Frailty, health literacy and self-care in patients admitted with acute heart failure.

Background: There is limited knowledge from Norway on clinical characteristics, self-care and health literacy in patients admitted to hospital with acute heart failure. Our aim was to identify these factors in this group.

Material And Method: We included patients admitted with acute heart failure over a period of six months (2022/2023) at Drammen Hospital and Vestfold Hospital Trust.

Brief group training of medical students in focused cardiac ultrasound may improve diagnostic accuracy of physical examination.

Background: Physical examination and auscultation can be challenging for medical students. The aim of this study was to investigate whether a brief session of group training in focused cardiac ultrasound (FCU) with a pocket-sized device would allow medical students to improve their ability to detect clinically relevant cardiac lesions at the bedside.

Methods: Twenty-one medical students in their clinical curriculum completed 4 hours of FCU training in groups.

The diagnostic accuracy of pocket-size cardiac ultrasound performed by unselected residents with minimal training.

Pocket-size imaging devices may represent a tool for fast initial cardiac screening in the emergency setting. Pocket-size cardiac ultrasound (PCU) examinations performed by experienced echocardiographers yield acceptable diagnostic accuracy compared to standard echocardiogram (SE). However, the success of this method when used by unselected non-cardiologists remains unexplored.

The anesthesia in abdominal aortic surgery (ABSENT) study: a prospective, randomized, controlled trial comparing troponin T release with fentanyl-sevoflurane and propofol-remifentanil anesthesia in major vascular surgery.

Background: On the basis of data indicating that volatile anesthetics induce cardioprotection in cardiac surgery, current guidelines recommend volatile anesthetics for maintenance of general anesthesia during noncardiac surgery in hemodynamic stable patients at risk for perioperative myocardial ischemia. The aim of the current study was to compare increased troponin T (TnT) values in patients receiving sevoflurane-based anesthesia or total intravenous anesthesia in elective abdominal aortic surgery.

Methods: A prospective, randomized, open, parallel-group trial comparing sevoflurane-based anesthesia (group S) and total intravenous anesthesia (group T) with regard to cardioprotection in 193 patients scheduled for elective abdominal aortic surgery.

Is 3D echocardiography superior to 2D echocardiography in general practice? A systematic review of studies published between 2007 and 2012.

Background: Recent developments in 3-dimensional echocardiography (3DE) have resulted in smaller probes, faster data acquisition and wider applicability. In spite of this, there is still an ongoing debate as to its ability to provide additional information to 2DE in general hospital clinical practice.

Methods: A systematic literature search in EMBASE and MEDLINE was performed in order to identify original articles comparing the two techniques.

Proinflammatory cytokines and complement activation in salvaged blood from abdominal aortic aneurism surgery and total hip replacement surgery.

Background: Levels of proinflammatory mediators in unwashed salvaged blood from abdominal aortic aneurism (AAA) surgery are unknown. We hypothesized that there are higher levels of these mediators in unwashed blood salvaged in AAA surgery compared to hip replacement surgery.

Study Design And Methods: Ten patients scheduled for AAA surgery (Group A) and 10 patients for total hip replacement surgery (Group H) were included.

The "smoker's paradox" in patients with acute coronary syndrome: a systematic review.

Background: Smokers have been shown to have lower mortality after acute coronary syndrome than non-smokers. This has been attributed to the younger age, lower co-morbidity, more aggressive treatment and lower risk profile of the smoker. Some studies, however, have used multivariate analyses to show a residual survival benefit for smokers; that is, the "smoker's paradox".

The effect of tobacco smoking and treatment strategy on the one-year mortality of patients with acute non-ST-segment elevation myocardial infarction.

Background: The aim of the present study was to investigate whether a previously shown survival benefit resulting from routine early invasive management of unselected patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) may differ according to smoking status and age.

Methods: Post-hoc analysis of a prospective observational cohort study of consecutive patients admitted for NSTEMI in 2003 (conservative strategy cohort [CS]; n = 185) and 2006 (invasive strategy cohort [IS]; n = 200). A strategy for transfer to a high-volume invasive center and routine early invasive management was implemented in 2005.

Effect of implementing routine early invasive strategy on one-year mortality in patients with acute myocardial infarction.

