In the American Heart Association’s Scientific Sessions 2021, the results of six clinical trials related to cardiovascular surgery were revealed. The PALACS trial demonstrated that posterior left pericardiotomy during open heart surgery was associated with a significant reduction in postoperative atrial fibrillation; the EPICCURE study found that injection of mRNA encoding vascular endothelial growth factor (VEGF-A mRNA) directly into the myocardium of patients undergoing elective coronary artery bypass grafting (CABG) improved patients’ heart function; the VEST trial once again proved the safety and potential value of external stent for vein graft. This article will interpret the above-mentioned three studies.
Objective To summarize and analyze the working experience of hospital performance evaluation and reporting system in America, so as to provide decision support to China on such work as establishing objective, scientific and effective hospital performance evaluation system, strengthening government’s supervision to health service, and promoting hospitals’ sound development.Methods American official websites and databases were searched to include relative policies, reports and documents on hospitals’ performance evaluation. Results Typical hospital performance evaluation and reporting system in America included National Healthcare Quality Report (NHQR), Consumer Assessment of Healthcare Providers and System (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS), Leapfrog Group Evaluation System and Thomson Reuters 100 Top Hospitals. Conclusion The enlightenments of American performance performance evaluation systems to China include: a) more attention should be paid to performance evaluation; b) combined evaluation models and results application methods should be considered; c) comparatively scientific evaluation methods and comprehensive evaluation contents should be established.
Hypertension is a strong risk factor for atherosclerotic cardiovascular disease (ASCVD), heart failure, and microvascular complications. Hypertension is common among patients with diabetes. Recently, the American Diabetes Association (ADA) published a new position statement which updated the assessment and treatment for hypertensive patients with diabetes. This interpretation is intended to help Chinese clinicians to understand the new ADA position statement.
The American Heart Association (AHA) released the 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality (2017 AHA guidelines update) in November 2017. The 2017 AHA guidelines update was updated according to the rules named " the update of the guideline is no longer released every five years, but whenever new evidence is available” in the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The updated content in this guideline included five parts: dispatch-assisted cardiopulmonary resuscitation (CPR), bystander CPR, emergency medical services - delivered CRP, CRP for cardiac arrest, and chest compression - to - ventilation ratio. This review will interpret the 2017 AHA guidelines update in detail.
In November 2019, the American Heart Association updated guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care. This update is not a comprehensive revision of the 2015 version. The updates for children and newborns mainly include three aspects: ① Pediatric basic life support: A. It is recommended that emergency medical dispatch centers offer dispatcher-assisted CPR instructions for presumed pediatric cardiac arrest. B. It is recommended that emergency dispatchers provide CPR instructions for pediatric cardiac arrest when no bystander CPR is in progress. ② Pediatric advanced life support: A. The bag-mask ventilation is reasonable compared with advanced airway interventions (endotracheal intubation or supraglottic airway) in the management of children during out-of-hospital cardiac arrest (OHCA). B. The extracorporeal CPR may be considered for pediatric patients with cardiac diagnoses who have in-hospital cardiac arrest (IHCA) in settings with existing extracorporeal membrane oxygenation protocols, expertise, and equipment. C. Continuous measurement of core temperature during targeted temperature management is recommended; for infants or children between 24 hours and 18 years of age who remain comatose after OHCA or IHCA, targeted temperature management is recommened. ③ Neonatal resuscitation: A. In term and late-preterm newborns (≥35 weeks of gestation) receiving respiratory support at birth, the initial use of 21% oxygen is reasonable. B. One hundred percent oxygen should not be used to initiate resuscitation because it is associated with excess mortality. C. In preterm newborns (<35 weeks of gestation) receiving respiratory support at birth, it may be reasonable to begin with 21% to 30% oxygen.
American Heart Association (AHA) updated the advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest in the AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care in November 2018. Based on the latest progress of relative evidence-based clinical evidence and 2015 AHA guidelines for cardiopulmonary resuscitation and cardiovascular emergency cardiovascular care. This update gave recommends on the use of antiarrhythmic drugs during resuscitation from adult shock-refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) cardiac arrest and immediately after restoration of spontaneous circulation following shock-refractory VF/pVT cardiac arrest, respectively. This review aims to interpret this update by reviewing the literature and comparing the recommends in this update with other guidelines.
The Standards of Medical Care in Diabetes released by the American Diabetes Association (ADA) is one of the most important guidelines for clinicians. Based on the latest evidence of clinical studies, the Standards of Medical Care in Diabetes is annually updated by ADA. The statements of ADA on diagnosis, assessment, and management in diabetes are recommended for clinicians, patients, and researchers. The latest edition of Standards of Medical Care in Diabetes was published in a supplementary issue of Diabetes Care in January 2018. This interpretation will focus on the updated contents and their best evidence and clinical importance in this guideline.
Cardiovascular disease is the number one cause of death worldwide. A large body of epidemiologic evidence suggests that regular physical activity (PA) and high levels of cardiorespiratory fitness can prevent the progression of atherosclerotic cardiovascular disease and reduce the incidence of cardiovascular events. "Physical activity, cardiorespiratory fitness, and cardiovascular health: a clinical practice statement of the ASPC" released in December, 2022 by the American Society for Preventive Cardiology (ASPC) and provided the most up-to-date guidance on the associations and mechanisms between PA and cardiorespiratory fitness, the development of exercise prescriptions, and exercise-associated cardiovascular risk. In this article, the main content of this guideline was interpreted, aiming to develop a more scientific exercise prescription for patients with cardiovascular disease.
In November 2018, the American Heart Association (AHA) updated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Rather than a comprehensive revision of the 2015 edition guidelines, the 2018 AHA guidelines update was updated again according to the rule " the update of the guideline is whenever new evidence is available”, providing the evidence review and treatment recommendation for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. The Pediatric Task Force of the International Liaison Committee on Resuscitation updated the guideline, reaffirming the 2015 pediatric advanced life support guideline recommendation that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.
Cutaneous squamous cell carcinoma (cSCC) is the second most common human skin tumor. In recent years, the incidence of cSCC is increasing annually. Although most cSCC is curable after basic treatment, the advanced cSCC progresses rapidly and poses a significant risk for the impact on quality of life and death. In 2017, the latest version of cSCC management guideline was developed by the American Academy of Dermatology (AAD) based on extensive evidence-based medical evidence, including cSCC biopsy techniques, histopathological assessment, clinical staging and grading, surgical and nonsurgical treatment, follow-up, recurrence prevention, and management of the advanced cSCC. The purpose of this article is to briefly introduce and interpretate this guideline.
