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Chest Pain Center

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https://www.readbyqxmd.com/read/28647935/evaluation-of-patients-with-acute-chest-pain-using-spect-myocardial-perfusion-imaging-prognostic-implications-of-mildly-abnormal-scans
#1
Ronen Goldkorn, Alexey Naimushin, Roy Beigel, Ekaterina Naimushin, Michael Narodetski, Shlomi Matetzky
BACKGROUND: While patients presenting to emergency departments (ER) with chest pain are increasingly managed in chest pain units (CPU) that utilize accelerated diagnostic protocols for risk stratification, such as single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), data are lacking regarding the prognostic implications of mildly abnormal scans in this population. OBJECTIVES: To evaluate the prognostic implications of mildly abnormal SPECT MPI results in patients with acute chest pain...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#2
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#3
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28600021/st-segment-elevation-myocardial-infarction-in-patients-hospitalized-for-non-cardiac-conditions
#4
Justin Tiulim, Kevin Mak, David M Shavelle
BACKGROUND: Timely use of primary percutaneous coronary intervention (PCI) is the standard of care for patients with ST segment elevation myocardial infarction (STEMI). Most patients with STEMI present via emergency medical services or self-transport to the emergency department (ED) and relatively little is known about the minority of patients that develop STEMI while hospitalized for non-cardiac conditions. The objective of this study was to analyze treatment times and clinical outcome for in-hospital STEMI patients...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28588172/primary-angioplasty-for-the-treatment-of-acute-st-elevated-myocardial-infarction-single-centre-experience
#5
K N Khan, M H Khan, R Rahman, M A Rashid, S Z Haque, Z Zakia
Worldwide primary angioplasty is a recommended strategy of reperfusion in patient with acute myocardial infarction as because it ensures reperfusion of the infarct-related vessels more than 90% whereas, with thrombolytics it is only 60-70%. This retrospective observational study includes all patients treated with primary angioplasty at United Hospital from Between March 2007 to January 2011. Total 114 consecutive patients with acute myocardial infarction were treated with primary angioplasty included. Those presented beyond 12 hours of onset of chest pain, in cardiogenic shock, resuscitate and intubated before the procedure were excluded from the study...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#6
S de Pascale, A Repici, F Puccetti, E Carlani, R Rosati, U Fumagalli
Achalasia is a neurodegenerative motility disorder of the esophagus; dysphagia, weight loss, chest pain, and regurgitation are its main symptoms. Surgical myotomy (HM) is considered the gold standard treatment. However, peroral endoscopic myotomy (POEM) seems to be a safe and effective alternative option. The aim of this study is to compare the safety and efficacy of these techniques. From March 2012 to June 2015, 74 patients with symptomatic primary achalasia underwent myotomy. The two groups were compared in terms of intraoperative and postoperative outcomes and Eckardt score at last follow-up...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28570317/safety-of-nebulized-epinephrine-in-smoke-inhalation-injury
#7
Guillermo Foncerrada, Francisco Lima, Robert P Clayton, Ronald P Mlcak, Perenlei Enkhbaatar, David N Herndon, Oscar E Suman
This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD], 12 ± 4 years) with burns covering more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care plus nebulized epinephrine (n = 8)...
May 16, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28523131/uniportal-video-assisted-thoracic-surgery-the-middle-east-experience
#8
Firas Abu Akar, Diego Gonzalez-Rivas, Mahmoud Ismail, Maher Deeb, Yefim Reichenshtein, Irith Hadas-Halpern, Rachel Tauber, Daniel Fink
BACKGROUND: The application of uniportal video-assisted thoracic surgery (VATS) for both minor and major thoracic procedures is gaining widespread use across the globe. Believing its advantages, both in superb surgical results and less morbidity, our center has the privilege to be one of the first centers in the Middle East to introduce this surgical technique into our standard practice. This study presents our initial experience using this technique in 192 procedures and demonstrates the results of postoperative pain level in a sample of 90 patients...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#9
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#10
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28496513/dog-footprint-in-the-heart
#11
Hassan Aghajani, Shahrooz Yazdani, Seyed Khalil Forouzan Nia, Hamed Vahidi, Faezeh Aghajani
Cardiac manifestations of the hydatid cyst are relatively uncommon. Cardiac involvement may lead to the compression of vital organs, pulmonary hypertension, pericardial effusion, and even anaphylaxis. A 45-year-old woman presented to the Emergency Department of Tehran Heart Center with chest pain. Cardiac examination revealed relatively muffled heart sounds. Echocardiography demonstrated a round echolucent well-defined mass (47 × 25 mm) on the base and the mid lateral wall of the left ventricle (LV) without septation...
