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https://www.readbyqxmd.com/read/29468074/development-of-a-patient-centred-evidence-based-and-consensus-based-discharge-care-bundle-for-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#1
Maria B Ospina, Marta Michas, Lesly Deuchar, Richard Leigh, Mohit Bhutani, Brian H Rowe, Darcy Marciniuk, Donna Goodridge, Gail Dechman, Jean Bourbeau, Meyer Balter, Pat Camp, Paul Hernandez, Roger S Goldstein, Michael K Stickland
Introduction: Hospital and emergency department discharge for patients with chronic obstructive pulmonary disease (COPD) is often poorly organised. We developed a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbations of COPD. Methods: A purposeful sample of clinicians and patients were invited to participate in a two-round Delphi study (July-November 2015). In round 1, participants rated on a seven-point Likert scale (1=not at all important; 7=extremely important) the importance of 29 unique COPD care actions...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29467072/social-gradients-in-myocardial-infarction-and-stroke-diagnoses-in-emergency-medicine
#2
Christoph Hanefeld, Alexander Haschemi, Thomas Lampert, Hans J Trampisch, Andreas Mügge, Janine Miebach, Cordula Kloppe, Renate Klaaßen-Mielke
BACKGROUND: Persons of lower socio-economic status are at higher risk of disease, especially with respect to severe and chronic illnesses. To date, there have not been any studies with large case numbers regarding acute medical emergencies in this population. METHODS: In a retrospective study, data were obtained on all cases treated by emergency physicians in Bochum, Germany, in 2014/2015, including the diagnoses that were made by the emergency physicians. There were a total of 16 767 cases...
January 26, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29467048/pregnancy-associated-spontaneous-coronary-artery-dissection-pascad-an-etiology-for-chest-pain-in-the-young-peripartum-patient
#3
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
https://www.readbyqxmd.com/read/29464655/glp-1-improves-diastolic-function-and-survival-in-heart-failure-with-preserved-ejection-fraction
#4
T Dung Nguyen, Yasushige Shingu, Paulo A Amorim, Christina Schenkl, Michael Schwarzer, Torsten Doenst
Heart failure with preserved ejection fraction (HFpEF) has emerged as a public health burden with currently no effective medication. We assessed the treatment effects of the incretin hormone glucagon-like peptide-1 (GLP-1) on cardiac metabolism and function in a model of HFpEF. Following aortic banding, rats developed HFpEF characterized by diastolic dysfunction, pulmonary congestion, and poor survival (38%). A 4-week GLP-1 treatment via osmotic pumps significantly improved survival (70%) and reduced left ventricular stiffness, diastolic dysfunction, and pulmonary congestion...
February 20, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29464221/a-young-puerperal-woman-presenting-to-emergency-department-with-severe-dyspnea
#5
Adnan Yamanoglu, Nalan Gokce Celebi Yamanoglu, Sumeyye Cakmak, Ozgur Sogut
Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure (HF) secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of HF is found. The symptoms and signs of this rare disorder mimic those of the physiological changes of pregnancy or other cardiovascular diseases. Consequently, its diagnosis is frequently delayed, which worsens an already poor prognosis. Here, we report a young adult who was diagnosed with PPCM, early, with the help of focused cardiac ultrasonography, performed after presenting to the emergency department with nonspecific respiratory complaints, including dyspnea and hemoptysis, which suggested at first pulmonary embolism...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29463343/characteristics-associated-with-mortality-in-patients-with-chronic-obstructive-pulmonary-disease-copd-heart-failure-coexistence
#6
Franciele Plachi, Fernanda M Balzan, Renata A Sanseverino, Dora V Palombini, Renata D Marques, Nadine O Clausell, Marli M Knorst, J Alberto Neder, Danilo C Berton
Aim To investigate if cardiac/pulmonary functional tests and variables obtained from clinical practice (body mass index, dyspnea, functional class, clinical judgment of disability to perform an exercise test and previous hospitalization rate) are related to mortality in patients with overlap chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). BACKGROUND: Although the coexistence of COPD and CHF has been growingly reported, description of survival predictors considering the presence of both conditions is still scarce...
February 21, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29462775/gait-analysis-in-patients-with-chronic-obstructive-pulmonary-disease-a-systematic-review
#7
REVIEW
Matteo Zago, Chiarella Sforza, Daniela Rita Bonardi, Enrico Eugenio Guffanti, Manuela Galli
BACKGROUND: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD. RESEARCH QUESTION: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD. METHODS: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases...
