• Title/Summary/Keyword: Cardiac Health

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Effect of National Implementation of Telephone CPR Program to Improve Outcomes from Out-of-Hospital Cardiac Arrest: an Interrupted Time-Series Analysis

  • Lee, Yu Jin;Hwang, Seung-sik;Shin, Sang Do;Lee, Seung Chul;Song, Kyoung Jun
    • Journal of Korean Medical Science
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    • v.33 no.51
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    • pp.328.1-328.12
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    • 2018
  • Background: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. Methods: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. Results: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1-3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3-2.9 [1.6%]; 1.4-1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. Conclusion: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.

The Influence of Maximal Aerobic Capacity on the Two Years Cardiac Related Re-Hospitalization in Patients with Heart Failure with Reduced Ejection Fraction in Korean Society

  • Ryu, Ho Youl;Hong, Do Sun;Kim, Tack Hoon
    • The Journal of Korean Physical Therapy
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    • v.31 no.5
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    • pp.322-327
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    • 2019
  • Purpose: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society. Methods: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%). Results: The relative peak $VO_2$ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio ($VCO_2/VO_2$, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO2 slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak $VO_2$ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by $VCO_2/VO_2$ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization. Conclusion: The maximal aerobic capacity, especially the relative peak $VO_2$, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.

Effects of the COVID-19 Pandemic on Cardiac Surgery Practice and Outcomes

  • Gopal, Kirun;Krishna, Neethu;Jose, Rajesh;Biju, Surya Sree Chitra;Pichandi, Jaya Suriya;Varma, Praveen Kerala
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.61-68
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    • 2022
  • Background: While the coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of health care, its impact on cardiac surgical practice and outcomes is yet to be determined. We compared the outcomes of our cardiac surgical practice from the past year during the pandemic to those in a similar pre-pandemic period. Methods: Retrospective data were collected from 307 patients who were involved in all adult cardiac surgical procedures performed between March 2020 and February 2021, which was considered the pandemic period, at Amrita Institute of Medical Sciences, India. These were compared with data from the 1-year period between March 2019 and February 2020. During that earlier period, 491 patients underwent surgery, and the surgical outcomes were assessed. Outpatient visit data were also collected to evaluate the effect of COVID-19 on outpatient follow-up visits. Results: A 37% decrease in surgical case volume was observed during the study period. No difference was found in operative mortality between the 2 time periods (3.3% vs. 2.6%, p=0.383). Overall postoperative complications were less frequent during this period, at 23% compared to 38% the previous year (p<0.001). Conclusion: The COVID-19 pandemic caused a dramatic decrease in surgical volume and outpatient medical follow-up. However, the pandemic and its attendant social restrictions did not yield a significant change in the surgical outcomes of our patients. Hence, it is reasonable to continue cardiac surgical care during global health crises, and this can be done with good results.

Implementation of Real-time Heart Activity Monitoring System Using Heart Sound (심음을 이용한 실시간 심장 활동 상태 모니터링 시스템 구현)

  • Kim, Jin-Hwan;Noh, Yun-Hong;Jeong, Do-Un
    • Journal of the Institute of Convergence Signal Processing
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    • v.19 no.1
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    • pp.14-19
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    • 2018
  • Recently, the smart health care industry has been rising rapidly and interest and efforts for public health have been greatly increased. As a result, the public does not visit medical specialists and medical facilities, but the desire to check their health condition in everyday life is increased. Therefore, many domestic and foreign companies continuously research and develop wearable devices that can measure body activity information anytime and anywhere And the market. Especially, it is used for heart activity measurement device using pulse wave sensor and electrocardiogram sensor. However, in this study, a monitoring system that can detect cardiac activity using cardiac sounds, heart sound measurement rather than pulse wave measurement and electrocardiogram measurement, was performed and its performance was evaluated. Experimental results confirmed the predictability of cardiac heart rate and heart valve disease during daily living.

