Acute Heart Failure Myocarditis.
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A 32-year-old man presented to the emergency department with recent onset chest pressure and dyspnea. He reported having a flu-like illness one week prior. On exam, his heart rate was 108 and regular, blood pressure was 105/70, and he had a pericardial rub and basilar rales. His troponin T level was elevated at 12. An electrocardiogram showed abnormal findings. The patient is likely experiencing myocarditis, which can develop after a viral illness, and immunosuppressive therapy with prednisone and azathioprine is least likely to improve his left ventricular function over the next six months.
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Cardiomyopathy is a disease of the heart muscle that weakens the heart's ability to pump blood effectively. The main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart chambers to enlarge over time. Treatment involves managing symptoms and risk factors with medications, lifestyle changes, surgery such as implantable devices or transplant, and treating any underlying causes. A heart transplant may be an option for severe cases but carries risks of organ rejection, infection, and side effects of immunosuppressant drugs.
MOGES classification of cardiomyopathy 2013
This document summarizes the evolution of cardiomyopathy classification over 50 years, from 1956 to the present. Early classifications in the 1950s-1970s were based on pathology and described broad categories like myocarditis, myocardiosis, and dilated, hypertrophic, restrictive cardiomyopathies. In the 1980s, genetic causes were recognized. Later classifications in the 1990s-2000s incorporated genetic testing results and distinguished primary from secondary cardiomyopathies. The current 2013 classification system from the World Heart Federation is based on a morphology-function-genetics-etiology-status approach to provide a standardized nomenclature incorporating both phenotype and genotype.
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Preventable cause of dilated cardiomyopathy in children
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Similar to Acute Heart Failure Myocarditis.
COVID-19 Vaccination in Patients Requiring Palliative Care
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr. Richard Lim Boon Leong is a Consultant Palliative Medicine Physician and Head of Palliative Care Unit, Selayang Hospital, Ministry of Health Malaysia.
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: September Cases
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
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• Innominate Artery Transection
• Dextrocardia
• Situs Inversus
• Pneumonia
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• Septic Pulmonary Emboli
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Pulmonary Embolism & Deep Vein Thrombosis - Handout.pdf
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Managing the Myths in Lipid Management
Early Diabetes and Dyslipidaemia Treatment Optimisation.
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Cardiologist, Electrophysiologist
Asian Heart & Vascular Centre
www.ahvc.com.sg
case scenario 1-chest pain
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- An ECG showed ST-elevation consistent with an acute anterior wall myocardial infarction (STEMI).
- Initial management included fibrinolytic therapy (e.g. streptokinase) within 12 hours of symptom onset to reperfuse the occluded coronary artery and reduce mortality.
Deciding When Hospice is Needed
This document provides guidance for healthcare professionals on determining a terminal prognosis and accessing hospice care. It discusses the challenges of prognosis, general clinical criteria like functional status and symptom burden, and disease-specific guidelines for predicting prognosis in cancers, end-stage cardiac or pulmonary disease, dementia, cerebrovascular disease, liver disease, HIV/AIDS, and end-stage renal disease without dialysis. Key points are that prognosis involves clinical judgment of multiple factors, physicians tend to overestimate survival, and guidelines provide population-level rather than individual predictions.
Deciding When Hospice Care is Needed | VITAS Healthcare
The goal of this webinar is to help healthcare professionals address the specific challenges of end-of-life care when determining a terminal prognosis, so they can provide the optimum care for the patient and family during the final stages of life.
Drs. Milam and Thomas's CMC X-Ray Mastery Project: July cases
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on: Sternal fracture, Left hemothorax, Traumatic aortic aneurysm, Acute chest syndrome, Right upper lobe pneumonia, Pericardial effusion, Pulmonary contusion, Pulmonary bleb, Non-small-cell lung cancer
Drs. Milam and Thomas's CMC X-Ray Mastery Project: August Cases
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on: Aortic Dissection, Hiatal Hernia, Pleural Effusion, Metastatic Cancer, Cystic Fibrosis, Pulmonary Contusions, Esophageal-pleural Fistula, Diaphragmatic Hernia, Pulmonary Artery Hypertension, Hemorrhagic Pericardial Effusion, Pulmonary Infarct
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: April Cases
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- Large Bowel Obstruction
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Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: December...
