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https://www.readbyqxmd.com/read/29046004/-coronary-computed-tomography-angiography-in-patients-with-stable-coronary-artery-disease
#1
Helen Ullrich, Tommaso Gori
The guidelines on the management of stable coronary artery disease (SCAD) recommend the use of coronary computed tomography angiography (CTA) in the process of diagnosing coronary artery disease in patients with low intermediate pre-test probability for SCAD. Particularly in cases where stress electrocardiogram or stress imaging provides unclear results, a computed tomographic examination can be considered as a reliable alternative to invasive coronary angiography. Due to its high negative predictive value, coronary CTA can provide accurate information on the presence of coronary artery stenosis and thus coronary artery disease can be reliably excluded without the risks associated with invasive procedures...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29037517/comparative-studies-of-different-types-of-osteosynthesis-on-the-human-corpse-preparation-in-bilateral-antero-lateral-flail-chest
#2
Sina Grupp, Veronika Fürst, Thomas Buder, Alexander Fichte, Sebastian Krinner, Roman T Carbon, Friedrich F Hennig, Andreas Langenbach, Stefan Schulz-Drost
INTRODUCTION: Bilateral flail chest injuries are challenging in treatment and comparatively often require an operative stabilization of the anterior chest wall to re-establish normal physiological conditions of the chest wall in shape and statics. Various procedures have been described which are technically sophisticated for the surgeon. Consequently there is an increasing interest in potentials of operative care and their effectiveness on the anterolateral chest wall. MATERIALS AND METHODS: 12 Human cadavers were prepared and the natural Sternum Position (NP) was marked...
October 9, 2017: Injury
https://www.readbyqxmd.com/read/28958364/radiology-for-trauma-and-the-general-surgeon
#3
REVIEW
Patrick K Kim
Conventional radiography (plain film), ultrasonography, and computed tomography (CT) are important modalities for the evaluation of patients with trauma. In meta-stable or unstable patients, the combination of chest radiograph, pelvis radiograph, and focused assessment for sonography in trauma (FAST) or extended FAST rapidly triages the torso. CT has become a standard for definitive imaging in blunt trauma. CT angiography is the modality of choice for suspected vascular injuries of the neck and extremities...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958142/serum-25-hydroxy-vitamin-d-concentration-in-acute-coronary-syndrome
#4
E Anastasi, M Suppa, V Viggiani, S Tartaglione, A Angeloni, T Granato
Vitamin D may have prognostic value in cardiovascular disease (CVD) patients and, in addition to conventional biomarkers, could be a valuable tool for disease management. The aim of this study was to assess the association of vitamin D status in patients with acute coronary syndrome (ACS) and to evaluate its prognostic utility. The levels of 25(OH) vitamin D were correlated with troponin T hs. Forty-eight consecutive outpatients (40 Caucasian and 8 Asian) aged between 40 and 70 years (mean 61.5, range 43-77 years) were enrolled in the study...
July 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28947562/magnitude-and-characteristics-of-patients-who-survived-an-acute-myocardial-infarction
#5
Mayra Tisminetzky, Tracy Y Wang, Jerry Gurwitz, Lisa A Kaltenbach, David McManus, Joel Gore, Eric Peterson, Robert J Goldberg
BACKGROUND: The purpose of this study was to describe the magnitude and characteristics of patients who did not experience any significant major adverse cardiovascular event early (within 6 weeks) and late (during the first year) after hospital discharge for an acute myocardial infarction (AMI). METHODS AND RESULTS: Data from 12 243 patients discharged after an AMI from 233 sites across the United States in the TRANSLATE-ACS (Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) study were analyzed...
