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A Randomized, Double-Blinded Trial Comparing The Effectiveness Of Tranexamic Acid And Epsilon-Aminocaproic Acid In Reducing Bleeding And Transfusion In Cardiac Surgery, J. Leff, A. Rhee, S. Nair, D. Lazar, S. Sathyanarayana, L. Shore-Lesserson Jan 2019

A Randomized, Double-Blinded Trial Comparing The Effectiveness Of Tranexamic Acid And Epsilon-Aminocaproic Acid In Reducing Bleeding And Transfusion In Cardiac Surgery, J. Leff, A. Rhee, S. Nair, D. Lazar, S. Sathyanarayana, L. Shore-Lesserson

Journal Articles

© 2019 Annals of Cardiac Anaesthesia. Objectives: To compare the effectiveness of epsilon aminocaproic acid (EACA) to tranexamic acid (TA) in reducing blood loss and transfusion requirements in patients undergone cardiac surgery under cardiopulmonary bypass. Design: Randomized, double blinded study. Outcome variables collected included; baseline demographic characteristics, type of surgery, amount of 24 hour chest tube drainage, amount of 24 hour blood products administered, 30 day mortality and morbidity and length of stay. We analyzed the data using parametric and non-parametric tests as appropriate. Setting: Single center tertiary-care university hospital setting. Participants: 114 patients who had undergone cardiac surgery under …


Anticoagulation Management And Heparin Resistance During Cardiopulmonary Bypass: A Survey Of Society Of Cardiovascular Anesthesiologists Members, R. M. Sniecinski, E. Bennett-Guerrero, L. Shore-Lesserson Jan 2019

Anticoagulation Management And Heparin Resistance During Cardiopulmonary Bypass: A Survey Of Society Of Cardiovascular Anesthesiologists Members, R. M. Sniecinski, E. Bennett-Guerrero, L. Shore-Lesserson

Journal Articles

We surveyed Society of Cardiovascular Anesthesiologists members regarding anticoagulation practices for cardiopulmonary bypass and attitudes on heparin resistance. Of 550 respondents (18.5% response rate), 74.9% (95% CI, 71.3%-78.5%) used empiric weight-based dosing of heparin, and 70.7% (95% CI, 66.9%-74.5%) targeted an activated clotting time of either 400 or 480 seconds to initiate cardiopulmonary bypass. Of note, 17.1% (95% CI, 13.9%-20.2%) of respondents reported activated clotting time targets lower than those recommended by recent 2018 Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology guidelines or failed to monitor heparin effects at all. When heparin resistance was encountered, 54.2% …


Wide Complex Tachycardia In An Elderly Woman Due To Ebstein's Anomaly With Two Accessory Pathways, V. Radulescu, J. Donnelly, J. Willner, S. Beldner, A. Patel, S. G. Saba Jan 2019

Wide Complex Tachycardia In An Elderly Woman Due To Ebstein's Anomaly With Two Accessory Pathways, V. Radulescu, J. Donnelly, J. Willner, S. Beldner, A. Patel, S. G. Saba

Journal Articles

No abstract provided.


A Novel Diagnostic Approach To A Mass On A Device Lead, D. Chang, J. Gabriels, S. Laighold, A. K. Williamson, H. Ismail, L. M. Epstein Jan 2019

A Novel Diagnostic Approach To A Mass On A Device Lead, D. Chang, J. Gabriels, S. Laighold, A. K. Williamson, H. Ismail, L. M. Epstein

Journal Articles

No abstract provided.