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Bladder Rupture
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EMGuideWire's Radiology Reading Room: Hypertrophic Cardiomyopathy
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Hypertrophic Cardiomyopathy and is brought to you by Ashley Moore-Gibbs, DNP, Claire Lawson, NP, Laszlo Littmann, MD, and John Symanski, MD.
Final year ospe
This document contains multiple patient case summaries and medical images/reports with questions related to diagnosis and management. Some key cases include:
- A 55-year-old male presenting with shortness of breath, whose chest X-ray shows cardiomegaly and upper lobe diversion.
- A 35-year-old male with progressive shortness of breath and cough presenting with bilateral hilar lymphadenopathy on chest X-ray, leading to a diagnosis of sarcoidosis.
- An ECG showing findings of atrial fibrillation in a 35-year-old female presenting with palpitations.
- A CT scan of a 30-year-old IV drug user presenting with fever
Dr. Michael Gibbs's CMC X-Ray Mastery Project - Week #7 Cases
Dr. Michael Gibbs is a Professor of Emergency Medicine and interested in educating others. Radiology is a passion of his. Follow along with the EMGuideWire.com team as they post Dr. Gibbs's weekly educational, self-guided radiology slides on: Hemopericardium, Cardiomyopathy, Heart Failure, Myocarditis, Ruptured Hemidiaphragm, Hydropneumothorax, Pneumothorax, ECMO
seminar intraventricular hemorrage and birth defects
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Case Study, Chapter 34, Management of Patients With Hematologic Neop.docx
Case Study, Chapter 34, Management of Patients With Hematologic Neoplasms
1. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)
a. What nursing management should the nurse provide the patient?
Explain the indication and action of the various medications ordered to treat the patient’s symptoms.
2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3)
a. What laboratory results would you anticipate due to her ecchymosis and petechia?
Why would it be important to inspect her gums and teeth?
a. Why is her liver enlarged?
Case Study, Chapter 37, Management of Patients With HIV Infection and AIDS
1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4)
a. What should the nurse include in the session considering the needs of the older population?
2. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails. (Learning Objective 5)
a. What clinical management is recommended for the patient during the pregnancy to help decrease the risk of transmitting HIV to the unborn child?
The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from getting HIV. How should the nurse respond?
What explanation about Retrovir should the nurse provide?
The patient asks the nurse if it will be safe to breast-feed her infant after the delivery. The nurse should provide what explanation?
a. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?
Case Study, Chapter 31, Assessment and Management of Patients With Hypertension
1. Joan Smith, 55 years of age, is a female patient who presents to the intensive care unit with the diagnosis of intracranial hemorrhage. The patient stopped taking her antihypertensives suddenly because of the cost of .
00003246 201506000-00015
This study aimed to clarify the relationship between lipid profile, morbidity assessed by Killip classification, and 30-day mortality in patients with acute myocardial infarction (AMI). The study found that low-density lipoprotein cholesterol (LDL-C) and triglyceride levels were significantly lower in patients with higher Killip classification (more severe heart failure) and in those who died within 30 days compared to survivors. After adjusting for risk factors, LDL-C less than 62.5 mg/dL and triglycerides less than 110 mg/dL were identified as cutoff values associated with higher 30-day mortality. Patients with both low LDL-C and triglycerides and high Killip classification had a nearly 11-fold
Drs. Milam and Thomas's CMC X-Ray Mastery Project: November Cases
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Acute coronary syndrome
This document presents a case study of a 28-year-old male who presented to the emergency department with chest pain. His initial troponin level was negative but later increased. His ECG showed ST elevations. He was diagnosed with an ST elevation myocardial infarction (STEMI) based on his symptoms, elevated troponin level, and ECG changes. He was admitted and managed medically with aspirin, clopidogrel, heparin, oxygen, nitroglycerin, and morphine as needed. He had an uneventful recovery and was discharged after 5 days.
Slideshare acs core content
This document discusses the evaluation and management of acute coronary syndrome (ACS) and ST-segment elevation myocardial infarction (STEMI). It begins by outlining the epidemiology of cardiovascular disease and ACS. It then reviews the history, physical exam findings, EKG findings, biomarkers, and risk scores used to evaluate patients with potential ACS. Various treatment options for STEMI are discussed including thrombolytics, percutaneous coronary intervention (PCI), anticoagulants, antiplatelets, and beta blockers. Complications of STEMI and strategies to reduce door-to-balloon times for PCI are also summarized.