September 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28910658/postural-regulatory-strategies-during-quiet-sitting-are-affected-in-individuals-with-thoracic-spinal-cord-injury
#6
Matija Milosevic, Dany H Gagnon, Philippe Gourdou, Kimitaka Nakazawa
Thoracic spinal cord injury (SCI) can have significant negative consequences, which can affect the ability to maintain unsupported sitting. The objectives of this study were to compare postural control of individuals with high- and low-thoracic SCI to able-bodied people and evaluate the effects of upper-limb support on postural control during quiet sitting. Twenty-five individuals were recruited into: (a) high-thoracic SCI; (b) low-thoracic SCI; and (c) able-body subgroups. Participants were seated and asked to maintain a steady balance in the following postures: (1) both hands resting on thighs; (2) both arms crossed over the chest; and (3) both arms extended...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28884108/characteristics-and-clinical-aspects-of-patients-with-spinal-cord-injury-undergoing-surgery
#7
João Simão de Melo-Neto, Lara Eduarda Leite Vidotto, Fabiana de Campos Gomes, Dionei Freitas de Morais, Waldir Antonio Tognola
OBJECTIVE: To identify the characteristics of patients with spinal cord injury (SCI) undergoing surgery. METHODS: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. RESULTS: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cervical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#8
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28854949/pulmonary-tumor-embolism-secondary-to-soft-tissue-and-bone-sarcomas-a-case-report-and-literature-review
#9
Nicholas Latchana, Vincent C Daniel, Robert W Gould, Raphael E Pollock
BACKGROUND: Tumor embolisms (TE) are an underappreciated source of pulmonary embolisms in sarcoma. Most evidence in the literature is limited to case reports and none have described the presence of TE secondary to myxofibrosarcoma. We report the first case of myxofibrosarcoma TE and perform a review of the literature for TE secondary to bone and soft tissue sarcomas (STS). CASE PRESENTATION: A 36-year-old female presented with debilitating pain of the right upper extremity secondary to a recurrent soft tissue sarcoma...
August 30, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28844640/early-versus-late-canalicular-laceration-repair-outcomes
#10
Yen-Chang Chu, Shu-Ya Wu, Yueh-Ju Tsai, Yi-Lin Liao, Hsueh-Yen Chu
PURPOSE: To determine whether delayed repair of traumatic canalicular laceration affects the final outcome. DESIGN: Retrospective case series. METHODS: The medical records of 334 patients who underwent primary traumatic canalicular laceration repair were retrospectively reviewed. Patients were divided into 2 groups according to the surgical timing within 48 hours (early) or after 48 hours (delayed). The anatomic results were compared between these 2 groups...
October 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28836006/management-of-superior-vena-cava-syndrome-in-critically-ill-cancer-patients
#11
Sarah Morin, Adeline Grateau, Danielle Reuter, Eric de Kerviler, Constance de Margerie-Mellon, Cédric de Bazelaire, Lara Zafrani, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
PURPOSE: The purpose of this study is to describe the management and outcome of critically ill cancer patients with Superior Vena Cava Syndrome (SVCS). METHODS: All cancer patients admitted to the medical intensive care unit (ICU) of the Saint-Louis University Hospital for a SVCS between January 2004 and December 2016 were included. RESULTS: Of the 50 patients included in the study, obstruction of the superior vena cava was partial in two-thirds of the cases and complete in one-third...
August 24, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28810091/preoperative-chest-radiography-in-elective-surgery-review-and-update
#12
Ethan M Young, Joel D Farmer
INTRODUCTION: The preoperative evaluation is designed to identify factors that may predispose a patient to perioperative complications in an effort to ensure patient safety. The use of chest radiography in the preoperative evaluation has progressed from routine testing to a more selective approach based on evidence that routine testing is low yield. However, preoperative chest radiography (POCR) may still be utilized more frequently than necessary as guidelines provide varying recommendations and providers continue to order the test by convention...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28761679/the-safety-efficacy-and-cost-effectiveness-of-stress-echocardiography-in-patients-with-high-pretest-probability-of-coronary-artery-disease
#13
Alexandros Papachristidis, Daniela Cassar Demarco, Damian Roper, Ioannis Tsironis, Michael Papitsas, Jonathan Byrne, Khaled Alfakih, Mark J Monaghan
OBJECTIVE: In this study, we assess the clinical and cost-effectiveness of stress echocardiography (SE), as well as the place of SE in patients with high pretest probability (PTP) of coronary artery disease (CAD). METHODS: We investigated 257 patients with no history of CAD, who underwent SE, and they had a PTP risk score >61% (high PTP). According to the National Institute for Health and Care Excellence guidance (NICE CG95, 2010), these patients should be investigated directly with an invasive coronary angiogram (ICA)...
