The Health Care System Structure
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The study and practice of medicine is generally structured on me basis of the various-specialties designated within the health care field. As will be noted from the listing of medical specialties in Table 2.1, most end with the suffix-logy, 'meaning "the study or science of" the specialty. Likewise, the individuals who practice in these fields are denoted by the suffix-ist or -I agist meaning "one who" and- "one who studies/' For example, given that the root word for heart is cardio, a cardiologist is one who practices (studies) in thefield on cardiology, treatment of heart disease.
Using Digital Health Technology to Promote Cardiovascular Disease Risk Reduction in Secondary Prevention
James M. Rippe in Lifestyle Medicine, 2019
Modern-day cardiovascular medicine is a “high tech” industry.13 According to a 2017 report of the ACC Task Force on Health Policy Statements and Systems of Care,14 key recent technologic innovations of paramount importance for the future transformation of cardiovascular care include: (1) digital health, with smartphone, wearable, sensor-based, and other electronic technologies; (2) big data, comprising the aggregation of large quantities of structured and unstructured health information and sophisticated analyses with artificial intelligence, machine learning, and natural language processing techniques; and (3) precision health, using approaches aimed at the identification of individual-level risks and the determinants of wellness and pathogenicity. The intra- and inter-connections among emerging innovations and developments in digital health, big data, and precision health, as summarized by the ACC, are shown in Figure 61.1. In this chapter, we focus primarily on the use of digital health to promote CVD risk reduction.
Endomyocardial biopsy: indications and procedures
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
Disorders of the heart muscle remain among the most poorly understood disease processes in all of cardiovascular medicine. Endomyocardial biopsy techniques have now been available for over 50 years to evaluate underlying primary myocardial pathology. Cardiac biopsy has been particularly useful in establishing diagnosis and prognosis in patients with recent-onset or rapidly deteriorating cardiomyopathy and in monitoring patients for rejection after cardiac transplantation. The role of endomyocardial biopsy continues to evolve as novel molecular and genetic analyses are being performed on biopsy specimens. This chapter will review the history of endomyocardial biopsy, define the anatomic considerations and basic biopsy technique, and discuss the indications, complications, and future directions of this important procedure.
Impact of multimorbidity and polypharmacy on the management of patients with atrial fibrillation: insights from the BALKAN-AF survey
Published in Annals of Medicine, 2021
Monika Kozieł, Stefan Simovic, Nikola Pavlovic, Aleksandar Kocijancic, Vilma Paparisto, Ljilja Music, Elina Trendafilova, Anca Rodica Dan, Zumreta Kusljugic, Gheorghe-Andrei Dan, Gregory Y. H. Lip, Tatjana S. Potpara
Data were collected using an electronic case report form (eCRF) designed by SAFA. The eCRF included patient characteristics, patient presentation and healthcare setting, diagnostic procedures undertaken within the last 12 months and at enrolment and AF management at enrolment and at discharge. Stroke risk was estimated using the CHA2DS2-VASc (congestive HF, hypertension, age ≥ 75 years, diabetes, stroke/transient ischaemic attack (TIA), vascular disease, age 65–74 years, sex category) score [8]. Bleeding risk was evaluated according to the HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio (INR), elderly (>65 years), drugs or alcohol concomitantly) score [8,17]. All the cardiovascular risk factors, diseases and risk scores definitions were defined according to individual European Society of Cardiology guidelines, other guidelines, scientific statements and textbooks presented previously in supplementary information [15].
Metabolic syndrome is associated to high-sensitivity cardiac troponin T elevation
Published in Biomarkers, 2019
Assi Milwidsky, Eyal Fisher, Rafael Y. Brzezinski, Michal Ehrenwald, Gabi Shefer, Naftali Stern, Itzhak Shapira, David Zeltser, Zach Rosenbaum, Dahlia Greidinger, Shlomo Berliner, Shani Shenhar-Tsarfaty, Ori Rogowski
The risk for cardiovascular morbidity is modifiable in its very early stages (Ponikowski et al.2016). Since metabolic risk factors also contribute to CVD progression and specifically to heart failure, major American and European cardiology societies advice routine follow-up and preventive steps for patients at high cardiovascular risk (Ponikowski et al.2016, Yancy et al.2017). Because not all of these patients will go on to develop overt heart failure or other CVD, more accurate and personalized risk assessment is needed. The findings of the ARIC sub-analysis suggest that hs-TnT testing can further refine risk stratification in patients with MetS. Our results corroborate this concept in that it establishes not only an association between Mets and hs-Tn but suggests a continuous relation between the metabolic burden (i.e. the number of MetS components) and hs-TnT in asymptomatic subjects.
Cardiac computed tomography in asymptomatic siblings of patients with premature coronary disease: illustrations and current knowledge
Published in Acta Cardiologica, 2020
Julien Higny, Michaël Dupont, Antoine Guédès
These clinical pictures exemplify that a family history of early-onset CAD may promote development and progression of subclinical coronary atherosclerosis in young asymptomatic individuals. Accordingly, preventive cardiology should develop its research to identify additional risk factors in susceptible individuals. In this regard, several previous genome-wide association studies have demonstrated the existence of genetic variants involved in the pathogenesis of coronary atherosclerosis [12,13]. Recently, researchers in molecular biology and genomics have suggested the polygenic contribution in subjects with premature CAD by demonstrating the association between early-onset CAD and higher genetic risk score (GRS) based on the presence of 182 independent genetic variants [14]. Hence, complementary models of risk prediction associating traditional risk factors and genetic markers may become useful for improving assessment of susceptibility to CAD in vulnerable patient populations. Thus, additional research is warranted to determine the precise impact of genetic testing in current clinical practice, both in terms of screening and risk prediction in young susceptible patients.
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