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https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#1
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29656169/international-multicenter-evaluation-of-a-new-d-dimer-assay-for-the-exclusion-of-venous-thromboembolism-using-standard-and-age-adjusted-cut-offs
#2
Blair Alden Parry, Anna Marie Chang, Sebastian M Schellong, Stacey L House, Gregory J Fermann, Erin K Deadmon, Nicholas J Giordano, Yuchiao Chang, Jason Cohen, Nancy Robak, Adam J Singer, Mary Mulrow, Ellen T Reibling, Samuel Francis, S Michelle Griffin, Jürgen H Prochaska, Barbara Davis, Patricia McNelis, Joao Delgado, Philipp Kümpers, Nikos Werner, Nina T Gentile, Eli Zeserson, Philipp S Wild, Alexander T Limkakeng, Elizabeth Lea Walters, Frank LoVecchio, Daniel Theodoro, Judd E Hollander, Christopher Kabrhel
INTRODUCTION: We sought to determine the test characteristics of an automated INNOVANCE D-dimer assay for the exclusion of pulmonary embolism (PE) and deep venous thrombosis (DVT) in emergency department (ED) patients using standard and age-adjusted cut-offs. METHODS: Cross-sectional, international, multicenter study of consecutive patients with suspected DVT or PE in 24 centers (18 USA, 6 Europe). Evaluated patients had low or intermediate Wells PE or DVT scores...
April 5, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29655828/venoarterial-extracorporeal-membrane-oxygenation-in-cardiogenic-shock
#3
REVIEW
Mary E Keebler, Elias V Haddad, Chun W Choi, Stuart McGrane, Sandip Zalawadiya, Kelly H Schlendorf, D Marshall Brinkley, Matthew R Danter, Mark Wigger, Jonathan N Menachem, Ashish Shah, JoAnn Lindenfeld
Venoarterial extracorporeal membrane oxygenation has emerged as a viable treatment for patients in cardiogenic shock with biventricular failure and pulmonary dysfunction. Advances in pump and oxygenator technology, cannulation strategies, patient selection and management, and durable mechanical circulatory support have contributed to expanded utilization of this technology. However, challenges remain that require investigation to improve outcomes.
April 5, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29649034/obstructive-sleep-apnea-in-pregnant-women-a-review-of-pregnancy-outcomes-and-an-approach-to-management
#4
Jennifer E Dominguez, Andrew D Krystal, Ashraf S Habib
Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors for sleep-disordered breathing in pregnancy, but certain physiologic changes of pregnancy may also increase a woman's risk of developing or worsening OSA. While it has been shown that untreated OSA in postmenopausal women is associated with a range of cardiovascular, pulmonary, and metabolic comorbidities, a body of literature is emerging that suggests OSA may also have serious implications for the health of mothers and fetuses during and after pregnancy...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29644546/imaging-of-urgencies-and-emergencies-in-the-lung-cancer-patient
#5
REVIEW
Bruno De Potter, Jef Huyskens, Birgitta Hiddinga, Maarten Spinhoven, Annelies Janssens, Jan P van Meerbeeck, Paul M Parizel, Annemie Snoeckx
Lung cancer patients often experience potentially life-threatening medical urgencies and emergencies, which may be a direct or indirect result of the underlying malignancy. This pictorial review addresses the most common thoracic, neurological and musculoskeletal medical emergencies in lung cancer patients, including superior vena cava syndrome, pulmonary embolism, spontaneous pneumothorax, cardiac tamponade, massive haemoptysis, central airway obstruction, oesophagorespiratory fistula, malignant spinal cord compression, carcinomatous meningitis, cerebral herniation and pathological fracture...
April 11, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29644062/granulomatous-interstitial-nephritis-secondary-to-adalimumab-therapy
#6
Vicki Sandys, Brona Moloney, Louise Lane, Junaid Qazi, Brendan Doyle, Maurice Barry, Sean Leavey, Peter Conlon
Tumour necrosis factor α (TNF-α) inhibitors are frequently used for the treatment of immune-mediated diseases. Conversely, cytokine therapy has the potential to paradoxically induce autoimmunity. A number of case reports have emerged concerning sarcoid-like granulomatosis secondary to TNF-α therapy, an adverse effect that typically affects the pulmonary and cutaneous systems. Granulomatous interstitial nephritis (GIN) is a relatively unknown, relatively under-reported consequence of adalimumab therapy that can have important clinical implications...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29643259/cerebrovascular-accidents-during-mechanical-circulatory-support-new-predictors-of-ischemic-and-hemorrhagic-strokes-and-outcome
#7
Saef Izzy, Daniel B Rubin, Firas S Ahmed, Feras Akbik, Simone Renault, Katelyn W Sylvester, Henrikas Vaitkevicius, Jennifer A Smallwood, Michael M Givertz, Steven K Feske
BACKGROUND AND PURPOSE: Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality...
