Bold Voices - August 2012 - (Page 15)

AT THE BEDSIDE Minimally Invasive Heart Valve Procedure Increases Patients’ Survival Patients with aortic stenosis have a higher survival rate with catheterbased heart valve replacement than with standard medical therapy, fi nds a study in The New England Journal of Medicine. “Two-Year Outcomes After Transcatheter or Surgical Aortic-Valve Replacement” notes that aortic stenosis affects an estimated 2 to 9 percent of U.S. adults ages 65 and older and requires open-heart surgery to repair the malfunctioning valve. One-third of those diagnosed have Two-year study compares minimally co-existing conditions invasive heart valve replacement and are too ill to undergo with medical treatment regimen. the surgery. Photo: University of Chicago Medicine Typically, they die from heart failure within five years or less, which is why minimally invasive procedures offer patients at high risk a viable treatment to extend their life. “The heart’s valves wear out as you age. And the older you are generally makes you a less attractive candidate for open heart surgery,” says director Eduardo Marbán of Cedars-Sinai Heart Institute, Los Angeles, in study information. Transcatheter aortic-valve implantation involves inserting a catheter through a small incision in the groin or the side of the chest. When the catheter reaches the heart, a balloon within an enclosed compressed artificial aortic valve is inflated, popping the valve open like an umbrella. The randomized two-year clinical trial at 21 medical centers studied 358 patients diagnosed with aortic stenosis that was too severe for surgery. One group of patients underwent less invasive procedures such as catheter-based heart valve replacement surgery. The other group received standard treatment that included prescription drugs. At the conclusion of the study, 68 percent of patients who received standard treatment died compared to 43 percent who underwent the less invasive procedures. Prepregnancy Obesity, Child Test Scores Linked Women who are obese before they become pregnant are at higher risk of giving birth to children with lower cognitive function — as measured by math and reading tests taken between ages 5 to 7 years — than are mothers with a healthy prepregnancy weight, according to a study published online in Maternal and Child Health Journal. “The Impact of Prepregnancy Obesity on Children’s Cognitive Test Scores” notes that prepregnancy obesity was associated, on average, with a three-point drop in reading scores and a two-point reduction in math scores on a commonly used test of children’s cognitive function. This large observational study, conducted at The Ohio State University (OSU), Columbus, included data on 3,412 U.S. children aged 60-83 months from the National Longitudinal Survey of Youth 1979 Mother and Child Survey. Previous research has suggested that a woman’s prepregnancy obesity can have a negative effect on fetal organs. Because fetal development is rapid and sensitive to a mother’s physiological characteristics, the researchers sought to determine whether a mother’s obesity also could affect the fetal brain. “The new piece here is we have a measure associated with the fetus’s environment to add to other potential risk factors,” Pamela Salsberry, senior author of the study and professor of nursing at OSU, says in a related Science Daily article. “If we have a good way to understand the risks each child is born with, we could tailor the postbirth environment in such a way that they could reach their maximum capabilities,” she adds. AACN BOLD VOICES AUGUST 2012 15

Table of Contents for the Digital Edition of Bold Voices - August 2012

Front/Digital Edition Viewing Guide
Another Angle
‘AACN CSI Academy’ National Leadership Program Launches
Canadian Dynamics 2012: ‘Speak Up, Speak Out’
Grana Padano May Lower Blood Pressure
New Medicare Patient Satisfaction Requirement Misses Mark, Nurse Argues
FDA, The Joint Commission Aim to Reduce Alarm Fatigue
Fast Food in Hospitals Counters Goal of Healthy Eating
New Federal Hospital Visitation Standards
Nurse Obesity Linked to Long Hours
First-Ever Nurses Float Joins the 2013 Tournament of Roses Parade
AMA Urges Greater Focus on Ambulatory Patient Safety
Minimally Invasive Heart Valve Procedure Increases Patient Survival
Older Patients' in ICU at High Risk for HAI
Tele-ICU Symposium Explores Leading-Edge Technology
In Our Journals
Certification Capsules
Dare To
Contribute to the Evidence: Apply for an AACN Research Grant by Nov. 1
From the President

Bold Voices - August 2012