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Chest Pain Center

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https://www.readbyqxmd.com/read/28523131/uniportal-video-assisted-thoracic-surgery-the-middle-east-experience
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#14
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28409655/9-1-1-triage-of-non-traumatic-chest-pain-association-with-hospital-diagnosis
#15
Greg Scott, Jeff J Clawson, Isabel Gardett, Meghan Broadbent, Nathan Williams, Conrad Fivaz, Gigi Marshall, Tracey Barron, Christopher Olola
OBJECTIVE: Chest pain is one of the most common reasons people seek emergency care-and one of the most critical. In the United States, chest pain is the second most common reason for emergency department (ED) visits. A patient's primary complaint of "chest pain" may reflect a broad range of underlying causes; therefore, it is important that emergency medical service (EMS) agencies gain a thorough understanding of these cases, beginning with the initial management of chest pain in the 9-1-1 center...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28396659/disease-phenotype-and-outcome-depending-on-the-age-at-disease-onset-in-patients-carrying-the-r92q-low-penetrance-variant-in-tnfrsf1a-gene
#16
Estíbaliz Ruiz-Ortiz, Estíbaliz Iglesias, Alessandra Soriano, Segundo Buján-Rivas, Marta Español-Rego, Raul Castellanos-Moreira, Adrià Tomé, Jordi Yagüe, Jordi Antón, José Hernández-Rodríguez
BACKGROUND: Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal-dominant autoinflammatory disease caused by mutations in the TNFRSF1A gene. R92Q, a low-penetrance variant, is usually associated with a milder TRAPS phenotype than structural or pathogenic mutations. No studies differentiating R92Q-related disease in patients with pediatric and adult onset have been performed to date. OBJECTIVE: To analyze clinical features and disease outcomes in patients diagnosed with TRAPS associated with R92Q variant and to investigate differences between patients with pediatric and adult disease onset...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28391413/self-expanding-metal-stents-improve-swallowing-and-maintain-nutrition-during-neoadjuvant-therapy-for-esophageal-cancer
#17
Zachary L Smith, Jason E Gonzaga, George B Haasler, Elizabeth M Gore, Kulwinder S Dua
BACKGROUND: Patients with locally advanced esophageal cancer can have significant dysphagia. Nutritional support during neoadjuvant therapy is often delivered via nasoenteric or percutaneous feeding tubes. These approaches do not allow for per-oral feeding. AIMS: Evaluate the safety and efficacy of fully covered self-expanding metal esophageal stents for nutritional support during neoadjuvant therapy. METHODS: This was a pilot, prospective study at a single tertiary center...
April 8, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28377546/high-prevalence-of-coronary-artery-calcification-in-saudi-patients-with-normal-myocardial-perfusion
#18
Ahmed L Fathala, Salwa Q Bukhari, Mohamed Shoukri, Hani El Sergani, Bandar Al-Ghamdi, Abdulaziz Al-Sugair
BACKGROUND: Normal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has a high negative predictive value for ischemic heart disease. Thus, the presence of subclinical coronary atherosclerosis detected by coronary artery calcification (CAC) score in patients who have under-gone SPECT MPI is unknown. OBJECTIVES: Determine the prevalence of coronary artery calcification (CAC) in patients with normal SPECT MPI and examine the association of CAC with conventional coronary artery disease (CAD) risk factors...
March 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28355246/search-8es-a-novel-point-of-care-ultrasound-protocol-for-patients-with-chest-pain-dyspnea-or-symptomatic-hypotension-in-the-emergency-department
#19
Jung Hwan Ahn, Jin Jeon, Hong-Chuen Toh, Vicki Elizabeth Noble, Jun Su Kim, Young Sik Kim, Han Ho Do, Young Rock Ha
OBJECTIVE: This study was conducted to evaluate a problem-oriented focused torso bedside ultrasound protocol termed "Sonographic Evaluation of Aetiology for Respiratory difficulty, Chest pain, and/or Hypotension" (SEARCH 8Es) for its ability to narrow differential diagnoses and increase physicians' diagnostic confidence, and its diagnostic accuracy, for patients presenting with dyspnea, chest pain, or symptomatic hypotension. METHODS: This single-center prospective observational study was conducted over 12 months in an emergency department and included 308 patients (184 men and 124 women; mean age, 67...
2017: PloS One
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#20
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
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