April 11, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29643111/cardiovascular-and-cerebrovascular-emergency-department-visits-associated-with-wildfire-smoke-exposure-in-california-in-2015
#8
Zachary S Wettstein, Sumi Hoshiko, Jahan Fahimi, Robert J Harrison, Wayne E Cascio, Ana G Rappold
BACKGROUND: Wildfire smoke is known to exacerbate respiratory conditions; however, evidence for cardiovascular and cerebrovascular events has been inconsistent, despite biological plausibility. METHODS AND RESULTS: A population-based epidemiologic analysis was conducted for daily cardiovascular and cerebrovascular emergency department (ED) visits and wildfire smoke exposure in 2015 among adults in 8 California air basins. A quasi-Poisson regression model was used for zip code-level counts of ED visits, adjusting for heat index, day of week, seasonality, and population...
April 11, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29642408/mucormycosis-battle-with-the-deadly-enemy-over-a-five-year-period-in-india
#9
Jagdish Chander, Mandeep Kaur, Nidhi Singla, R P S Punia, Surinder K Singhal, Ashok K Attri, Ana Alastruey-Izquierdo, Alberto M Stchigel, Jose F Cano-Lira, Josep Guarro
Mucormycosis is an emerging opportunistic fungal infection. Increasing immunocompromization, widespread use of antibacterial and antifungal agents (such as voriconazole prophylaxis), carcinomas, transplantation and lifestyle diseases such as diabetes are the main contributors to this situation. The predominant clinical manifestations of mucormycosis vary from host to host, with rhino-orbital-cerebral, pulmonary, cutaneous, and gastrointestinal infections being the most common. In India, the prevalence of mucormycosis is approximately 0...
April 6, 2018: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29629994/the-achilles-heel-of-left-ventricular-assist-device-therapy-right-ventricle
#10
Neel K Ranganath, Deane E Smith, Nader Moazami
PURPOSE OF REVIEW: Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29629898/classical-il-6-signaling-a-promising-therapeutic-target-for-pulmonary-arterial-hypertension
#11
Soni Savai Pullamsetti, Werner Seeger, Rajkumar Savai
Current therapies for pulmonary arterial hypertension (PAH) provide symptomatic relief and improve prognosis but fall short of improving long-term survival. There is emerging evidence for a role of inflammatory mediators, primarily IL-6, in the pathogenesis of PAH. However, the mechanisms by which IL-6 potentially affects PAH are unknown. In this issue of the JCI, Tamura, Phan, and colleagues identified ectopic upregulation of the membrane-bound IL-6 receptor (IL6R), indicating classical IL-6 signaling in the smooth muscle layer of remodeled vessels in human and experimental PAH...
April 9, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29628582/predictors-and-outcomes-of-postoperative-pulmonary-complications-following-abdominal-surgery-in-a-south-indian-population
#12
Lakshmi Kumar, Keerthi N Satheesan, Sunil Rajan, Bindu K Vasu, Jerry Paul
Background: Postoperative pulmonary complications (PPC) following abdominal surgery are associated with increased morbidity and poorer outcomes. We prospectively examined risk factors associated with the development of PPC in patients undergoing abdominal surgery. Aims: The primary outcome was to determine the association of predefined risk factors in the prediction of PPC after abdominal surgery. Secondary outcomes were evaluation of outcomes of PPC. Setting and Design: This was a prospective study conducted in the gastrosurgical and urological units of a tertiary care referral hospital in patients undergoing abdominal surgery over a period of 6 months (November 2015-April 2016)...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628173/-the-plague-an-overview-and-hot-topics
#13
A Galy, P Loubet, N Peiffer-Smadja, Y Yazdanpanah
Plague is a bacterial zoonosis caused by Yersinia pestis, usually found in fleas and small rodents that constitute the reservoir of the disease. It is transmitted to humans by flea bite, contact with rodents or inhalation of infected droplets. There are three clinical forms: bubonic plague, pulmonary plague and septicemic plague. The usual presentation is a flu-like syndrome possibly accompanied by an inflammatory lymphadenopathy which appears after 1 to 7days of incubation. Bubonic plague has a case fatality rate of about 50% while other forms of plague are almost always fatal without treatment...
April 5, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29626985/asthma-chronic-obstructive-pulmonary-disease-overlap-aco-an-emerging-entity-in-allergic-respiratory-diseases
#14
EDITORIAL
Jun Tamaoki, Kenji Izuhara
No abstract text is available yet for this article.
