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Biomedical subjects

Mariell Jessup

Publications and source records attributed to Mariell Jessup.

29 records · Page 2Linked to original sources
PubMed2004

Practice guidelines: role of internists and primary care physicians.

This article discusses practice guidelines for internists and primary care physicians who care for patients at risk for heart failure (HF).These guidelines include identifying the risk factors for the development of HF, identifying patients at risk for the development of HF, learning guideline goals for treatment and other recommendations concerning the management of patients at risk for HF, performing serial assessment of how well guideline goals have been met in patients at risk for HF, performing serial assessment of patients at risk for HF to determine possible progression of disease,considering consultation with other health personnel for patients with progressive stages of HF, enlisting hospitals and other care facilities to promote evidence-based management of patients in all stages of HF, and accessing educational materials for patients and other health care personnel.

Algorithms↗
PubMed2004

Thoracic organ transplantation.

This article presents an overview of factors associated with thoracic transplantation outcomes over the past decade and provides valuable information regarding the heart, lung, and heart-lung waiting lists and thoracic organ transplant recipients. Waiting list and post-transplant information is used to assess the importance of patient demographics, risk factors, and primary cardiopulmonary disease on outcomes. The time that the typical listed patient has been waiting for a heart, lung, or heart-lung transplant has markedly increased over the past decade, while the number of transplants performed has declined slightly and survival after transplant has plateaued. Waiting list mortality, however, appears to be declining for each organ and for most diseases and high-severity subgroups, perhaps in response to recent changes in organ allocation algorithms. Based on perceived inequity in organ access and in response to a mandate from Health Resources and Services Administration, the lung transplant community is developing a lung allocation system designed to minimize deaths on the waiting list while maximizing the benefit of transplant by incorporating post-transplant survival and quality of life into the algorithm. Areas where improved data collection could inform evolving organ allocation and candidate selection policies are emphasized.

Algorithms↗
PubMed2004

History of depression as a predictor of adverse outcomes in patients hospitalized for decompensated heart failure.

STUDY OBJECTIVE: To evaluate the prevalence and impact of depression on the risk of in-hospital death or need for cardiopulmonary resuscitation (CPR) in patients admitted for decompensated heart failure. DESIGN: Observational single-center study. SETTING: Coronary care unit and cardiac intermediate-care unit of a tertiary referral center. PATIENTS: One hundred seventy-one patients hospitalized with decompensated heart failure who were included in the Acute Decompensated Heart Failure Registry (ADHERE). MEASUREMENTS AND MAIN RESULTS: The 34 patients with a history of depression had a higher likelihood of experiencing the combined end point of in-hospital death or CPR compared with the 137 patients without a history of depression (17.7% vs 6.6%, p<0.05). A history of depression (odds ratio 3.3, 95% confidence interval 1.01-10.6, p<0.05) was still predictive of in-hospital death or CPR in a multivariate analysis after adjusting for predictors of the combined end point. CONCLUSIONS: This study suggests that a history of depression is associated with an increased risk of in-hospital mortality or CPR in patients hospitalized for decompensated heart failure. Our results require confirmation in larger trials.

Antidepressive Agents↗
PubMed2003

Heart failure.

Explore the source record for details and available documents.

Adrenergic beta-Antagonists↗
PubMed2003

Epilogue: support devices for end stage heart failure.

The present approach to circulatory assist/replacement devices is to use them as rescue for a patient in shock while awaiting transplant. In the next decade, the paradigm will shift to a more widespread use of such devices in patients without subsequent transplantation. Achievement of the ultimate goals of improved survival and quality of life for patients with advanced heart disease may depend on the strategic use of support devices more frequently than on the total replacement heart.

Cardiac Pacing, Artificial↗
PubMed2003

Resynchronization therapy is an important advance in the management of congestive heart failure: view of an antagonist.

The antagonist portion of the debate acknowledges that cardiac resynchronization therapy (CRT) is an important advance in the management of congestive heart failure, but the eligible treatment population currently is small relative to the whole. The impact of CRT on mortality without an implantable cardioverter defibrillator (ICD) probably is not significant, although a beneficial effect on morbidity associated with heart failure has clearly been achieved. The costs of CRT are not negligible. The morbidity and mortality of the procedure to implant these devices must be considered in future trial design.

Cardiac Pacing, Artificial↗
PubMed2003

The new staging system for heart failure. What every primary care physician should know.

The primary care physician is in a unique position to have a major impact on the prevention of heart failure. Using the new system of classifying heart failure, the primary care physician can better evaluate and treat patients in the primary care setting. The new American College of Cardiology/American Heart Association staging system for heart failure emphasizes the structural condition of the heart as well as the prevention, evolution, and progression of heart failure. It is meant to complement the NYHA classification system, which has been used to describe functional limitations, not structural abnormalities.

Cardiotonic Agents↗
PubMed2002

Recipient selection in cardiac transplantation: contraindications and risk factors for mortality.

Currently the only acknowledged, definitive treatment for refractory heart failure is heart transplantation (HTx). During the past 10 years, selection criteria for heart transplant recipients have been developed that use an analysis of risk factors associated with mortality, which were identified by consensus opinion and by single-center and multi-center database review. A number of other studies also have been designed to evaluate specific risk factors for transplant such as advanced age, diabetes, and sex. This review identifies variables that continue to provoke controversy during the candidate selection process or variables that have changed from absolute to relative contraindications for HTx. Clinicians may use the data summarized in this review as a guide to making decisions about patient candidacy for HTx. One could conclude from this analysis that a more formalized and objective scale to select patients and to assess risk of death after HTx is necessary. Moreover, as alternative therapies to HTx become reality, a better instrument for triaging patients to one form of therapy or another may be necessary.

Age Factors↗