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Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace

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https://www.readbyqxmd.com/read/29975018/patients-self-evaluation-of-symptoms-signs-and-compliance-to-therapy-for-heart-failure-surveillance-a-pilot-study-on-identification-of-worsening-heart-failure
#1
Vittorio Palmieri, Antonio Palermo
In patients with chronic heart failure (HF), it is unclear whether self-evaluation of HF-related symptoms and signs may contribute to the surveillance of clinical stability over time or the early identification of worsening HF.   Therefore, HF-related symptoms and signs, and compliance to therapy were investigated by a self-administrated questionnaire in patients hospitalized due to worsening HF (cases) as well in those with stable HF (controls).  The temporal interval of interest for the questionnaire focused on 2 to 7 days before the hospitalization of the control visit...
July 5, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29962193/association-of-esophageal-dilatation-in-chest-ct-scan-with-gastroesophageal-reflux-disease-a-case-control-study
#2
Seyed Jalal Hashemi, Seyed Ali Javad Moosavi, Esmaeil Idani, Ali Javaherforoushzadeh, Hanieh Raji
The presence of increased air bubble in the lumina of esophagus on a chest CT scan may be associated with esophageal disorders. The purpose of this study was to determine the association between the appearance of air bubbles on chest CT scan and gastroesophageal Reflux Disease (GERD). In this case-control study, thirty-two patients with endoscopically proved GERD and 32 subjects without GERD underwent chest computed tomography (CT) scanning. Esophageal dilatation (ED) was defined as the presence of air bubbles greater than 10 mm in the supra ventricle (SV) and ventricle (CV), and air bubbles >15 mm in the ventricle to the lower esophageal sphincter (V-LES)...
July 2, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29962189/best-practice-in-psychological-activities-in-cardiovascular-prevention-and-rehabilitation-position-paper
#3
Marinella Sommaruga, Elisabetta Angelino, Paola Della Porta, Mara Abatello, Giacomo Baiardo, Gianluigi Balestroni, Ornella Bettinardi, Edward Callus, Chiara Ciracì, Ombretta Omodeo, Claudia Rizza, Paolo Michielin, Marco Ambrosetti, Raffaele Griffo, Roberto F E Pedretti, Antonia Pierobon
Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability...
July 2, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29936788/diagnostic-utility-of-endobronchial-ultrasound-features-in-differentiating-malignant-and-benign-lymph-nodes
#4
Sumita P Agrawal, Pranav Ish, Akhil D Goel, Nitesh Gupta, Shibdas Chakrabarti, Dipak Bhattacharya, Manas K Sen, Jagdish C Suri
Endobronchial ultrasound (EBUS) features have been shown to be useful in predicting etiology of enlarged malignant lymph nodes. However, there is dearth of evidence especially from developing countries. We assessed the EBUS characteristics across various mediastinal and hilar lymphadenopathies. In this prospective study, all patients with mediastinal and hilar lymphadenopathy on CT Chest and who were planned for EBUS-FNA (Fine Needle Aspiration) were included. EBUS features of lymph nodes studied were shape, size, margins, echogenicity, central hilar structure (CHS), coagulation necrosis sign and colour power doppler index (CPDI)...
June 25, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29929353/pneumomediastinum-after-transbronchial-cryobiopsy
#5
Emanuela Barisione, Rita Bianchi, Roberto Fiocca, Mario Salio
Pneumomediastinum is defined as the presence of air or gas within the mediastinum and it rarely complicates bronchoscopy. We report, to our best knowledge, the first case of pneumomediastinum following a transbronchial cryobiopsy (TBLC). TBLC is considered a safe procedure as compared with both transbronchial biopsy and surgical lung biopsy. Systematic reviews, metanalysis and a Pubmed research, revealed that in literature no pneumomediastinum has been mentioned after TBLC. We report this case for to make it known to interventional pulmonologists the possibility that a pneumomediastinum can follow a TBLC...
June 22, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29929352/the-effect-of-19-gauge-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-biopsies-on-characterisation-of-malignant-and-benign-disease-the-bristol-experience
#6
Rachel C Jones, Nidhi Bhatt, Andrew R L Medford
EBUS-TBNA is a recent mediastinal staging and diagnostic technique. We have previously reported superior characterisation with 21G biopsies over 22G biopsies for benign and malignant mediastinal nodes. A new 19G needle now exists but there are limited studies. We hypothesised 19G biopsies would improve both benign and malignant characterisation due to larger samples. We retrospectively analysed sequential patients referred for EBUS-TBNA with unexplained mediastinal adenopathy performed with 19G, 21G and 22G needles respectively (100 patients each)...
