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  1. Article ; Online: SARS-CoV-2 pandemic and the cardiovascular system: What the non-cardiologist needs to know.

    Davis, Gershan K / Adlan, Ahmed / Majewski, Jacek / Ibrahim, Bassem

    Clinical medicine (London, England)

    2020  Volume 20, Issue 3, Page(s) 262–265

    Abstract: There has been the need to make major modifications to the way cardiology is practised in light of the COVID-19 pandemic. There has also been the need to recognise the complex cardiovascular manifestations and complications of COVID-19. In this article ... ...

    Abstract There has been the need to make major modifications to the way cardiology is practised in light of the COVID-19 pandemic. There has also been the need to recognise the complex cardiovascular manifestations and complications of COVID-19. In this article we provide guidance on the management of cardiac patients without COVID-19 in the current pandemic as well as patients with cardiac disease and COVID-19 and patients with cardiac complications of COVID-19. There is also a focus on indications and interpretation of commonly performed cardiac investigations in the setting of COVID-19. References are included from a number of specialist societies and groups.
    Keywords covid19
    Language English
    Publishing date 2020-05-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmed.2020-0158
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  2. Article: SARS-CoV-2 pandemic and the cardiovascular system: What the non-cardiologist needs to know

    Davis, Gershan K / Adlan, Ahmed / Majewski, Jacek / Ibrahim, Bassem

    Abstract: There has been the need to make major modifications to the way cardiology is practised in light of the COVID-19 pandemic. There has also been the need to recognise the complex cardiovascular manifestations and complications of COVID-19. In this article ... ...

    Abstract There has been the need to make major modifications to the way cardiology is practised in light of the COVID-19 pandemic. There has also been the need to recognise the complex cardiovascular manifestations and complications of COVID-19. In this article we provide guidance on the management of cardiac patients without COVID-19 in the current pandemic as well as patients with cardiac disease and COVID-19 and patients with cardiac complications of COVID-19. There is also a focus on indications and interpretation of commonly performed cardiac investigations in the setting of COVID-19. References are included from a number of specialist societies and groups.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #154966
    Database COVID19

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  3. Article ; Online: Trick or treat? Pseudohyperaldosteronism due to episodic licorice consumption.

    Wynn, Gareth J / Davis, Gershan K / Maher, Bridget

    Journal of clinical hypertension (Greenwich, Conn.)

    2011  Volume 13, Issue 3, Page(s) E3–4

    MeSH term(s) Arrhythmias, Cardiac/chemically induced ; Arrhythmias, Cardiac/etiology ; Female ; Glycyrrhiza/adverse effects ; Humans ; Hyperaldosteronism/chemically induced ; Hyperaldosteronism/complications ; Middle Aged ; Receptors, Mineralocorticoid/drug effects ; Risk Factors ; Time Factors
    Chemical Substances Receptors, Mineralocorticoid
    Language English
    Publishing date 2011-01-10
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 2077222-1
    ISSN 1751-7176 ; 1524-6175
    ISSN (online) 1751-7176
    ISSN 1524-6175
    DOI 10.1111/j.1751-7176.2010.00413.x
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  4. Article: Endocarditis in a large district general hospital: A study of the microbiological spectrum between 2000 and 2011.

    Ashrafi, Reza / McKay, Ewan / Ebden, Lloyd / Jones, Julia / Davis, Gershan K / Burgess, Malcolm I

    Experimental and clinical cardiology

    2013  Volume 17, Issue 4, Page(s) 175–178

    Abstract: Infective endocarditis is one of three common cardiac infections in the United Kingdom, in addition to myocarditis and pericarditis, with a reported incidence of 1.7 to 6.2 cases per 100,000 patient years. Infective endocarditis can often have serious ... ...