Similar to Acute Heart Failure Myocarditis. (20)
COVID-19 Vaccination in Patients Requiring Palliative Care
COVID-19 Vaccination in Patients Requiring Palliative Care
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: September Cases
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: September Cases
Pulmonary Embolism & Deep Vein Thrombosis - Handout.pdf
Pulmonary Embolism & Deep Vein Thrombosis - Handout.pdf
Deciding When Hospice Care is Needed | VITAS Healthcare
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Drs. Milam and Thomas's CMC X-Ray Mastery Project: July cases
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Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: April Cases
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Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: December...
EMGuideWire's Radiology Reading Room: Hypertrophic Cardiomyopathy
EMGuideWire's Radiology Reading Room: Hypertrophic Cardiomyopathy
Dr. Michael Gibbs's CMC X-Ray Mastery Project - Week #7 Cases
Dr. Michael Gibbs's CMC X-Ray Mastery Project - Week #7 Cases
seminar intraventricular hemorrage and birth defects
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Case Study, Chapter 34, Management of Patients With Hematologic Neop.docx
Case Study, Chapter 34, Management of Patients With Hematologic Neop.docx
Drs. Milam and Thomas's CMC X-Ray Mastery Project: November Cases
Drs. Milam and Thomas's CMC X-Ray Mastery Project: November Cases
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This document discusses functional mitral regurgitation (FMR) in heart failure patients. It presents evidence that even mild FMR results in poor survival outcomes, and that FMR is not just a late marker but also a cause of worse prognosis. Surgical mitral repair using a small, complete, rigid ring to reduce the mitral annulus has been shown to improve survival, ventricular remodeling, and functional status compared to no repair or incomplete repairs that do not fully correct FMR. Ongoing studies are exploring newer percutaneous approaches to treating FMR, but surgical repair remains the standard treatment when anatomically feasible to fully correct FMR.
Aortic Valve Stenosis with low EF : TAVR versus Replacement
1) Patients with low ejection fraction (EF < 50%) and severe aortic stenosis who undergo transcatheter aortic valve replacement (TAVI) have similar mortality at 1 year compared to those with higher EF, despite being higher risk.
2) TAVI is associated with significant improvements in EF, symptoms, and quality of life over 1 year in patients with very low EF (≤30%). However, mortality remains higher compared to those with EF >30%.
3) Both TAVI and surgical aortic valve replacement (SAVR) are associated with improvements in EF at 3 months in propensity matched populations with low EF. Short term outcomes are similar, but TAVI is associated with more pacemakers
When is less more minimally invasive surgery in low ef
The document discusses treatment options for patients with reduced ejection fraction and secondary mitral regurgitation, including the use of minimally invasive mitral valve surgery which can be considered for elderly patients or those with comorbidities. It presents a case study of a 69-year-old male with severe secondary mitral regurgitation who underwent a minimally invasive mitral valve repair which eliminated his mitral regurgitation and improved his symptoms and ejection fraction. Long-term data on isolated mitral valve surgery in patients with reduced ejection fraction shows improvement in mitral regurgitation and functional status with no difference in survival between repair and replacement
When to consider tricuspid valve repair
The document discusses when to consider tricuspid valve repair. Tricuspid regurgitation is associated with poor prognosis, especially when secondary to left-sided heart lesions, cardiomyopathy, pulmonary hypertension, or in the setting of LVAD placement or heart transplantation. Tricuspid valve repair is indicated for severe, symptomatic primary tricuspid regurgitation, and may also be considered for significant functional regurgitation concurrent with mitral valve surgery, after isolated mitral valve surgery if regurgitation is severe, or when placing a continuous-flow LVAD. Prophylactic tricuspid annuloplasty during heart transplantation reduces the severity of post-operative regurgitation and is associated with improved long-term survival
Cad and low ef does viability assessment matter
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Multimodality imaging.
This document discusses the conundrum of managing mitral regurgitation (MR) in patients with heart failure. It highlights the importance of using multimodality imaging to:
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2) Evaluate left ventricular function, dyssynchrony, viability and ischemia to determine indications for cardiac resynchronization therapy or revascularization.
3) Assess left ventricular remodeling and mitral valve deformation to predict risk of recurrent MR after repair and determine the best repair/replacement option.
