8 results on '"Melissa McCabe"'
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2. Evaluation of a survey for acute care programme directors on the utilisation of point-of-care ultrasound
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Briahnna Austin, Stephanie James, Annie Wang, Esther Gow-Lee, Melissa McCabe, Davinder Ramsingh, Dustin Wailes, and Vi Am Dinh
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medicine.medical_specialty ,Point-of-Care Systems ,Specialty ,Certification ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Documentation ,030202 anesthesiology ,Acute care ,medicine ,Internal Medicine ,Humans ,Child ,Curriculum ,Ultrasonography ,business.industry ,Point of care ultrasound ,Internship and Residency ,General Medicine ,medicine.disease ,Institutional review board ,Medical emergency ,business - Abstract
Purpose Point-of-care ultrasound (POCUS) is ultrasound brought to the patient's bedside and performed in ‘real time’ by the healthcare provider. The utility of POCUS to facilitate management of the acutely ill patient has been demonstrated for multiple pathologies. However, the integration of ultrasonography and echocardiography training into residency curriculum varies across the acute care specialties. Study design After an institutional review board approval, anaesthesiology, emergency medicine, family medicine, internal medicine, paediatrics and general surgery programme directors (PDs) were surveyed. The survey consisted of 11 questions evaluating the primary bedside assessment tool for common acute care situations, POCUS topics that the PDs were comfortable practising and topics that the PDs felt were useful for their specialty. Barriers to POCUS use, certification and documentation were also surveyed. Results Overall, 270 PD surveys were completed. The preferred primary assessment tool for common acute care situations varied with specialty; emergency medicine PDs consistently responded that POCUS was the diagnostic modality of choice (p Conclusions This study is the first to evaluate differences in the preferred initial bedside assessment tool between the acute care specialties. Although POCUS is a superior tool for evaluating acute pathologies, disconnect between education and utilisation remains. This study highlights the need to incorporate POCUS into the acute care specialty curriculum. more...
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- 2021
Catalog
3. Real-time echocardiographic guidance for confirming septal placement of right ventricular leads: A pilot study
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Tahmeed Contractor, Elyse Guran, Manshu Yan, Melissa McCabe, and Uoo Kim
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medicine.medical_specialty ,030204 cardiovascular system & hematology ,cardiac implantable electronic device ,03 medical and health sciences ,transthoracic echocardiography ,0302 clinical medicine ,Primary outcome ,medicine ,Fluoroscopy ,Diseases of the circulatory (Cardiovascular) system ,030212 general & internal medicine ,Lead (electronics) ,medicine.diagnostic_test ,business.industry ,Point of care ultrasound ,point of care ultrasound ,fluoroscopy ,body regions ,RC666-701 ,right ventricular lead ,Radiology ,Transthoracic echocardiogram ,Cardiology and Cardiovascular Medicine ,business ,Lead Placement ,Rapid Communication - Abstract
Introduction Accuracy of fluoroscopy in predicting septal placement of the right ventricular (RV) leads is poor. This pilot study evaluated the feasibility and impact of real‐time transthoracic echocardiogram (TTE) during RV lead placement. Method Consecutive patients undergoing transvenous RV lead placement and had a point of care ultrasound team available for TTE guidance were included in the study. TTE was performed to confirm or refute the septal position of RV lead initially positioned using fluoroscopy; leads were repositioned until a septal position was confirmed on TTE. The primary outcome measured was whether the use of TTE resulted in lead repositioning. Result Among the 26 patients included in the study, real‐time TTE during RV lead placement resulted in reposition of the lead to a septal position in 38.5% of patients. Conclusion Use of real‐time TTE guidance during fluoroscopic RV lead placement is feasible and can aid in confirming a septal position., Pilot study evaluating the feasibility and impact of real‐time transthoracic echocardiogram during cardiac implantable electronic device (CIED) right ventricular lead placement. more...
