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https://www.readbyqxmd.com/read/27897967/an-observational-study-of-donor-ex-vivo-lung-perfusion-in-uk-lung-transplantation-develop-uk
#1
Andrew Fisher, Anders Andreasson, Alexandros Chrysos, Joanne Lally, Chrysovalanto Mamasoula, Catherine Exley, Jennifer Wilkinson, Jessica Qian, Gillian Watson, Oli Lewington, Thomas Chadwick, Elaine McColl, Mark Pearce, Kay Mann, Nicola McMeekin, Luke Vale, Steven Tsui, Nizar Yonan, Andre Simon, Nandor Marczin, Jorge Mascaro, John Dark
BACKGROUND: Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. OBJECTIVE: The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity. DESIGN: A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transplant outcomes between EVLP-assessed and standard donor lungs...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27871877/journal-allergy-clinical-immunology-perspective-clinical-potential-for-imaging-in-asthma-and-other-lung-disorders
#2
Emily M DeBoer, David R Spielberg, Alan S Brody
The ability of lung imaging to phenotype patients, determine prognosis, and to predict response to treatments is expanding in clinical and translational research. The purpose of this perspective is to describe current imaging modalities that may be useful clinical tools in asthma and other lung disorders and to explore some of the new developments in imaging modalities of the lung. These imaging modalities include chest radiography (CXR), computed tomography (CT), lung magnetic resonance imaging (MRI), electrical impedance tomography (EIT), bronchoscopy, and others...
November 18, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27870565/concurrent-chemotherapy-and-radiation-therapy-for-inoperable-locally-advanced-non-small-cell-lung-cancer
#3
Kenneth E Rosenzweig, Jorge E Gomez
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
November 21, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27831547/recombinant-tissue-plasminogen-activator-to-restore-catheter-patency-efficacy-and-safety-analysis-from-a-multihospital-nicu-system
#4
D M Scott, C Y Ling, B C MacQueen, V L Baer, E Gerday, R D Christensen
OBJECTIVE: In 2001, the US Food and Drug Administration approved recombinant tissue plasminogen activator (alteplase, Cathflo Activase) to reestablish patency of central catheters occluded, presumably, by a fibrin clot. We conducted a multicenter quality improvement study to determine the value of this procedure in our Neonatal Intensive Care Unit (NICUs), including analyses of efficacy, safety and costs. STUDY DESIGN: We conducted a retrospective quality analysis of neonates in level III NICUs, who received alteplase for the purpose of reestablishing patency of occluded central catheters...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27818329/liberation-from-mechanical-ventilation-in-critically-ill-adults-executive-summary-of-an-official-american-college-of-chest-physicians-american-thoracic-society-clinical-practice-guideline
#5
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miguel Ferrer, Gilles L Fraser, Michelle Gong, Catherine L Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, William Schweickert, Thomas Strøm, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A multi-disciplinary panel posed six clinical questions in a Population, Intervention, Comparator and Outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27814824/acr-appropriateness-criteria-%C3%A2-stage-i-breast-carcinoma
#6
Phan Tuong Huynh, Sergy V Lemeshko, Mary C Mahoney, Mary S Newell, Lisa Bailey, Lora D Barke, Carl D'Orsi, Jennifer A Harvey, Mary K Hayes, Peter M Jokich, Su-Ju Lee, Constance D Lehman, Martha B Mainiero, David A Mankoff, Samir B Patel, Handel E Reynolds, M Linda Sutherland, Bruce G Haffty
Stage I breast carcinoma is classified when an invasive breast carcinoma is ≤2 cm in diameter (T1), with no regional (axillary) lymph node metastases (N0) and no distant metastases (M0). The most common sites for metastases from breast cancer are the skeleton, lung, liver, and brain. In general, women and health care professionals prefer intensive screening and surveillance after a diagnosis of breast cancer. Screening protocols include conventional imaging such as chest radiography, bone scan, ultrasound of the liver, and MRI of brain...