June 22, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29927196/microscopic-polyangiitis-presented-with-biopsy-confirmed-pleuritis
#7
Naoto Ishimaru, Hisashi Ohnishi, Mao Fujii, Masako Yumura, Sho Yoshimura, Saori Kinami
We describe a case of microscopic polyangiitis manifested as pleuritis confirmed by thoracoscopic biopsy. An 80-year-old man presented with a three-day history of shortness of breath and cough. Chest radiography revealed patchy opacities in the lower fields of the bilateral lung and right-sided pleural effusion. Thoracentesis revealed lymphocytic pleural exudates. Thoracoscopic biopsy specimens were compatible with fibrotic pleuritis. He developed rapidly progressive glomerulonephritis with elevated myeloperoxidase anti-neutrophil cytoplasmic antibody titer in blood and pleural effusion...
June 21, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29927195/fibrotic-lung-toxicity-induced-by-cytotoxic-drugs-radiation-and-immunotherapy-in-patients-treated-for-lung-cancer
#8
Elena Bargagli, Viola Bonti, Alessandra Bindi, Vieri Scotti, Massimo Pistolesi, Luca Voltolini, Katia Ferrari
Patients treated for lung cancer may develop lung toxicity induced by chemotherapy (DILD), radiation or combined radiation recall pneumonitis. In the literature, some cases of immune-mediated pneumonitis have been reported associated with immunotherapy. The clinical and radiologic features of interstitial lung toxicity are unspecific, dyspnoea and dry cough are the most common symptoms while the most frequent radiological pattern is the cryptogenic organizing pneumonia (COP). Why only some individuals treated with these drugs develop interstitial lung toxicity is unclear...
June 21, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877671/management-of-hypertension-in-the-elderly-looking-for-a-trade-off-between-cardiovascular-prevention-and-serious-adverse-events
#9
Agata Buonacera, Benedetta Stancanelli, Lorenzo Malatino
Despite the effectiveness of anti-hypertensive therapy is well recognized, the most adequate target to achieve in the management of hypertension in the elderly is still under debate. Indeed, looking at the balance between benefits and risks, accumulating evidence has recently specifically addressed this issue, focusing on controversies. Evidence surrounding a more aggressive treatment may lead to a turnaround in the clinical care of older adult hypertensives, but a balanced trade-off between benefits and risks needs to be programmed and achieved, particularly in this clinical setting...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877670/blood-pressure-control-in-older-patients-with-carotid-artery-stenosis
#10
Pompilio Faggiano, Marta Scodro, Marco Sbolli, Luca Branca, Dario Cani, Francesca Valentini, Carlotta Perego, Martino Provini
Stroke is the second largest cause of European cardiovascular and total mortality, largely due to atherosclerotic carotid artery narrowing or thromboembolism consequent to internal carotid artery stenosis. Current therapeutic indications suggest lifestyle interventions (smoking cessation, healthy diet and physical activity), adequate control of LDL-cholesterol and glycemic balance. It is nonetheless established that the most important factors in preventing stroke are antiplatelet therapy and blood pressure regulation...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877669/arterial-hypertension-does-the-j-curve-exist-and-then
#11
Gian Francesco Mureddu
The concept that 'the lower the blood pressure (BP) achieved the better the outcome' rests on the demonstration of a direct relationship between BP and incident outcomes, down to levels of 115 mmHg of systolic BP (sBP) and 75 mmHg of diastolic BP (dBP) carried out in 1 million individuals from 61 cohorts recruited between 1950 and 1990 and followed for about 14 years. The alternative to the 'lower the better' concept is the hypothesis of a J-shaped relationship, according to which the benefits of reducing sBP or dBP to low values may be dangerous leading even to an increase in total mortality and/or in CV outcomes...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877668/beta-blockers-after-myocardial-infarction-are-they-useful-to-all-patients-and-how-long-should-be-the-beta-blocker-therapy
#12
Roberto F E Pedretti
Some observational studies raised questions about the need for β-blockers in all patients after a first heart attack. Surprisingly, in some clinical settings, a limited mortality reduction was found in those who received β-blockade.Some studies suggest that patients without heart failure may not need post-MI β-blockers. The lack of data from randomized controlled clinical trials has led to clinical uncertainty and conflicting recommendations. Therefore, there are multiple information to revaluate the value of β-blocker therapy after a heart attack in absence of heart failure or left ventricular dysfunction and the time for new trials of an old group of drugs has arrived...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877667/dapt-plus-anticoagulant-therapy-the-difficult-coexistence-post-acs-in-older-patients-with-atrial-fibrillation
#13
Mauro Di Bari, Alessandra Pratesi, Francesca M Nigro, Irene Marozzi, Stefano Fumagalli