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- 2021
4. Neuroendovascular Treatment of Acute Stroke during Covid-19: A Guide from the Frontlines
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Randi Collinson, Melissa McCabe, Ike Thacker, Bryan Pukenas, Colin Hoey, Mougnyan Cox, Robert W. Hurst, Kennith F. Layton, Jessica Lehmann, Preethi Ramchand, David Kung, and Neda I. Sedora-Roman
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,acute stroke ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,coronavirus ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,mechanical thrombectomy ,0302 clinical medicine ,PPE, Personal Protective Equipment ,ACT, Activated Clotting Time ,ICU, Intensive Care Unit ,medicine ,Advanced and Specialised Nursing ,Myocardial infarction ,Acute stroke ,Coronavirus ,Advanced and Specialized Nursing ,CTA, Computed Tomography Angiography ,Radiological and Ultrasound Technology ,business.industry ,EMS, Emergency Medical Services ,IV, Intravenous Catheter ,COVID-19 ,CT, Computed Tomography ,medicine.disease ,radiology nurses ,NIHSS, National Institutes of Health Stroke Severity Scale ,Mechanical thrombectomy ,Increased risk ,Emergency medicine ,tPA, Tissue Plasminogen Activator ,business ,Loss of life - Abstract
Since the initial reports surfaced of a novel Coronavirus causing illness and loss of life in Wuhan, China, COVID-19 has rapidly spread across the globe infecting millions and leaving hundreds of thousands dead. As hospitals cope with the influx of COVID-19 patients, new challenges have arisen as healthcare systems care for COVID-19 patients while still providing essential emergency care for patients with acute strokes and acute myocardial infarction. Adding to this complex scenario are new reports that COVID-19 patients are at increased risk of thromboembolic complications including strokes. In this paper, we detail our experience caring for acute stroke patients, and provide some insight into neurointerventional workflow modifications that have helped us adapt to the COVID-19 era., Highlights: • COVID-19 continues its relentless march through the United States and the globe, presenting unique challenges for healthcare providers as they treat other emergent conditions while minimizing the risk of COVID-19 exposure and infection. • Acute stroke is especially challenging during the COVID-19 due to time constraints required for effective mechanical thrombectomy to improve neurologic outcomes and survival in patients whose COVID infection status is unknown. • The institutional protocol for mechanical thrombectomy described in this article may help inform models at other centers as they prepare for their respective COVID peaks more...
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- 2020
5. Appropriate Delivery of Antitachyarrhythmia Therapy Despite Magnet Placement Over Implanted Cardioverter-Defibrillator: A Case Report
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Ryan C Tone, Carin R Mascetti, Melissa McCabe, Vishal K Gajendran, and Tahmeed Contractor
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Inappropriate shock ,business.industry ,Case Report ,General Medicine ,Perioperative ,medicine.disease ,equipment and supplies ,Monopolar electrosurgery ,Electromagnetic interference ,Defibrillators, Implantable ,Cardioverter-Defibrillator ,Magnet ,Magnets ,Medicine ,Humans ,Medical emergency ,business ,human activities - Abstract
The fundamental perioperative concern for patients with implantable cardioverter-defibrillators (ICDs) is the potential for electromagnetic interference (EMI) from monopolar electrosurgery. The ICD may interpret electromagnetic signals as a tachyarrhythmia and deliver an inappropriate shock to the patient. Magnet placement is often used to avoid this problem since a magnet will often deactivate an ICD's tachyarrhythmia therapy. We report a case in which magnet placement over an ICD failed to suspend tachyarrhythmia therapy because of imprecise magnet positioning. This case demonstrates the possibility for error when relying on a magnet to suspend tachyarrhythmia therapies. more...
