Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Aug 2021
ReviewConsidering additive effects of polypharmacy : Analysis of adverse events in geriatric patients in long-term care facilities.
Potential additive effects of polypharmacy are rarely considered in adverse events of geriatric patients living in long-term care facilities. Our aim, therefore, was to identify adverse events in this setting and to assess plausible concomitant drug causes. ⋯ Patients in long-term facilities frequently suffer from many adverse events. Concomitantly administered drugs have to be frequently considered as plausible causes for adverse events. These additive effects of drugs should be more focused in patient care and research.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewTranscatheter treatment by valve-in-valve and valve-in-ring implantation for prosthetic tricuspid valve dysfunction.
Valve degeneration after surgical tricuspid valve replacement or repair is frequent and may require repeat replacement/repair. For high-risk patients, transcatheter valve-in-valve and valve-in-ring procedures have emerged as valuable treatment alternatives. Preprocedural transthoracic echocardiography is the method of choice to detect malfunction of the prosthesis including degenerative stenosis and/or regurgitation requiring reintervention. ⋯ Suitable transcatheter valves are the Edwards Sapien 3 and the Medtronic Melody valves. Differences in surgical prostheses or annuloplasty implants are important for device selection, height consideration and additional ballooning prior to or after implantation. Transesophageal echocardiography postimplantation is convenient for the assessment of transvalvular gradients or paravalvular leaks.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewNew strategies in the management of valvular heart disease : A critical appraisal on the top 10 messages of the 2020 ACC/AHA guidelines for the management of patients with valvular heart disease.
The advent of transcatheter procedures for treatment of valvular heart disease has accelerated the pace of research in the diagnosis and treatment of heart valve disease. Rapid accumulation of novel knowledge in the field necessitates timely revisions of clinical guidelines. This paper comments on some important and novel issues addressed in the recently published American College of Cardiology/American Heart Association (ACC/AHA) guidelines.
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Wien. Klin. Wochenschr. · Aug 2021
Multicenter Study Observational StudyClinical pharmacist interventions in cardiovascular disease pharmacotherapy in elderly patients on excessive polypharmacy : A retrospective pre-post observational multicentric study.
Cardiovascular diseases (CVD) are often treated with excessive polypharmacy (10 or more medications) in primary care, and these patients are mostly excluded from trials. Collaborative care, including clinical pharmacists (CP), is one of the possible approaches to address these problems; however, it has not been studied yet in this part of Europe. Hence, the main aim of the study was to determine how CP interventions in a medical review form (MR) can have an impact on the pharmacotherapy in patients on excessive polypharmacy with CVD (number of medications, potential drug-drug interactions of type X-pXDDI, potentially inappropriate medications in the elderly-PIM and treatment guidelines adherence). ⋯ CPs' interventions significantly improved the quality of pharmacotherapy prescribing by reducing the total number of medications and pXDDIs and led to better hypertension treatment guidelines adherence.
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Wien. Klin. Wochenschr. · Aug 2021
Excess short-term mortality in noncritical patients with atrial fibrillation presenting to the emergency department.
Mortality data of non-critically ill patients presenting with symptomatic atrial fibrillation to an emergency department are scarce. We aimed to analyze the short-term mortality of these patients compared with that of the general Austrian population. ⋯ The short-term mortality of patients with symptomatic atrial fibrillation presenting to the emergency department was substantially higher compared with the general Austrian population.