Publications by authors named "James Kirkpatrick"

Introduction: Nonbacterial thrombotic endocarditis (NBTE) is a rare cardiac manifestation in patients with advanced malignancies of the lungs, pancreas, gynecological system, and gastrointestinal tract. It is often confirmed postmortem by histopathological evidence of sterile platelet-fibrin deposits attached to the endocardium, most often on heart valves. To the best of our knowledge, our case is the first to report multiple heart lesions caused by the systemic effect of cholangiocarcinoma.

View Article and Find Full Text PDF

: Cardiac point of care ultrasound (POCUS) has been used with increasing frequency. As a result of this trend, this study sought to characterize cardiologists' perspectives on cardiac POCUS. An 18-question survey on demographics, cardiac POCUS clinical practice, education, and infrastructure was distributed by 16 academic medical centers.

View Article and Find Full Text PDF

Heart failure (HF) is characterized by significant symptoms, compromised quality of life, frequent hospital admissions, and high mortality rates; palliative care (PC) is, therefore, highly relevant for patients with HF and their clinicians. Multiple guidelines and consensus statements recommend the provision of PC alongside HF management. However, few resources exist to guide the integration of PC into HF care, for both primary PC (provided by HF clinicians in the course of HF care) and specialty PC (provided by PC specialists).

View Article and Find Full Text PDF

Telemedicine is an effective method to monitor patients at home and improve outcomes of heart failure (HF), especially HF with reduced ejection fraction (HFrEF). However, little is known about the impact of telemedicine on the quality of life (QoL) among outpatients with HFrEF in lower-middle-income countries (LMICs). In this single-center, prospective, randomized, controlled, open, and parallel-group clinical trial in northern Vietnam, patients with HFrEF were allocated to either telemedicine or control groups.

View Article and Find Full Text PDF
Article Synopsis
  • The study examines how frailty and delirium affect in-hospital mortality and discharge outcomes for older adults hospitalized due to acute decompensated heart failure (ADHF).
  • Data from over 3.5 million hospitalizations showed that both conditions significantly increase the risk of death and the likelihood of a non-home discharge.
  • The most severe outcomes were observed in patients experiencing both high frailty and delirium, indicating a need for greater awareness and intervention strategies for these vulnerable patients.
View Article and Find Full Text PDF

Point-of-care ultrasound (POCUS) involves the acquisition, interpretation, and immediate clinical integration of ultrasonographic imaging performed by a treating clinician. The current state of cardiac POCUS terminology is heterogeneous and ambiguous, in part because it evolved through siloed specialty practices. In particular, the medical literature and colloquial medical conversation contain a wide variety of terms that equate to cardiac POCUS.

View Article and Find Full Text PDF

The surge in wildlife-vehicle collision research has not yet translated into a substantial decrease in animal fatalities. In line with the prevailing view, we suspect that drivers' behaviour may be the most crucial element. We address a research gap in drivers' attitudes towards and behaviour in response to wildlife-vehicle collisions from a tourist perspective.

View Article and Find Full Text PDF

Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM.

View Article and Find Full Text PDF

The modern practice of cardiovascular medicine involves many ethical controversies in the care of our complex patients. Accordingly, we propose a framework for a practical, clinically based "cardioethics" curriculum that might be incorporated into fellowship training to prepare cardiologists to cope with increasingly complex ethical dilemmas. This work can also be adopted into continuing medical education for cardiologists and other cardiovascular practitioners given the critical importance of collaborative care in cardiology.

View Article and Find Full Text PDF

Donation after circulatory determination of death (DCDD) is an accepted practice in the United States, but heart procurement under these circumstances has been debated. Although the practice is experiencing a resurgence due to the recently completed trials using ex vivo perfusion systems, interest in thoracoabdominal normothermic regional perfusion (TA-NRP), wherein the organs are reanimated in situ prior to procurement, has raised many ethical questions. We outline practical, ethical, and equity considerations to ensure transplant programs make well-informed decisions about TA-NRP.

