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https://www.readbyqxmd.com/read/28718268/oxymorphone-induced-thrombotic-microangiopathy-mimicking-atypical-haemolytic-uremic-syndrome
#1
Amibhen Gandhi, Saad Ullah, Shani Kotadia, Samer Nasser
Atypical Haemolytic Uremic Syndrome (aHUS) is a rare life threatening entity characterized by thrombocytopenia, haemolytic anaemia and renal dysfunction. It is a thrombotic microangiopathy related to genetic mutations in the alternate complement pathway and has a distinct pathophysiology which makes it harder to distinguish from other microangiopathies. We present a case of a 25-year-old male patient with history of polysubstance abuse who presented with chest pain and dyspnoea. He admitted to using injectable oxymorphone (Opana) two weeks before presentation...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28718249/frequency-of-undiagnosed-chronic-obstructive-pulmonary-disease-in-patients-with-coronary-artery-disease
#2
Raza Ullah, Shahid Salam, Tahir Ghaffar, Rahim Muhammad, Imran Khan
BACKGROUND: Chronic obstructive airway disease (COPD) is considered as risk factor for coronary artery disease (CAD) along with other risk factors. This study was conducted to determine the frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease. METHODS: This cross-sectional study was conducted in the Pulmonology and Cardiology wards/OPD's of Khyber Teaching Hospital Peshawar. Patients more than 35 years of age, diagnosed with CAD of either gender were included...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717781/spinal-cord-infarction-mimicking-ischemic-heart-disease
#3
Dae Won Lee, Yoon Hee Choi
Spinal cord infarction is a rare condition and is easily misdiagnosed owing to its initial non-specific manifestation. We report a case of a 77-year-old man who presented with chest pain and upper back pain initially, and was misdiagnosed with a myocardial infarction. Four hours after admission, he complained of numbness in his entire left leg below the knee, with rapid deterioration of neurological symptoms. After 9 hours, loss of sensation progressed up to the T4 dermatome, strength of both lower extremities deteriorated to grade 0, and decrease in anal tone and deep tendon reflex was observed...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717742/simplified-graded-baseline-symptom-assessment-in-patients-with-lung-cancer-undergoing-first-line-chemotherapy-correlations-and-prognostic-role-in-a-resource-constrained-setting
#4
Potsangbam Sarat Singh, Ashutosh Nath Aggarwal, Digambar Behera, Rakesh Kapoor, Navneet Singh
PURPOSE: There are limited data from developing countries on graded baseline symptom (BS) assessment in lung cancer. This prospective study aimed to assess the prognostic role of BS and correlation of BS with comorbidity, demographic, and investigation profiles in a cohort of 238 patients with lung cancer undergoing first-line chemotherapy over a 15-month period. METHODS: The Medical Research Council (MRC) scale was used to assess dyspnea, whereas the visual analog scale (VAS; score of 1 to 10) was used to assess anorexia, fatigue, chest pain, and cough...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28717722/gestational-trophoblastic-neoplasia-treatment-at-the-butaro-cancer-center-of-excellence-in-rwanda
#5
Ignace Nzayisenga, Roanne Segal, Natalie Pritchett, Mary J Xu, Paul H Park, Edgie V Mpanumusingo, Denis G Umuhizi, Donald P Goldstein, Ross S Berkowitz, Vedaste Hategekimana, Clemence Muhayimana, Fidel Rubagumya, Temidayo Fadelu, Neo Tapela, Tharcisse Mpunga, Rahel G Ghebre
PURPOSE: Gestational trophoblastic neoplasia (GTN) is a highly treatable disease, most often affecting young women of childbearing age. This study reviewed patients managed for GTN at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda to determine initial program outcomes. PATIENTS AND METHODS: A retrospective medical record review was performed for 35 patients with GTN assessed or treated between May 1, 2012, and November 30, 2014. Stage, risk score, and low or high GTN risk category were based on International Federation of Gynecology and Obstetrics staging and the WHO scoring system and determined by beta human chorionic gonadotropin level, chest x-ray, and ultrasound per protocol guidelines for resource-limited settings...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28715432/an-efficacy-analysis-of-whole-body-magnetic-resonance-imaging-in-the-diagnosis-and-follow-up-of-polymyositis-and-dermatomyositis
#6
Zhen-Guo Huang, Bao-Xiang Gao, He Chen, Min-Xing Yang, Xiao-Liang Chen, Ran Yan, Xin Lu, Kai-Ning Shi, Queenie Chan, Guo-Chun Wang
OBJECTIVES: To evaluate the value of whole-body magnetic resonance imaging (WBMRI) in diagnosing muscular and extra muscular lesions in patients with polymyositis (PM) and dermatomyositis (DM). METHODS: A retrospective analysis of WBMRI data from PM/DM patients who met the Bohan and Peter diagnostic criteria was performed. X2 test was used to compare the rate of positive diagnosis of newly diagnosed patients using WBMRI, serum creatine kinase test, and EMG. McNemar test was used to compare the performance of WBMRI and chest CT in detecting interstitial lung disease (ILD)...