Imaging provides essential information to optimize treatment strategies for MR in heart failure.
The complex patient vad transplant exchange or hospice
This document discusses the case of a 76-year-old man presenting with heart failure symptoms and recurrent cough syncope. Testing revealed cardiac amyloidosis due to a TTR gene mutation. For patients with TTR amyloidosis, treatment options include organ transplantation, TTR stabilizers in clinical trials, or enrollment in hospice. Given his age and comorbidities, the man's options included a left ventricular assist device, extended criteria transplant, or a clinical trial for TTR amyloidosis treatment. He was ultimately listed and transplanted, and has since recovered well.
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This document discusses the case of a 76-year-old man presenting with heart failure symptoms and recurrent cough syncope. Testing revealed cardiac amyloidosis due to a TTR gene mutation. For patients with TTR amyloidosis, treatment options include organ transplantation, TTR stabilizers in clinical trials, or enrollment in hospice. Given his age and comorbidities, the man's options included a left ventricular assist device, extended criteria transplant, or a clinical trial for TTR amyloidosis treatment. He was ultimately listed and transplanted within a month, and has since recovered well.
Surgical director heart transplant and mechanical assist device program
The document discusses a 55-year-old female patient with a history of rheumatic valve disease and multiple prior heart surgeries who was admitted with recurrent heart failure and an ejection fraction below 10%, outlining her medical history and current status, treatment options, and clinical course including optimization, a redo aortic valve replacement and implantation of a HeartMate II left ventricular assist device.
The complex patient vad ransplant vad exchange or hospice
L.B. is a 62-year-old man with a long history of coronary artery disease and heart failure who has undergone multiple coronary bypass surgeries. He now has an ejection fraction of 25% and intractable ventricular tachycardia despite medical management. Due to the risks of ablation, the team is considering options like hospice care, cardiac transplantation, VAD implantation, or VAD exchange to treat his advanced heart failure. A cardiac catheterization revealed multiple occluded arteries and stenoses. Given his medical history and surgical history, the team must determine the best treatment approach for his condition.
The road ahead.
This document discusses the management of mitral regurgitation (MR) in heart failure patients. It explores the differences between primary and functional (secondary) MR, and notes that correcting primary MR may improve outcomes but the benefits are less clear for functional MR which is primarily a ventricular problem. The document reviews potential management options for MR in heart failure including optimal medical therapy, cardiac resynchronization therapy, surgery, and percutaneous techniques such as the MitraClip system. It presents evidence from studies on the acute effects of CRT and the impact of CRT on functional MR severity. It also discusses guidelines on indications for mitral valve surgery in chronic secondary MR and barriers to surgery.
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This document discusses the treatment of mitral regurgitation in patients with heart failure. It describes the mechanisms of functional and ischemic mitral regurgitation. While medical therapy can improve symptoms and survival, cardiac resynchronization therapy may also help reduce mitral regurgitation severity and improve outcomes. Surgery to repair the mitral valve is an option but the risk of recurrence of mitral regurgitation is high, especially with more advanced left ventricular remodeling. Randomized trials are still needed to determine whether surgical correction provides clear benefits over medical therapy alone in high-risk patients. Percutaneous mitral valve repair may be a lower risk option for inoperable patients to reduce symptoms.
Devices and intervention in heart failure.
- The document discusses the speaker's receipt of honoraria and research support from numerous pharmaceutical and device companies.
- It summarizes several journal articles and studies related to left ventricular remodeling post-myocardial infarction, baroreflex activation therapy for heart failure, and the effects of bi-ventricular pacing on left ventricular ejection fraction and end-systolic volume.
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This document contains information about Prof. Fausto J. Pinto who is the Head of Cardiology at University Hospital Sta Maria-HPV and University of Lisbon in Portugal. It discloses that he has received consultancy fees and lecture fees from various pharmaceutical companies. It also contains several figures and images from various medical studies and publications related to cardiology.
The EHJ's and EJHF's Year in Cardiology
This document lists the collaborations and conflicts of interest for speakers Thomas F. Lüscher and Marco Metra. It notes that they have received research grants, educational grants, and honoraria from numerous pharmaceutical companies. The rest of the document discusses the European Heart Journal, including new associate editors, submission rates and acceptance rates, impact factors, and plans to launch new open access and supplement journals.
Acute and advanced heart failure.