View Article and Find Full Text PDF
Article Synopsis
  • Calcific aortic stenosis serves as a model for understanding cardiovascular issues in older adults, influenced by multiple factors related to aging.
  • Research on transcatheter aortic valve replacement has primarily involved older patients, leading to the recognition of frailty and other geriatric risks as important for better assessing patient conditions.
  • The review emphasizes the need for a comprehensive approach to diagnosis and management of aortic stenosis in older adults, advocating for improved patient engagement and identifying key areas for future research.
View Article and Find Full Text PDF

Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on 57 statements in domains including: (1) The definition and clinical role of POCUS; (2) Training pathways; (3) Credentialing; (4) Cleaning and maintenance of POCUS devices; (5) Consent and education; (6) Security, storage, and sharing of POCUS studies; (7) Uploading, archiving, and reviewing POCUS studies; and (8) Documenting POCUS studies.

View Article and Find Full Text PDF

Optical coherence tomography angiography (OCTA) is widely used for non-invasive retinal vascular imaging, but the OCTA methods used to assess retinal perfusion vary. We evaluated the different methods used to assess retinal perfusion between OCTA studies. MEDLINE and Embase were searched from 2014 to August 2021.

View Article and Find Full Text PDF

The 1986 Bethesda Conference on Cardiovascular Disease (CVD) in the Elderly, co-chaired by Drs. Nanette Wenger, Frank Marcus, and Robert O'Rourke, delineated the anticipated social, political, ethical, economic and technological impact of an aging population on the incidence, prevalence, and management of CVD in the US and worldwide. In the ensuing 4 decades, older patients have come to comprise an increasingly large proportion of the CVD population, and there has been an explosion of research in all aspects of CVD affecting older adults.

View Article and Find Full Text PDF

Introduction: The Paris System (TPS) provides a uniform reporting system of urine cytology based on well-defined cytologic criteria. Due to their rarity, there are limited data on the utility of TPS in upper urinary tract (UUT) lesions and follow-up histology of cases with abnormal cytology. We aimed to evaluate the utility of TPS for UUT lesions by correlating the cytologic diagnoses using TPS criteria with subsequent histology.

View Article and Find Full Text PDF
Article Synopsis
  • * Researchers analyzed data from 544 CA patients, 200 controls with similar symptoms, and 174 healthy subjects using AI software and echocardiographic assessments.
  • * Despite identifying higher impairment in LV global longitudinal strain and ASR in CA patients, the ASR was only moderately effective at distinguishing CA from controls, highlighting its limitations as a specific biomarker for CA.
View Article and Find Full Text PDF

Background: Insufficient data exists regarding the relationship between body mass index (BMI) and the prognosis of chronic heart failure (CHF) specifically within low- and middle-income Asian countries. The objective of this study was to evaluate the impact of BMI on adverse outcomes of ambulatory patients with CHF in Vietnam.

Methods: Between 2018 and 2020, we prospectively enrolled consecutive outpatients with clinically stable CHF in an observational cohort, single-center study.

View Article and Find Full Text PDF

Increasing seismic activity due to fluid injections for oil and gas production may be contributing to leakage along non-producing oil and gas wells and emitting methane, a potent greenhouse gas. However, the extent to which nearby seismicity may drive or exacerbate methane emissions and cause well integrity issues is unknown. Therefore, we analyze field evaluations at 448 non-producing oil and gas wells in Northeast British Columbia (NEBC) and geospatially analyze oil and gas well and fluid injection data alongside locations of 3515 earthquakes from 2001 to 2021 and 130 faults.

View Article and Find Full Text PDF

There are a growing number of patients with mechanical circulatory support (MCS) in the setting of bridge to transplant and destination therapy and temporary support. Preparedness planning is an important aspect of care that involves device-specific Goals of Care and Advance Care Planning and should ideally be used in MCS candidates before initiation of therapy and revisited periodically. The withdrawal of both temporary and durable MCS can be complex and controversial.

View Article and Find Full Text PDF

The COVID-19 pandemic has evolved since the publication of the initial American Society of Echocardiography (ASE) statements providing guidance to echocardiography laboratories. In light of new developments, the ASE convened a diverse, expert writing group to address the current state of the COVID-19 pandemic and to apply lessons learned to echocardiography laboratory operations in future pandemics. This statement addresses important areas specifically impacted by the current and future pandemics: (1) indications for echocardiography, (2) application of echocardiographic services in a pandemic, (3) infection/transmission mitigation strategies, (4) role of cardiac point-of-care ultrasound/critical care echocardiography, and (5) training in echocardiography.

View Article and Find Full Text PDF