2017: PloS One
https://www.readbyqxmd.com/read/28713599/lyme-carditis-buried-beneath-st-segment-elevations
#7
Basia Michalski, Adrian Umpierrez De Reguero
Lyme disease is caused by the spirochete Borrelia burgdorferi and is carried to human hosts by infected ticks. There are nearly 30,000 cases of Lyme disease reported to the CDC each year, with 3-4% of those cases reporting Lyme carditis. The most common manifestation of Lyme carditis is partial heart block following bacterial-induced inflammation of the conducting nodes. Here we report a 45-year-old gentleman that presented to the hospital with intense nonradiating chest pressure and tightness. Lab studies were remarkable for elevated troponins...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28712814/safety-and-efficacy-of-rivaroxaban-compared-with-warfarin-in-patients-undergoing-peripheral-arterial-procedures
#8
Anjan Talukdar, S Keisin Wang, Lauren Czosnowski, Nassim Mokraoui, Alok Gupta, Andres Fajardo, Michael Dalsing, Raghu Motaganahalli
OBJECTIVE: Rivaroxaban is a United States Food and Drug Administration-approved oral anticoagulant for venous thromboembolic disease; however, there is no information regarding the safety and its efficacy to support its use in patients after open or endovascular arterial interventions. We report the safety and efficacy of rivaroxaban vs warfarin in patients undergoing peripheral arterial interventions. METHODS: This single-institution retrospective study analyzed all sequential patients from December 2012 to August 2014 (21 months) who were prescribed rivaroxaban or warfarin after a peripheral arterial procedure...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711123/care-of-the-patient-with-chest-pain-in-the-observation-unit
#9
REVIEW
Joseph B Borawski, Louis G Graff, Alexander T Limkakeng
Care of the patient presenting to an emergency department (ED) with chest pain remains a common yet challenging aspect of emergency medicine. Acute coronary syndrome presents in nonspecific fashion. The development and evolution of the ED-based observation unit has helped to safely assess and diagnose those most at risk for an adverse cardiac event. Furthermore, there are several provocative testing modalities to help assess for coronary artery disease. This article serves to describe and discuss the modern ED-based observation unit approach to patients with chest pain and/or angina equivalents presenting to an ED...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28710871/detection-and-quantification-of-coronary-calcium-from-dual-energy-chest-x-rays-phantom-feasibility-study
#10
Bo Zhou, Di Wen, Katelyn Nye, Robert C Gilkeson, Brendan Eck, David Jordan, David L Wilson
PURPOSE: We have demonstrated the ability to identify coronary calcium, a reliable biomarker of coronary artery disease, using non-gated, 2-shot, dual energy (DE) chest x-ray imaging. Here we will use digital simulations, backed up by measurements, to characterize DE calcium signals and the role of potential confounds such as beam hardening, x-ray scatter, cardiac motion, and pulmonary artery pulsation. For the DE calcium signal, we will consider quantification, as compared to CT calcium score, and visualization...