2017: Open Heart
https://www.readbyqxmd.com/read/28743074/coronary-perfusion-pressure-and-compression-quality-in-maternal-cardiopulmonary-resuscitation-in-supine-and-left-lateral-tilt-positions-a-prospective-crossover-study-using-mannequins-and-swine-models
#14
Satoshi Dohi, Kiyotake Ichizuka, Ryu Matsuoka, Kohei Seo, Masaaki Nagatsuka, Akihiko Sekizawa
OBJECTIVE: The risk of maternal and fetal mortality is high if cardiopulmonary arrest occurs during pregnancy. To assess the best position for maternal cardiopulmonary resuscitation (CPR), a prospective randomized crossover study was undertaken, involving basic life support mannequin-based simulation (BLS-MS) and a swine model of pulseless electrical activity (an unstable cardiac state) incorporating a fetal mannequin (PEA-FM). STUDY DESIGN: The BLS-MS (performed by certified rescuers) served to evaluate the quality of chest compressions in 30° left lateral tilt (LLT) and supine positions...
July 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28732653/sestrins-increase-in-patients-with-coronary-artery-disease-and-associate-with-the-severity-of-coronary-stenosis
#15
Jing Ye, Menglong Wang, Yao Xu, Jianfang Liu, Huimin Jiang, Zhen Wang, Yingzhong Lin, Jun Wan
BACKGROUND: Sestrins (Sesns) family, which including three members Sesn1, Sesn2 and Sesn3, is known as stress-inducible proteins and participate in multiple diseases via regulating oxidative stress, inflammatory response and cell apoptosis. The present study aimed to investigate the plasma levels and the clinical significance of Sesns in patients with coronary artery disease (CAD). METHODS: In the case-control study, 119 CAD patients, including stable angina pectoris (SAP, n=44), unstable angina pectoris (UAP, n=41) and acute myocardial infarction (AMI, n=29) were included...
July 18, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28614245/wellens-syndrome-in-hiv-infected-patients-two-case-reports
#16
Bowei Tan, Carlos Morales-Mangual, Dan Zhao, Abdullah Khan, Hal Chadow
BACKGROUND: Wellens syndrome is a pattern of electrocardiographic (ECG) changes in the context of unstable angina characterized with deep inverted T-waves or biphasic T-waves in the precordial leads. These specific ECG changes are highly suggestive of stenosis in the left anterior descending artery (LAD), which can result in acute myocardial infarction, left ventricular dysfunction, or death. Human immunodeficiency virus (HIV) infection is known as an independent risk factor for the cardiovascular disease...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#17
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28598043/clinical-profile-of-hypertensive-emergencies-in-an-intensive-care-unit
#18
Shubhangi V Dhadke, Vithal N Dhadke, Dhruv S Batra
AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28580737/pragmatic-approach-to-chest-pain-patients-discharged-with-undetectable-high-sensitivity-troponin-t-and-normal-electrocardiogram-the-stabs-ct-protocol
#19
Warrick Bishop, Gary Girao
A strategy that discharges chest pain patients with negative high-sensitivity troponin and non-ischaemic electrocardiography changes may still result in 0.44% of patients experiencing myocardial infarction within 30 days. We observed that a pragmatic approach that systematically discharged 25 patients on cardio-protective medications of aspirin, metoprolol and atorvastatin followed with prompt (<10 days) coronary computed tomography angiography resulted in no major adverse cardiac event and adverse drug reaction 30 days post-presentation...
June 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28575302/impact-of-computed-tomography-myocardial-perfusion-following-computed-tomography-coronary-angiography-on-downstream-referral-for-invasive-coronary-angiography-revascularization-and-outcome-at-12-months
#20
Alexander R van Rosendael, Aukelien C Dimitriu-Leen, Michiel A de Graaf, Erik W van Zwet, J Wouter Jukema, Jeroen J Bax, Lucia J Kroft, Arthur J Scholte
Aims: The aim of this study was to assess the impact of adding stress computed tomography (CT) myocardial perfusion (CTP) to coronary CT angiography (CTA) on downstream referral for invasive coronary angiography (ICA), revascularization, and outcome in patients presenting with new-onset chest pain. Methods and results: Three hundred and eighty-four patients were referred for cardiac CT. Patients with lesions ≥50% stenosis underwent subsequently stress CTP. Perfusion scans were considered abnormal if a defect was observed in ≥ 1 segment...
September 1, 2017: European Heart Journal Cardiovascular Imaging
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