Conduction Abnormalities After Transcatheter Aortic Valve Replacement, S. Kanjanauthai, K. Bhasin, L. Pirelli, C. A. Kliger Jan 2019

Conduction Abnormalities After Transcatheter Aortic Valve Replacement, S. Kanjanauthai, K. Bhasin, L. Pirelli, C. A. Kliger

Journal Articles

© RADCLIFFE CARDIOLOGY 2019 Transcatheter aortic valve replacement (TAVR) has been established as a therapeutic option for patients with severe symptomatic aortic stenosis who are of intermediate or higher surgical risk. Several periprocedural complications are reduced with newer transcatheter heart valve generations; however, conduction abnormalities and the need for permanent pacemaker implantation have remained unchanged and are the most frequent TAVR complications. The close relationship of the atrioventricular node and left bundle branch to the subaortic region explains these potential conduction abnormalities. This article highlights conduction abnormalities after TAVR with a focus on basic conduction system anatomy in relation to …


Longitudinal Low Density Lipoprotein Cholesterol Goal Achievement And Cardiovascular Outcomes Among Adult Patients With Familial Hypercholesterolemia: The Cascade Fh Registry, P. B. Duell, S. S. Gidding, R. L. Andersen, T. Knickelbine, L. Anderson, E. Gianos, P. Shrader, I. Kindt, E. C. O'Brien, J. W. Knowles, +17 Additional Authors Jan 2019

Longitudinal Low Density Lipoprotein Cholesterol Goal Achievement And Cardiovascular Outcomes Among Adult Patients With Familial Hypercholesterolemia: The Cascade Fh Registry, P. B. Duell, S. S. Gidding, R. L. Andersen, T. Knickelbine, L. Anderson, E. Gianos, P. Shrader, I. Kindt, E. C. O'Brien, J. W. Knowles, +17 Additional Authors

Journal Articles

© 2019 [The Author/The Authors] Background and aims: There are limited data from the US on outcomes of patients in specialty care for familial hypercholesterolemia (FH). Methods: CASCADE FH Registry data were analyzed to assess longitudinal changes in medication usage, in low density lipoprotein cholesterol (LDL-C) levels, and the rate of major adverse cardiovascular events (MACE (myocardial infarction, coronary revascularization, stroke or transient ischemic attack) in adults with FH followed in US specialty clinics. Results: The cohort consisted of 1900 individuals (61% women, 87% Caucasian), with mean age of 56 ± 15 years, 37% prevalence of ASCVD at enrollment, mean …


Peak Left Atrial Strain As A Single Measure For The Non-Invasive Assessment Of Left Ventricular Filling Pressures, A. Singh, D. Medvedofsky, A. Mediratta, B. Balaney, E. Kruse, B. Ciszek, A. P. Shah, J. E. Blair, F. Maffessanti, R. M. Lang, +2 Additional Authors Jan 2019

Peak Left Atrial Strain As A Single Measure For The Non-Invasive Assessment Of Left Ventricular Filling Pressures, A. Singh, D. Medvedofsky, A. Mediratta, B. Balaney, E. Kruse, B. Ciszek, A. P. Shah, J. E. Blair, F. Maffessanti, R. M. Lang, +2 Additional Authors

Journal Articles

No abstract provided.


Cardiovascular Risk Factor Control And Lifestyle Factors In Young To Middle-Aged Adults With Newly Diagnosed Obstructive Coronary Artery Disease, M. S. Garshick, G. D. Vaidean, A. Vani, J. A. Underberg, J. D. Newman, J. S. Berger, E. A. Fisher, E. Gianos Jan 2019

Cardiovascular Risk Factor Control And Lifestyle Factors In Young To Middle-Aged Adults With Newly Diagnosed Obstructive Coronary Artery Disease, M. S. Garshick, G. D. Vaidean, A. Vani, J. A. Underberg, J. D. Newman, J. S. Berger, E. A. Fisher, E. Gianos

Journal Articles

No abstract provided.


Myocardial Fibrosis And Arrhythmogenesis In Elite Athletes, S. A. Ahmad, N. Khalid, E. Shlofmitz, L. Chhabra Jan 2019

Myocardial Fibrosis And Arrhythmogenesis In Elite Athletes, S. A. Ahmad, N. Khalid, E. Shlofmitz, L. Chhabra

Journal Articles

No abstract provided.


