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https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#1
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643750/evaluation-of-clinical-process-in-osteosarcoma-patients-treated-with-chemotherapy-including-cisplatin-adriamycin-ifosfamide-and-etoposide-and-determination-of-the-treatment-sequels-in-a-long-term-11-year-follow-up
#2
Mozaffar Aznab, Maryam Hematti
AIM: The aim of this study was to evaluate the effect of adding etoposide and ifosfamide chemotherapy drugs to treatment regimen of patients affected with osteosarcoma and to determine the clinical process and response to treatment during a follow-up period of 11 years. MATERIALS AND METHODS: Forty patients with osteosarcoma participated in this study from July 2005 to 2016. Treatments were started based on the following schema and after initial examinations including biochemical profile, checking for lung metastasis by simple radiography, chest computed tomography scan, and bones scan...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28642733/a-case-of-pulmonary-carcinoid-tumor-with-a-superimposed-aspergilloma-presenting-as-a-covert-ectopic-adrenocorticotropic-hormone-syndrome
#3
Kyoung Jin Kim, Ji Hee Yu, Nan Hee Kim, Young Hye Kim, Young Sik Kim, Ji A Seo
Ectopic adrenocorticotropic hormone (ACTH) syndrome is a challenging diagnosis only responsible for approximately 10% of Cushing syndrome cases. It has been associated with a variety of benign and malignant tumors including a carcinoid tumor accompanied by aspergilloma in our case that was significantly difficult to be detected. We report a patient over 70 years old with uncontrolled hypertension and hypokalemia presenting with generalized edema. Laboratory results revealed ACTH-dependent Cushing syndrome, but imaging studies did not show any discrete lesions secreting ACTH...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28641703/a-randomised-controlled-trial-to-assess-the-cost-effectiveness-of-intensive-versus-no-scheduled-follow-up-in-patients-who-have-undergone-resection-for-colorectal-cancer-with-curative-intent
#4
David Mant, Alastair Gray, Siân Pugh, Helen Campbell, Stephen George, Alice Fuller, Bethany Shinkins, Andrea Corkhill, Jane Mellor, Elizabeth Dixon, Louisa Little, Rafael Perera-Salazar, John Primrose
BACKGROUND: Intensive follow-up after surgery for colorectal cancer is common practice but lacks a firm evidence base. OBJECTIVE: To assess whether or not augmenting symptomatic follow-up in primary care with two intensive methods of follow-up [monitoring of blood carcinoembryonic antigen (CEA) levels and scheduled imaging] is effective and cost-effective in detecting the recurrence of colorectal cancer treatable surgically with curative intent. DESIGN: Randomised controlled open-label trial...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28640655/usual-interstitial-pneumonia-can-be-detected-in-transbronchial-biopsies-using-machine-learning
#5
Daniel G Pankratz, Yoonha Choi, Urooj Imtiaz, Grażyna M Fedorowicz, Jessica D Anderson, Thomas V Colby, Jeffrey L Myers, David A Lynch, Kevin K Brown, Kevin R Flaherty, Mark P Steele, Steve D Groshong, Ganesh Raghu, Neil M Barth, P Sean Walsh, Jing Huang, Giulia C Kennedy, Fernando J Martinez
RATIONALE: Usual interstitial pneumonia (UIP) is the histopathologic hallmark of idiopathic pulmonary fibrosis. While UIP can be detected by high-resolution computed tomography (HRCT) of the chest, HRCT results are frequently inconclusive, and pathology from transbronchial biopsy (TBB) has poor sensitivity. Surgical lung biopsy (SLB) may be necessary for a definitive diagnosis. OBJECTIVES: To develop a genomic classifier in tissue obtained by TBB that distinguishes UIP from non-UIP, trained against central pathology as the reference standard...
June 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28639114/imaging-guided-chest-biopsies-techniques-and-clinical-results
#6
REVIEW
Michele Anzidei, Andrea Porfiri, Fabrizio Andrani, Michele Di Martino, Luca Saba, Carlo Catalano, Mario Bezzi
BACKGROUND: This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. METHODS: Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive...
June 21, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28637440/acute-airway-compromise-due-to-parathyroid-tumour-apoplexy-an-exceptionally-rare-and-potentially-life-threatening-presentation
#7
Aoife Garrahy, David Hogan, James Paul O'Neill, Amar Agha
BACKGROUND: Spontaneous haemorrhage into a parathyroid adenoma is a rare and potentially life-threatening presentation. CASE PRESENTATION: We report the case of a 45 year old female recently diagnosed with primary hyperparathyroidism who presented with chest discomfort and acute airway compromise due to spontaneous extracapsular haemorrhage into a parathyroid adenoma. Computed tomography (CT) imaging showed a hypopharyngeal haematoma extending 10 cm into the superior mediastinum...
