Electromechanical Window and Spontaneous Ventricular Tachyarrhythmias in Takotsubo Syndrome.

QT interval prolongation is common in patients hospitalized with Takotsubo syndrome (TTS), however, only a minority experience ventricular tachyarrhythmias. Our aim was to characterize the electromechanical window (EMW) in patients with TTS and to evaluate its association with ventricular tachyarrhythmias. We preformed aretrospective analysis of 84 patients hospitalized with TTS in the Tel-Aviv Medical Center between 2013 and 2022.

Diurnal cardio-respiratory changes in ambulatory individuals deciphered using a multi-parameter wearable device.

Background: Recent technological developments enable big data-driven insights on diurnal changes. This study aimed to describe the trajectory of multiple and advanced parameters using a medical-grade wearable remote patient monitor.

Methods: Parameters were monitored for 24 h in 256 ambulatory participants who kept living their normal life.

Comparing body temperature measurements using the double sensor method within a wearable device with oral and core body temperature measurements using medical grade thermometers-a short report.

Body temperature is essential for diagnosing, managing, and following multiple medical conditions. There are several methods and devices to measure body temperature, but most do not allow continuous and prolonged measurement of body temperature. Noninvasive skin temperature sensor combined with a heat flux sensor, also known as the "double sensor" technique, is becoming a valuable and simple method for frequently monitoring body temperature.

Clinical validation of a wearable respiratory rate device: A brief report.

Background: Respiratory rate (RR) is used for the diagnosis and management of medical conditions and can predict clinical changes. Heavy workload, understaffing, and errors related to poor recording make it underutilized. Wearable devices may facilitate its use.

Assessing the use of a noninvasive monitoring system providing multiple cardio-pulmonary parameters following revascularization in STEMI patients.

Background: Continuous monitoring of ECG, respiratory rate, systolic and diastolic blood pressure, pulse rate, cardiac output, and cardiac index is important in patients with ST-elevation myocardial infarction (STEMI) admitted to the intensive cardiac care unit (ICCU). However, monitoring these parameters in this setting and in these patients using noninvasive, wireless devices has not been conducted so far. We aimed to assess the use of a novel noninvasive continuous monitoring device in STEMI patients admitted to the ICCU.

Developing a real-time detection tool and an early warning score using a continuous wearable multi-parameter monitor.

Currently-used tools for early recognition of clinical deterioration have high sensitivity, but with low specificity and are based on infrequent measurements. We aimed to develop a pre-symptomatic and real-time detection and warning tool for potential patients' deterioration based on multi-parameter real-time warning score (MPRT-WS). A total of more than 2 million measurements were collected, pooled, and analyzed from 521 participants, of which 361 were patients in general wards defined at high-risk for deterioration and 160 were healthy participants allocation as controls.

Advanced Hemodynamic Monitoring Allows Recognition of Early Response Patterns to Diuresis in Congestive Heart Failure Patients.

There are no clear guidelines for diuretic administration in heart failure (HF), and reliable markers are needed to tailor treatment. Continuous monitoring of multiple advanced physiological parameters during diuresis may allow better differentiation of patients into subgroups according to their responses. In this study, 29 HF patients were monitored during outpatient intravenous diuresis, using a noninvasive wearable multi-parameter monitor.

Central catheter tip migration in critically ill patients.

Objectives: Chest X-ray (CXR) is routinely required for assessing Central Venous Catheter (CVC) tip position after insertion, but there is limited data as to the movement of the tip location during hospitalization. We aimed to assess the migration of Central Venous Catheter (CVC) position, as a significant movement of catheter tip location may challenge some of the daily practice after insertion.

Design And Settings: Retrospective, single-center study, conducted in the Intensive Care and Cardiovascular Intensive Care Units in Tel Aviv Sourasky Medical Center 'Ichilov', Israel, between January and June 2019.

Influence of Sex, BMI, and Skin Color on the Accuracy of Non-Invasive Cuffless Photoplethysmography-Based Blood Pressure Measurements.

Vital signs obtained by photoplethysmography-based devices might be influenced by subcutaneous fat and skin color. This observational comparison study aimed to test the accuracy of blood pressure (BP) measurements between a photoplethysmography-based device and cuff-based BP device in ambulatory individuals, coming for a routine BP checkup. Systolic BP (SBP) and diastolic BP (DBP) measurements were stratified based on sex, BMI (<25; 25 ≤BMI<30; 30 ≤kg/m), and skin color (types 1-3 and 4-6 by the Fitzpatrick scale).

Comparing Cardiac Output Measurements Using a Wearable, Wireless, Noninvasive Photoplethysmography-Based Device to Pulse Contour Cardiac Output in the General ICU: A Brief Report.

Objectives: Cardiac output (CO) measurements in the ICU are usually based on invasive techniques, which are technically complex and associated with clinical complications. This study aimed to compare CO measurements obtained from a noninvasive photoplethysmography-based device to a pulse contour cardiac output device in ICU patients.