    Abstract Infective endocarditis is one of three common cardiac infections in the United Kingdom, in addition to myocarditis and pericarditis, with a reported incidence of 1.7 to 6.2 cases per 100,000 patient years. Infective endocarditis can often have serious consequences and a wide variety of organisms may be the causative pathogen. There are little published data regarding the exact spectrum of organisms that cause endocarditis in the United Kingdom and whether organisms such as streptococci still dominate. In the present study, all cases of endocarditis at the authors' institution, representing a typical nontertiary centre, were retrospectively examined and audited to provide a snapshot of the organism spectrum in these patients. The cases of more than 120 patients who were coded as having endocarditis by the institution's clinical coding department during the period between December 2000 and January 2011 were examined. Microbiological tests and clinical case notes of all patients were reviewed. Of the 101 patients diagnosed with and treated for endocarditis, 64 were male, with a mean age of 60.57 years. The most common organisms identified were Streptococcus species (31%), Staphylococcus aureus (27%) and Enterococcus faecalis (21%). The organisms with the highest associated mortality rate were S aureus and the 'other organism' group, which included non-HACEK group (Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella species) pathogens such as Candida albicans. Streptococcus species and S aureus remain the main cause of endocarditis in a typical hospital setting in the United Kingdom, although in a smaller proportion of cases than historical data suggests. Overall, mortality remains high, and the clinician should remain vigilant to endocarditis in any patient with a positive blood culture because the number of cases of endocarditis caused by less typical organisms are increasing.
    Language English
    Publishing date 2013-04-12
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2061162-6
    ISSN 1205-6626
    ISSN 1205-6626
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  5. Article ; Online: NICE recommendations for the assessment of stable chest pain: assessing the early economic and service impact in the rapid-access chest pain service.

    Ashrafi, Reza / Raga, Santosh / Abdool, Ali / Disney, Andrew / Wong, Peter / Davis, Gershan K

    Postgraduate medical journal

    2013  Volume 89, Issue 1051, Page(s) 251–257

    Abstract: Background: In 2010, guidelines published by the National Institute for Clinical Excellence (NICE) suggested a change in the way patients with stable chest pain of suspected cardiac origin were investigated. These guidelines removed exercise treadmill ... ...

    Abstract Background: In 2010, guidelines published by the National Institute for Clinical Excellence (NICE) suggested a change in the way patients with stable chest pain of suspected cardiac origin were investigated. These guidelines removed exercise treadmill testing from routine use and introduced cardiac CT to regular use.
    Objective: To investigate whether these guidelines had improved our service provision by reducing the number of further investigations required to make a diagnosis, and to see if our costs had increased now that the less expensive exercise treadmill tests were not recommended.
    Methods: Clinic letters were used to assess patients pretest likelihood of coronary artery disease for two six-month cohorts of consecutive patients seen in the rapid access chest pain clinic (January-June 2010 and July-December 2011) using NICE published methodology, and to ascertain which investigations patients had. Using NICE modelled costs, we generated comparative hypothetical costs for each cohort and an average cost per patient.
    Results: In the January-June 2010 cohort, 435 patients with chest pain were seen, and in July-December 2011, 334 patients were seen. In the pre-NICE guidelines cohort, 23% of patients required two investigations as compared with 11.4% in the post-NICE guidelines cohort, with no patient requiring three investigations as compared with 3% in the original cohort. There was no significant increase in costs per patient in the post-NICE guidance group.
    Conclusions: Implementing NICE guidance reduced the number of investigations needed per patient, and did not prove more expensive for our department in the short term.
    MeSH term(s) Aged ; Ambulatory Care/economics ; Ambulatory Care/statistics & numerical data ; Cardiac Care Facilities/economics ; Cardiac Care Facilities/statistics & numerical data ; Chest Pain/diagnosis ; Chest Pain/economics ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic ; Retrospective Studies
    Language English
    Publishing date 2013-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1136/postgradmedj-2012-131098
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  6. Article ; Online: Images in cardiovascular medicine. Thromboembolism in real-time two-dimensional echocardiography.