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Prevention is the best treatment
This document discusses the importance of prevention in treating cardiovascular disease. It outlines stages of heart failure progression from asymptomatic left ventricular dysfunction to refractory heart failure. Clinical trials show benefits of treating hypertension and post-MI left ventricular dysfunction to prevent heart failure. Treatment with ACE inhibitors reduces mortality and morbidity from heart failure. Prevention of risk factors is emphasized as the best strategy to avoid full-blown heart disease.
Can we afford heart failure management in the future
Heart failure is a major global health problem, affecting 26 million people worldwide. It accounts for 1-3% of hospital admissions in Europe and North America. Hospitalization is the main driver of the high economic costs of heart failure management, which is estimated to rise significantly in the coming decade. To better manage heart failure costs in the future, new models of coordinated and integrated care will need to be implemented, with a focus on preventing hospitalizations and readmissions through improved education, care transitions, and treatment of comorbidities.
The deadly statistics of heart failure.
This document discusses statistics related to heart failure. It summarizes data on outcomes for hospitalized heart failure patients compared to chronic heart failure patients. Hospitalized patients generally have worse outcomes, with high 1-year mortality rates around 25-27%. Chronic heart failure patients have lower but still significant 1-year mortality rates of around 5-6%. The document also reviews real-world data showing high readmission rates after hospitalization for heart failure. It concludes that while treatments for chronic heart failure with reduced ejection fraction have improved outcomes over decades, more efforts are still needed to improve care and outcomes for hospitalized patients and those with preserved ejection fraction.
The heart failure association global awareness programme.
The Global Heart Failure Awareness Programme aims to make the prevention and management of heart failure a global health priority. It is led by the Heart Failure Association of the European Society of Cardiology and supported by educational grants. The programme's objectives are to build a common global approach to raising awareness of heart failure among targeted audiences and to call for heart failure to be a health priority in every country. It plans to achieve this through developing educational content, building advocacy coalitions, and implementing initiatives at the national and local levels between 2015 and 2017.
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Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
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CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdf
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
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nurs fpx 4050 assessment 4 final care coordination plan.pdf
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Research, Monitoring and Evaluation, in Public Health
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
Monopoly PCD Pharma Franchise in Tripura
Our company incorporates various drug formulations covering pharma tablets, syrups, capsules, gels, sachets, ointments, creams, injectables.
Hypotension and role of physiotherapy in it
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
This edition features a handful of Innovative Minds: France's Most Impactful Healthcare Leaders that are leading us into a better future.
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
According to TechSci Research report, “India Medical Devices Market Industry Size, Share, Trends, Competition, Opportunity and Forecast, 2019-2029,” the India Medical Devices Market was valued at USD 15.35 billion in 2023 and is anticipated to witness impressive growth in the forecast period, with a Compound Annual Growth Rate (CAGR) of 5.35% through 2029. This growth is driven by various factors, including strategic collaborations and partnerships among leading companies, a growing population, and the increasing demand for advanced healthcare solutions.
Recent Trends
Strategic Collaborations and Partnerships
One of the most significant trends driving the India Medical Devices Market is the increasing number of collaborations and partnerships among leading companies. These alliances aim to merge the expertise of individual companies to strengthen their market position and enhance their product offerings. For instance, partnerships between local manufacturers and international companies bring advanced technologies and manufacturing techniques to the Indian market, fostering innovation and improving product quality.
Browse over XX market data Figures and spread through XX Pages and an in-depth TOC on " India Medical Devices Market.” - https://www.techsciresearch.com/report/india-medical-devices-market/8161.html
Top 5 Benefits of Cancer Registry Services
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
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Acute Heart Failure Myocarditis.
