126 results match your criteria: "Bart's Heart Centre[Affiliation]"

Cardiovascular disease (CVD) is a major global health challenge, and its co-occurrence with diabetes mellitus (DM) contributes significantly to morbidity and mortality. Yemen, a nation facing unique healthcare complexities, necessitates an in-depth investigation into the prevalence of cardiovascular risk (CVR) factors among its population with DM. This systematic review and meta-analysis aimed to determine the prevalence of CVR factors among individuals with diabetes in Yemen, to understand and highlight the knowledge gap, and to influence targeted interventions and policies.

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Article Synopsis
  • * A systematic review analyzed 61 articles, with seven randomized controlled trials included, focusing on mortality, hospital readmission, electrolyte imbalances, and renal function among combination therapy subjects.
  • * Results showed combination therapies reduced body weight significantly but had no notable effect on mortality or readmission rates; however, they did present risks like electrolyte imbalances and renal function decline, prompting discussions for personalized treatment strategies.
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Importance: The emergence of novel programming guidelines that reduce premature and inappropriate therapies along with the availability of new implantable cardioverter-defibrillator (ICD) technologies lacking traditional endocardial antitachycardia pacing (ATP) capabilities requires the reevaluation of ATP as a first strategy in terminating fast ventricular tachycardias (VTs) in primary prevention ICD recipients.

Objective: To assess the role of ATP in terminating fast VTs in primary prevention ICD recipients with contemporary programming.

Design, Setting, And Participants: This global, prospective, double-blind, randomized clinical trial had an equivalence design with a relative margin of 35%.

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Article Synopsis
  • Wolff-Parkinson-White (WPW) syndrome is a heart condition causing tachycardia, especially common in children, and can be linked to other syndromes like MELAS and LEOPARD.
  • A 17-year-old male experienced a collapse due to WPW syndrome type A, diagnosed through ECG, which showed specific heart wave patterns and abnormalities in blood tests.
  • He had a history of sensorineural deafness and underwent successful ablation treatment, which corrected the WPW symptoms as seen in a follow-up ECG.
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Recurrent Pericardial Effusion Secondary to Cardiac Angiosarcoma.

Cureus

May 2024

Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.

Cardiac angiosarcoma is a malignant cardiac tumour. We present the case of a young patient in his mid-30s with recurrent pericardial effusion. He had flu-like symptoms a month earlier and had shortness of breath, lethargy, and tightness in his throat for the past ten days.

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Osteosarcoma in a Teenage Athlete With a Swollen Knee Joint.

Cureus

March 2024

Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.

Osteosarcoma is a malignant mesenchymal tumour. This primarily manifests in the formation of immature osteoid cells by tumour cells. Osteosarcoma is the most common primary bone tumour in children and adolescents.

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Diagnosis and prognosis of abnormal cardiac scintigraphy uptake suggestive of cardiac amyloidosis using artificial intelligence: a retrospective, international, multicentre, cross-tracer development and validation study.

Lancet Digit Health

April 2024

Institute of Cardiovascular Science, University College London, London, UK; Department of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria; Bart's Heart Centre, St Bartholomew's Hospital, West Smithfield, London, London, UK. Electronic address:

Background: The diagnosis of cardiac amyloidosis can be established non-invasively by scintigraphy using bone-avid tracers, but visual assessment is subjective and can lead to misdiagnosis. We aimed to develop and validate an artificial intelligence (AI) system for standardised and reliable screening of cardiac amyloidosis-suggestive uptake and assess its prognostic value, using a multinational database of Tc-scintigraphy data across multiple tracers and scanners.

Methods: In this retrospective, international, multicentre, cross-tracer development and validation study, 16 241 patients with 19 401 scans were included from nine centres: one hospital in Austria (consecutive recruitment Jan 4, 2010, to Aug 19, 2020), five hospital sites in London, UK (consecutive recruitment Oct 1, 2014, to Sept 29, 2022), two centres in China (selected scans from Jan 1, 2021, to Oct 31, 2022), and one centre in Italy (selected scans from Jan 1, 2011, to May 23, 2023).

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Myocardial dysfunction is common in patients admitted to the intensive care unit (ICU). Septic disease frequently results in cardiac dysfunction, and sepsis represents the most common cause of admission and death in the ICU. The association between left ventricular (LV) systolic dysfunction and mortality is not clear for critically ill patients.

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Rheumatic diseases are a group of disorders that affect the joints, muscles, and bones. These diseases, such as rheumatoid arthritis, lupus, and psoriatic arthritis, can cause pain, stiffness, and swelling, leading to reduced mobility and disability. Recent studies have identified the microbiome, the diverse community of microorganisms that live in and on the human body, as a potential factor in the development and progression of rheumatic diseases.

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Effectiveness of Cardiac Rehabilitation Services in Low- and Middle-Income Countries: A Systematic Review.

Cureus

December 2023

Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.

Cardiac rehabilitation (CR) is a cost-effective intervention that can reduce cardiovascular disease (CVD) morbidity and mortality by 20%. Despite the clear benefits of CR, it remains unavailable and underutilized. This study aimed to assess the effectiveness of different CR models in reducing CVD-related morbidity and mortality in low-and middle-income countries.

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Background: There is increasing evidence to suggest vitamin D plays a role in immune and vascular function; hence, it may be of biological and clinical relevance for patients undergoing major surgery. With a greater number of randomised studies being conducted evaluating the impact of vitamin D supplementation on surgical patients, it is an opportune time to conduct further analysis of the impact of vitamin D on surgical outcomes.