February 13, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29462672/use-of-high-dose-intermittent-systemic-glucocorticoids-and-the-risk-of-fracture-in-patients-with-chronic-obstructive-pulmonary-disease
#8
Olorunfemi A Oshagbemi, Andrea M Burden, Kimberly N Shudofsky, Johanna H M Driessen, Peter Vestergaard, Andreas Krings, Frits Franssen, Joop van den Bergh, Frank de Vries
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterised by persistent airflow obstruction and respiratory symptoms. While short course systemic GCs are prescribed in patients with acute COPD exacerbations, little is known of the risk of fractures with intermittent exposure to high-dose GC and the effect of proxies of disease severity. METHODS: A case-control study was conducted using the Danish National Hospital Discharge Registry (NHDR) between January 1996 to December 2011...
February 17, 2018: Bone
https://www.readbyqxmd.com/read/29460648/telemonitoring-and-home-hospitalization-in-patients-with-chronic-obstructive-pulmonary-disease-study-telepoc
#9
Manuel Mirón Rubio, Rocío Ceballos Fernández, Inmaculada Parras Pastor, Amaya Palomo Iloro, Borja Manuel Fernández Félix, Jenifer Medina Miralles, Esther Zamudio López, Javier González Pastor, Caridad Amador Lorente, Nazaret Mena Hortelano, Alejandro Domínguez Sánchez, Soledad Alonso-Viteri
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major consumer of healthcare resources, with most costs related to disease exacerbations. Telemonitoring of patients with COPD may help to reduce the number of exacerbations and/or the related costs. On the other hand, home hospitalization is a cost-saving alternative to inpatient hospitalization associated with increased comfort for patients. The results are reported regarding using telemonitoring and home hospitalization for the management of patients with COPD...
February 20, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29459308/air-pollution-and-emergency-department-visits-for-respiratory-diseases-a-multi-city-case-crossover-study
#10
Mieczysław Szyszkowicz, Termeh Kousha, Jessica Castner, Robert Dales
Increasing evidence suggests that ambient air pollution is a major risk factor for both acute and chronic respiratory disease exacerbations and emergencies. The objective of this study was to determine the association between ambient air pollutants and emergency department (ED) visits for respiratory conditions in nine districts across the province of Ontario in Canada. Health, air pollutant (PM2.5 , NO2 , O3 , and SO2 ), and meteorological data were retrieved from April 2004 to December 2011. Respiratory diseases were categorized as: chronic obstructive pulmonary disease (COPD, including bronchiectasis) and acute upper respiratory diseases...
February 16, 2018: Environmental Research
https://www.readbyqxmd.com/read/29458107/wnt-receptor-signalling-in-lung-physiology-and-pathology
#11
REVIEW
Wioletta Skronska-Wasek, Reinoud Gosens, Melanie Königshoff, Hoeke Abele Baarsma
The WNT signalling cascades have emerged as critical regulators of a wide variety of biological aspects involved in lung development as well as in physiological and pathophysiological processes in the adult lung. WNTs (secreted glycoproteins) interact with various transmembrane receptors and co-receptors to activate signalling pathways that regulate transcriptional as well as non-transcriptional responses within cells. In physiological conditions, the majority of WNT receptors and co-receptors can be detected in the adult lung...
February 16, 2018: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29456641/multiple-site-bleeding-at-pleural-adhesions-and-massive-hemothorax-following-percutaneous-coronary-intervention-with-stent-implantation-a-case-report
#12
Xiaoli Luo, Weibin Shi, Xiaoqun Zhang, Xiaoli Yang, Wei Wang, Chunyu Zeng, Hongyong Wang
An elderly male patient with coronary heart disease underwent coronary angiography, which revealed bilateral severe coronary artery stenosis. Four stents were implanted, and at 5 h post-surgery, typical hemorrhagic shock appeared. Echocardiography verified heavy bleeding in the right thoracic cavity. Emergency angiography excluded injury or perforation of the coronary artery, aorta, right subclavian artery and brachiocephalic artery. Considering the patient's history of chronic obstructive pulmonary disease and severe cough during the operation, it was suspected that hemothorax was induced by a blood vessel rupture in the pleura...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29455822/pulmonary-hemorrhage-due-to-unrecognized-bronchial-collateral-after-arterial-switch-operation
#13
Sreelakshmi P Leeladharan, Jessin P Jayashankar, Brijesh P Kottayil, Mahesh Kappanayil, Krishnakumar Raman, Rakhi Balachandran
We report a neonate with transposition of great arteries and intact ventricular septum who had a massive pulmonary hemorrhage soon after an arterial switch operation. An emergency cardiac catheterization revealed a large bronchial collateral artery from the descending aorta feeding the right lung. The hemorrhage was controlled by coil embolization of the collateral, and the patient recovered after prolonged intensive care.