A Prospective, Single-Arm, Multicenter Trial Of Catheter-Directed Mechanical Thrombectomy For Intermediate-Risk Acute Pulmonary Embolism The Flare Study, T. Tu, C. Toma, V. F. Tapson, C. Adams, W. A. Label, M. Silver, S. Khandhar, R. Amin, M. Weinberg, K. Rosenfield, +8 Additional Authors Jan 2019

A Prospective, Single-Arm, Multicenter Trial Of Catheter-Directed Mechanical Thrombectomy For Intermediate-Risk Acute Pulmonary Embolism The Flare Study, T. Tu, C. Toma, V. F. Tapson, C. Adams, W. A. Label, M. Silver, S. Khandhar, R. Amin, M. Weinberg, K. Rosenfield, +8 Additional Authors

Journal Articles

No abstract provided.


Nonemergent Percutaneous Coronary Intervention On An Unprotected Left Main Coronary Artery Supported With Impella® Heart Pump In Patients Ineligible For Surgical Revascularization, P. M. Meraj, S. Dixon, J. Moses, K. Ibrahim, A. Schäfer, I. Akin, J. Hill, T. Schreiber, W. W. O'Neill Jan 2019

Nonemergent Percutaneous Coronary Intervention On An Unprotected Left Main Coronary Artery Supported With Impella® Heart Pump In Patients Ineligible For Surgical Revascularization, P. M. Meraj, S. Dixon, J. Moses, K. Ibrahim, A. Schäfer, I. Akin, J. Hill, T. Schreiber, W. W. O'Neill

Journal Articles

© 2019 Perwaiz M. Meraj et al. Objectives. We sought to assess if ineligibility to coronary artery bypass grafting (CABG) constitutes a risk factor in patients who underwent a nonemergent unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) with prophylactic Impella® heart pump support. Background. ULMCA PCI in patients not deemed eligible for CABG is associated with significantly worse outcomes compared to ULMCA PCI in eligible patients. Methods. Patients from the cVAD Registry and the PROTECT II trial who underwent a nonemergent ULMCA PCI were identified. We compared in-hospital mortality and major adverse cardiac and cerebrovascular event (MACCE) …


First Series Of Minimally Invasive, Robot-Assisted Tracheobronchoplasty With Mesh For Severe Tracheobronchomalacia, R. Lazzaro, B. Patton, P. Lee, J. Karp, E. Mihelis, S. Vatsia, S. J. Scheinerman Jan 2019

First Series Of Minimally Invasive, Robot-Assisted Tracheobronchoplasty With Mesh For Severe Tracheobronchomalacia, R. Lazzaro, B. Patton, P. Lee, J. Karp, E. Mihelis, S. Vatsia, S. J. Scheinerman

Journal Articles

No abstract provided.


The Role Of Novel Oral Anticoagulants And Antiplatelet Therapy After Percutaneous Coronary Intervention: Individualizing Therapy To Optimize Outcomes, E. Shlofmitz, R. Shlofmitz, M. S. Lee Jan 2019

The Role Of Novel Oral Anticoagulants And Antiplatelet Therapy After Percutaneous Coronary Intervention: Individualizing Therapy To Optimize Outcomes, E. Shlofmitz, R. Shlofmitz, M. S. Lee

Journal Articles

No abstract provided.


Single-Direction Thoracoscopic Lobectomy: A Step In The Right Direction, J. S. Young, P. C. Lee Jan 2019

Single-Direction Thoracoscopic Lobectomy: A Step In The Right Direction, J. S. Young, P. C. Lee

Journal Articles

No abstract provided.


Robotic Sleeve Resections: New Territory But Not The Final Frontier, B. D. Patton Jan 2019

Robotic Sleeve Resections: New Territory But Not The Final Frontier, B. D. Patton

Journal Articles

No abstract provided.


Predictors And Impact Of Right Heart Failure Severity Following Left Ventricular Assist Device Implantation, R. D. Baxter, K. M. Tecson, S. Still, J. D. G. Collier, J. Felius, S. M. Joseph, S. A. Hall, B. Lima Jan 2019

Predictors And Impact Of Right Heart Failure Severity Following Left Ventricular Assist Device Implantation, R. D. Baxter, K. M. Tecson, S. Still, J. D. G. Collier, J. Felius, S. M. Joseph, S. A. Hall, B. Lima

Journal Articles

No abstract provided.