Atrial fibrillation (AF) and coronary artery disease requiring percutaneous coronary intervention (PCI) and stenting often coexist in older patients. This poses the difficult problem of concurrent anticoagulant and double antiplatelet therapy (triple therapy). Current treatment guidelines do recommend triple therapy, especially in the course of acute coronary syndrome (ACS), with limitations due to an excessive risk of bleeding associated with this therapeutic regimen. This review summarizes randomized clinical trials and observational studies that compared triple therapy with a variety of different therapeutic options...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877666/antiplatelet-therapy-in-elderly-patients-with-acute-coronary-syndrome-between-scientific-evidence-and-future-perspectives
#14
Francesco Barillà, Concetta Torromeo, Riccardo Iorio, Luigina Porco, Vincenzo Paravati, Carlo Gaudio
Dual antiplatelet therapy (DAPT) is an important strategy for reducing cardiovascular events (CV) after an acute coronary syndrome (ACS). Elderly patients undergoing DAPT have a higher risk of bleeding than younger patients for a variety of reasons. Stratification of thrombotic/hemorrhagic risk is mandatory in order to decide on the type and duration of DAPT. The percentage of patients ≥ 75 years represented in clinical trials is not large, so very often elderly people are prescribed treatment protocols only experimented on younger patients with a lower hemorrhagic risk...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877665/net-clinical-benefit-of-anticoagulation-therapy-in-the-elderly-patients-with-atrial-fibrillation
#15
Lorenzo Palleschi, Eleonora Nunziata
Old age remains one of the strongest risk factors for stroke in patients with atrial fibrillation (AF). Oral anticoagulation (OAC) is the most effective way to prevent thromboembolic disease in patients with atrial fibrillation (AF). Until few years ago, aspirin and vitamin-K antagonists (VKAs) were the primary agents used to prevent thromboembolic disease in patients with AF. The approval of non-vitamin K oral anticoagulants (NOACs) has now expanded the range of therapeutic agents available to providers. The authors highlight practical considerations regarding the selection and use of OAC in older adults to aid clinical decision making...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877664/rate-control-vs-rhythm-control-of-atrial-fibrillation-in-elderly-patients-from-new-age-oriented-outcomes-to-a-more-complex-management-strategy
#16
Stefano Fumagalli, Serena Boni, Simone Pupo, Marta Migliorini, Irene Marozzi, Eleonora Barghini, Flavia Sacco, Niccolò Marchionni
Atrial fibrillation (AF) is the most frequent arrhythmia in elderly people. Findings derived from clinical trials seem to demonstrate that a rate-control strategy of AF in aged patients improves prognosis if compared to a rhythm-control one. However, epidemiological studies concordantly show that the arrhythmia is associated to increased hospitalization and mortality rates. In last years, the proportion of patients admitted to hospital for AF has progressively increased; this trend is observed in subjects >75 and >85 years, while no change was found in younger cohorts...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877663/prognostic-impact-of-digoxin-use-for-rate-control-of-atrial-fibrillation-in-patients-%C3%A2-75-years-of-age
#17
Maria Teresa La Rovere, Egidio Traversi
Digoxin use remains a common therapeutic option in the pharmacological control of heart rate in patients with atrial fibrillation, endorsed in current guidelines with the same level of evidence than beta-blockers in patients with and without heart failure. Digoxin has a narrow therapeutic range and is influenced by drug-to-drug interactions, serum electrolyte concentrations, and renal function. Conflicting data exist regarding adverse outcomes that are associated with digoxin use in patients with atrial fibrillation...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877662/cognitive-impairment-in-patients-with-atrial-fibrillation-what-is-the-importance-of-anticoagulant-therapy
#18
Giovanni Capobianco
Atrial fibrillation represents one of the most significant aging markers and its prevalence increases with age, reaching 11.1% in men and 9.1% in women aged over 85 years. Fragility is nowadays defined according to two different phenotypes: the biologic-physiologic phenotype developed by L. Fried and Baltimora School and the clinic-multidimensional phenotype, proposed by Rockwood and Halifax School. If the clinical characteristics of elder patients hospitalized in acute geriatric unit care are considered, differences appear in the clinical features, in co-morbidity, in therapy and prognosis...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877661/rhythm-control-vs-rate-control-in-the-elderly-when-to-do-it-and-which-drug-to-prefer
#19
Giovanni Luca Botto, Carlo Piemontese, Giovanni Russo
Atrial fibrillation (AF) is a relevant cardiovascular condition that is more prevalent in the elderly patients aged over 65 years. AF, with abnormal rate and rhythm can cause symptoms directly or indirectly by exacerbating other frequently coexisting cardiac conditions such as valvular heart disease, hypertension, ischemic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. Evidence suggests that aging-related cardiovascular changes predispose to the elderly to AF. Current therapeutic options such as antiarrhythmic drugs have not been extensively evaluated in the elderly population...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29877660/efficacy-and-safety-of-oral-anticoagulant-therapy-in-frail-patients-with-atrial-fibrillation
#20
Giuseppe Patti, Ludmilla Mantione, Edoardo Bressi, Antonio Bisignani
Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation  (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
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