Methods: MEDLINE, EMBASE and the Cochrane Trials Register were interrogated up to December 2023 to identify randomised controlled trials of vitamin D supplementation in surgery.

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Ventricular arrhythmias in cardiac channelopathies are linked to autonomic triggers, which are sub-optimally targeted in current management strategies. Improved molecular understanding of cardiac channelopathies and cellular autonomic signalling could refine autonomic therapies to target the specific signalling pathways relevant to the specific aetiologies as well as the central nervous system centres involved in the cardiac autonomic regulation. This review summarizes key anatomical and physiological aspects of the cardiac autonomic nervous system and its impact on ventricular arrhythmias in primary inherited arrhythmia syndromes.

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ECG Features of Pulmonary Embolism in a Patient With Normal D-Dimer and Hypoxia.

Cureus

November 2023

Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.

Pulmonary embolism is a life-threatening condition that requires urgent treatment. We present the case of a 76-year-old male referred to our medical team with dyspnoea, shortness of breath on exertion, and chest pain. Upon further questioning, the patient reported a two-week history of right-sided parasternal pleuritic chest pain without radiation.

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Article Synopsis
  • * There's a lack of knowledge on how inflammation and immune responses function in CS, unlike in other critical conditions such as sepsis, which might hinder treatment effectiveness.
  • * The review suggests using advanced molecular profiling techniques to distinguish different patient subtypes of CS, potentially leading to more tailored treatments and improved clinical trial designs.
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Introduction Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. It is projected that the prevalence of CVD will continue to rise in developing countries, largely driven by an increase in the prevalence of potentially modifiable risk factors. Atherosclerotic cardiovascular risk assessment among individuals with risk factors for CVD but without CVD is an inexpensive and viable strategy in CVD risk stratification and prevention.

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Electrocardiographic abnormalities in patients with cardiomyopathies.

Heart Fail Rev

January 2024

UCL Centre for Heart Muscle Disease and Lead of the Inherited Cardiovascular Disease Unit, Bart's Heart Centre, London, UK.

Abnormalities in impulse generation and transmission are among the first signs of cardiac remodeling in cardiomyopathies. Accordingly, 12-lead electrocardiogram (ECG) of patients with cardiomyopathies may show multiple abnormalities. Some findings are suggestive of specific disorders, such as the discrepancy between QRS voltages and left ventricular (LV) mass for cardiac amyloidosis or the inverted T waves in the right precordial leads for arrhythmogenic cardiomyopathy.

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With the global rise of cardiovascular disease including atherosclerosis, there is a high demand for accurate diagnostic tools that can be used during a short consultation. In view of pathology, abnormal blood flow patterns have been demonstrated to be strong predictors of atherosclerotic lesion incidence, location, progression, and rupture. Prediction of patient-specific blood flow patterns can hence enable fast clinical diagnosis.

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Patients with hypertrophic cardiomyopathy may exhibit impaired functional capacity, associated with increased morbidity and mortality. Systolic function is one of the determinants of functional capacity. Early identification of systolic disfunction may identify patients at risk for adverse outcomes.

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Myxedema Coma Precipitated by Sepsis in a Patient With a Complex Mental Health History.

Cureus

August 2023

Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.

Myxedema coma is a rare and life-threatening manifestation of severe hypothyroidism. Myxedema refers to altered mental status observed in these patients. Clinical characteristics observed include hypothermia, bradycardia, respiratory failure, hyponatremia, and altered mental status.

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Brugada syndrome is an arrhythmogenic condition characterized by ST-segment elevation and J-point elevation in at least two precordial leads. Most ST segment elevations are associated with myocardial infarction, although other conditions such as pericarditis, channelopathies, and a few genetic conditions should be considered. Brugada syndrome is an inherited cardiac condition associated with an increased risk of sudden cardiac death (SCD).

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Analysis of Gender-Based Inequality in Cardiovascular Health: An Umbrella Review.

Cureus

August 2023

Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.

This umbrella review aims to investigate possible gender-based inequality in cardiovascular health and improve understanding surrounding differing presentations seen in women. Searches of current literature were conducted using Medline; Cochrane; Cumulative Index of Nursing and Allied Health Literature (CINAHL Plus); and PubMed databases. Focusing on systematic reviews and meta-analyses from the last decade, searches were expanded to the publication year of 2000 onwards, to enable a broader review of current practices.

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Primary hyperparathyroidism (PHPT) can cause hypercalcemia secondary to high parathyroid hormone secretion. Hyperparathyroidism- and hypercalcemia-related acute psychotic symptoms can be challenging to diagnose in patients with mental health-related disorders, and it should be considered a possible differential in these patients besides medications. It can sometimes be the first manifestation of the disease, and diagnosis can be challenging, especially in patients with a previous psychiatric history without checking their biochemistry profile.

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Helicobacter pylori (H. pylori) infection is a common chronic infection responsible for upper gastrointestinal symptoms such as indigestion, belching, heartburn, and abdominal fullness along with nausea and vomiting. It is considered a transmissible infection, although the exact chain of transmission is not clear.

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Article Synopsis
  • The safety of exercise for patients with abdominal aortic aneurysms (AAA) is debated due to concerns about the risk of rupture from increased blood pressure during physical activity.
  • This review involves experts from various medical fields who argue that patients should not avoid rigorous exercise and that the fear of rupture is often overstated.
  • By examining the positive effects of exercise and providing tailored safety recommendations, the authors suggest that the benefits of exercise and cardiopulmonary testing exceed the short-term risks related to AAA rupture.
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