF have had equivocal results. Early studies of remote haemodynamic monitoring showed promise, but issues with device integrity and implantation-associated adverse events hindered progress. Nonetheless, these early studies established that haemodynamic congestion precedes clinical congestion by several weeks and that remote monitoring of intracardiac pressures may be a viable and practical management strategy. Recently, the safety and efficacy of remote pulmonary artery pressure-guided HF management was established in a prospective, single-blind trial where randomisation to active pressure-guided HF management reduced future HF hospitalisations. Subsequent commercial use studies reinforced the utility of this technology and post hoc analyses suggest that tight haemodynamic management of patients with HF may be an additional pillar of therapy alongside established guideline-directed medical and device therapy. Currently, there is active exploration into utilisation of this technology and management paradigm for the timing of implantation of durable left ventricular assist devices (LVAD) and even optimisation of LVAD therapy. Several ongoing clinical trials will help clarify the extent and utility of this strategy along the spectrum of patient with HF from individuals with chronic, stable HF to those with more advanced disease requiring heart replacement therapy.

scholarly journals Pendidikan Kesehatan tentang Anemia pada Remaja Putri di SMA N 12 Kabupaten Merangin

2021 ◽  
Vol 3 (1) ◽  
pp. 41
Author(s):  
Dini Junita ◽  
Arnati Wulansari
Keyword(s):  
Health Workers ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Nutritional Anemia ◽  
Post Test ◽  
Service Activity ◽  
Implementation Method ◽  
Clinical Signs And Symptoms ◽  
Indicators Of Success ◽  
The Impact

Anemia is the impact of nutritional problems on teenager girl. Nutritional anemia is caused by a lack of nutrients that play a role in the formation of hemoglobin, it can be due to lack of consumption or absorption disorders. Only 62% of anemia mothers have received iron supplemented tablets in the working area of Puskesmas Simpang Limbur, while the iron supplemented tablet program for teenager girls in high school has not been implemented. The purpose of this community service activity is to provide information and motivation to teenagers to prevent anemia. Providing information in the form of health education regarding the definition, signs, clinical signs and symptoms and the impact of anemia. The implementation method is in the form of counseling, discussion, practice simulation and pre-post test evaluation. Monitoring evaluation is carried out by looking at the indicators of success in the aspect of target attendance attending every meeting in service and practice activities to the target, reflections and feedback from the participants. The results of the activity show that school support is very good, students' knowledge of anemia is more than 80%. The material still needs to be improved regarding the risk factors for anemia in adolescents. Collaboration with health workers is needed to gain new knowledge on a regular basis, as well as empowering students as youth cadres.

Patient monitoring in heart failure

ESC CardioMed ◽  
2018 ◽  
pp. 1902-1905
Author(s):  
Dirk J. van Veldhuisen ◽  
Adriaan A. Voors
Keyword(s):  
Heart Failure ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Problem ◽  
Cardiac Resynchronization ◽  
Haemodynamic Instability ◽  
Cardiac Implantable Electronic Devices ◽  
Clinical Signs And Symptoms

Heart failure decompensation and hospital admission is a significant clinical problem. Close counselling and monitoring of patients seems attractive, to avoid clinical and haemodynamic instability. However, patient monitoring based on clinical signs and symptoms has not led to overwhelmingly positive results. The reasons for these disappointing results are unclear, but include not optimally defined protocols, and (too) easy access to healthcare providers in the intervention arm, leading to unnecessary hospitalizations, thereby making it difficult to prove benefit in a randomized controlled trial. Telemonitoring of intracardiac pressures (by stand-alone devices), in particular measurement of pulmonary artery pressure, has shown more promising results, although these data primarily come from one trial. The value of telemonitoring using cardiac implantable electronic devices (implantable cardioverter defibrillator and/or cardiac resynchronization therapy) is still unclear, but studies examining the value of intrathoracic impedance monitoring have shown disappointing results. Currently ongoing studies in all these fields will help to further define the place of telemonitoring in heart failure. Nevertheless, patient (tele)monitoring has definitely gained a place in the management of heart failure patients, and more data are needed to further establish the value and limitations of the various programmes, modalities, and components.

Abstract TP226: Predictors and Impact of Paramedic Recognition of Hemorrhagic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
John A Oostema ◽  
Christian Negronrolon ◽  
Mathew J Reeves
Keyword(s):  
Hemorrhagic Stroke ◽  
Prehospital Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Hospital Data ◽  
Discharge Disposition ◽  
Transportation Times ◽  
Clinical Signs And Symptoms ◽  
Department Evaluation ◽  
The Impact

Introduction: Utilization of EMS is associated with faster emergency department evaluation and treatment of patients with stroke, especially among EMS-recognized patients. However, most research focuses on patients with ischemic stroke. We sought to identify factors associated with prehospital recognition of hemorrhagic stroke and the impact of recognition on prehospital and in-hospital care. Methods: A cohort of hospital-confirmed hemorrhagic stroke cases transported by EMS to 2 primary stroke centers in Kent County, Michigan over a 12-month time period was assembled. Data regarding prehospital care (Cincinnati stroke screen [CPSS] documentation, GCS, clinical signs and symptoms, transportation times, and paramedic impression) were linked to in-hospital data on door-to-CT (DTCT) times, mortality, and discharge disposition. We examined the relationships between clinical factors and stroke recognition by paramedics as well as between recognition and in-hospital outcomes. Results: Over 12 months, 73 confirmed hemorrhagic stroke patients arrived by EMS. Forty-seven (64.4%) were correctly identified by EMS as stroke; 26 (35.6%) were missed. EMS recognition was associated with greater likelihood CPSS documentation, intracerebral hemorrhage, dispatch impression of stroke, absence of seizure, and higher systolic blood pressure (Table). Multiple logistic regression confirmed a strong independent relationship between CPSS documentation and stroke recognition (OR 40.3 [5.0 to 323.5]). EMS recognized cases had shorter on-scene times (17 vs. 21 minutes, p=0.004), total transport times (33 vs. 43 minutes, p=0.003), and DTCT times (30 vs. 48 minutes, p=0.004). Recognition was not associated with mortality or discharge disposition. Conclusion: CPSS documentation is strongly associated with hemorrhagic stroke recognition by EMS providers. EMS recognition is associated with more efficient transportation and faster DTCT times upon hospital arrival.

Sign in / Sign up

Export Citation Format

Share Document