scholarly journals The Role of Implantable Cardioverter Defibrillators in Ischemic and Non-Ischemic Cardiomyopathy and Effect on Mortality and Sudden Death

2016 ◽  
Vol 23 (1) ◽  
pp. 12
Author(s):  
Shervin Eshaghian
Keyword(s):  
Clinical Trials ◽  
High Risk ◽  
Ischemic Cardiomyopathy ◽  
Randomized Clinical Trials ◽  
Therapeutic Option ◽  
Implantable Cardioverter Defibrillators ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Cardioverter Defibrillators

Implantable Cardioverter Defibrillators (ICDs) have evolved from a treatment of last resort to the current and rapidly growing use as a first line therapeutic option. Early clinical trials captured what had only been apparent in observational studies that subsequently paved the way for the utilization of ICDs as secondary prevention in patients who had survived life-threatening arrhythmias. As a result, these randomized clinical trials exhibited a benefit with ICD only in high-risk patients with ischemic cardiomyopathy. However, recent studies have been able to demonstrate a significant role for primary prevention in selected high-risk patients with non-ischemic cardiomyopathy.

Behavioral Emergencies and Crises

2010 ◽  
pp. 739-762
Author(s):  
Phillip M. Kleespies ◽  
Justin M. Hill
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
High Risk ◽  
Work Environment ◽  
Emotional Impact ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Behavioral Emergencies ◽  
And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

scholarly journals Follicular lymphoma: are we ready for a risk-adapted approach?

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 358-364 ◽  
Author(s):  
Brad S. Kahl
Keyword(s):  
High Risk ◽  
Follicular Lymphoma ◽  
Randomized Clinical Trials ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Predictive Biomarkers ◽  
Western Hemisphere ◽  
Ongoing Research ◽  
High Risk Patients ◽  
Risk Patients

Abstract Follicular lymphoma is the most common indolent non-Hodgkin lymphoma in the Western hemisphere. The natural history of FL appears to have been favorably impacted by the introduction of rituximab after randomized clinical trials demonstrated that the addition of rituximab to standard chemotherapy induction has improved the overall survival. Yet, the disease is biologically and clinically heterogeneous with wide variations in outcomes for individual patients. The ability to accurately risk-stratify patients and then tailor therapy to the individual is an area of ongoing research. Historically, tumor grade, tumor burden, and the FL international prognostic index (version 1 and version 2) have been used to distinguish low-risk from high-risk patients. Biologic factors such as mutations in key genes can identify patients at high risk for poor outcomes to first-line therapy (mutational status of 7 genes [EZH2, ARID1A, MEF2B, EP300, FOX01, CREBBP, and CARD11] with Follicular Lymphoma International Prognostic Index). More recently, the quality of the response to initial therapy, as measured by either PET imaging or by remission duration, has been show to identify individuals at high risk. However, several unmet needs remain, including a better ability to identify high-risk patients at diagnosis, the development of predictive biomarkers for targeted agents, and strategies to reduce the risk of transformation.

Psychosocial Issues of Patients With Implantable Cardioverter Defibrillators

2005 ◽  
Vol 14 (4) ◽  
pp. 294-303 ◽  
Author(s):  
Sandra B. Dunbar
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Standard Therapy ◽  
Ventricular Arrhythmias ◽  
Evidence Based ◽  
Psychosocial Issues ◽  
Implantable Cardioverter Defibrillators ◽  
Life Threatening ◽  
Cardioverter Defibrillators

Use of implantable cardioverter defibrillators has become standard therapy for patients at high risk for life-threatening ventricular arrhythmias. Although acceptance of the device is generally high among patients and their families, quality of life and psychosocial issues associated with use of the defibrillators deserve greater attention to improve outcomes. Psychosocial issues, their ramifications, and theory-and evidence-based approaches to improving outcomes are described.

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