Publications by authors named "MacIsaac A"

Background: Glucagon-like peptide-1 receptor agonist (GLP-1RA) therapies are increasingly used for the treatment of type 2 diabetes mellitus and obesity. Despite growing awareness of potentially increased risk of pulmonary aspiration due to delayed gastric emptying, the risks and benefits of their perioperative use in patients undergoing cardiac procedures remains unexplored. A scoping review was performed to investigate the perioperative GLP-1RA use in patients undergoing cardiac procedures and recommendations.

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Background: Technology use may be one strategy to promote mental health and wellbeing among young adults in post-secondary education settings experiencing increasing distress and mental health difficulties. The JoyPop™ app is mobile mental health tool with a growing evidence base. The objectives of this research are to (1) evaluate the effectiveness of the JoyPop™ app in improving emotion regulation skills (primary outcome), as well as mental health, wellbeing, and resilience (secondary outcomes); (2) evaluate sustained app use once users are no longer reminded and determine whether sustained use is associated with maintained improvements in primary and secondary outcomes; (3) determine whether those in the intervention condition have lower mental health service usage and associated costs compared to those in the control condition; and (4) assess users' perspectives on the quality of the JoyPop™ app.

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The retina has low dopamine levels early in diabetes. To determine how low dopamine levels affected dopamine signaling, the effects of dopamine receptor agonists and mRNA localization were measured after 6 weeks of diabetes. Whole retina ex vivo electroretinogram (ERG) recordings were used to analyze how dopamine type 1 receptor (D1R) and type 4 (D4R) agonists change the light-evoked retinal responses of non-diabetic and 6-week diabetic (STZ injected) mouse retinas.

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Background: Air emboli are a life-threatening diagnosis, which may form through a range of mechanisms. In this case, we describe the case of extensive multi-territory air emboli in a patient with a history of intravenous drug abuse.

Case Summary: This case describes a 41-year-old male who presented with confusion following fall with long lie.

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  • Cardiopulmonary complications in connective tissue diseases (CTDs) like pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) significantly impact patient health and survival rates.
  • Multidisciplinary meetings can enhance diagnostic precision and treatment strategies for these conditions.
  • The review covers existing literature on these meetings in relation to CTD-ILD and PAH, along with insights from the authors' own experience at a specialized medical center.
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  • Pericardial Decompression Syndrome (PDS) is a rare but serious complication that can occur after draining excess fluid from around the heart, leading to sudden drops in blood pressure and heart function.
  • The case study highlights two patients who developed acute right ventricular failure right after procedures to relieve pressure on the heart, emphasizing this as a critical aspect of PDS.
  • Current understanding of PDS is limited, but it's thought to be linked to heart mechanics, with complications that can lead to high rates of severe outcomes, underscoring the need for awareness and further research.
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Intimacy is essential for fulfilling romantic relationships. Although many factors can impact intimacy, the increased regular use of technological devices within our daily lives makes an important one to consider. Technoference (i.

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  • Methamphetamines, a type of stimulant drug, are becoming more common and pure, leading to an increase in methamphetamine-associated cardiomyopathy (MAC), which is linked to serious heart issues and poor health outcomes.
  • Patients with MAC tend to be younger and face multiple health challenges compared to those with other types of heart disease, complicating their treatment.
  • Effective management of MAC includes creating personalized treatment plans focused on stopping methamphetamine use, optimizing heart failure treatment, and providing comprehensive support to improve patient outcomes.
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Objective: To assess whether hypertension is an independent risk factor for mortality among patients hospitalised with COVID-19, and to evaluate the impact of ACE inhibitor and angiotensin receptor blocker (ARB) use on mortality in patients with a background of hypertension.

Method: This observational cohort study included all index hospitalisations with laboratory-proven COVID-19 aged ≥18 years across 21 Australian hospitals. Patients with suspected, but not laboratory-proven COVID-19, were excluded.

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  • Patients with Type 2 Diabetes Mellitus (T2DM) have a higher burden of coronary artery disease (CAD) than those without diabetes, but this risk seemed to decrease over time from 2013 to 2019.
  • A comparison of medication use showed that a higher percentage of patients with T2DM were on statins, RAS inhibitors, and anti-platelet drugs compared to non-diabetic patients.
  • After accounting for medication usage, the difference in CAD severity between patients with and without T2DM disappeared, suggesting that preventative therapies may help mitigate the risk associated with diabetes.
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  • The document outlines the minimum standards for accreditation of medical institutions and operators related to Transcatheter Aortic Valve Implantation (TAVI), endorsed by key heart surgery societies in Australia and New Zealand.
  • It serves as an updated position statement, replacing the original from August 2014, and reflects a consensus from various committees involved in TAVI accreditation.
  • The accreditation standards consider important regional, legislative, and health system factors rather than serving as a guideline, ensuring they are relevant to the Australian healthcare context.
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Objectives: Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia.