Incidence Of Acute Kidney Injury In Patients With Chronic Renal Insufficiency: Transcatheter Versus Surgical Aortic Valve Replacement, M. Catalano, D. Lin, H. Cassiere, N. Kohn, B. Rutkin, G. Maurer, J. A. Berg, R. Esposito, A. Hartman, P. Yu, +1 Additional Author Jan 2019

Incidence Of Acute Kidney Injury In Patients With Chronic Renal Insufficiency: Transcatheter Versus Surgical Aortic Valve Replacement, M. Catalano, D. Lin, H. Cassiere, N. Kohn, B. Rutkin, G. Maurer, J. A. Berg, R. Esposito, A. Hartman, P. Yu, +1 Additional Author

Journal Articles

No abstract provided.


Touch Preparation Of Skin Biopsy Specimen For Rapid Diagnosis Of Cutaneous Nocardia Nova In The Immunocompromised Host, E. C. Traver, S. Husain, M. E. Grossman Jan 2019

Touch Preparation Of Skin Biopsy Specimen For Rapid Diagnosis Of Cutaneous Nocardia Nova In The Immunocompromised Host, E. C. Traver, S. Husain, M. E. Grossman

Journal Articles

No abstract provided.


Opportunities For Research In Mental Health Emergencies: Executive Summary And Methodology, M. P. Wilson, C. Shenvi, L. Rives, K. Nordstrom, S. Schneider, M. Gerardi Jan 2019

Opportunities For Research In Mental Health Emergencies: Executive Summary And Methodology, M. P. Wilson, C. Shenvi, L. Rives, K. Nordstrom, S. Schneider, M. Gerardi

Journal Articles

© 2019 Wilson et al. Introduction: Despite the ever-increasing numbers of mental health patients presenting to United States emergency departments, there are large gaps in knowledge about acute care of the behavioral health patient. To address this important problem, the Coalition on Psychiatric Emergencies convened a research consensus conference in December 2016 consisting of clinical researchers, clinicians from emergency medicine, psychiatry and psychology, and representatives from governmental agencies and patient advocacy groups. Methods: Participants used a standardized methodology to select and rank research questions in the order of importance to both researchers and patients. Results: Three working groups (geriatrics, substance …


Integration Of Entrustable Professional Activities With The Milestones For Emergency Medicine Residents, D. Hart, D. Franzen, M. Beeson, R. Bhat, M. Kulkarni, L. Thibodeau, M. Weizberg, S. Promes Jan 2019

Integration Of Entrustable Professional Activities With The Milestones For Emergency Medicine Residents, D. Hart, D. Franzen, M. Beeson, R. Bhat, M. Kulkarni, L. Thibodeau, M. Weizberg, S. Promes

Journal Articles

© 2019 Hart et al. Introduction: Medical education is moving toward a competency-based framework with a focus on assessment using the Accreditation Council for Graduate Medical Education Milestones. Assessment of individual competencies through milestones can be challenging. While competencies describe characteristics of the person, the entrustable professional activities (EPAs) concept refers to work-related activities. EPAs would not replace the milestones but would be linked to them, integrating these frameworks. Many core specialties have already defined EPAs for resident trainees, but EPAs have not yet been created for emergency medicine (EM). This paper describes the development of milestone-linked EPAs for EM. …


Standardized Video Interviews Do Not Correlate To United States Medical Licensing Examination Step 1 And Step 2 Scores, D. J. Egan, A. Husain, M. C. Bond, W. Caputo, L. Cygan, J. Van Dermark, J. M. Shoenberger, I. Li, B. Ardolic, M. Weizberg, +7 Additional Authors Jan 2019

Standardized Video Interviews Do Not Correlate To United States Medical Licensing Examination Step 1 And Step 2 Scores, D. J. Egan, A. Husain, M. C. Bond, W. Caputo, L. Cygan, J. Van Dermark, J. M. Shoenberger, I. Li, B. Ardolic, M. Weizberg, +7 Additional Authors

