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Chest Pain Center

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https://www.readbyqxmd.com/read/29768319/contrast-enhanced-stress-echocardiography-and-myocardial-perfusion-imaging-in-patients-hospitalized-with-chest-pain-a-randomized-study
#1
Gerald Salame, Whitney E Juselius, Marisha Burden, Carlin S Long, Tiffany Bendelow, Brenda Beaty, Frederick A Masoudi, Mori J Krantz
Ultrasound contrast-enhanced stress echocardiography improves endocardial visualization, but diagnostic test rates versus stress myocardial perfusion imaging (MPI) have not been studied. A prospective randomized trial was performed between April 2012 and October 2014 at a single-center, safety net hospital. Hospitalized patients referred for noninvasive stress imaging were randomized 1:1 to stress echocardiography or stress MPI. The primary outcome was diagnostic test rate defined as interpretable images and achievement of >85% of age-predicted maximal heart rate (for dobutamine and exercise)...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29762925/association-between-myxomatous-mitral-valve-disease-and-skeletal-back-abnormalities
#2
Alireza Movahed, David Majdalany, Marc Gillinov, William Schiavone
BACKGROUND: Myxomatous mitral valve disease (MMVD) is one of the most prevalent valvular heart diseases, while back pain, neck pain and upper-extremity numbness are some of the most common complaints in outpatient settings. Decreased thoracic kyphosis (straight back) is a known cause of hastening back or neck problems, radiculopathy, or even myelopathy. The study aim was to examine the relationship between MMVD, straight back, and the need for cervical fusion. METHODS: In this single-center retrospective study, patients who underwent mitral valve repair or replacement due to MMVD (cases) based on age, gender and body mass index (BMI), were matched with patients who underwent coronary artery bypass grafting (CABG) surgery and had no history of mitral valve disease (controls)...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29760864/3-for-the-price-of-1-teaching-chest-pain-risk-stratification-in-a-multidisciplinary-problem-based-learning-workshop
#3
William D Alley, Cynthia Burns, Nicholas D Hartman, Kim Askew, Simon A Mahler
Introduction: Chest pain is a common chief complaint among patients presenting to health systems and often leads to complex and intensive evaluations. While these patients are often cared for by a multidisciplinary team (primary care, emergency medicine, and cardiology), medical students usually learn about the care of these patients in a fragmented, single-specialty paradigm. The present and future care of patients with chest pain is multidisciplinary, and the education of medical students on the subject should be as well...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29750984/liquid-nitrogen-spray-cryotherapy-for-dysphagia-palliation-in-patients-with-inoperable-esophageal-cancer
#4
Toufic Kachaamy, Ravi Prakash, Madappa Kundranda, Raman Batish, Jeffrey Weber, Scott Hendrickson, Leon Yoder, Hannah Do, Theresa Magat, Rajeev Nayar, Digant Gupta, Trisha DaSilva, Ashish Sangal, Shivangi Kothari, Vivek Kaul, Pankaj Vashi
BACKGROUND AND AIMS: Dysphagia is a debilitating symptom in patients with inoperable esophageal cancer contributing to poor quality of life and worsening nutritional status. The 2 most commonly used palliative modalities for dysphagia are radiation therapy (RT) and esophageal stent placement. However, RT is limited by adverse events (AEs) and total dose, and stent placement has a high rate of AEs including reflux, migration, and chest pain. A relatively new modality of liquid nitrogen endoscopic spray cryotherapy has been described as salvage when other options have been exhausted and when patients are no longer receiving systemic therapy...
May 8, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29748750/clinical-and-laboratory-features-of-children-with-community-acquired-pneumonia-are-associated-with-distinct-radiographic-presentations
#5
Oana G Falup-Pecurariu, Javier Diez-Domingo, Susanna Esposito, Adam Finn, Fernanda Rodrigues, Vana Spoulou, George A Syrogiannopoulos, Vytautas Usonis, David Greenberg
Chest radiographs from children with community-acquired pneumonia (CAP) were categorized into three distinct presentations and each presentation was correlated to clinical and laboratory findings. Children < 59 months with CAP presenting to pediatric emergency rooms during two years were enrolled prospectively in eight centers across Europe. Clinical and laboratory data were documented and radiographs obtained from patients. Of the 1107 enrolled patients, radiographs were characterized as 74.9% alveolar CAP, 8...