The aim of the present study was to investigate whether the implementation of an early invasive strategy for unselected patients with acute myocardial infarction (AMI) would be associated with reduced long-term mortality compared to a conservative approach. In this prospective observational cohort study of consecutive patients admitted for AMI in 2003 (conservative cohort, n = 311) and 2006 (invasive cohort [IC], n = 307), an 11% absolute and 41% relative reduction in 1-year mortality was found for patients with AMI in the IC compared to the conservative cohort (p = 0.001).

Reference values for left ventricular volumes with real-time 3-dimensional echocardiography.

Objectives: Obtain normal reference ranges for left ventricular (LV) volume indexes (VI) and ejection fraction (EF) with fast real-time 3-dimensional echocardiography (RT3DE) with online analysis.

Design: After a screening visit 166 healthy participants, 79 males and 87 females aged 29-80 years were examined with RT3DE and Doppler.

Results: Upper normal values (mean + 2 standard deviations [SD]) for LV end-diastolic volume index (LVEDVI) and LV end-systolic volume index (LVESVI) were 82 ml/m(2) and 38 ml/m(2), respectively.

The limited usefulness of real-time 3-dimensional echocardiography in obtaining normal reference ranges for right ventricular volumes.

Background: To obtain normal reference ranges and intraobserver variability for right ventricular (RV) volume indexes (VI) and ejection fraction (EF) from apical recordings with real-time 3-dimensional echocardiography (RT3DE), and similarly for RV area indexes (AI) and area fraction (AF) with 2-dimensional echocardiography (2DE).

Methods: 166 participants; 79 males and 87 females aged between 29-79 years and considered free from clinical and subclinical cardiovascular disease. Normal ranges are defined as 95% reference values and reproducibility as coefficients of variation (CV) for repeated measurements.

Normal reference ranges for left and right atrial volume indexes and ejection fractions obtained with real-time three-dimensional echocardiography.

Aims: The aim of this study was to obtain normal reference ranges and intra-observer reproducibility for left (L) and right (R) atrial (A) volume indexes (VI, corrected for body surface area) and ejection fractions (EF) with real-time three-dimensional echocardiography.

Methods And Results: One hundred and sixty-six participants, 79 males and 87 females, aged 29-79 years considered free from clinical and subclinical cardiovascular disease, were included. Normal ranges are defined as 95% reference values for atrial dimensions and reproducibility as coefficients of variations (CVs) for repeated measurements.

High mortality rates in conservatively managed patients with acute coronary syndrome.

Objectives: The revised diagnostic criteria for the acute coronary syndrome (ACS) have created the need for accurate and representative data on treatment and outcome for the three categories of ACS.

Design: Consecutive patients admitted with a suspected ACS (n = 755) from February 1, 2003 to January 31, 2004 was registered and categorised into five diagnostic groups: 1) ST-elevation myocardial infarction (STEMI) (n = 126), 2) Non-ST-elevation myocardial infarction (NSTEMI) (n = 185), 3) Unstable angina pectoris (UAP) (n = 55), 4) Coronary heart disease (CHD) without ACS (n = 164) and 5) Non-coronary chest pain (n = 225).

Results: All-cause one-year mortality rates were 20%, 32%, 7%, 10% and 3%, in patients with STEMI, NSTEMI, UAP, CHD without ACS and non-coronary chest pain, respectively.

[Referral to elective and emergency coronary investigation from a medium-size central hospital].

Background: Little is known about regional differences in the incidence of acute and elective invasive coronary procedures in Norway. Such information is important in the planning of new invasive centres.

Materials And Methods: In this prospective study all patients referred to coronary angiography at the Rikshospitalet University Hospital in Oslo (100 km remote) from the county of Vestfold (218,000 inhabitants) from 1 December 2002 to 30 November 2003 were included.

[Prehospital diagnosis and treatment of acute myocardial infarction in Vestfold].

Background: Pre-hospital thrombolysis is a relatively new treatment modality in Norway. The present study is a county-based evaluation of the first phase of this procedure after its introduction in 2002.

Materials And Methods: This is a retrospective cohort study of all patients who, over a nine-month period, had a pre-hospital ECG taken by paramedics and transmitted to the county's two coronary care units.