November 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27798020/optimum-a-protocol-for-a-multicentre-randomised-controlled-trial-comparing-out-patient-talc-slurry-via-indwelling-pleural-catheter-for-malignant-pleural-effusion-vs-usual-inpatient-management
#7
P Sivakumar, A Douiri, A West, D Rao, G Warwick, T Chen, L Ahmed
INTRODUCTION: The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis...
October 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27778056/-unilateral-spinal-anesthesia-literature-review-and-recommendations
#8
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27762608/official-executive-summary-of-an-american-thoracic-society-american-college-of-chest-physicians-clinical-practice-guideline-liberation-from-mechanical-ventilation-in-critically-ill-adults
#9
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A multi-disciplinary panel posed six clinical questions in a Population, Intervention, Comparator and Outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27742624/focused-ultrasound-examination-of-the-chest-on-patients-admitted-with-acute-signs-of-respiratory-problems-a-study-protocol-for-a-pragmatic-randomised-controlled-multicentre-trial
#10
M Riishede, C B Laursen, L S Teglbjærg, A T Lassen, G Baatrup
INTRODUCTION: Patients with acute respiratory problems poses a diagnostic challenge because similar symptoms can be caused by various pathological conditions. Focused ultrasound examination (f-US) of the heart and lungs has proven to increase the diagnostic accuracy in these patients. In this protocol of a randomised multicentre trial, we study the effect of f-US of the heart and lungs in patients with respiratory problems performed by emergency physicians (EP) as soon as the patient arrives to the emergency department (ED)...
October 14, 2016: BMJ Open
https://www.readbyqxmd.com/read/27673392/inhaled-bronchodilators-for-acute-chest-syndrome-in-people-with-sickle-cell-disease
#11
Jennifer M Knight-Madden, Ian R Hambleton
BACKGROUND: Bronchodilators are used to treat bronchial hyper-responsiveness in asthma. Bronchial hyper-responsiveness may be a component of acute chest syndrome in people with sickle cell disease. Therefore, bronchodilators may be useful in the treatment of acute chest syndrome. This is an update of a previously published Cochrane Review. OBJECTIVES: To assess the benefits and risks associated with the use of bronchodilators in people with acute chest syndrome...
September 27, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27668912/unilateral-lung-whiteout-in-children-four-cases-and-a-discussion-of-management
#12
Itaru Iwama, Moriyasu Kohama
Unilateral lung whiteout is not a common pediatric chest radiograph finding, but when it is encountered, timely and accurate interpretations of the radiograph are required because life-threatening respiratory failure can be associated. Lung whiteout may result from several conditions, and the differential diagnosis has a broad range. We describe 4 pediatric patients with different etiologies of unilateral lung whiteout: a large pleural effusion, mainstem bronchial plugging with a large cast, a mediastinal tumor, and consolidation...
September 24, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27625060/study-protocol-for-a-randomised-controlled-trial-of-invasive-versus-conservative-management-of-primary-spontaneous-pneumothorax
#13
Simon G A Brown, Emma L Ball, Kyle Perrin, Catherine A Read, Stephen E Asha, Richard Beasley, Diana Egerton-Warburton, Peter G Jones, Gerben Keijzers, Frances B Kinnear, Ben C H Kwan, Y C Gary Lee, Julian A Smith, Quentin A Summers, Graham Simpson
INTRODUCTION: Current management of primary spontaneous pneumothorax (PSP) is variable, with little evidence from randomised controlled trials to guide treatment. Guidelines emphasise intervention in many patients, which involves chest drain insertion, hospital admission and occasionally surgery. However, there is evidence that conservative management may be effective and safe, and it may also reduce the risk of recurrence. Significant questions remain regarding the optimal initial approach to the management of PSP...
September 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27614946/electrocardiographic-indicators-of-acute-coronary-syndrome-are-more-common-in-patients-with-ambulance-transport-compared-to-those-who-self-transport-to-the-emergency-department-journal-of-electrocardiology
#14
Jessica K Zègre-Hemsey, David Pickham, Michele M Pelter
INTRODUCTION: The American Heart Association recommends individuals with symptoms suggestive of acute coronary syndrome (ACS) activate the Emergency Medical Services' (EMS) 911 system for ambulance transport to the emergency department (ED), which enables treatment to begin prior to hospital arrival. Despite this recommendation, the majority of patients with symptoms suspicious of ACS continue to self-transport to the ED. The IMMEDIATE AIM study was a prospective study that enrolled individuals who presented to the ED with ischemic symptoms...