Design: Observational cohort study.

Setting: Twenty-one (21) Australian hospitals.

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Background: Resilience is the capability, resources, and processes that are available to a person or system to adapt successfully in the face of stress or adversity. Given that resilience can be enhanced, using advances in technology to deliver and evaluate the impact of resilience interventions is warranted. Evidence supports the effectiveness of the resilience-building JoyPop app in improving resilience-related outcomes after use; however, experiential data from users is also needed to provide a more comprehensive account of its utility.

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  • The study examines how telehealth usage in Australia surged during the COVID-19 pandemic, focusing on distinctions between telephone (TP) and video consultations (VC) among cardiology outpatients.
  • It found that older patients and specific demographics favored TP, while VC patients tended to have earlier appointments and follow-up visits.
  • Importantly, overall patient outcomes such as mortality and emergency department visits were similar across both telehealth modalities, indicating both can effectively maintain care access during the pandemic.
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Background: The effects of adverse childhood experiences (ACEs) on mental health, self-regulatory capacities, and overall resilience are well-known. Given such effects, ACEs may play a role in how individuals adjust to challenges later in life. Of interest in this study is the transition to university, a time of heightened stress when adapting to circumstances is required and when those with ACEs may need additional in-the-moment support to exercise resilience.

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Introduction: The coronavirus 2019 disease (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pre-existing cardiovascular disease (CVD) increases the morbidity and mortality of COVID-19, and COVID-19 itself causes serious cardiac sequelae. Strategies to minimise the risk of viral transmission to health care workers and uninfected cardiac patients while prioritising high quality cardiac care are urgently needed.

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Background: Exercise capacity is frequently reduced in people with diabetes mellitus (DM) and may be due to subclinical cardiac dysfunction. Speckle-tracking echocardiography is now widely available; however, the clinical utility and significance of left ventricular (LV) strain and twist parameters remain uncertain. We hypothesized that LV strain and twist would be reduced in DM subjects during exercise.

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Exercise capacity is frequently reduced in people with diabetes mellitus (DM), and the contribution of pulmonary microvascular dysfunction remains undefined. We hypothesized that pulmonary microvascular disease, measured by a novel exercise echocardiography technique termed pulmonary transit of agitated contrast (PTAC), would be greater in subjects with DM and that the use of pulmonary vasodilator agent sildenafil would improve exercise performance by reducing right ventricular afterload. Forty subjects with DM and 20 matched controls performed cardiopulmonary exercise testing and semisupine exercise echocardiography 1 h after placebo or sildenafil ingestion in a double-blind randomized crossover design.

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  • TAVI is a treatment for severe aortic stenosis (AS), and this study evaluates differences between self-expandable valves (SEV) and balloon-expandable valves (BEV) in terms of procedural success and 30-day outcomes.
  • A total of 151 patients were analyzed, finding similar procedural success rates but significantly higher complications like paravalvular aortic regurgitation, pacemaker insertion, and strokes in the SEV group compared to the BEV group.
  • The study concludes that while mortality rates at 30 days are similar, SEV patients experience more complications than those with BEV after TAVI.
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  • * The Heart Team approach involves both doctors and surgeons in making treatment decisions, considering factors like frailty from geriatric assessments to determine the best course of action, whether it be TAVI, surgical options, or conservative management.
  • * TAVI has become a standard procedure in Australia since 2018, with advancements leading to fewer complications and shorter recovery times, and it's anticipated that more elderly patients will require this life-saving treatment in the future
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  • - The study focuses on pregnancy-associated spontaneous coronary artery dissection (P-SCAD), reviewing demographics, management, and outcomes over time.
  • - A total of 138 P-SCAD cases from 273 screened publications were analyzed, revealing significant improvements in management and outcomes, particularly from 2006-2016.
  • - Maternal mortality dropped from 85% to 4%, and foetal mortality from 50% to 0% over the decades, linked to advancements like earlier angiography and conservative treatment strategies.
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  • The study compared microvascular function in patients with STEMI receiving thrombolysis and those with NSTEMI undergoing PCI, involving 17 STEMI and 20 NSTEMI patients.
  • Results showed that the baseline microcirculatory function was significantly worse in the STEMI group, but both groups improved post-PCI.
  • Notably, post-PCI IMR was linked to left ventricular function, indicating its potential as a predictor of recovery in STEMI patients.
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