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- 2021
6. MULTIDISCIPLINARY APPROACH AND BEST PRACTICES FOR USE OF PERCUTANEOUS VENTRICULAR ASSIST DEVICE FOR HIGH RISK VENTRICULAR TACHYCARDIA ABLATION
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Rahul Bhardwaj, Ravi Mandapati, Hyungjin Myra Kim, Dmitry Abramov, Anthony Hilliard, Antoine Sakr, Aditya Bharadwaj, Tahmeed Contractor, Melissa McCabe, and Amrit Kanwar
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medicine.medical_specialty ,Percutaneous ,Ventricular tachycardia ablation ,business.industry ,Multidisciplinary approach ,Ventricular assist device ,medicine.medical_treatment ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
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7. Left ventricular endocardial and epicardial strain changes with apical myocardial ischemia in an open-chest porcine model
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Aman Mahajan, Melissa McCabe, Einat Mazor, Wei Zhou, Alexander Cheng, Kentaro Yamakawa, Kimberly Howard-Quijano, and Jennifer Scovotti
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Cardiovascular Conditions, Disorders and Treatments ,medicine.medical_specialty ,Myocardial ischemia ,Physiology ,Swine ,Ischemia ,Myocardial Ischemia ,Strain (injury) ,Blood Pressure ,ischemia ,030204 cardiovascular system & hematology ,Anterior Descending Coronary Artery ,03 medical and health sciences ,Ventricular Dysfunction, Left ,left ventricular function ,0302 clinical medicine ,strain ,Heart Rate ,Physiology (medical) ,Internal medicine ,Occlusion ,Medicine ,Animals ,030212 general & internal medicine ,cardiovascular diseases ,Endocardium ,Original Research ,Ejection fraction ,business.industry ,Heart ,medicine.disease ,Biomechanical Phenomena ,Disease Models, Animal ,Echocardiography ,Cardiology ,business ,Radial stress - Abstract
Early detection of acute myocardial ischemia is critical to prevent permanent myocardial damage. The impact of apical ischemia on global left ventricular (LV) function can be difficult to characterize using traditional volume‐based echocardiography measures. Myocardial strain imaging is a sensitive, quantitative marker of myocardial deformation that can measure ventricular function. Recent advances allow layer‐specific measurement of endo‐ and epicardial strain, enhancing the ability to evaluate myocardial ischemia. This study investigates the effects of apical ischemia on LV function using epi‐ and endocardial strain. We hypothesize that myocardial strain will identify changes in regional and global myocardial function associated with focal apical ischemia as compared to ejection fraction (EF), and that longitudinal strain will be a better indicator of myocardial dysfunction compared to circumferential or radial strain. In a porcine model (n = 9), acute ischemia was induced by left anterior descending coronary artery occlusion. Echocardiograms were performed at baseline, during 15‐min ischemia, and after reperfusion. Global longitudinal strain decreased with acute focal ischemia of the left ventricular apical region (baseline: −16.4% vs. ischemia: −12.2%; P = 0.010), with no change observed in global circumferential and radial strain or EF. Both endocardial and epicardial longitudinal strain decreased by 68% (P more...
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- 2016
8. Speckle-Tracking Strain Imaging Identifies Alterations in Left Atrial Mechanics With General Anesthesia and Positive-Pressure Ventilation
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Melissa McCabe, Einat Mazor, John Anderson-Dam, Michael O. Hall, Aman Mahajan, and Kimberly Howard-Quijano
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Male ,medicine.medical_specialty ,Strain (injury) ,Anesthesia, General ,Contractility ,Positive-Pressure Respiration ,Left atrial ,Internal medicine ,Medicine ,Humans ,Heart Atria ,Prospective Studies ,Prospective cohort study ,Positive pressure ventilation ,Aged ,business.industry ,Mechanics ,Middle Aged ,medicine.disease ,Cardiac surgery ,Preload ,Anesthesiology and Pain Medicine ,Echocardiography ,Anesthesia ,Breathing ,Cardiology ,Atrial Function, Left ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
The primary aim of this study was to use speckle-tracking strain imaging to evaluate the effect of general anesthesia (GA) and positive-pressure ventilation (PPV) on left atrial (LA) mechanics. The authors hypothesized that GA and PPV would be associated with a decrease in LA strain. The secondary aims were to investigate the effects of GA and PPV on traditional Doppler-derived measures of LA function and Doppler echocardiographic grade of diastolic function.A prospective observational study.A university hospital.Adult patients undergoing cardiac surgery.Transthoracic echocardiography was performed at baseline and under GA with PPV.Changes in LA function associated with GA and PPV were assessed using LA speckle-tracking strain imaging. A reduction was observed in LA peak longitudinal strain (24% v 18%, p0.001) and preatrial contraction strain (13% v 8%, p0.001). No difference was seen in LA contraction strain or atrial ejection fraction. Indexed LA volume and Doppler diastolic indices also were reduced significantly, and 39% of patients had a change in measured diastolic grade under GA with PPV.Speckle-tracking strain imaging of the left atrium demonstrated that GA and PPV had a significant impact on LA mechanics by decreasing strain measures of LA preload, with a lesser effect on LA contractility. more...
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- 2014
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