    Davis, Gershan K / Fisk, Clive / Talwar, Sandeep

    Circulation

    2003  Volume 107, Issue 1, Page(s) e1

    MeSH term(s) Aged ; Echocardiography ; Humans ; Kinetics ; Male ; Microscopy, Video ; Thromboembolism/diagnostic imaging
    Language English
    Publishing date 2003-01-07
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/01.cir.0000046072.10311.41
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  7. Article ; Online: Stroke complicating cardiac catheterization--a preventable and treatable complication.

    Sankaranarayanan, Rajiv / Msairi, Adel / Davis, Gershan K

    The Journal of invasive cardiology

    2007  Volume 19, Issue 1, Page(s) 40–45

    Abstract: Stroke is a rare but serious complication of cardiac catheterization. Due to the low incidence of stroke complicating catheterization of the left heart, there is no clearly defined optimal treatment. With increasing numbers of diagnostic and ... ...

    Abstract Stroke is a rare but serious complication of cardiac catheterization. Due to the low incidence of stroke complicating catheterization of the left heart, there is no clearly defined optimal treatment. With increasing numbers of diagnostic and interventional cardiac procedures being performed, definitive management pathways for periprocedural neurological complications need to be defined. Many studies have shown excellent results with both thrombolytic and catheter-based neurovascular rescue, but equal attention should be paid to identify measures to prevent this iatrogenic complication. It is also imperative that management decisions be taken jointly by the cardiologist and stroke physician. We review the literature regarding the features of ischemic stroke complicating cardiac catheterization, the various management modalities and suggest a management protocol.
    MeSH term(s) Cardiac Catheterization/adverse effects ; Cardiac Catheterization/methods ; Clinical Trials as Topic ; Coronary Angiography/adverse effects ; Coronary Angiography/methods ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/mortality ; Coronary Artery Disease/therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Primary Prevention/methods ; Prognosis ; Risk Assessment ; Stroke/drug therapy ; Stroke/etiology ; Stroke/prevention & control ; Survival Rate ; Thrombolytic Therapy/methods ; Tomography, X-Ray Computed
    Language English
    Publishing date 2007-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1154372-3
    ISSN 1557-2501 ; 1042-3931
    ISSN (online) 1557-2501
    ISSN 1042-3931
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  8. Article ; Online: Retroperitoneal hematoma after diagnostic coronary angiography caused by collateralization of a chronic common femoral artery occlusion secondary to childhood femoral cannulation.

    Morris, Gwilym M / O'Grady, Elizabeth A / Wynn, Gareth J / Davis, Gershan K

    Circulation. Cardiovascular interventions

    2009  Volume 2, Issue 6, Page(s) 580–581

    MeSH term(s) Angiography, Digital Subtraction ; Arterial Occlusive Diseases/diagnostic imaging ; Arterial Occlusive Diseases/etiology ; Arterial Occlusive Diseases/physiopathology ; Cardiac Catheterization/adverse effects ; Collateral Circulation ; Constriction, Pathologic ; Coronary Angiography/adverse effects ; Embolization, Therapeutic ; Female ; Femoral Artery/diagnostic imaging ; Femoral Artery/physiopathology ; Hematoma/diagnostic imaging ; Hematoma/etiology ; Hematoma/therapy ; Humans ; Middle Aged ; Retroperitoneal Space
    Language English
    Publishing date 2009-12
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2450797-0
    ISSN 1941-7632 ; 1941-7640
    ISSN (online) 1941-7632
    ISSN 1941-7640
    DOI 10.1161/CIRCINTERVENTIONS.109.869511
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  9. Article ; Online: Clinical pre-test probability for obstructive coronary artery disease: insights from the European DISCHARGE pilot study.

