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https://www.readbyqxmd.com/read/28072761/immediate-chest-x-ray-for-patients-at-risk-of-lung-cancer-presenting-in-primary-care-randomised-controlled-feasibility-trial
#1
Richard D Neal, Allan Barham, Emily Bongard, Rhiannon Tudor Edwards, Jim Fitzgibbon, Gareth Griffiths, Willie Hamilton, Kerenza Hood, Annmarie Nelson, David Parker, Cath Porter, Hayley Prout, Kirsty Roberts, Trevor Rogers, Emma Thomas-Jones, Angela Tod, Seow Tien Yeo, Chris N Hurt
BACKGROUND: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation. METHODS: We undertook a mixed methods feasibility individually randomised controlled trial (the ELCID trial) to assess the feasibility and inform the design of a definitive, fully powered, UK-wide, Phase III trial of lowering the threshold for urgent investigation of suspected lung cancer...
January 10, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28039499/omega-%C3%AE-advancement-flap-a-circular-flap-design-for-the-aesthetic-closure-of-circular-skin-defect
#2
Enver Arpaci, Serdar Altun, Nilgün Markal Ertas, Ahmet Cagri Uysal, Emre Inozu
BACKGROUND: Most skin defects that require reconstruction with a local skin flap have a circular- or oval-shaped pattern. The majority of the skin flaps are planned in an angled shape. Therefore, it may be necessary to modify the shape of the defect or the distal flap border to minimize tissue distortion. We have designed a circular-shaped advancement flap to be compatible with the circular defect. METHODS: Eighteen cases of reconstruction of skin defects in the face, chest wall, hand and buttock area were performed using the omega advancement flap between 2010 and 2014...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28035515/anesthesia-of-torek-s-operation-the-first-successful-resection-of-a-cancer-in-the-thoracic-esophagus-an-abridged-translation-of-an-essay-in-japanese
#3
REVIEW
Hiromasa Fujita
The first successful resection of a cancer in the thoracic esophagus was performed by Franz Torek around one hundred years ago. Awareness of developments in surgery and the early history can stimulate and foster innovation among surgeons, as well as promote a deeper appreciation of the pioneers of the methods still used today. Here we report the conditions leading to Torek's operation performed in 1913. In the operation, anesthesia was achieved by tracheal insufflation. Ernst Sauerbruch, a surgeon in Germany, first developed a negative-pressure chamber for anesthesia in 1903 and subsequently used this in many open-chest operations...
December 29, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28029328/when-what-and-why-of-perioperative-treatment-of-potentially-curable-pancreatic-adenocarcinoma
#4
Kimberly Perez, Thomas E Clancy, Joseph D Mancias, Michael H Rosenthal, Brian M Wolpin
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...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28029320/pulmonary-infiltrates-in-a-patient-with-advanced-melanoma
#5
Charles A Powell
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...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27979724/a-peer-reviewed-instructional-video-is-as-effective-as-a-standard-recorded-didactic-lecture-in-medical-trainees-performing-chest-tube-insertion-a-randomized-control-trial
#6
Tomas J Saun, Scott Odorizzi, Celine Yeung, Marjorie Johnson, Glen Bandiera, Shelly P Dev
OBJECTIVE: Online medical education resources are becoming an increasingly used modality and many studies have demonstrated their efficacy in procedural instruction. This study sought to determine whether a standardized online procedural video is as effective as a standard recorded didactic teaching session for chest tube insertion. DESIGN: A randomized control trial was conducted. Participants were taught how to insert a chest tube with either a recorded didactic teaching session, or a New England Journal of Medicine (NEJM) video...
December 12, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27897967/an-observational-study-of-donor-ex-vivo-lung-perfusion-in-uk-lung-transplantation-develop-uk
#7
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
#8
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
#9
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...
January 2017: 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
#10
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
#11
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 Ng Gong, Catherine L Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, William D Schweickert, Curtis N Sessler, 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 the American College of Chest Physicians (CHEST). METHODS: A multidisciplinary panel posed six clinical questions in a population, intervention, comparator, outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach...
January 2017: Chest
https://www.readbyqxmd.com/read/27814824/acr-appropriateness-criteria-%C3%A2-stage-i-breast-carcinoma
#12
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
#13
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
#14
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
#15
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 Ng Gong, Catherine L Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, William D Schweickert, Curtis N Sessler, 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 and the American College of Chest Physicians. METHODS: A multidisciplinary panel posed six clinical questions in a Population, Intervention, Comparator, and Outcomes format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
January 1, 2017: 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
#16
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
#17
REVIEW
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
#18
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
#19
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
#20
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...
November 2016: Journal of Electrocardiology
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