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The Role Of Bnp Testing In Heart Failure, Jenny Doust, Richard Lehman, Paul Glasziou
The Role Of Bnp Testing In Heart Failure, Jenny Doust, Richard Lehman, Paul Glasziou
Jenny Doust
Brain natriuretic peptide (BNP) levels are simple and objective measures of cardiac function. These measurements can be used to diagnose heart failure, including diastolic dysfunction, and using them has been shown to save money in the emergency department setting. The high negative predictive value of BNP tests is particularly helpful for ruling out heart failure. Treatment with angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, spironolactone, and diuretics reduces BNP levels, suggesting that BNP testing may have a role in monitoring patients with heart failure. However, patients with treated chronic stable heart failure may have levels in the normal range (i.e., BNP …
Is Pulse Palpation Helpful In Detecting Atrial Fibrillation? A Systematic Review, Georga Cooke, Jenny Doust, Sharon Sanders
Is Pulse Palpation Helpful In Detecting Atrial Fibrillation? A Systematic Review, Georga Cooke, Jenny Doust, Sharon Sanders
Jenny Doust
Background: Atrial fibrillation in the elderly is common and potentially life threatening. The classical sign of atrial fibrillation is an irregularly irregular pulse. Objective: The objective of this research was to determine the accuracy of pulse palpation to detect atrial fibrillation. Methods: We searched Medline, EMBASE, and the reference lists of review articles for studies that compared pulse palpation with the electrocardiogram (ECG) diagnosis of atrial fibrillation. Two reviewers independently assessed the search results to determine the eligibility of studies, extracted data, and assessed the quality of the studies. Results: We identified 3 studies (2385 patients) that compared pulse palpation …
Evidence Based Answers - Is Salmeterol Safe In Asthma?, Geoffrey Spurling, Jenny Doust
Evidence Based Answers - Is Salmeterol Safe In Asthma?, Geoffrey Spurling, Jenny Doust
Jenny Doust
Case history SW, 21 years of age, presented for a prescription for her salbutamol puffer. She had a long history of chronic persistent asthma usually exacerbated by upper respiratory tract infections (URTIs). These exacerbations had occasionally landed her in hospital but never in intensive care. After a friend died of an asthma attack, SW adhered rigorously to her asthma plan and always used a spacer for her preventer, fluticasone. It therefore surprised me when I noticed that she had had no URTIs yet had been prescribed salbutamol by another general practitioner in the practice only 2 weeks previously. In response …