- 1. Leslie T. Cooper, Jr., MDLeslie T. Cooper, Jr., MD Chair, Cardiovascular DepartmentChair, Cardiovascular Department Mayo Clinic in FloridaMayo Clinic in Florida Myocarditis in the Emergency Department May 23rd, 2015
- 3. 32 year old man presents to your ED with recent onset chest pressure and dyspnea •• He reports a flu-like illness 1 week priorHe reports a flu-like illness 1 week prior •• Exam: HR 108 regular. BP 105/70.Exam: HR 108 regular. BP 105/70. •• + Pericardial rub, + basilar rales+ Pericardial rub, + basilar rales •• JVP 9 cm. No peripheral edema.JVP 9 cm. No peripheral edema. •• Troponin T 12Troponin T 12
- 6. Which of the following is least likely to improve his left ventricular function over the next 6 months? •• LisinoprilLisinopril •• CarvedilolCarvedilol •• Prednisone and AzathioprinePrednisone and Azathioprine
- 7. And….. avoid competitive sports for at least 3-6 months
- 8. Immunosuppression for Chronic iDCM
- 9. Inflammatory, Infiltrative, Infectious Cardiomyopthies •• MyocarditisMyocarditis Post-viral/idiopathic, giant cell,Post-viral/idiopathic, giant cell, rheumatologic or hypersensitivity-rheumatologic or hypersensitivity- relatedrelated •• Sarcoidosis-Sarcoidosis- 50%50% isolated to the heartisolated to the heart •• HIV, Chagas’ and Lyme DiseasesHIV, Chagas’ and Lyme Diseases •• AmyloidosisAmyloidosis
- 10. Cumulative Incidence Rates of Death, Heart Transplantation and Left Ventricular Recovery in Children with Myocarditis Time to occurrence of event (years) Eventprobability No event Echocardiographic normalization Death Transplant Foerster et al: Circ Heart Fail, 2010
- 11. 28 yo woman with same symptoms And the following EKG
- 12. CP1304423-1
- 13. According to current ESC and AHA scientific statements, which of the following is a Class I indication for EMB in acute DCM? •• Failure to improve with GDMT after 2Failure to improve with GDMT after 2 weeksweeks •• Sustained or symptomatic VTSustained or symptomatic VT •• Mobitz type 2 or higher heart blockMobitz type 2 or higher heart block •• All of the aboveAll of the above
- 17. 21%
- 19. 18 yo man with pericardidic chest pain, Troponin 10, normal LVEF and MRI:
- 20. According to a recent randomzed clinical trial which of the following are useful to control his chest pain? •• Colchicine, dosed by weightColchicine, dosed by weight •• Prednisone 20 mg/dayPrednisone 20 mg/day •• HydrocodoneHydrocodone •• None of the aboveNone of the above
- 21. Imazio, M. et al. Circ 2013 No Deaths
- 23. NewNew onset heart failure ofonset heart failure of 22 weeks to 3 monthsweeks to 3 months durationduration associated with a dilated leftassociated with a dilated left ventricle…andventricle…and Class I, LOE B Cooper, LT, et al Circulation 2007 •Ventricular arrhythmias, or •High degree heart block, or •Failure to respond to usual care within 1 to 2 weeks
- 24. Giant Cell versus Lymphocytic Myocarditis Transplant-Free Survival CP977755-6 Survival (yr)Survival (yr) ProportionsurvivingProportionsurviving LM groupLM group GCM groupGCM group Cooper, LT, NEJM 1997
- 25. 25% of 72 patients 18- 55 with initially unexplained AV block had GCM or cardiac sarcoidosis on endomyocardial biopsy Circ. Arrhy and EP 2011:4(3). 303 -9
- 26. 21% changed management Bennett, et al. Circ Heart Fail 2013
- 27. Immunohistology Predicts Outcome in Patients with Acute Myocarditis Freedomfromcardiac deathandHTx Months after biopsy Kindermann et al: Circ 118:639, 2008 CP1324648-2 Positive Negative P<0.001 Immunohistology Results Histopathological Results According to DALLAS Criteria 1.0 0.8 0.6 0.4 0.2 0.0 Months after biopsy DALLAS negative DALLAS positive P=0.192
- 28. TIMIC Study •• RCT- Biopsy guided therapy in chronicRCT- Biopsy guided therapy in chronic DCM, n=DCM, n=8585; Screened; Screened 512512 •• AZA and prednisone-mean LVEFAZA and prednisone-mean LVEF increased fromincreased from 26% to 46%26% to 46% at 6 monthsat 6 months •• Immunosuppression may improve LVEFImmunosuppression may improve LVEF in select patients with non-viral,in select patients with non-viral, inflammatory DCM thatinflammatory DCM that fails to respondfails to respond to usual careto usual care Frustaci, A, et al. Eur Heart J 2009
- 29. Anti-CD3 Anti-CD68HLA-class II antigen H and E Select Histological Definitions of Myocarditis From Staudt et al: Circ 2001