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Biomedical subjects

K Dracup

Publications and source records attributed to K Dracup.

At least 73 records · Page 4Linked to original sources
PubMed1996

Agency for health care policy and research: Clinical practice guidelines for heart failure.

The Agency for Health Care Policy and Research (AHCPR) and Rand Corporation convened a panel of experts to review published studies on care of the patient with heart failure. The outcome was the Clinical Practice Guideline for the evaluation and care of patients with left ventricular systolic dysfunction, published in June 1994. This article reviews key points in the clinical practice guideline and summarizes important areas for future research to improve patient outcomes.

Health Planning Organizations↗
PubMed1996

Making mistakes.

Explore the source record for details and available documents.

Critical Care↗
PubMed1996

Heart failure secondary to left ventricular systolic dysfunction. Therapeutic advances and treatment recommendations.

Although heart failure secondary to left ventricular systolic dysfunction remains a serious disease with high morbidity and mortality, pharmacologic intervention has been shown to be associated with improved survival and a decreased number of hospitalizations. Primary-care providers must be aware of the potential benefits of recent therapeutic advances and current treatment recommendations for patients with heart failure to receive optimal care. Important aspects of nonpharmacologic care are dietary restrictions, exercise training, and through patient education and counseling. Pharmacologic therapy includes diuretics, angiotensin-converting enzyme inhibitors (ACE) and other vasodilating agents, and digoxin. ACE inhibitors are currently recommended for all patients with left ventricular dysfunction in whom use of these agents is not contraindicated. The mortality and morbidity from heart failure even with ACE inhibitors remain high, however. Promising clinical findings with such investigational agents as vesnarinone and pimobendan and the new-generation beta-blocker carvedilol suggest future new treatments to further improve the prognosis of these patients.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1995

Causes of delay in seeking treatment for heart attack symptoms.

With the advent of thrombolytic therapy and other coronary reperfusion strategies, rapid identification and treatment of acute myocardial infarction greatly reduces mortality. Unfortunately, many patients delay seeking medical care and miss the benefits afforded by recent advances in treatment. Studies have shown that the median time from onset of symptoms to seeking care ranges from 2 to 61/2 hours, while optimal benefit is derived during the first hour from symptom onset. The phenomenon of delay by AMI patients and those around them needs to be understood prior to the design of education and counseling strategies to reduce delay. In this article the literature is reviewed and variables that increase patient delay are identified. A theoretical model based on the health belief model, a self regulation model of illness cognition, and interactionist role theory is proposed to explain the response of an individual to the signs and symptoms of acute myocardial infarction. Finally, recommendations are made for future research.

Attitude to Health↗
PubMed1995

Predictors of between-method differences in cardiac output measurement using thoracic electrical bioimpedance and thermodilution.

OBJECTIVES: To evaluate the usefulness of transthoracic electrical bioimpedance in trending changes in cardiac output after cardiac surgery, and to identify predictors of differences between cardiac output measured by thermodilution and transthoracic electrical bioimpedance methods. DESIGN: Prospective repeated-measures study. SETTING: University-affiliated tertiary care center. PATIENTS: Thirty-four adult patients undergoing elective cardiac surgery with routine pulmonary artery catheter placement. INTERVENTIONS: Simultaneous paired cardiac output measurements by transthoracic electrical bioimpedance and thermodilution were made at four time points: within 2 hrs of intensive care unit (ICU) admission; when the patient reached a normothermic temperature; after extubation; and 24 hrs after ICU admission. MEASUREMENTS AND MAIN RESULTS: Mean measurements by each method over time did not differ, except at ICU admission, when compared by repeated-measures analysis of variance. For each time point, bias and precision between methods were calculated. Bias calculations ranged from 0.02 to 0.21 L/min/m2. Precision calculations ranged from 1.06 to 1.52 L/min/m2. Predictors of between-method differences identified by a multiple regression model of hemodynamic variables were: increased systemic vascular resistance index, decreased mean arterial pressure (MAP), and the presence of atrial or ventricular pacing. CONCLUSIONS: While mean postoperative cardiac output measurements did not differ by method over time, agreement between transthoracic electrical bioimpedance and thermodilution methods was poor in the immediate postoperative period, with precision calculations indicative of clinically significant differences. Increased systemic vascular resistance index and decreased MAP were predictive of larger between-method differences.

Aged↗