Publications by authors named "Pupalan Iyngkaran"

Congestive heart failure (CHF) is a complex chronic disease, and it is associated with a second comorbid condition in more than half of cases. Self-management programs can be specific to CHF or generic for chronic diseases. Several tools have been validated for CHF.

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Article Synopsis
  • Heart failure (HF) is a complicated condition with various causes that requires a comprehensive, multidisciplinary treatment approach; however, existing self-management programs may not effectively reduce readmissions.
  • This study evaluated a simplified one-page chronic disease self-management (CDSM) tool against a detailed program, focusing on its ability to assess self-management potential and predict hospital readmissions and major cardiovascular events.
  • Out of 117 patients studied, results showed different categorizations of self-management abilities, highlighting the simplified tool's potential effectiveness in identifying patients at risk of poor self-management capabilities.
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Biomarkers are critical for diagnostic, monitoring and management of cardiovascular diseases. Opportunities to improve how biomarkers are used are important. This editorial on biomarkers in coronary artery disease provides commentary on the study as well as broad benchmarks on what make ideal biomarkers.

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Introduction: Chronic disease self-management (CDSM) is a vital component of congestive heart failure (CHF) programmes. Recent CHF guidelines have downgraded CDSM programmes citing a lack of gold-standard evidence. This protocol describes the aims and methods of a systematic review to collate and synthesise the published research evidence to determine the effectiveness of CDSM programmes and interventions for patients treated for CHF.

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Mixed methods research forms the backbone of translational research methodologies. Qualitative research and subjective data lead to hypothesis generation and ideas that are then proven via quantitative methodologies and gathering objective data. In this vein, clinical trials that generate subjective data may have limitations, when they are not followed through with quantitative data, in terms of their ability to be considered gold standard evidence and inform guidelines and clinical management.

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Background: Cardiovascular diseases (CVDs) are a rising global burden. Preventative strategies such as cardiac rehabilitation (CR) have shown a marked reduction in disease burden. Despite this, CR is underutilized worldwide.

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The healthcare sector generates approximately 30% of all the world's data volume, mostly for record keeping, compliance and regulatory requirements, and patient care. Healthcare data often exist in silos or on different systems and platforms due to decentralised storage and data protection laws, limiting accessibility for health service research. Thus, both the lack of access to data and more importantly the inability to control data quality and explore post-trial (phase IV) data or data with translational relevance have an impact on optimising care and research of congestive heart failure (CHF).

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Introduction: Congestive heart failure (CHF) causes significant morbidity and mortality. It is an epidemic, and costs are escalating. CHF is a chronic disease whose trajectory includes stable phases, periods of decompensation, and finally palliation.

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Article Synopsis
  • * Coordinating organized care programs with large hospitals is essential for improving CHF management and promoting sustainable health improvements.
  • * This review emphasizes the potential of health technologies to fill the gaps in CHF treatment and support the shift towards more community-focused care.
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Article Synopsis
  • - The document highlights gaps in heart failure (HF) and chronic disease research, specifically in areas like screening, self-management, and patient-reported outcomes, all aimed at improving patient outcomes cost-effectively.
  • - It outlines a methodology involving a literature review that investigates the translation of cardiovascular research into clinical practice, identifying various types of studies from observational to large randomized trials.
  • - The conclusion emphasizes the need for better implementation research to connect findings with real-world patient outcomes, while outlining important steps and skills needed to enhance the translation of chronic disease research into clinical practice, particularly within the context of HF.
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Background: Enhancing community based Chronic Disease Management (CDM) will make significant impacts on all major chronic disease management outcome measures. There are no successful models of community hubs to triage and manage chronic diseases that significantly reduce readmissions, cost and improve chronic disease knowledge. Chronic heart failure (CHF) management foundations are built on guideline derived medical therapies (GDMT).

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Background: Congestive heart failure (CHF) management has proven devastating on morbidity, mortality, quality of life and also costly to health systems. Therapeutics for CHF have advanced and benefited greatly due to large multicentre randomised controlled trials and the evidence obtained from them. Management for chronic diseases and nonpharmaceutical therapies such as chronic disease self-management has lagged, and for CHF the evidence base has even been questioned.

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Congestive Heart Failure is a chronic disease that can be associated with poor outcomes. Some patients are more vulnerable, while others who are vulnerable appear absent or silent to health services. COVID-19 pandemic is a good opportunity to explore this important area.

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Congestive Heart Filur is an epidemic and its trajectory apppears to be escaling. Undoubtly tremendous gains have seen improvement in life expectancy and quality of life, however, hospital readmissions, resource utilization and health system cost continue to create challenges. In this short perspective, we raise the prospect of extending the research phases the community and real world setting.

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Article Synopsis
  • * Despite progress in applying clinical trial findings to real-world HF treatment through studies like OPTIMIZE-HF, there are still challenges for vulnerable groups with severe HF or other health complications.
  • * The pandemic presents a unique opportunity to explore innovative health technologies that could enhance HF management models beyond traditional methods, as observed in the Australian healthcare system.
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Congestive Heart Failure (CHF) is an emerging epidemic. Within one generation, the medical community has learned much of CHF syndromes. It has two distinct mechanisms, systolic and diastolic abnormalities, to account for the common CHF presentation.

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At least half of all heart failure (CHF) patients will have a comorbidity that could be undertreated, requires additional speciality input and/or polypharmacy. These patients are then at risk of iatrogenic and disease-related complications and readmissions if not closely supervised. Common comorbidities of relevance are cardiorenal and cardiometabolic syndromes (DM, obesity, OSA), chronic airways disease, elderly age, and accompanying pharmacotherapies.

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Diabetic heart disease (DHD) can be classified as a primary consequence from several pathophysiological manifestation of diabetes mellitus (DM) on cardiac tissues or secondarily in extracardiac tissues and is encountered as either primary or secondary complications of DM. Endothelitis is inflammation of the vascular endothelium and is likely to be seen in the majority of patients who start to manifest an end organ complication of DM in this case DHD. Diabetes is a leading cause for many cardiovascular syndromes and diseases including congestive heart failure (CHF) however much remains unknown about the transition from diagnosed DM to clinical state and the contribution of the various mechanical and counterregulatory systems in the manifested complaint.

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Purpose Of Review: Coronary artery disease (CAD) is the leading contributor to cardiovascular disease; it is the most prevalent non-communicable disease globally and has high morbidity, mortality and health care cost. Risk stratification is defined as prevention or containment of disease prior to it occurring or progressing, and non-invasive surrogates include history, examination, biomarkers and non-invasive imaging. This review aims to highlight advancement in current diagnostic strategies and explores gaps for CAD secondary to atherosclerosis and non-obstructive vascular diseases.

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Background: Telemedicine and digital health technologies hold great promise for improving clinical care of heart failure. However, inconsistent and contradictory findings from randomized controlled trials have so far discouraged widespread adoption of digital health in routine clinical practice. We undertook this review study to summarize the study outcomes of the use of exploring the evidence for telemedicine in the clinical care of patients with heart failure and readmissions.

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Coronary artery disease (CAD) screening and diagnosis are core cardiac specialty services. From symptoms, autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies. While angina remains a clinical diagnosis, most cases require correlation with a diagnostic modality.

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