Acta cardiologica
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Automated external defibrillators (AEDs) placed in public locations can save lives of cardiac arrest victims. In this paper, we try to estimate the cost-effectiveness of AED placement in Belgian schools. This would allow school policy makers to make an evidence-based decision about an on-site AED project. ⋯ As our literature survey shows that AED use in schools is feasible and effective, the placement of these devices in all Belgian schools is undoubtedly to be considered. The major counter-arguments are the very low incidence and the high costs to set up a school-based AED programme. Our review may fuel the discussion about Whether or not school-based AED projects represent good value for money and should be preferred above other health care interventions.
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Review
Spinal cord stimulation in refractory angina. A systematic review of randomized controlled trials.
Spinal cord stimulation (SCS) is an invasive method used for treating patients with refractory angina. Although SCS is recommended by the European Society of Cardiology and American Heart Association (class lib, level of evidence B and C, respectively), the method is used very rarely and data on its effectiveness is limited. The aim of this work was to perform a systematic review of all randomized controlled trials (RCTs) that investigated the effectiveness of SCS as a treatment for refractory angina. ⋯ RCTs investigating the efficacy of SCS were small and they demonstrated a small effect in angina improvement. Due to great differences in their design the interpretation of the results is complex. Before this method is recommended as a routine therapy for refractory angina, a larger, well-designed, multicentre RCT is needed.
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Comparative Study
3D and 2D left ventricular systolic function imaging-- from ejection fraction to deformation. Cardiac resynchronization therapy--substudy.
3D echocardiography offers options of left ventricular systolic function analysis. The aims of this study are: to assess the usefulness of 3D echocardiography, to test 3D regional measurements (with area strain) among a spectrum of patients and then to check prospectively the value of 3D echocardiography vs 2D in the assessment of response to resynchronization. ⋯ 3D echocardiography is applicable in the assessment of both preserved and reduced left ventricular ejection fraction. This assessment is fast and requires minimal user intervention. 3D strain may help in cardiac resynchronization therapy candidates and response assessment. After cardiac resynchronization, none of the patients were incorrectly identified as responder to cardiac resynchronization therapy by 3D algorithms compared to 2D Simpson's reference.
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Pulmonary hypertension is emerging as one of the causes of morbidity and mortality in adults with sickle cell disease. The prevalence of pulmonary hypertension in Nigerian adults with sickle cell anaemia is unknown. We decided to estimate the pulmonary artery systolic and diastolic pressures in subjects with sickle cell anaemia seen at the University College Hospital, Ibadan, Nigeria, and to determine the frequency of pulmonary hypertension among them. ⋯ We conclude that pulmonary artery systolic and diastolic pressures are higher in subjects with sickle cell disease than normal controls. Male sex and low PCV are independent determinants of pulmonary arterial pressure in subjects with sickle cell anaemia in Nigeria.
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It is unknown if the severity of left ventricular dysfunction in patients with transient left ventricular ballooning syndrome (TLVBS) adversely affects clinical outcome. Furthermore, it remains unclear if the patterns of ventricular involvement are distinct patterns or if they represent varying stages of ventricular involvement. ⋯ In TLVBS patients the severity of LV dysfunction determines the incidence of cardiogenic shock and early cardiac events. Apical and mid-ventricular forms of TLVBS appear to be distinct patterns.