April 2018: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/29625777/tai-chi-and-pulmonary-rehabilitation-compared-for-treatment-naive-patients-with-copd-a-randomized-controlled-trial
#15
Michael I Polkey, Zhi-Hui Qiu, Lian Zhou, Meng-Duo Zhu, Ying-Xin Wu, Yong-Yi Chen, Sheng-Peng Ye, Yu-Shan He, Mei Jiang, Bai-Ting He, Bhavin Mehta, Nan-Shan Zhong, Yuan-Ming Luo
BACKGROUND: In COPD, functional status is improved by pulmonary rehabilitation (PR) but requires specific facilities. Tai Chi, which combines psychological treatment and physical exercise and requires no special equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world. We hypothesized that Tai Chi is equivalent (ie, difference less than ±4 St. George's Respiratory Questionnaire [SGRQ] points) to PR. METHODS: A total of 120 patients (mean FEV1 , 1...
March 28, 2018: Chest
https://www.readbyqxmd.com/read/29625182/idiopathic-pulmonary-fibrosis-epithelial-mesenchymal-interactions-and-emerging-therapeutic-targets
#16
REVIEW
Justin C Hewlett, Jonathan A Kropski, Timothy S Blackwell
Idiopathic pulmonary fibrosis (IPF) is a chronic fibrotic disease of the lung that is marked by progressive decline in pulmonary function and ultimately respiratory failure. Genetic and environmental risk factors have been identified that indicate injury to, and dysfunction of the lung epithelium is central to initiating the pathogenic process. Following injury to the lung epithelium, growth factors, matrikines and extracellular matrix driven signaling together activate a variety of repair pathways that lead to inflammatory cell recruitment, fibroblast proliferation and expansion of the extracellular matrix, culminating in tissue fibrosis...
April 3, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#17
M U Ziegler, H Reinelt
BACKGROUND: Patients undergoing cardiac surgery need extensive and invasive monitoring, which needs to be individually adapted for each patient and requires a diligent risk-benefit analysis. The use of a pulmonary artery catheter (PAC) seems to be justifiable in certain cases; therefore, the preoperative diagnosis of pulmonary hypertension represents an indication for perioperative monitoring with PAC in the S3 guidelines of the German Society for Anesthesiology and Intensive Care Medicine (DGAI)...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29622717/scorpion-bite-induced-unilateral-pulmonary-oedema
#18
Nandakishore Bompelli, Rakesh Reddy C, Anirudda Deshpande
A 24-year-old woman came to the emergency room of our hospital, 6 hours after a sting to the pulp of her middle finger of her left upper limb by an Indian red scorpion. On examination, she had tachycardia, tachypnoea, hypotension and low oxygen saturation at room temperature. On auscultation, there was poor air entry in all areas of the right lung along with crackles. The left lung field was normal on auscultation. Chest X-ray showed unilateral haziness of right lung field. Two-dimensional echocardiography showed clinical findings of myocarditis...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29620721/pediatric-coccidioidomycosis-case-series-from-a-california-pediatric-infectious-diseases-clinic
#19
Lauren A Lee, Gail L Sondermeyer Cooksey, Janice J Kim, Amandeep Kahal, Debra Gilliss, Fouzia Naeem, James M McCarty, Duc J Vugia
BACKGROUND: Coccidioidomycosis is not as well described in the pediatric population as it is in the adult population. We describe clinical findings, diagnosis, and management of coccidioidomycosis in 108 pediatric patients seen in an outpatient clinic in the California Central Valley, an area endemic for coccidioidomycosis. METHODS: We reviewed medical records of a convenience sample of pediatric patients (≤17 years of age) diagnosed with coccidioidomycosis who visited an infectious diseases clinic in Madera, CA during January 1-October 1, 2012...
April 9, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29620545/endobronchial-biopsy-in-the-final-diagnosis-of-chronic-obstructive-pulmonary-disease-and-asthma-a-clinicopathological-study
#20
Maria Abdulrahim Arafah, Emad Raddaoui, Faisal Al Kassimi, Esam H Alhamad, Ahmed Amer Alboukai, Ahlam Abdullah Alshedoukhy, Abderrahman Ouban
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are chronic conditions with an increasing prevalence in developing countries. The evaluation of endobronchial biopsies has emerged as a tool to differentiate between both conditions via the measurement of the reticular basement membrane (RBM) thickness with various conclusions drawn from different studies. OBJECTIVES: Compare the thickness of the RBM between asthma and COPD and evaluate other histomorphological features in both groups...
March 2018: Annals of Saudi Medicine
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