Kardiol Pol
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Randomized Controlled Trial Multicenter Study
Study design and rationale for Optimal aNtiplatelet pharmacotherapy guided by bedSIDE genetic or functional TESTing in elective percutaneous coronary intervention patients (ONSIDE TEST): a prospective, open-label, randomised parallel-group multicentre trial (NCT01930773).
High platelet reactivity (HPR) and presence of CYP2C19 loss-of-function alleles are associated with higher risk for periprocedural myocardial infarction in clopidogrel-treated patients undergoing percutaneous coronary intervention (PCI). It is unknown whether personalised treatment based on platelet function testing or genotyping can prevent such complications. ⋯ The ONSIDE TEST trial is expected to verify the clinical utility of an individualised antiplatelet strategy in preventing periprocedural myocardial injury by either phenotyping or genotyping.
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Out-of-hospital cardiac arrest (OHCA) is the sudden, unexpected loss of heart function, which occurs out of specialist healthcare facilities and inevitably leads to death if uninterrupted by effective cardiopulmonary resuscitation (CPR). ⋯ OHCA incidence in the Bielsko-Biala population in 2013 was high, increased with age, and was twice as high for men than women. OHCA occurred most often at home, in the presence of a witness; however, CPR was not always undertaken promptly at the scene. CPR was effective for approximately 30% of the victims. The prehospital mortality was high with no differences between genders.
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Comparative Study
Comparison of the effectiveness of cardiopulmonary resuscitation with standard manual chest compressions and the use of TrueCPR and PocketCPR feedback devices.
High effectiveness of chest compressions is an important element of cardiopulmonary resuscitation (CPR), improving survival and reducing neurological deficits resulting from sudden cardiac arrest. ⋯ During simulated CPR, TrueCPR device significantly increased the effectiveness of chest compressions compared to SMCC and the use of PocketCPR smartphone application. Further studies are required to confirm these findings in clinical practice.
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Prevention of thromboembolic complications is a priority in patients with atrial fibrillation (AF). Based on the current guidelines, the role of vitamin K antagonists (VKA) in stroke prevention has decreased in favour of novel oral anticoagulants (NOAC). ⋯ A NOAC was used in one fifth of all hospitalised AF patients receiving anticoagulant treatment. The risk of thromboembolic and bleeding complications did not differ between AF patients treated with NOAC or VKA. Factors associated with an increased likelihood of NOAC prescription included a history of bleeding, age ≥ 80 years, paroxysmal arrhythmia, hospitalisation due to AF, and living in a rural area.
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Severe accidental hypothermia is a condition associated with significant morbidity and mortality. In the years 2009–2012 the Polish National Statistics Department reported 1836 deaths due to exposure to excessive natural cold. ⋯ It is a unit functioning within the structure of the Cardiac Surgery Clinic, established in order to improve the effectiveness of the treatment of patients in the advanced stages of severe hypothermia. Early identification of hypothermia, binding algorithm and coordination leading to extracorporeal rewarming, are the most important elements in the deep hypothermia management.