Design: Observational, prospective, comparative clinical trial.

Exploring Early Pre-Symptomatic Detection of Influenza Using Continuous Monitoring of Advanced Physiological Parameters during a Randomized Controlled Trial.

Early detection of influenza may improve responses against outbreaks. This study was part of a clinical study assessing the efficacy of a novel influenza vaccine, aiming to discover distinct, highly predictive patterns of pre-symptomatic illness based on changes in advanced physiological parameters using a novel wearable sensor. Participants were frequently monitored 24 h before and for nine days after the influenza challenge.

Continuous Remote Patient Monitoring Shows Early Cardiovascular Changes in COVID-19 Patients.

COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This retrospective multi-center observational cohort study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable providing continuous remote patient monitoring of numerous vital signs. The study was conducted in five COVID-19 isolation units.

[ON THE EQUATOR].

Elective clerkships in low income countries have been an integral part of the curriculum in the majority of medical schools worldwide. These programs expose students to global challenges, to a diversity of cultures and healthcare systems, and have been shown to improve medical knowledge, as well as clinical and communication skills. In 2018 and 2019, the Faculty of Medicine at the Technion, in cooperation with the Department for Infectious Diseases in the Rambam Health Care campus and the "Brit Olam" nonprofit organization, offered a clinical clerkship in Kiboga hospital, Uganda.

Repair of peri-implant bone loss after occlusal adjustment: a case report.

Background: Peri-implantitis generally is attributed to a bacterial challenge, with occlusion being a modifying factor. The author presents a case of peri-implant marginal bone loss that was treated successfully with only occlusal adjustment.

Case Description: A 63-year-old female patient with a history of bruxism reported for a yearly periodontal examination 38 months after restoration of an implant in the tooth no.

Adult oral sedation in California: what can a dentist do without a special permit or certificate from the Dental Board of California?

A significant percentage of patients are fearful of dental procedures, and this has not changed significantly over the past 50 years. Apprehensive patients tend to avoid necessary dental treatment, and their quality of life is compromised in the long term. This article discusses the use of zaleplon, triazolam, and lorazepam to provide oral sedation for apprehensive adult dental patients.

Summary of the California blue ribbon panel report on anesthesia.

At the request of the Dental Board of California, a panel reviewed mortality data from the Dental Board, lawsuits from a major California malpractice insurance company, anesthesia regulations from other states, and the published scientific literature. In California between 1991 and 2000, there were 12 deaths related to general anesthesia permits, 0 deaths related to conscious sedation permits, and 8 deaths related to nonpermit holders (four deaths with oral sedation in children and four deaths with local anesthesia alone). The panel was concerned about the increased use of repeated oral or sublingual doses of sedatives and recommended a certificate process.

The immediate dental implant.

Numerous clinical studies have shown that dental implants can be placed immediately in extraction sockets with success when sites are carefully selected. Dental implants have been placed at the time of extraction with a variety of techniques. All the techniques report survival rates of 94 percent to 100 percent over a varied healing period of three months to approximately seven years.

Therapeutic choices in the molar region.

Treatment of the damaged molar often presents a set of challenges unique to the posterior dentition. Traditional dental treatments continue to be refined to improve the prognosis when treating the posterior dentition. Daily treatment-planning decisions include whether to treat with conventional dental or implant therapeutic approaches, and involve consideration of local host factors as well as limitations in specific therapeutic approaches.

Periodontal disease and systemic health--what you and your patients need to know.

For many years, dentists have recognized the importance of dental health to general health. Recent research findings point to possible associations between chronic oral infections such as periodontitis and systemic health problems. This article will review the evidence for some of these associations and explore factors that may underlie oral-systemic disease connections.

Simplifying implant prosthetics.

This article presents a method of restoring an anterior single-tooth implant using the less complicated, less costly and less time-consuming method of a cement-retained restoration. With this method, the restorative dentist needs only the normal crown and bridge supplies.

New directions in the treatment of heart failure: some paradoxical observations.

The alpha-agonist drug phenylephrine has been generally considered to be contraindicated in patients with heart failure for the reason that increased afterload produced by the vasoconstriction should decrease ventricular function; the beta-adrenergic blocking drugs generally have been considered to be contraindicated in heart failure because of the dependence of the failing heart on beta-sympathetic agonism; the angiotensin converting enzyme inhibitors have been indicted recently as causing undesirable cardiovascular depression in patients for coronary artery bypass surgery. Yet recently, phenylephrine has been shown to have positive cardiac inotropic effects in a variety of experimental preparations including intact humans; the beta-adrenergic blocking drugs have been shown to be therapeutically effective in treating patients with chronic congestive heart failure (CHF); and the "gold standard" for treating chronic CHF at present are the ACEI. Consequently, the clinician caring for patients with cardiac disease needs to reevaluate the use of classic drugs whose original pharmacological properties may either have changed because of advances in technology or may be producing effects that were unanticipated previously.