Journal Articles

© 2019 Egan et al. Introduction: In 2017, the Standardized Video Interview (SVI) was required for applicants to emergency medicine (EM). The SVI contains six questions highlighting professionalism and interpersonal communication skills. The responses were scored (6-30). As it is a new metric, no information is available on correlation between SVI scores and other application data. This study was to determine if a correlation exists between applicants' United States Medical Licensing Examination (USMLE) and SVI scores. We hypothesized that numeric USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores would not correlate with the SVI score, but that performance …


Simulation-Based Remediation In Emergency Medicine Residency Training: A Consensus Study, N. A. Nadir, D. Hart, M. Cassara, J. Noelker, T. Moadel, M. Kulkarni, C. S. Sampson, S. Bentley, N. K. Naik, C. Strother, +4 Additional Authors Jan 2019

Simulation-Based Remediation In Emergency Medicine Residency Training: A Consensus Study, N. A. Nadir, D. Hart, M. Cassara, J. Noelker, T. Moadel, M. Kulkarni, C. S. Sampson, S. Bentley, N. K. Naik, C. Strother, +4 Additional Authors

Journal Articles

© 2019 Nadir et al. Introduction: Resident remediation is a pressing topic in emergency medicine (EM) training programs. Simulation has become a prominent educational tool in EM training and been recommended for identification of learning gaps and resident remediation. Despite the ubiquitous need for formalized remediation, there is a dearth of literature regarding best practices for simulation-based remediation (SBR). Methods: We conducted a literature search on SBR practices using the terms "simulation," "remediation," and "simulation based remediation." We identified relevant themes and used them to develop an open-ended questionnaire that was distributed to EM programs with experience in SBR. Thematic …


Enhanced Macrophage Pannexin 1 Expression And Hemichannel Activation Exacerbates Lethal Experimental Sepsis, W. Chen, S. Zhu, Y. Wang, J. Li, X. Qiang, X. Zhao, L. Becker, P. Wang, K. J. Tracey, H. Wang, +2 Additional Authors Jan 2019

Enhanced Macrophage Pannexin 1 Expression And Hemichannel Activation Exacerbates Lethal Experimental Sepsis, W. Chen, S. Zhu, Y. Wang, J. Li, X. Qiang, X. Zhao, L. Becker, P. Wang, K. J. Tracey, H. Wang, +2 Additional Authors

Journal Articles

No abstract provided.


A Research Agenda For Assessment And Management Of Psychosis In Emergency Department Patients, J. Peltzer-Jones, K. Nordstrom, G. Currier, J. S. Berlin, C. Singh, S. Schneider Jan 2019

A Research Agenda For Assessment And Management Of Psychosis In Emergency Department Patients, J. Peltzer-Jones, K. Nordstrom, G. Currier, J. S. Berlin, C. Singh, S. Schneider

Journal Articles

© 2019 Peltzer-Jones et al. Introduction: Emergency departments (ED) manage a wide variety of critical medical presentations. Traumatic, neurologic, and cardiac crises are among the most prevalent types of emergencies treated in an ED setting. The high volume of presentations has led to collaborative partnerships in research and process development between experts in emergency medicine (EM) and other disciplines. While psychosis is a medical emergency frequently treated in the ED, there remains a paucity of evidence-based literature highlighting best practices for management of psychotic presentations in the ED. In the absence of collaborative research, development of best practice guidelines cannot …


Incoming Interns Perceived Preparedness For Core Entrustable Professional Activities, R. E. Pearlman, M. A. Pawelczak, J. B. Bird, A. C. Yacht, G. A. Farina Jan 2019

Incoming Interns Perceived Preparedness For Core Entrustable Professional Activities, R. E. Pearlman, M. A. Pawelczak, J. B. Bird, A. C. Yacht, G. A. Farina