July 15, 2017: Medical Physics
https://www.readbyqxmd.com/read/28708723/preliminary-results-can-dual-energy-computed-tomography-help-distinguish-cardiogenic-pulmonary-edema-and-acute-interstitial-lung-disease
#11
Hitoshi Takeuchi, Shigeru Suzuki, Haruhiko Machida, Takuya Ishikawa, Eiko Ueno
OBJECTIVE: We compared iodine concentration in pulmonary ground-glass opacity on iodine density images of contrast-enhanced chest dual-energy computed tomography (DECT) between patients with cardiogenic pulmonary edema (CPE) and acute interstitial lung disease (AILD). METHODS: Five of 12 patients who underwent contrast-enhanced chest DECT to exclude pulmonary embolism were clinically diagnosed with CPE and 7, with AILD. We compared the mean CT value on monochromatic images at 65 keV and iodine concentration on iodine density images between the affected and normal areas...
July 13, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28708268/screening-protocols-to-monitor-respiratory-status-in-primary-immunodeficiency-disease-findings-from-a-european-survey-and-subclinical-infection-working-group
#12
Stephen Jolles, Silvia Sánchez-Ramón, Isabella Quinti, Pere Soler-Palacín, Carlo Agostini, Benoit Florkin, Louis-Jean Couderc, Nicholas Brodszki, Alison Jones, Hilary Longhurst, Klaus Warnatz, Filomeen Haerynck, Andrea Matucci, Esther de Vries
Many patients with primary immunodeficiency (PID) who have antibody deficiency develop progressive lung disease due to underlying subclinical infection and inflammation. To understand how these patients are monitored we conducted a retrospective survey based on patient records of 13 PID centres across Europe, regarding the care of 1,061 adult and 178 paediatric patients with PID on IgG replacement. The most common diagnosis was common variable immunodeficiency in adults (75%), and hypogammaglobulinaemia in children (39%)...
July 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28708228/clinical-and-subclinical-cardiac-late-effects-in-pediatric-hodgkin-s-lymphoma-survivors
#13
Carlo Materazzo, Maura Massimino, Elisabetta Schiavello, Marta Podda, Lorenza Gandola, Graziella Cefalo, Serena Catania, Cristina Meazza, Ivan Moschetti, Monica Terenziani
PURPOSE: Cardiac late effects are responsible for a significant burden of mortality and morbidity among pediatric Hodgkin's lymphoma (HL) survivors (HLS). The aim of our study was to assess clinical and subclinical cardiac sequelae in a cohort of childhood HLS treated in the 1980s with doxorubicin, bleomycin, vinblastine, and dacarbazine (the ABVD regimen) and limited-field radiotherapy (RT). METHODS: We retrospectively examined a series of HLS treated from 1979 to 1989...
July 8, 2017: Tumori
https://www.readbyqxmd.com/read/28707988/first-clinical-report-of-helical-tomotherapy-with-simultaneous-integrated-boost-for-synchronous-bilateral-breast-cancer
#14
Tabassum Wadasadawala, Shanu Jain, Siji Paul, Reena Phurailatpam, Kishore Joshi, Palak Popat, Sandip Tandon, Aruna Alahari, Rajiv Sarin
OBJECTIVE: Radiotherapy for synchronous bilateral breast cancer (SBBC) is technically very challenging. This study reports the clinical feasibility, dosimetry and safety of helical tomotherapy (HT) with simultaneous integrated boost (SIB) in patients treated with adjuvant radiotherapy for SBBC. MATERIAL AND METHODS: Twenty one women with SBBC treated with HT from January 2013 to June 2016 were retrospectively evaluated. Radiation lung toxicity was assessed using pulmonary function test (PFT) and high resolution computerized tomography scan (HRCT) scan at baseline and 1 year post RT in 18 patients...
July 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28707974/the-effect-of-benign-and-malignant-pleural-disease-on-chest-wall-mechanics
#15
Ghazi Elshafie, Prem Kumar, Madava Djearaman, Andrea Aliverti, Babu Naidu
No abstract text is available yet for this article.