May 11, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29715707/rib-radiography-versus-chest-computed-tomography-in-the-diagnosis-of-rib-fractures
#6
Atsushi Sano
BACKGROUND:  The accurate diagnosis of rib fractures is important in chest trauma. Diagnostic images following chest trauma are usually obtained via chest X-ray, chest computed tomography, or rib radiography. This study evaluated the diagnostic characteristics of rib radiography and chest computed tomography. METHODS:  Seventy-five rib fracture patients who underwent both chest computed tomography and rib radiography between April 2008 and December 2013 were included...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29702988/enteritis-as-initial-manifestation-of-systemic-lupus-erythematosus-in-early-pregnancy-a-case-report
#7
Anna Maria Bellou, Dominik Bös, Guido Kukuk, Ulrich Gembruch, Waltraut Maria Merz
RATIONAL: Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE). We report of a patient who presented with enteritis as manifestation of new-onset SLE during the first trimester of pregnancy. PATIENTS CONCERNS: The 23-year nulliparous patient was admitted to a district hospital with abdominal pain, nausea, vomiting and bloody diarrhea at a gestational age (GA) of 10 weeks. Her symptoms improved with symptomatic treatment and she was discharged a few days later...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29687656/cha-2-ds-2-vasc-score-and-clinical-outcomes-of-patients-with-chest-pain-discharged-from-internal-medicine-wards-following-acute-coronary-syndrome-rule-out
#8
Guy Topaz, Ory Haisraely, Yacov Shacham, Gil Beery, Lotan Shilo, Nuha Kassem, David Pereg, Yona Kitay-Cohen
BACKGROUND: Chest-pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes. HYPOTHESIS: CHA2 DS2 -VASc score improves risk stratification of low-risk chest-pain patients discharged after acute coronary syndrome (ACS) rule-out. METHODS: We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010-2016 and discharged following an ACS rule-out...
April 23, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29673795/electrochemotherapy-for-breast-cancer-results-from-the-inspect-database
#9
Louise Wichmann Matthiessen, Mohammed Keshtgar, Pietro Curatolo, Christian Kunte, Eva-Maria Grischke, Joy Odili, Tobian Muir, David Mowatt, James P Clover, Se Hwang Liew, Karin Dahlstroem, Jackie Newby, Valerie Letulé, Eva Stauss, Alison Humphreys, Shramana Banerjee, Annette Klein, Roberta Rotunno, Francesca de Terlizzi, Julie Gehl
BACKGROUND: Cutaneous recurrence from breast cancer can pose a clinical challenge. It might be the only disease site, or could be part of disseminated disease, and often profoundly affects quality of life. Electrochemotherapy is a palliative treatment using electric pulses to locally permeabilize tumor cells and thereby significantly increase bleomycin cytotoxicity. Collaborating with the International Network for Sharing Practice on ElectroChemoTherapy (INSPECT), we consecutively and prospectively accrued data on patients treated with electrochemotherapy for cutaneous metastases from breast cancer...
March 14, 2018: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29664430/-kounis-syndrome-a-paradoxal-non-st-elevation-myocardial-infarction-case-after-triamcinolone-treatment-for-dermatitis
#10
Mücahid Yılmaz, Hasan Korkmaz
Kounis syndrome is defined as the clinical development of acute coronary syndrome caused by the activation of inflammatory cells due to an allergy, hypersensitivity, anaphylaxis, or anaphylactic reaction. Corticosteroids that are used in the treatment of many inflammatory conditions may paradoxically cause allergic reactions and even anaphylaxis. This article is a description of the case of a 52-yearold female patient who had a non-ST elevation myocardial infarction after the administration of triamcinolone that was relieved with antihistaminic treatment...