Journal Articles

© 2019, International Association of Medical Science Educators. Introduction: The AAMC described 13 core entrustable professional activities (EPAs) for which every graduating medical student should perform proficiently on day 1 of residency. We studied how prepared starting interns felt in the core EPAs. Methods: Interns from a diverse health system were surveyed on how well medical school prepared them in the 13 core EPAs. Data were collected on type of medical school, participation in an acting/sub-internship (AI/SI), knowledge of EPAs, and participation in an EPA experience. Results: We collected 224 surveys out of 384 (58%) interns. 61.2% attended allopathic, 14.6% …


Free Open Access Medical Education Applications: A Critical Appraisal Of Techniques For Quality Assessment And Content Discovery, A. Zhi, A. Husain Jan 2019

Free Open Access Medical Education Applications: A Critical Appraisal Of Techniques For Quality Assessment And Content Discovery, A. Zhi, A. Husain

Journal Articles

No abstract provided.


Assessment Of Physician Well-Being, Part Two: Beyond Burnout, M. D. Lall, T. J. Gaeta, A. S. Chung, S. A. Chinai, M. Garg, A. Husain, C. Kanter, S. Khandelwal, C. S. Rublee, N. T. Himelfarb, +3 Additional Authors Jan 2019

Assessment Of Physician Well-Being, Part Two: Beyond Burnout, M. D. Lall, T. J. Gaeta, A. S. Chung, S. A. Chinai, M. Garg, A. Husain, C. Kanter, S. Khandelwal, C. S. Rublee, N. T. Himelfarb, +3 Additional Authors

Journal Articles

© 2019 Lall et al. Part One of this two-article series reviews assessment tools to measure burnout and other negative states. Physician well-being goes beyond merely the absence of burnout. Transient episodes of burnout are to be expected. Measuring burnout alone is shortsighted. Well-being includes being challenged, thriving, and achieving success in various aspects of personal and professional life. In this second part of the series, we identify and describe assessment tools related to wellness, quality of life, resilience, coping skills, and other positive states.


Does Training Level Affect The Accuracy Of Visual Assessment Of Capillary Refill Time?, K. Shinozaki, L. S. Jacobson, K. Saeki, N. Kobayashi, S. Weisner, J. M. Falotico, T. Li, J. Kim, J. W. Lampe, L. B. Becker Jan 2019

Does Training Level Affect The Accuracy Of Visual Assessment Of Capillary Refill Time?, K. Shinozaki, L. S. Jacobson, K. Saeki, N. Kobayashi, S. Weisner, J. M. Falotico, T. Li, J. Kim, J. W. Lampe, L. B. Becker

Journal Articles

No abstract provided.


Camp Metabolism Controls Caspase-11 Inflammasome Activation And Pyroptosis In Sepsis, R. Chen, L. Zeng, S. Zhu, J. Liu, H. J. Zeh, G. Kroemer, H. Wang, T. R. Billiar, J. Jiang, R. Kang, +1 Additional Author Jan 2019

Camp Metabolism Controls Caspase-11 Inflammasome Activation And Pyroptosis In Sepsis, R. Chen, L. Zeng, S. Zhu, J. Liu, H. J. Zeh, G. Kroemer, H. Wang, T. R. Billiar, J. Jiang, R. Kang, +1 Additional Author

Journal Articles

No abstract provided.


Recent Advances In Personalizing Cardiac Arrest Resuscitation, C. E. Kuschner, L. B. Becker Jan 2019

Recent Advances In Personalizing Cardiac Arrest Resuscitation, C. E. Kuschner, L. B. Becker

Journal Articles

© 2019 Kuschner CE and Becker LB. Cardiac arrest remains a significant cause of death and disability throughout the world. However, as our understanding of cardiac arrest and resuscitation physiology has developed, new technologies are fundamentally altering our potential to improve survival and neurologic sequela. Some advances are relatively simple, requiring only alterations in current basic life support measures or integration with pre-hospital organization, whereas others, such as extra-corporeal membrane oxygenation, require significant time and resource investments. When combined with consistent rescuer and patient-physiologic monitoring, these innovations allow an unprecedented capacity to personalize cardiac arrest resuscitation to patient-specific pathophysiology. However, …