Testing of Common Electromagnetic Environments for Risk of Interference with Cardiac Pacemaker Function

  • Tiikkaja, Maria;Aro, Aapo L.;Alanko, Tommi;Lindholm, Harri;Sistonen, Heli;Hartikainen, Juha E.K.;Toivonen, Lauri;Juutilainen, Jukka;Hietanen, Maila
    • Safety and Health at Work
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    • v.4 no.3
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    • pp.156-159
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    • 2013
  • Background: Cardiac pacemakers are known to be susceptible to strong electromagnetic fields (EMFs). This in vivo study investigated occurrence of electromagnetic interference with pacemakers caused by common environmental sources of EMFs. Methods: Eleven volunteers with a pacemaker were exposed to EMFs produced by two mobile phone base stations, an electrically powered commuter train, and an overhead high voltage transmission lines. All the pacemakers were programmed in normal clinically selected settings with bipolar sensing and pacing configurations. Results: None of the pacemakers experienced interference in any of these exposure situations. However, often it is not clear whether or not strong EMFs exist in various work environments, and hence an individual risk assessment is needed. Conclusions: Modern pacemakers are well shielded against external EMFs, and workers with a pacemaker can most often return to their previous work after having a pacemaker implanted. However, an appropriate risk assessment is still necessary after the implantation of a pacemaker, a change of its generator, or major modification of its programming settings.

A survived case after 150J defibrillation and CPR were performed for out-of-hospital infant cardiac arrest (병원 전 영아 심정지 환자에서 150J 제세동과 심폐소생술 시행 후 생존한 1례)

  • Yun, Hyeong-Wan;Hong, Soo-Mi;Jeon, Yoon-Chul;Lee, Jae-Min
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.3
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    • pp.53-60
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    • 2013
  • Purpose: The purpose of the study is to emphasize the importance of out-of-hospital cardiac arrest resuscitation. This resuscitation by paramedic is very effectively performed under the medical direction of the doctors. Methods: The cardiac arrest victim was 4 month old infant. Informed consent from the parents of the infant was received. CPR combined with 150J defibrillation was performed to the 4 month old infant. Results: We reported that the 4 month old infant survived the cardiac arrest. Out-of-hospital cardiac arrest infant survived after 150J automated external defibrillator and CPR performance. Conclusion: Specific operative protocol is important because the paramedic can apply the proper manual defibrillator effectively. It is important to extend the work scpoe of the EMT.

Clinical Effects of Preoperative treated-Methylprednisolone in Pediatric Cardiac Surgery with Cardiopulmonary Bypass

  • Choi Seok-Cheol;Kim Yang-Weon;Jang Jung Hoon
    • Biomedical Science Letters
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    • v.11 no.3
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    • pp.407-416
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    • 2005
  • Cardiopulmonary bypass (CPB) for cardiac surgery induces the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that causes postoperative major organ dysfunctions. We performed a randomized, prospective study to investigate clinical effects of preoperative treated-methylprednisolone for preventing inflammation in pediatric cardiac surgery with CPB. Thirty pediatric patients scheduled for elective cardiac surgery were randomized to either control(n=15) or steroid group (n=15, 10 mg/kg of methylprednisolone). Arterial blood samples were taken before and after the operations for measuring total leukocyte (T-WBC) and differential counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), neuron specific enolase (NSE), troponin-I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine levels. Postoperative parameters such as pulmonary index (PI, $PaO_2/FiO_2$), 24 hrs and total bleeding volumes, mechanical ventilating (MVP) and intensive care unit (ICU)-staying periods, and hospitalization were assessed. T-WBC, neutrophil fraction, IL-6, MPO, NSE, TNI, AST and creatinine levels, bleeding volumes, PI, and MVP at the postoperative periods were lower or shorter in steroid group than in control group (P<0.05). These findings indicated that preoperative administration of methylprednisolone attenuated CPB-induced inflammatory reactions, contributing to postoperative recovery of patients underwent cardiac surgery.

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Portable Electrocardiograph and Smart Device-based Heart Health Monitoring and Risk Notification System (휴대용 심전도 측정기와 스마트 기기 기반의 심건강 모니터링 및 위험도 알림 시스템)

  • Cho, Jinsoo
    • Journal of the Semiconductor & Display Technology
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    • v.12 no.2
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    • pp.73-78
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    • 2013
  • This paper proposes a portable electrocardiograph and smart device-based heart health monitoring and risk notification system. The proposed system consists of a portable electrocardiograph and a smart device for a system user, and a web-based monitoring system for observers. This system can improve the convenience and efficiency of measurement by using a light-weight portable electrocardiograph and a smart device. In addition, any authorized person such as caregiver or family member who is not related to medical institution can monitor users'heart health in real-time using the web-based monitoring system. Therefore, a user and authorized remote observers can efficiently monitor and manage user's heart health in daily-life even without any medical institution's help, and can preemptively deal with any possible dangerous situations, such as degeneration of a cardiac disorder and sudden cardiac death.

