52 research outputs found
sj-csv-1-hpx-10.1177_00185787211066456 – Supplemental material for Comparison of Higher-Than-Standard to D-Dimer Driven Thromboprophylaxis in Hospitalized Patients With COVID-19
No full textsj-csv-1-hpx-10.1177_00185787211066456 for Comparison of Higher-Than-Standard to D-Dimer Driven Thromboprophylaxis in Hospitalized Patients With COVID-19 by Maya R. Chilbert, Collin M. Clark, Ashley E. Woodruff, Kimberly Zammit, Cynthia Lackie, Kristen Kusmierski, Patrick McGrath, Gregory Fuhrer, Anna Augostini, Olivia Denny, Nicole Ross, Marissa Saber and Natalie DelGuidice in Hospital Pharmacy</p
Impact of Cardiac Implantable Electronic Device Infection: A Clinical and Economic Analysis of the WRAP-IT Trial
No full textBackground: Current understanding of the impact of cardiac implantable electronic device (CIED) infection is based on retrospective analyses from medical records or administrative claims data. The WRAP-IT (Worldwide Randomized Antibiotic Envelope Infection Prevention Trial) offers an opportunity to evaluate the clinical and economic impacts of CIED infection from the hospital, payer, and patient perspectives in the US healthcare system. Methods: This was a prespecified, as-treated analysis evaluating outcomes related to major CIED infections: mortality, quality of life, disruption of CIED therapy, healthcare utilization, and costs. Payer costs were assigned using medicare fee for service national payments, while medicare advantage, hospital, and patient costs were derived from similar hospital admissions in administrative datasets. Results: Major CIED infection was associated with increased all-cause mortality (12-month risk-adjusted hazard ratio, 3.41 [95% CI, 1.81-6.41]; P<0.001), an effect that sustained beyond 12 months (hazard ratio through all follow-up, 2.30 [95% CI, 1.29-4.07]; P=0.004). Quality of life was reduced (P=0.004) and did not normalize for 6 months. Disruptions in CIED therapy were experienced in 36% of infections for a median duration of 184 days. Mean costs were 45 802 for the hospital, 14 893, for medicare fee for service and 29 431 for Medicare Advantage (mean hospital margin of -39 757 for medicare fee for service and -45 033 for medicare advantage). Mean out-of-pocket costs for patients were 1999 for medicare fee for service, and 1250 for medicare advantage. Conclusions: This large, prospective analysis corroborates and extends understanding of the impact of CIED infections as seen in real-world datasets. CIED infections severely impact mortality, quality of life, healthcare utilization, and cost in the US healthcare system. Registration: URL: https://www.clinicaltrials.gov Unique Identifier: NCT02277990
Safety of Implantation of a Leadless Pacemaker via Femoral Approach in the Presence of an Inferior Vena Cava Filter
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Emerg Infect Dis
No full textNitroimidazoles (metronidazole and tinidazole) are the only recommended drugs for treating Trichomonas vaginalis infection, and previous samples that assessed resistance of such isolates have been limited in geographic scope. We assessed the prevalence of in vitro aerobic metronidazole and tinidazole resistance among T. vaginalis isolates from multiple geographic sites in the United States. Swab specimens were obtained from women who underwent routine pelvic examinations at sexually transmitted disease clinics in 6 US cities. Cultured T. vaginalis isolates were tested for nitroimidazole resistance (aerobic minimum lethal concentration [MLC] >50 \ub5g/mL). Of 538 T. vaginalis isolates, 23 (4.3%) exhibited low-level in vitro metronidazole resistance (minimum lethal concentrations 50-100 \ub5g/mL). No isolates exhibited moderate- to high-level metronidazole resistance or tinidazole resistance. Results highlight the possibility that reliance on a single class of antimicrobial drugs for treating T. vaginalis infections may heighten vulnerability to emergence of resistance. Thus, novel treatment options are needed.PS08-865/PS/NCHHSTP CDC HHS/United State
T-wave oversensing from postural changes: A rare cause of inappropriate shock from a subcutaneous defibrillator
No full textReply to “Misleading Title and Communication Regarding Brief Communication entitled: First clinical use of real‐time remote programming in cardiac implantable electronic devices”
No full textHigher energy synchronized external direct current cardioversion for refractory atrial fibrillation
No full textAbstractOBJECTIVESWe sought to evaluate the safety and efficacy of higher energy synchronized cardioversion in patients with atrial fibrillation refractory to standard energy direct current (DC) cardioversion.BACKGROUNDStandard external electrical cardioversion fails to restore sinus rhythm in 5% to 30% of patients with atrial fibrillation.METHODSPatients with atrial fibrillation who failed to achieve sinus rhythm after at least two attempts at standard external cardioversion with 360 J were included in the study. Two external defibrillators, each connected to its own pair of R-2 patches in the anteroposterior position, were used to deliver a synchronized total of 720 J.RESULTSFifty-five patients underwent cardioversion with 720 J. Mean weight was 117 ± 23 kg (body mass index 48.3 ± 4.1 kg/m2). Structural heart disease was present in 76% of patients. Mean left ventricular ejection fraction was 45 ± 12%. Atrial fibrillation was present for over three months in 55% of the patients. Sinus rhythm was achieved in 46 (84%) of the 55 patients. No major complications were observed. No patient developed hemodynamic compromise and no documented cerebrovascular accident occurred within one month after cardioversion. Of the 46 successful cardioversions, 18 patients (39%) remained in sinus rhythm over a mean follow-up of 2.1 months.CONCLUSIONSExternal higher energy cardioversion is effective in restoring sinus rhythm in patients with atrial fibrillation refractory to standard energy DC cardioversion. This method is safe and does not result in clinical evidence of myocardial impairment. It may be a useful alternative to internal cardioversion because it could be done within the same setting of the failed standard cardioversion and obviates the need to withhold protective anticoagulation for internal cardioversion
TCT-134 Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea in Patients with Reduced Ejection Fraction: A Report from the remede(r) System Pilot Study
No full textTechniques for successful early retrieval of the Micra transcatheter pacing system: A worldwide experience
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