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29455309/right-heart-failure-caused-by-direct-pressure-of-distal-arch-aneurysm
#14
Hironobu Sugiyama, Ryo Tohma, Takuya Misato, Kazuma Okamoto, Taro Hayashi, Satoshi Tobe, Tatsuro Matsuo, Kotaro Tsunemi, Takanori Oka, Nobuhiro Tanimura
We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast computed tomography (CT) of the thorax delineated a 78 mm aortic arch aneurysm pressing the main to left pulmonary artery and a 40 mm pericardial effusion at maximum depth at posterior side. Echocardiography showed the acceleration flow from main to left pulmonary artery and moderate pulmonary hypertension...
February 17, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29455044/timing-of-surgical-site-infection-and-pulmonary-complications-after-laparotomy
#15
Ossian Gundel, Sofie Kirchhoff Gundersen, Rikke Maria Dahl, Lars Nannestad Jørgensen, Lars S Rasmussen, Jørn Wetterslev, Ditte Sæbye, Christian S Meyhoff
BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur. The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy. MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent laparotomy...
February 15, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29454717/superior-approach-for-supracardiac-total-anomalous-pulmonary-venous-connection
#16
Rong Liufu, Guocheng Shi, Fang Zhu, Yongmei Guan, Zhaohui Lu, Weimin Chen, Zhongqun Zhu, Huiwen Chen
BACKGROUND: Studies on the outcomes of surgical repair for supracardiac total anomalous pulmonary venous connection through the superior approach are uncommon. METHODS: From January 2004 to January 2016, 198 patients with supracardiac total anomalous pulmonary venous connection underwent side-to-side anastomosis between the common pulmonary vein and left atrium through the superior approach. Kaplan-Meier curve was used to demonstrate the survival estimates. Cox proportional hazard model and competing risk regression model were used to identify risk factors for death and postoperative pulmonary venous obstruction...
February 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29450523/effect-of-the-pulmonary-embolism-rule-out-criteria-on-subsequent-thromboembolic-events-among-low-risk-emergency-department-patients-the-proper-randomized-clinical-trial
#17
Yonathan Freund, Marine Cachanado, Adeline Aubry, Charlotte Orsini, Pierre-Alexis Raynal, Anne-Laure Féral-Pierssens, Sandrine Charpentier, Florence Dumas, Nacera Baarir, Jennifer Truchot, Thibaut Desmettre, Karim Tazarourte, Sebastien Beaune, Agathe Leleu, Mehdi Khellaf, Mathias Wargon, Ben Bloom, Alexandra Rousseau, Tabassome Simon, Bruno Riou
Importance: The safety of the pulmonary embolism rule-out criteria (PERC), an 8-item block of clinical criteria aimed at ruling out pulmonary embolism (PE), has not been assessed in a randomized clinical trial. Objective: To prospectively validate the safety of a PERC-based strategy to rule out PE. Design, Setting, and Patients: A crossover cluster-randomized clinical noninferiority trial in 14 emergency departments in France. Patients with a low gestalt clinical probability of PE were included from August 2015 to September 2016, and followed up until December 2016...
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29450510/utility-of-a-clinical-prediction-rule-to-exclude-pulmonary-embolism-among-low-risk-emergency-department-patients-reason-to-perc-up
#18
Jeffrey A Kline
No abstract text is available yet for this article.
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#19
Burr Fong, Daniel Novak, Michael Dalley, Gregory Alfred
BACKGROUND: Deep vein thrombosis (DVT) is a common disease that is diagnosed in approximately 1 in 1000 adults annually. Extensive DVT can lead to life- or limb-threatening diagnoses such as phlegmasia cerulea dolens (PCD), phlegmasia alba dolens, and venous gangrene. PCD, also known as massive iliofemoral venous thrombosis, is rare, and a severe complication of DVT. CASE REPORT: We report a case of a 94-year-old bedridden woman with past medical history of dementia, hypertension, pulmonary embolism, DVT, and atrial fibrillation...
February 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29447273/molecular-epidemiology-and-drug-sensitivity-pattern-of-mycobacterium-tuberculosis-strains-isolated-from-pulmonary-tuberculosis-patients-in-and-around-ambo-town-central-ethiopia
#20
Melaku Tilahun, Gobena Ameni, Kassu Desta, Aboma Zewude, Lawrence Yamuah, Markos Abebe, Abraham Aseffa
INTRODUCTION: Tuberculosis (TB) is caused by M. tuberculosis complex and remains a major global public health problem. The epidemic remains a threat to sub-Saharan Africa, including Ethiopia, with further emergence of drug resistant TB. We investigated the drug sensitivity pattern and molecular epidemiology of mycobacterial strains isolated from pulmonary TB patients in and around Ambo town in Oromia Region, Central Ethiopia. METHODS: A cross-sectional study was conducted involving 105 consecutive new smear positive pulmonary TB patients diagnosed at Ambo Hospital and surrounding Health Centers between May 2014 and March 2015 upon informed consent...
2018: PloS One
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