    Feger, Sarah / Ibes, Paolo / Napp, Adriane E / Lembcke, Alexander / Laule, Michael / Dreger, Henryk / Bokelmann, Björn / Davis, Gershan K / Roditi, Giles / Diez, Ignacio / Schröder, Stephen / Plank, Fabian / Maurovich-Horvat, Pal / Vidakovic, Radosav / Veselka, Josef / Ilnicka-Suckiel, Malgorzata / Erglis, Andrejs / Benedek, Teodora / Rodriguez-Palomares, José /
    Saba, Luca / Kofoed, Klaus F / Gutberlet, Matthias / Ađić, Filip / Pietilä, Mikko / Faria, Rita / Vaitiekiene, Audrone / Dodd, Jonathan D / Donnelly, Patrick / Francone, Marco / Kepka, Cezary / Ruzsics, Balazs / Müller-Nordhorn, Jacqueline / Schlattmann, Peter / Dewey, Marc

    European radiology

    2020  Volume 31, Issue 3, Page(s) 1471–1481

    Abstract: Objectives: To test the accuracy of clinical pre-test probability (PTP) for prediction of obstructive coronary artery disease (CAD) in a pan-European setting.: Methods: Patients with suspected CAD and stable chest pain who were clinically referred ... ...

    Abstract Objectives: To test the accuracy of clinical pre-test probability (PTP) for prediction of obstructive coronary artery disease (CAD) in a pan-European setting.
    Methods: Patients with suspected CAD and stable chest pain who were clinically referred for invasive coronary angiography (ICA) or computed tomography (CT) were included by clinical sites participating in the pilot study of the European multi-centre DISCHARGE trial. PTP of CAD was determined using the Diamond-Forrester (D+F) prediction model initially introduced in 1979 and the updated D+F model from 2011. Obstructive coronary artery disease (CAD) was defined by one at least 50% diameter coronary stenosis by both CT and ICA.
    Results: In total, 1440 patients (654 female, 786 male) were included at 25 clinical sites from May 2014 until July 2017. Of these patients, 725 underwent CT, while 715 underwent ICA. Both prediction models overestimated the prevalence of obstructive CAD (31.7%, 456 of 1440 patients, PTP: initial D+F 58.9% (28.1-90.6%), updated D+F 47.3% (34.2-59.9%), both p < 0.001), but overestimation of disease prevalence was higher for the initial D+F (p < 0.001). The discriminative ability was higher for the updated D+F 2011 (AUC of 0.73 95% confidence interval [CI] 0.70-0.76 versus AUC of 0.70 CI 0.67-0.73 for the initial D+F; p < 0.001; odds ratio (or) 1.55 CI 1.29-1.86, net reclassification index 0.11 CI 0.05-0.16, p < 0.001).
    Conclusions: Clinical PTP calculation using the initial and updated D+F prediction models relevantly overestimates the actual prevalence of obstructive CAD in patients with stable chest pain clinically referred for ICA and CT suggesting that further refinements to improve clinical decision-making are needed.
    Trial registration: https://www.clinicaltrials.gov/ct2/show/NCT02400229 KEY POINTS: • Clinical pre-test probability calculation using the initial and updated D+F model overestimates the prevalence of obstructive CAD identified by ICA and CT. • Overestimation of disease prevalence is higher for the initial D+F compared with the updated D+F. • Diagnostic accuracy of PTP assessment varies strongly between different clinical sites throughout Europe.
    MeSH term(s) Computed Tomography Angiography ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Coronary Stenosis/diagnostic imaging ; Coronary Stenosis/epidemiology ; Europe ; Female ; Humans ; Male ; Patient Discharge ; Pilot Projects ; Predictive Value of Tests ; Risk Assessment ; Risk Factors
    Language English
    Publishing date 2020-09-09
    Publishing country Germany
    Document type Clinical Trial ; Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-020-07175-z
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  10. Article: Pilot programme to support a skills and competencies-based workforce in medicine.

    Davis, Gershan / Jackson, Cathy / Auckland-Lewis, Julian / Crean, StJohn / Fletcher, Iwan / Poulton, Katherine

    Future healthcare journal

    2019  Volume 6, Issue Suppl 1, Page(s) 108

    Language English
    Publishing date 2019-02-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 3016427-8
    ISSN 2514-6653 ; 2514-6645
    ISSN (online) 2514-6653
    ISSN 2514-6645
    DOI 10.7861/futurehosp.6-1-s108
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