August 20, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27601550/timing-is-everything-what-is-the-optimal-duration-after-chemoradiation-for-surgery-for-rectal-cancer
#15
Karyn A Goodman
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
September 6, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27582394/duration-of-intravenous-antibiotic-therapy-in-people-with-cystic-fibrosis
#16
Amanda Plummer, Martin Wildman, Tim Gleeson
BACKGROUND: Respiratory disease is the major cause of mortality and morbidity in cystic fibrosis. Life expectancy of people with cystic fibrosis has increased dramatically in the last 40 years. One of the major reasons for this increase is the mounting use of antibiotics to treat chest exacerbations caused by bacterial infections. The optimal duration of intravenous antibiotic therapy is not clearly defined. Individuals usually receive intravenous antibiotics for 14 days, but treatment may range from 10 to 21 days...
September 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27578292/do-external-support-devices-reduce-sternal-wound-complications-after-cardiac-surgery
#17
William Tsang, Amit Modi, Ishtiaq Ahmed, Sunil K Ohri
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether external support devices reduce sternal wound complications after cardiac surgery with sternotomy. Altogether 116 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, year, journal, study type, patient group studied, relevant outcomes, results and study weaknesses are tabulated. Six randomized controlled trials investigating the effect of external chest support devices on sternal wound complications in adult patients undergoing sternotomy for cardiac surgery were selected...
August 30, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27574910/blood-transfusions-for-treating-acute-chest-syndrome-in-people-with-sickle-cell-disease
#18
REVIEW
Saeed Dastgiri, Roya Dolatkhah
BACKGROUND: Sickle cell disease is an inherited autosomal recessive blood condition and is one of the most prevalent genetic blood diseases worldwide. Acute chest syndrome is a frequent complication of sickle cell disease, as well as a major cause of morbidity and the greatest single cause of mortality in children with sickle cell disease. Standard treatment may include intravenous hydration, oxygen as treatment for hypoxia, antibiotics to treat the infectious cause and blood transfusions may be given...
August 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27558904/is-the-incidence-of-heart-attack-still-decreasing-in-australia-developing-reliable-methods-for-monitoring-trends-in-myocardial-infarction-and-coronary-heart-disease-aus-mocha-a-study-protocol
#19
Lee Nedkoff, Matthew Knuiman, Michael S T Hobbs, Joseph Hung, Sushma Mathur, John Beilby, Anna Reynolds, Tom G Briffa, Derrick Lopez, Frank M Sanfilippo
INTRODUCTION: Accurate monitoring of acute coronary heart disease (CHD) is essential for understanding the effects of primary and secondary prevention and for planning of healthcare services. The ability to reliably monitor acute CHD has been affected by new diagnostic tests for myocardial infarction (MI) and changing clinical classifications and management of CHD. Our study will develop new and reliable methods for monitoring population trends in incidence, outcomes and health service usage for acute CHD and chest pain...
August 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27526969/acr-appropriateness-criteria-staging-of%C3%A2-testicular-malignancy
#20
Joseph H Yacoub, Aytekin Oto, Brian C Allen, Fergus V Coakley, Barak Friedman, Matthew S Hartman, Keyanoosh Hosseinzadeh, Christopher Porter, V Anik Sahni, Gary S Sudakoff, Sadhna Verma, Carolyn L Wang, Erick M Remer, Steven C Eberhardt
Testicular cancer represents only 1% of all malignancies occurring in men. However, it is the most frequent malignancy in men between the ages of 20 and 34 years, accounting for 10% to 14% of cancer incidence in that age group. In most instances, the diagnosis of testicular tumors is established with a carefully performed physical examination and scrotal ultrasonography. Tumor markers are useful for determining the presence of residual disease. Cross-sectional imaging studies (CT, MRI) are useful in determining the location of metastases...
October 2016: Journal of the American College of Radiology: JACR
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