July 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28707404/sustained-versus-standard-inflations-during-neonatal-resuscitation-to-prevent-mortality-and-improve-respiratory-outcomes
#16
REVIEW
Matteo Bruschettini, Colm Pf O'Donnell, Peter G Davis, Colin J Morley, Lorenzo Moja, Simona Zappettini, Maria Grazia Calevo
BACKGROUND: At birth, infants' lungs are fluid-filled. For newborns to have a successful transition, this fluid must be replaced by air to enable effective breathing. Some infants are judged to have inadequate breathing at birth and are resuscitated with positive pressure ventilation (PPV). Giving prolonged (sustained) inflations at the start of PPV may help clear lung fluid and establish gas volume within the lungs. OBJECTIVES: To assess the efficacy of an initial sustained (> 1 second duration) lung inflation versus standard inflations (≤ 1 second) in newly born infants receiving resuscitation with intermittent PPV...
July 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28706901/intraoperative-intracavitary-hyperthermic-chemotherapy-for-malignant-pleural-mesothelioma
#17
REVIEW
Kazunori Okabe
Malignant pleural mesothelioma (MPM) is a dreadful disease with a poor prognosis. Multimodality therapy including surgical macroscopic complete resection is performed to treat operable MPM. Intraoperative intracavitary hyperthermic chemotherapy for MPM was reviewed. Appropriate papers published between 2006 and present were extracted by the PubMed advanced search by MPM (Title/Abstract), chemotherapy (Title/Abstract), and hyperthermia (All fields). Among the selected papers, those written in English, and treated more than ten MPM patients were reviewed...
June 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28706850/pneumothorax-caused-by-cystic-and-nodular-lung-metastases-from-a-malignant-uterine-perivascular-epithelioid-cell-tumor-pecoma
#18
Shouichi Okamoto, Moegi Komura, Yasuhisa Terao, Aiko Kurisaki-Arakawa, Takuo Hayashi, Tsuyoshi Saito, Shinsaku Togo, Akira Shiokawa, Keiko Mitani, Etsuko Kobayashi, Toshio Kumasaka, Kazuhisa Takahashi, Kuniaki Seyama
Perivascular epithelioid cell tumors (PEComas) are mesenchymal neoplasms with immunoreactivity for both melanocytic and smooth muscle markers. PEComas occur at multiple sites, and malignant PEComas can undergo metastasis, recurrence and aggressive clinical courses. Although the lung is a common metastatic site of PEComas, they usually appear as multiple nodules but rarely become cystic or cavitary. Here, we describe a female patient whose lungs manifested multiple cystic, cavity-like and nodular metastases 3 years after the resection of uterine tumors tentatively diagnosed as epithelioid smooth muscle tumors with uncertain malignant potential...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28705304/clinical-practice-of-acute-respiratory-distress-syndrome-in-japan-a-nationwide-survey-and-scientific-evidences
#19
Sadatomo Tasaka, Koichiro Tatsumi
BACKGROUND: There has been limited information about epidemiology and clinical practice of acute respiratory distress syndrome (ARDS) in Japan. METHODS: An invitation letter to the web-based survey was mailed to all 871 board certified hospitals of the Japanese Respiratory Society. The questionnaires were designed to collect data on epidemiology and clinical practice of ARDS, including diagnostic measures and therapeutics. RESULTS: Within 4 months of the survey period, valid responses were obtained from 296 (34%) hospitals...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28705289/association-of-piebaldism-with-caf%C3%A3-au-lait-macules
#20
Naveen Kumar Kansal, Saurabh Agarwal
A 45-day-old infant was brought by his parents to the dermatology outpatient department with chief complaints of asymptomatic, depigmented lesions that had been present on his skin since birth. On mucocutaneous examination, large rhomboid-shaped depigmented macules were noted on the abdomen and lower extremities bilaterally (Figure 1). A depigmented macule was present on the forehead, with white hair (leukotrichia; a "developing forelock") (Figure 2). Three hyperpigmented lesions (café-au-lait macules [CALMs]) were also noted on the chest (Figure 1a)...
2017: Skinmed
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