October 3, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28489642/pupillary-reflex-for-evaluation-of-thoracic-paravertebral-block-a-prospective-observational-feasibility-study
#12
Baptiste Duceau, Mélanie Baubillier, Gaëlle Bouroche, Aline Albi-Feldzer, Christian Jayr
BACKGROUND: Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB. METHODS: This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28479774/renal-medullary-carcinoma-with-an-ophthalmic-metastasis
#13
Christine Ibilibor, Allen Medway, Thomas Nelius
Renal medullary carcinoma (RMC) is a rare, aggressive primary renal malignancy that classically occurs in adolescent males with sickle cell trait and universally presents with metastatic disease at presentation. We report a case of medullary carcinoma in a young man with likely ophthalmic metastasis. We also review relevant literature available to date. The patient is a 20-year-old African-American male with a past medical history significant to for sickle cell trait who presented to the University Medical Center with cough and the right eye pain for 1 month as well as painless gross hematuria for 1 week...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28471977/clinical-characteristics-and-outcomes-of-left-ventricular-pseudoaneurysm-a-retrospective-study-in-a-single-center-of-china
#14
Xu Meng, Yan-Kun Yang, Kun-Qi Yang, Ying Zhang, Pei-Pei Lu, Peng Fan, Li-Hong Ma, Xian-Liang Zhou
Left ventricular (LV) pseudoaneurysm is a fatal and rare condition with a high risk of rupture. The symptoms are nonspecific and diagnosis is often delayed. The purpose of this study is to analysis a series of cases in our institution.Between March 2009 and April 2016, 10 patients (5 males and 5 females) with LV pseudoaneurysm were retrospectively enrolled. Clinical information, diagnostic imaging modalities, treatment, and outcomes were evaluated.The mean age was 58.2 ± 11.0 years (28-71 years). The common symptoms were chest pain (3 cases), dyspnea (3 cases), and syncope (2 cases)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28461275/isolated-transverse-process-fractures-and-markers-of-associated-injuries-the-ucla-experience
#15
Timothy T Bui, Daniel T Nagasawa, Carlito Lagman, Cheng Hao Jacky Chen, Lawrance K Chung, Brittany L Voth, Joel S Beckett, Alexander M Tucker, Tianyi Niu, Bilwaj Gaonkar, Isaac Yang, Luke Macyszyn
OBJECTIVES: To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. Additionally, the authors evaluate the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs. METHODS: The Ronald Reagan UCLA Medical Center patient database was queried (years 2005 to 2016) using International Classification of Diseases, Ninth Revision code 805: fracture of the vertebral column without mention of spinal cord injury...
April 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28460770/barriers-to-early-discharge-after-elective-percutaneous-coronary-intervention-bed-pci-a-single-center-study
#16
Francis D Graziano, Sandeep Banga, Denise K Busman, Purushothaman Muthusamy, David H Wohns
OBJECTIVE: To identify patient characteristics and procedural factors that may play a role in hindering same-day discharge (SDD) practices. BACKGROUND: Multiple studies have shown the safety and cost effectiveness of SDD following elective percutaneous coronary intervention (PCI), but factors that hinder SDD practices have not been thoroughly studied. MATERIAL AND METHODS: A retrospective comparative analysis of elective PCI patients who had an overnight stay (OS) (n=345) vs...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28459900/association-between-radiologic-incidental-findings-and-resource-utilization-in-patients-admitted-with-chest-pain-in-an-urban-medical-center
#17
Venkat P Gundareddy, Nisa M Maruthur, Abednego Chibungu, Preetam Bollampally, Regina Landis, Shaker M Eid
BACKGROUND: Increasing use of testing among hospitalized patients has resulted in an increase in radiologic incidental findings (IFs), which challenge the provision of high-value care in the hospital setting. OBJECTIVE: To understand impact of radiologic incidental findings on resource utilization in patients hospitalized with chest pain. DESIGN: Retrospective observational cross sectional study. SETTING: Academic medical center...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28457113/stereotactic-ablative-body-radiation-for-stage-i-lung-cancer-in-israel-a-retrospective-single-center-report
#18
Sarit Appel, Yaacov R Lawrence, Jeffery Goldstein, Raphael M Pfeffer, Ilana Weiss, Tatiana Rabin, Shira Felder, Maoz Ben-Ayun, Lev Tzvang, Dror Alezra, David Simansky, Alon Ben-Nun, Jair Bar, Zvi Symon
BACKGROUND: Stereotactic ablative radiation therapy (SABR) is the application of a very high radiation dose to a small treatment volume. It is the new standard of care in medically inoperable early-stage lung cancer. OBJECTIVES: To report the outcomes of SABR in stage I lung cancer at Sheba Medical Center since its introduction in 2009. METHODS: We conducted a retrospective chart review of patients with stage I lung cancer treated during the period 2009-2015...
January 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28454822/noncardiac-chest-pain-after-acute-myocardial-infarction-frequency-and-association-with-health-status-outcomes
#19
Mohammed Qintar, John A Spertus, Yuanyuan Tang, Donna M Buchanan, Paul S Chan, Amit P Amin, Adam C Salisbury
BACKGROUND: The frequency of noncardiac chest pain (CP) hospitalization after acute myocardial infarction (AMI) is unknown, and its significance from patients' perspectives is not studied. OBJECTIVES: To assess the frequency of noncardiac CP admissions after AMI and its association with patients' self-reported health status. METHODS: We identified cardiac and noncardiac CP hospitalizations in the year after AMI from the 24-center TRIUMPH registry...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28444489/biodegradable-stents-for-caustic-esophageal-strictures-do-they-work
#20
Rakesh Kochhar, Jayanta Samanta, Jahangeer Basha, Abhai Verma, Gourdas Choudhuri, Sundeep Lakhtakia, D Nageshwar Reddy
Biodegradable (BD) stents have been used for the management of various esophageal strictures (ES) but the experience of its use in caustic strictures is limited. The present study, aimed at evaluating efficacy of BD stents for the treatment of refractory caustic-induced ES, was a retrospective multi-center study conducted at three tertiary care centers in India wherein adult patients with refractory caustic induced strictures underwent placement of a BD stent. Patients were followed up for immediate complications and long term outcome...
April 25, 2017: Dysphagia
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