Use of Defibrillator(AED) on Prehospital Cardiac Arrests (심정지 환자 이송 시 구급대원의 자동제세동기 사용현황)

  • Koh, Bong-Yeun;Choi, Yong-Chul;Lee, Jae-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.10 no.2
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    • pp.53-62
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    • 2006
  • Purpose: There has been an increase in the number of prehospital cardiac arrests due to the increasing number of cardiovascular diseases and the increase in the average age of the population. We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrests. Methods: This studied 159 victims with prehospital cardiac arrests(VF or VT rhythm) by EMT's Reports from January to August, 2005. Results: 108 of 159 victims(67.9%) were shocked by AED. Eighty of 159 victims(50.9%) were recorded with AED shock in prehospital cardiac arrests. A number of shocks is averaged 2.19; 46.2% of one-shock and 86.1% of 1-3 shock. EMS first-tier response interval from time of dispatch to scene arrival was 5.88 minutes, from scene arrival to scene start was 7.36 minutes, from scene start to hospital admission was 9.91 minutes and from scene arrival to AED shock was 6.84 minutes. EMT provided advanced care to prehospital cardiac arrests: 97.5% in CPR, 10.1% in advanced airway management, 67.9% in AED shock. Conclusion: With the increase in cardiovascular disease and old age, the number of prehospital cardiac arrests has risen gradually. However, there were lack of CPR by bystander, defibrillation and advanced cardiac life support(ACLS) in prehospital stage. To improve the adequacy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

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The Relationship between Health Belief.Self-efficacy and Exercise.Diet Compliance in Coronary Heart Disease Patients (관상동맥질환자의 건강신념 및 자기효능감과 운동 및 식이요법 이행과의 관계)

  • Nam, Myung-Hee;Kim, Chung-Nam;Oh, Yun-Jung
    • Research in Community and Public Health Nursing
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    • v.8 no.2
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    • pp.262-276
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    • 1997
  • This study evaluates the relationship between health belief. self-efficacy and exercise and diet compliance in coronary heart disease patients. The study subjects were 96 CHD patients who visited the outpatient clinic at 3 general hospitals in Taegu city from April 3, 1997 to May 3, 1997. Data was collected by the researcher and two registered nurses who work at a cardiac outpatient clinic. Face-to-face interview was conducted. Moon's health belief scale(l990) and Hicky and others' Cardiac Diet Self-Efficacy Instrument (CDSEI, 1992), Cardiac Exercise Self-Efficacy Instrument (CESEI, 1992) were used. The instrument developed by the researcher based on the reference review was used to measure exercise and diet compliance. The data were analyzed by using descriptive statistics, Pearson correlation coefficient, t-test, ANOVA, Tukey verification and Stepwise multiple regression with the SAS program. The results of this study were as follows; 1. The degree of health belief(score range: 1-4) perceived benefit: 3.06 barrier: 2.04 severity: 2.93 2. The degree of self-efficacy(score range: 1-5) exercise self-efficacy: 2.91 diet self-efficacy: 3.32 3. The degree of compliance (score range: 1-4) exercise compliance: 2.34 diet compliance: 2.95 4. The exercise compliance had a positive correlation with perceived benefit(r=0.5327, p=0. 0001), severity(r=0.2780, p=0.0061), exercise self-efficacy(r=0.6675, p=0.0001), and a negative correlation with barrier{r= -0.4236, p=0.0001). The diet compliance had a positive correlation with perceived benefit (r=0.6439, p=0.0001), severity(r=0.4244, p=0.0001), diet self-efficacy(r=0.6629, p=0.0001), and a negative correlation with barrier{r= -0.5098, p=0.0001). 5. According to pt's education level, (F=3.02, p=0.0336), received massage from mass media on exercise and diet(t=3.81, p=0.0002), presence of cardiac patients in the family members or friends(t=2.00, p=0.0478), created significant differences in exercise compliance. According to occuption(F=3.03, p=0.0215), hospitalized experience(t=4.59, p=0.0000), presence of chest pain(t=3.63, p=0.0005), there was also a significant difference in diet compliance. 6. The combination of exercise self-efficacy, perceived benefit and pt's education level explained 50.18% of the variance in exercise compliance. The combination of diet self-efficacy, perceived benefit and barrier explained 56.76% of the variance in diet compliance. On the basis of the above findings, the follow ing recommendations are suggested: 1. To promote the exercise. diet compliance for CHD patients, a well organized health teaching and nursing intervention program should be developed. 2. More research is needed to investigate other variables affecting exercise and diet compliance of CHD patients. 3. To promote self-efficacy and a positive health belief in CHD patients, a well organized and an approachable nursing intervention program should be developed. 4. Factors other than diet. exercise compliance should be evaluated to discover the impact on CHD patients.

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