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29656480/development-of-a-risk-prediction-model-for-middle-east-respiratory-syndrome-coronavirus-infection-in-dialysis-patients
#11
Anwar E Ahmed, Abeer N Alshukairi, Hamdan Al-Jahdali, Mody Alaqeel, Salma S Siddiq, Hanan A Alsaab, Ezzeldin A Sakr, Hamed A Alyahya, Munzir M Alandonisi, Alaa T Subedar, Nouf M Aloudah, Salim Baharoon, Majid A Alsalamah, Sameera Al Johani, Mohammed G Alghamdi
Introduction The Middle East respiratory syndrome coronavirus (MERS-CoV) infection can cause transmission clusters and high mortality in hemodialysis facilities. We attempted to develop a risk-prediction model to assess the early risk of MERS-CoV infection in dialysis patients. Methods This two-center retrospective cohort study included 104 dialysis patients who were suspected of MERS-CoV infection and diagnosed with rRT-PCR between September 2012 and June 2016 at King Fahd General Hospital in Jeddah and King Abdulaziz Medical City in Riyadh...
April 14, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29655771/iodinated-contrast-media-allergy-in-patients-hospitalized-for-investigation-of-chest-pain
#12
Guy Topaz, Adi Karas, Nuha Kassem, Yona Kitay-Cohen, David Pereg, Lotan Shilo, Adi Zoref-Lorenz, Alon Y Hershko
BACKGROUND: Iodinated contrast media (ICM) allergy may entail severe adverse events in patients who undergo percutaneous coronary intervention (PCI). Premedication protocols and low-osmolality contrast media have been thought to improve the outcomes of these individuals. OBJECTIVE: To assess the prevalence and severity of allergic reactions during PCI in patients admitted for investigation of chest pain. METHODS: This is a retrospective analysis of 13,652 patients who were hospitalized with chest pain during the years 2010-2016, at the Department of Internal Medicine, Meir Medical Center...
April 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29642752/lupus-myocarditis-a-single-center-experience-and-a-comparative-analysis-of-observational-cohort-studies
#13
J Tanwani, K Tselios, D D Gladman, J Su, M B Urowitz
Background Lupus myocarditis (LM) is reported in 3-9% of patients with systemic lupus erythematosus (SLE) but limited evidence exists regarding optimal treatment and prognosis. This study aims to describe LM in a defined lupus cohort as compared with the existing literature. Patients and methods Patients with LM were identified from the University of Toronto Lupus Clinic database. Diagnosis was based on clinical manifestations and electrocardiographic, imaging, and biochemical criteria. Demographic, clinical, diagnostic and therapeutic variables and outcomes were collected in a standardized data retrieval form...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29594190/complex-pulmonary-aspergilloma-surgical-challenges-in-a-third-world-setting
#14
Bernadette Ngo Nonga, Guy Aristide Bang, Bonaventure Jemea, Eric Savom, Perfura Yone, Ngahane Mbatchou, Jean Jacques Ze
Background: Surgery for pulmonary aspergilloma (PA), especially complex forms, is greatly challenging in a resource-poor setting such as Cameroon. We report our experience of surgical management of PA in this environment. Method: We prospectively assessed patients who underwent surgery for PA from January 2012 to May 2015, at the University Hospital Center of Yaoundé. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures, and outcomes...
2018: Surgery Research and Practice
https://www.readbyqxmd.com/read/29579428/socio-demographic-profile-and-outcome-of-tb-patients-registered-at-dtc-rewa-of-central-india
#15
Rohit Trivedi Rohit, Anjana Niranjan, Paharam Adhikari Pawan
BACKGROUND: Tuberculosis is a specific infectious disease caused by Mycobacterium tuberculosis. The disease is usually chronic with cardinal features such as persistent cough with or without expectoration, intermittent fever, and loss of appetite, weight loss, chest pain and hemoptysis. OBJECTIVE: (1) To assess the socio-demographic profile of the patients attending DOTS Center. (2) To assess outcome of treatment under DOTS Center. METHODOLOGY: This is a Prospective Longitudinal study conducted among the patients attending DOTS center of DTC located at S...