June 21, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28637439/a-qualitative-analysis-of-smokers-perceptions-about-lung-cancer-screening
#8
Lindsay Gressard, Amy S DeGroff, Thomas B Richards, Stephanie Melillo, Julia Kish-Doto, Christina L Heminger, Elizabeth A Rohan, Kristine Gabuten Allen
BACKGROUND: In 2013, the US Preventive Services Task Force (USPSTF) began recommending lung cancer screening for high risk smokers aged 55-80 years using low-dose computed tomography (CT) scan. In light of these updated recommendations, there is a need to understand smokers' knowledge of and experiences with lung cancer screening in order to inform the design of patient education and tobacco cessation programs. The purpose of this study is to describe results of a qualitative study examining smokers' perceptions around lung cancer screening tests...
June 21, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28637050/ultrasonography-for-the-diagnosis-of-pneumothorax-after-transbronchial-lung-cryobiopsy-in-diffuse-parenchymal-lung-diseases
#9
Luca Viglietta, Riccardo Inchingolo, Cristina Pavano, Sara Tomassetti, Sara Piciucchi, Andrea Smargiassi, Claudia Ravaglia, Alessandra Dubini, Christian Gurioli, Carlo Gurioli, Venerino Poletti
BACKGROUND: Transbronchial lung cryobiopsy (TBLC) can be indicated in diffuse parenchymal lung diseases (DPLDs) when a confident noninvasive diagnosis cannot be made. The 2 most relevant complications of TBLC are bleeding and pneumothorax (PTX). The accuracy of chest ultrasonography (US) for the detection of PTX is higher when compared to chest X-ray (CXR) with reference to computed tomography (CT) scan as a gold standard. OBJECTIVE: We evaluated the accuracy of chest US in detecting PTX after TBLC in patients with DPLDs...
June 22, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28637046/the-preoperative-composite-physiologic-index-may-predict-mortality-in-lung-cancer-patients-with-combined-pulmonary-fibrosis-and-emphysema
#10
Fumika Ueno, Yoshiaki Kitaguchi, Takayuki Shiina, Shiho Asaka, Kentaro Miura, Masanori Yasuo, Yosuke Wada, Akihiko Yoshizawa, Masayuki Hanaoka
BACKGROUND: It remains unclear whether the preoperative pulmonary function parameters and prognostic indices that are indicative of nutritional and immunological status are associated with prognosis in lung cancer patients with combined pulmonary fibrosis and emphysema (CPFE) who have undergone surgery. OBJECTIVE: The aim of this study is to identify prognostic determinants in these patients. METHODS: The medical records of all patients with lung cancer associated with CPFE who had undergone surgery at Shinshu University Hospital were retrospectively reviewed to obtain clinical data, including the results of preoperative pulmonary function tests and laboratory examinations, chest high-resolution computed tomography (HRCT), and survival...
June 22, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28635205/recurrence-of-right-lower-lobe-pneumonia-3-years-after-the-first-episode-in-an-otherwise-healthy-13-year-old-girl
#11
Antonino Capizzi, Oliviero Sacco, Giovanni A Rossi, Michela Silvestri
Recurrent pneumonia is one of the most frequent reasons for referral to paediatric chest physicians. The diagnostic work-up is dependent on whether infection repeatedly occurs in the same lung lobe, or affects multiple lobes and/or different areas in different episodes. A 13-year-old girl was admitted with a second episode of right lower lobe pneumonia. The chest x-ray demonstrated an inhomogeneous opacity, without a clearly recognizable segmental distribution. A contrast-enhanced CT scan, was therefore performed that showed a polycyclic consolidation with blood supply from a systemic artery, originated from the thoracic aorta...
May 25, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28635204/esophago-pulmonary-fistula-manifesting-as-recurrent-pneumonias-and-migrating-mediastinal-calcifications
#12
Jadd Kebbe, Sai Yendamuri, Charles Roche, Kassem Harris, Samjot Singh Dhillon
A 43-year old man presented with recurrent pneumonias, episodes of hemoptysis and an enlarging right lower lobe mass. A clear diagnosis was not previously established in spite of multiple radiological evaluations and biopsies. