Books on the topic 'Cardiovascular screening'
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1
Group, Family Heart Study, ed. Randomised controlled trial evaluating cardiovascular screening and intervention in general practice: Principal results of British family heart study. [London]: British Medical Journal, 1994.
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2
Danieli, Gian Antonio. Genetics and genomics for the cardiologist. Dordrecht: Kluwer Academic Pub., 2002.
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3
F, Oliver M., Ashley-Miller Michael, Wood David, University of Edinburgh. Cardiovascular Research Unit., and Great Britain. Chief Scientist Office., eds. Screening for risk of coronary heart disease: Proceedings of a workshop on strategies for screening for risk of coronary heart disease organised jointly by the Cardiovascular Research Unit, Edinburgh University and the Chief Scientist Office, Scottish Home and Health Department and held at the King Khalid Conference Centre, Royal College of Surgeons, Edinburgh on 14 and 15 November 1985. Chichester: Wiley, 1987.
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4
Banerjee, Amitava, and Kaleab Asrress. Screening for cardiovascular disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0351.
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Screening involves testing asymptomatic individuals who have risk factors, or individuals who are in the early stages of a disease, in order to decide whether further investigation, clinical intervention, or treatment is warranted. Therefore, screening is classically a primary prevention strategy which aims to capture disease early in its course, but it can also involve secondary prevention in individuals with established disease. In the words of Geoffrey Rose, screening is a ‘population’ strategy. Examples of screening programmes are blood pressure monitoring in primary care to screen for hypertension, and ultrasound examination to screen for abdominal aortic aneurysm. The effectiveness and feasibility of screening are influenced by several factors. First, the diagnostic accuracy of the screening test in question is crucial. For example, exercise ECG testing, although widely used, is not recommended in investigation of chest pain in current National Institute for Health and Care Excellence guidelines, due to its low sensitivity and specificity in the detection of coronary artery disease. Moreover, exercise ECG testing has even lower diagnostic accuracy in asymptomatic patients with coronary artery disease. Second, physical and financial resources influence the decision to screen. For example, the cost and the effectiveness of CT coronary angiography and other new imaging modalities to assess coronary vasculature must be weighed against the cost of existing investigations (e.g. coronary angiography) and the need for new equipment and staff training and recruitment. Finally, the safety of the investigation is an important factor, and patient preferences and physician preferences should be taken into consideration. However, while non-invasive screening examinations are preferable from the point of view of patients and clinicians, sometimes invasive screening tests may be required at a later stage in order to give a definitive diagnosis (e.g. pressure wire studies to measure fractional flow reserve in a coronary artery). The WHO’s principles of screening, first formulated in 1968, are still very relevant today. Decision analysis has led to ‘pathways’ which guide investigation and treatment within screening programmes. There is increasing recognition that there are shared risk factors and shared preventive and treatment strategies for vascular disease, regardless of arterial territory. The concept of ‘vascular medicine’ has gained credence, leading to opportunistic screening in other vascular territories if an individual presents with disease in one territory. For example, post-myocardial infarction patients have higher incidence of cerebrovascular and peripheral arterial disease, so carotid duplex scanning and measurement of the ankle–brachial pressure index may be valid screening approaches for arterial disease in other territories.
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Hage, Fadi G., Ayman Farag, and Gilbert J. Zoghbi. Screening Asymptomatic Subjects. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0016.
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Cardiovascular disease is the leading cause of death in the United States and accounts for more deaths than all cancers combined. Many apparently healthy adults first present to the health system with a myocardial infarction or sudden cardiac death. It is therefore imperative to assess the risk of cardiovascular events among currently asymptomatic individuals to try and intervene early in the disease process to prevent future events. Risk factors for the development of coronary artery disease in particular, and cardiovascular disease in general, have been identified from epidemiological studies and used to develop global risk scores to risk stratify populations. Although these scores work well at the level of the population, unfortunately they are imperfect at estimating risk at the level of the individual. In this Chapter we will discuss the use of exercise stress testing and other imaging modalities as screening methods for the detection of coronary disease and predicting risk in asymptomatic adults. The hope is to develop a screening program to identify cardiovascular disease early in the disease process to introduce interventions that will favorably impact outcomes in a manner similar to the current screening programs available for several cancers.
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New Frontiers of Cardiovascular Screening Using Unobtrusive Sensors, AI, and IoT. Elsevier, 2022. http://dx.doi.org/10.1016/c2019-0-05510-0.
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Choudhury, Anirban Dutta, Rohan Banerjee, Sanjay Kimbahune, and Arpan Pal. New Frontiers of Cardiovascular Screening Using Unobtrusive Sensors, AI, and IoT. Elsevier Science & Technology Books, 2022.
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8
Choudhury, Anirban Dutta, Rohan Banerjee, Sanjay Kimbahune, and Arpan Pal. New Frontiers of Cardiovascular Screening Using Unobtrusive Sensors, AI, and IoT. Elsevier Science & Technology, 2022.
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9
V, Luepker Russell, ed. Cardiovascular survey methods. 3rd ed. Geneva: World Health Organization, 2004.
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10
Mitchell, MRCPsych, Alex J., and James C. Coyne, PhD. Screening for Depression in Clinical Practice. Oxford University Press, 2009. http://dx.doi.org/10.1093/oso/9780195380194.001.0001.
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Mood disorders are a global health issue. National guidance for their detection and management have been published in the US and in Europe. Despite this, the rate at which depression is recognized and managed in primary and secondary care settings remains low and suggests that many clinicians are still unsure how to screen people for mood disorders. Against the backdrop of this problem, the editors of this volume have designed a book with a dynamic two-fold purpose: to provide an evidence-based overview of screening methods for mood disorders, and to synthesize the evidence into a practical guide for clinicians in a variety of settings--from cardiologists and oncologists, to primary care physicians and neurologists, among others. The volume considers all important aspects of depression screening, from the overview of specific scales, to considerations of technological approaches to screening, and to the examination of screening with neurological disorders, prenatal care, cardiovascular conditions, and diabetes and cancer care, among others. This book is sure to capture the attention of any clinician with a stake in depression screening.
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Atta-ur-Rahman and M. Iqbal Choudhary, eds. Frontiers in Cardiovascular Drug Discovery: Volume 4. BENTHAM SCIENCE PUBLISHERS, 2019. http://dx.doi.org/10.2174/97816810839951180401.
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Frontiers in Cardiovascular Drug Discovery is an eBook series devoted to publishing the latest advances in cardiovascular drug design and discovery. Each volume brings reviews on the biochemistry, in-silico drug design, combinatorial chemistry, high-throughput screening, drug targets, recent important patents, and structure-activity relationships of molecules used in cardiovascular therapy. The eBook series should prove to be of great interest to all medicinal chemists and pharmaceutical scientists involved in preclinical and clinical research in cardiology. The fourth volume of the series covers the following topics: -Aspirin administration -Adenosine receptor targeting for cardiovascular therapy -Drug treatment of patients with coronary stenting -Immunosuppressive drugs in heart transplantation -PCSK9 inhibition for lowering LDL-C levels.
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M, Garber Alan, and United States. Congress. Office of Technology Assessment. Health Program., eds. Costs and effectiveness of cholesterol screening in the elderly. Washington, DC: Health Program, Office of Technology Assessment, Congress of the U.S., 1989.
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13
Schwartz, Peter J., and Lia Crotti. Monogenic and oligogenic cardiovascular diseases: genetics of arrhythmias—catecholaminergic polymorphic ventricular tachycardia. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0152.
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Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited disorder associated with syncope and sudden death manifesting in the young during sympathetic activation. The electrocardiogram is normal and the heart is structurally normal. The diagnosis is usually made with an exercise stress test that shows a typical pattern of onset and offset of adrenergically induced ventricular arrhythmias. Molecular screening of RyR2, the major CPVT gene, is recommended whenever the suspicion of CPVT is high. If a disease-causing mutation is identified, cascade screening allows pre-symptomatic diagnosis among family members. All affected subjects should be treated with beta blockers (nadolol or propranolol). Preliminary data support the association of beta blockers with flecainide. After a cardiac arrest, an implantable cardioverter defibrillator (ICD) should be implanted, but it is accompanied by a disquietingly high incidence of adverse effects. After syncope on beta blocker therapy, left cardiac sympathetic denervation is most effective, preserves quality of life, and does not preclude a subsequent ICD implantation.
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Tülümen, Erol, and Martin Borggrefe. Monogenic and oligogenic cardiovascular diseases: genetics of arrhythmias—short QT syndrome. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0150.
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Short QT syndrome (SQTS) is a very rare, sporadic or autosomal dominant inherited channelopathy characterized by abnormally short QT intervals on the electrocardiogram and increased propensity to atrial and ventricular tachyarrhythmias and/or sudden cardiac death. Since its recognition as a distinct clinical entity in 2000, significant progress has been made in defining the clinical, molecular, and genetic basis of SQTS. To date, several causative gain-of-function mutations in potassium channel genes and loss-of-function mutations in calcium channel genes have been identified. The physiological consequence of these mutations is an accelerated repolarization, thus abbreviated action potentials and shortened QT interval with an increased inhomogeneity and dispersion of repolarization. Regarding other rare monogenetic arrhythmias, a genetic basis of atrial fibrillation was considered very unlikely until very recently. However, in the last decade the heritability of atrial fibrillation in the general population has been well described in several epidemiological studies. So far, more than 30 genes have been implicated in atrial fibrillation through candidate gene approach studies, and 14 loci were found to be associated with atrial fibrillation through genome-wide association studies. This genetic heterogeneity and the low prevalence of mutations in any single gene restrict the clinical utility of genetic screening in atrial fibrillation.
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Battalora, Linda A., and Benjamin Young. HIV and Bone Health. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0045.
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With improved long-term survival among populations of people living with HIV, it has been suggested that HIV/AIDS may hasten the aging process. There is increasing evidence that cardiovascular, renal, and bone disease and neurocognitive deficits may be more common among long-term survivors of HIV infection. Findings from cohort and prospective randomized studies suggest that people living with HIV are at increased risk of metabolic bone disease and related fractures. There are limited HIV-specific evidence-based recommendations regarding screening for bone disease. Several organizations recommend using dual-energy X-ray absorptiometry and/or the Fracture Risk Assessment Tool for screening of HIV-infected persons at risk of fractures.
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Edun, Babatunde, Michelle K. Haas, Christopher Brendemuhl, Jason V. Baker, and Anthony C. Speights. Health Maintenance. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0012.
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The introduction of highly potent antiretroviral agents has transformed HIV from a disease with a once dismal prognosis to a manageable chronic medical condition. The primary care provider as well as the HIV care provider must focus on aspects of preventive medicine that improve the quality of life and life expectancy of the HIV-infected person. Accurate record-keeping is essential, and examples of HIV primary care flow sheets are presented in this chapter. In addition, tuberculosis screening indications and methods are reviewed. Regular preventative dental and gynecological care should be given. Reviewing the treatment of traditional cardiovascular risk factors with patients will be helpful in educating them and reducing the risk of cardiovascular disease.
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Kotseva, Kornelia, Neil Oldridge, and Massimo F. Piepoli. Evaluation of preventive cardiology. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656653.003.0026.
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The Joint European Societies guidelines on cardiovascular disease (CVD) prevention define lifestyle and risk factor targets for patients with coronary or other atherosclerotic disease and people at high risk of developing CVD. However, several surveys in Europe and the United States showed inadequate lifestyle and risk factor management and under-use of prophylactic drug therapies in primary and secondary CVD prevention. Various professional associations have developed core components, standards, and outcome measures to evaluate quality of care and provide guidelines for identifying opportunities for improvements. Optimal control of cardiovascular risk factors is one of the most effective methods for reducing vascular events in patients with atherosclerotic disease or high cardiovascular risk. Improving treatment adherence is also very important. Health-related quality of life (HRQL) is considered as an outcome measure in research studies and in clinical practice. HRQL measures can help in improving patient-clinician communication, screening, monitoring, and continuous assessment of quality of care.
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Kotseva, Kornelia, Neil Oldridge, and Massimo F. Piepoli. Evaluation of preventive cardiology. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199656653.003.0026_update_001.
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The Joint European Societies guidelines on cardiovascular disease (CVD) prevention define lifestyle and risk factor targets for patients with coronary or other atherosclerotic disease and people at high risk of developing CVD. However, several surveys in Europe and the United States showed inadequate lifestyle and risk factor management and under-use of prophylactic drug therapies in primary and secondary CVD prevention. Various professional associations have developed core components, standards, and outcome measures to evaluate quality of care and provide guidelines for identifying opportunities for improvements. Optimal control of cardiovascular risk factors is one of the most effective methods for reducing vascular events in patients with atherosclerotic disease or high cardiovascular risk. Improving treatment adherence is also very important. Health-related quality of life (HRQL) is considered as an outcome measure in research studies and in clinical practice. HRQL measures can help in improving patient-clinician communication, screening, monitoring, and continuous assessment of quality of care.
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Deaton, Christi, Margaret Cupples, and Kornelia Kotseva. Settings and stakeholders. Edited by Massimo Piepoli. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0786.
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Cardiovascular disease remains a leading cause of death and disability globally, and cardiovascular prevention should take place everywhere. Reducing the burden of cardiovascular disease requires a concerted effort in multiple settings (primary care, acute care, community, and home), and from multiple stakeholders such as government, public health, non-governmental organizations, healthcare, industry, and individuals. Primary care provides the majority of healthcare to populations, and is in an optimal position to screen and assess patients for cardiovascular risk and deliver cardiovascular prevention. Improving screening, risk assessment, and use of evidence-based guidelines requires collaboration between specialist cardiology services and primary care. Nurse-led and multiprofessional teams are effective in delivering prevention across a variety of settings. Prevention should be a priority prior to patient discharge from hospital following an acute cardiovascular event, and should encompass both medications and advice regarding lifestyle behaviours. Secondary prevention through specialized prevention programmes is needed by patients in order to reduce the risk of subsequent events. Cardiac rehabilitation is one of the most effective methods of delivering prevention and improving patient well-being following an acute event or procedure. There is a need to get more patients participating by using alternative methods of delivery and ensuring that women, older patients, and those with low fitness are encouraged and supported to attend. Stakeholders such as government, non-governmental organizations, and industry have important roles to play in improving public health. Healthcare providers should disseminate their research in lay language, and play a role in advising on and supporting public health measures.
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Machtinger, Edward L., and Peter A. Nigrovic. Spanish for Pediatric Medicine. Edited by Janice A. Lowe. 2nd ed. American Academy of Pediatrics, 2005. http://dx.doi.org/10.1542/9781581104554.
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Enhance patient and parent encounters with this newly expanded and enhanced pocket guide! Here's the easy-to-use manual you need to communicate with Spanish-speaking patients and parents more efficiently and effectively. Spanish for Pediatric Medicine features a quick-reference design that enables you to rapidly identify and explore common medical problems. English and Spanish equivalents are shown side-by-side for instant, precise use. This handy resource fits right in your pocket as you travel between well-child, sick visit, and emergency department settings. Optimized for use with Bright Futures--visit-specific translations from prenatal to 18- to 21-year visits reflect the organization of the AAP Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition. All-new audio program--electronic access to downloadable audio clips of translations from a native Spanish speaker helps you improve comprehension and pronunciation. The new 2nd edition includes general visit translations--medical history, family history, description of pain, examination instructions, immunization screening, and discharge instructions; Bright Futures stage visit translations--spanning issues addressed in prenatal and newborn through late adolescent visits; emergency department (ED) visit translations--ED history, description of pain, examination instructions, and discharge instructions; system-specific translations--hematology/oncology, skin, respiratory, cardiovascular, gastrointestinal, genitourinary, and musculoskeletal; special issues translations--abuse screening, developmental milestones, lead toxicity screening, and obesity prevention and treatment; and translations for commonly used expressions/greetings--terms of endearment for children.
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Castle, David J., Peter F. Buckley, and Fiona P. Gaughran. Physical Health and Schizophrenia (Oxford Psychiatry Library). Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198811688.001.0001.
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The association between mental health and physical health forms the core of this book. While it is recognized that serious mental illnesses such as schizophrenia carry a reduced life expectancy, it is often assumed that suicide is the main cause of this disparity. But in actuality, suicide accounts for no more than a third of the early mortality associated with schizophrenia: the vast majority is due to cardiovascular factors. This book seeks to put this stark fact in context, detailing the extent of cardiovascular risk, sharing information regarding reasons for this excess, and outlining approved approaches for screening for and treatment of such risk factors in people with schizophrenia. As such, this book seeks to inform those caring for people with schizophrenia of these parameters and suggests ways in which they may be addressed, using a holistic model which embraces shared decision-making and which is compatible with the recovery framework. It provides guidance regarding monitoring as well as information about focused interventions that can help ameliorate risk. It also addresses those physical health factors apart from cardiovascular, that add to the burden of ill health amongst people with schizophrenia: pulmonary health, bone health, sexual health, and cancer risk are just some of these. In addition, the book provides patient and carer information material that can be used to try to ensure that all involved have a truly informed role in decision-making about their treatment and that both psychiatric and physical health issues are taken seriously.
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Sprynger, Muriel, Iana Simova, and Scipione Carerj. Vascular echo imaging. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0068.
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Arterial diseases are heavily intertwined with atherosclerosis and coronary artery disease and the presence of both symptomatic and asymptomatic peripheral artery diseases is known to affect the rate of cardiovascular events and deaths. Screening for abdominal aortic aneurysm (AAA) in selected populations is also a major issue for the cardiologist. Additionally, intima-media thickness and ankle-brachial index (ABI) measurements, screening for carotid or femoral plaques, and new techniques looking at the rigidity and elasticity of arteries may further help with risk stratification, especially in intermediary risk populations. Cardiologists may also encounter other conditions such as subclavian artery disease, arterial dissection, arterial entrapment, and arteritis (e.g. giant cell or Takayasu’s arteritis). Even if they don’t undertake imaging themselves, they should know about these diseases and when to refer patients. Although cardiac and vascular ultrasounds are complementary, they require a completely different skill set and formal training. The ultimate goal of this chapter is to define the basic principles that any cardiologist should know, and also provide guidance to cardiologists more interested in vascular diseases. For the benefit of the patient there is a need for collaboration between the different disciplines involved in vascular diseases according to local medical availability and skill.
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Jorge, April, and Rosalind Ramsey-Goldman. Management of special situations in systemic lupus erythematosus. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739180.003.0009.
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In caring for patients with systemic lupus erythematosus (SLE), there are several important treatment considerations. Since many patients with SLE are female and of childbearing potential, it is important to address conception planning, contraceptive options, and the maternal and fetal risks associated with pregnancy, which are increased when there is higher SLE disease activity. It is also pertinent to address medication safety issues throughout pregnancy and lactation, as some commonly used medications can increase risks of adverse pregnancy outcomes. Additionally, patients with SLE are at higher risk for cardiovascular disease (CVD) than the general population. Therefore, these patients must undergo aggressive risk factor modification. Patients with SLE are also at increased risk for osteoporosis, and bone health is an important treatment consideration. Routine cancer screening and vaccinations are also important elements of the comprehensive treatment of the patient with SLE.
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Jarnert, Christina, Linda Mellbin, Lars Rydén, and Jaakko Tuomilehto. Glucose intolerance and diabetes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656653.003.0016.
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Diabetes dramatically increases the risk of cardiovascular diseases (CVD). Diabetes is defined by elevated glucose in blood circulation. The level of glycaemia has a graded relation with CVD risk and diabetes is very frequent in people with CVD. In the general population half of the people with type 2 diabetes are undiagnosed, yet efficient methods for population screening exist. Despite considerable improvements in the management of CVD, patients with disturbed glucose metabolism have not benefited to the same extent as those without diabetes. Primary and secondary prevention of CVD in people with diabetes and other disturbances in glucose metabolism must be multifactorial and treatment targets stricter than for patients without glucose aberrations. Increased collaboration between different therapeutic disciplines including diabetologists, cardiologists, general practitioners, and dieticians is key to improved management for this large and high-risk population. Some important aspects of these issues are presented in this chapter.
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Jarnert, Christina, Linda Mellbin, Lars Rydén, and Jaakko Tuomilehto. Glucose intolerance and diabetes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199656653.003.0016_update_001.
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Diabetes dramatically increases the risk of cardiovascular diseases (CVD). Diabetes is defined by elevated glucose in blood circulation. The level of glycaemia has a graded relation with CVD risk and diabetes is very frequent in people with CVD. In the general population half of the people with type 2 diabetes are undiagnosed, yet efficient methods for population screening exist. Despite considerable improvements in the management of CVD, patients with disturbed glucose metabolism have not benefited to the same extent as those without diabetes. Primary and secondary prevention of CVD in people with diabetes and other disturbances in glucose metabolism must be multifactorial and treatment targets stricter than for patients without glucose aberrations. Increased collaboration between different therapeutic disciplines including diabetologists, cardiologists, general practitioners, and dieticians is key to improved management for this large and high-risk population. Some important aspects of these issues are presented in this chapter.
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Turner, Neil, and Stewart Cameron. Proteinuria. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0050.
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Excess protein in the urine almost always comes from the kidney. Proteinuria up to 150 mg/day in an adult (protein:creatinine ratio (PCR) up to 15 mg/mmol) is considered normal. Daily average excretion is 80 mg, of which about 30 mg is albumin that has been filtered and not reabsorbed. Other components comprise low-molecular-weight filtered proteins that have escaped reabsorption, and proteins secreted or lost into urine from cells of the nephron. Increased permeability of the glomerulus to high-molecular-weight proteins is the most common cause of the clinically detected proteinuria, and albumin is the major component of excess glomerular proteinuria. Even small amounts of proteinuria are associated with increased cardiovascular risk and long-term renal risk. In patients with renal disease, regardless of type, proteinuria is a strong predictor of loss of glomerular filtration rate and proteinuria at levels higher than an equivalent of 1 g/24 hours can be considered high renal risk. This limit should be lowered in young patients, and if microscopic haematuria is also present. For both cardiovascular and renal outcomes, risk is graded with severity of proteinuria. In routine clinical practice, ratios of albumin or total protein to creatinine level (ACR or PCR) in spot urine samples are usually more pragmatic and useful than 24-hour collections. ACR is more sensitive as a screening test (normal range up to 2.5 mg/mmol in men, 3.5 mg/mmol in women).
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Sinagra, Gianfranco, Marco Merlo, and Davide Stolfo. Dilated cardiomyopathy: clinical diagnosis and medical management. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0356.
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Dilated cardiomyopathy (DCM) is a relatively rare primary heart muscle disease with genetic or post-inflammatory aetiology that affects relatively young patients with a low-risk co-morbidity profile. Therefore, DCM represents a particular heart failure model with specific characteristics and long-term evolution. The progressively earlier diagnosis derived from systematic familial screening programmes and the current therapeutic strategies have greatly modified the prognosis of DCM with a dramatic reduction of mortality over recent decades. A significant number of DCM patients present an impressive response to pharmacological and non-pharmacological evidence-based therapy in terms of haemodynamic improvement with subsequent left ventricular reverse remodelling, which confer a favourable long-term prognosis. However, in some DCM patients the outcome is still severe. This prognostic heterogeneity is possibly related to the aetiological variety of this disease. Maximal effort towards an early aetiological diagnosis of DCM, by using all diagnostic available tools (including cardiovascular magnetic resonance imaging, endomyocardial biopsy, and genetic testing when indicated), as well as the individualized long-term follow-up appear crucial in improving the prognostic stratification and the clinical management of these patients.
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Davey, Patrick, and David Sprigings, eds. Diagnosis and Treatment in Internal Medicine. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.001.0001.
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Diagnosis and Treatment in Internal Medicine is a new textbook, written by experts in their field, that provides succinct and authoritative guidance across the breadth of internal medicine. Diagnosis is the bedrock of management, and so how to reach a differential diagnosis of symptoms or presenting problems is a major element of the book. There is also comprehensive coverage of disorders of the body systems, including psychological aspects and palliative care. Chapters are structured so that key information can rapidly be found. Doctors need a broad perspective on health and its promotion, and there are sections addressing nutrition, lifestyle and prevention of disease. Diagnosis and Treatment in Internal Medicine is the ideal reference for doctors early in their careers in hospital medicine or primary care, and senior medical students. Sections of the book: • The approach to the patient • Assessment of symptoms and presenting problems • Cardiovascular disorders • Respiratory disorders • Intensive care medicine • Disorders of the kidney and urinary tract • Diabetes mellitus and endocrine disorders • Gastro-intestinal disorders • Disorders of the liver • Neurological disorders • Disorders of the skin • Disorders of the musculoskeletal system • Haematological disorders • Disorders of the immune system • Infectious diseases • Nutrition and its disorders • Lifestyle and environmental causes of disease • Prevention of disease • Screening for disease
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AlJaroudi, Wael. Risk Assessment Before Noncardiac Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0014.
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Perioperative risk assessment is essential in screening patients before noncardiac surgery. Cardiovascular complications such as fatal and non-fatal myocardial infarction (MI), ventricular arrhythmia, pulmonary edema, and stroke are important in-hospital causes of morbidity and mortality intra and post-operatively. The optimal approach is to identify patients at increased risk so that appropriate testing and therapeutic interventions are undertaken a priori to minimize such risk. The initial preoperative evaluation includes identification of surgery-specific risk, patient exercise functional capacity and clinical risk profile. Patients with major predictors of events such as acute coronary syndromes, recent MI, unstable arrhythmia, and severe valvular disease warrant further management and optimization that often lead to delaying surgery. Those with three or more predictors (history of ischemic heart disease, compensated heart failure, diabetes, renal insufficiency, or history of cerebrovascular disease) undergoing high- risk surgery often require stress testing. Although data from randomized prospective trials are lacking, numerous studies have demonstrated the utility of myocardial perfusion imaging (MPI) for determination of perioperative cardiac risk. The goal of this chapter is to review the use of MPI for preoperative risk assessment and the recommendations from the current guidelines. The focus will be on short-term and long-term prognosis including special groups such as after coronary stenting and before vascular surgery, liver and renal transplantation.
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Coates, Laura C., and Philip S. Helliwell. Psoriatic arthritis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0114.
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Psoriasis is a chronic skin condition affecting about 3% of Europeans and North Americans. About 15% of people afflicted with psoriasis will develop psoriatic arthritis—cutaneous risk factors for this are psoriasis of the nails, scalp, and flexures. Since most cases of arthritis develop in people with psoriasis, new screening tools, both clinical and imaging, are available. Some genetic factors may also explain susceptibility and severity. Historically, five clinical subgroups have been described but these may be simplified to axial and peripheral involvement, the latter dividing into oligo- and polyarticular patterns. The importance of these clinical subdivisions is still under debate and research but it is clear that there is marked heterogeneity in all manifestations of this disease. In recent times the importance of extra-articular features has gained prominence such that the metabolic syndrome and cardiovascular morbidity are now seen as important features of 'psoriatic disease'. The diverse changes seen in bone on imaging reflect both the underlying pathogenic mechanisms and the ways in which the disease progresses. Recent work with animal models and immunohistochemistry has further advanced our understanding of these features. In the biologic era renewed interest in psoriatic arthritis has stimulated research into outcome assessment and permitted clearer understanding of how these new drugs work on the different aspects of the disease. In addition, improved recognition of the impact of the disease on the person has stimulated the development of new patient-reported outcome tools.
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Coates, Laura C., and Philip S. Helliwell. Psoriatic arthritis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0114_update_003.
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Psoriasis is a chronic skin condition affecting about 3% of Europeans and North Americans. About 15% of people afflicted with psoriasis will develop psoriatic arthritis—cutaneous risk factors for this are psoriasis of the nails, scalp, and flexures. Since most cases of arthritis develop in people with psoriasis, new screening tools, both clinical and imaging, are available. Some genetic factors may also explain susceptibility and severity. Historically, five clinical subgroups have been described but these may be simplified to axial and peripheral involvement, the latter dividing into oligo- and polyarticular patterns. The importance of these clinical subdivisions is still under debate and research but it is clear that there is marked heterogeneity in all manifestations of this disease. In recent times the importance of extra-articular features has gained prominence such that the metabolic syndrome and cardiovascular morbidity are now seen as important features of ’psoriatic disease’. The diverse changes seen in bone on imaging reflect both the underlying pathogenic mechanisms and the ways in which the disease progresses. Recent work with animal models and immunohistochemistry has further advanced our understanding of these features. In the biologic era renewed interest in psoriatic arthritis has stimulated research into outcome assessment and permitted clearer understanding of how these new drugs work on the different aspects of the disease. In addition, improved recognition of the impact of the disease on the person has stimulated the development of new patient-reported outcome tools.
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Reinecke, Holger. Epidemiology and global burden of peripheral arterial disease and aortic aneurysms. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0068.
Full textAbstract:
Peripheral artery disease (PAD) and aortic aneurysms are common diseases which show an increasing prevalence and incidence. From community-based trials assessing ankle–brachial indices, 2–4% of the general population have been shown to be affected by PAD, which increases up to 15% in those above 70 years of age. About 30–40% of the in-hospital cases with PAD have critical limb ischaemia and suffer from a 1-year mortality of 20–40%. Abdominal aortic aneurysms (AAAs) also show a relatively high prevalence of about 1–2% in the general population as found by large-scale, systematic duplex screening. Of these, about 5% come to hospital admittance with a ruptured AAA which is still associated with an in-hospital mortality of up to 50%. The prevalence of thoracic aortic aneurysms (TAAs) was reported to be at about 0.16–0.34% in selected subgroups of the general population. The incident cases of TAAs have risen from 10/100,000 cases in the late 1980s up to about 17/100,000 cases in the first decade of this millennium. It is noteworthy that PAD and aortic aneurysms as well as their associated co-morbidities remain in many cases underdiagnosed and undertreated. This leads to a high cardiovascular morbidity and mortality which could not be obviously markedly reduced in the recent decades. Since nearly all vascular disorders are systemic diseases, not only the specific vessel bed which leads to a presentation should be assessed but also all other possible vascular manifestations should be thoroughly examined to reduce adverse events.