April 2018: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/29576785/incidental-finding-of-a-large-mobile-aortic-arch-mass-during-conventional-angiography
#16
Hassan Aghajani, Shahrooz Yazdani, Mohammad Ghafaripoor, Zahra Shajari
Thromboembolism occurs commonly in general practice and leads to significant health burden. Apart from cardiac sources, aortic atherosclerotic plaques contribute considerably to thromboembolism. A 63-year-old diabetic hypertensive woman referred to our center due to exertional chest pain unresponsive to optimal medical therapy and underwent coronary angiography. Owing to resistance during guide-wire advancement, an aortography was performed. Aortic arch injection demonstrated a large suspended mass distal to the left subclavian artery with free movement in the descending thoracic aorta...
October 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/29553278/patients-discharged-from-the-emergency-department-after-referral-for-hospitalist-admission
#17
Christopher A Caulfield, John Stephens, Zarina Sharalaya, Jeffrey P Laux, Carlton Moore, Daniel E Jonas, Edmund A Liles
OBJECTIVES: To describe the characteristics and outcomes of patients discharged from the emergency department (ED) by hospitalist physicians. STUDY DESIGN: Retrospective cohort study at a tertiary academic medical center. METHODS: We used consultation Current Procedural Technology codes to identify patients discharged from the ED after referral for hospitalist admission from April 2011 to April 2014. We report patient demographics and primary diagnoses...
March 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29540151/anxiety-about-anxiety-a-survey-of-emergency-department-provider-beliefs-and-practices-regarding-anxiety-associated-low-risk-chest-pain
#18
Paul I Musey, John A Lee, Cassandra A Hall, Jeffrey A Kline
BACKGROUND: Approximately 80% of patients presenting to emergency departments (ED) with chest pain do not have any true cardiopulmonary emergency such as acute coronary syndrome (ACS). However, psychological contributors such as anxiety are thought to be present in up to 58%, but often remain undiagnosed leading to chronic chest pain and ED recidivism. METHODS: To evaluate ED provider beliefs and their usual practices regarding the approach and disposition of patients with low risk chest pain associated with anxiety, we constructed a 22-item survey using a modified Delphi technique...
March 14, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29538525/sensitive-troponin-i-assay-in-patients-with-chest-pain-association-with-significant-coronary-lesions-with-or-without-renal-failure
#19
Alexandre de Matos Soeiro, Danielle Menosi Gualandro, Aline Siqueira Bossa, Cindel Nogueira Zullino, Bruno Biselli, Maria Carolina Feres de Almeida Soeiro, Tatiana de Carvalho Andreucci Torres Leal, Carlos Vicente Serrano, Mucio Tavares de Oliveira Junior
INTRODUCTION: Despite having higher sensitivity as compared to conventional troponins, sensitive troponins have lower specificity, mainly in patients with renal failure. OBJECTIVE: Study aimed at assessing the sensitive troponin I levels in patients with chest pain, and relating them to the existence of significant coronary lesions. METHODS: Retrospective, single-center, observational. This study included 991 patients divided into two groups: with (N = 681) and without (N = 310) significant coronary lesion...
January 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29526358/patients-with-anomalous-aortic-origin-of-the-coronary-artery-remain-at-risk-after-surgical-repair
#20
Shannon N Nees, Jonathan N Flyer, Anjali Chelliah, Jeffrey D Dayton, Lorraine Touchette, David Kalfa, Paul J Chai, Emile A Bacha, Brett R Anderson
OBJECTIVES: Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva is a rare cardiac anomaly associated with sudden cardiac death (SCD). Single-center studies describe surgical repair as safe, although medium- and long-term effects on symptoms and risk of SCD remain unknown. We sought to describe outcomes of surgical repair of AAOCA. METHODS: We reviewed institutional records for patients who underwent AAOCA repair, from 2001 to 2016, at 2 affiliated institutions...
June 2018: Journal of Thoracic and Cardiovascular Surgery
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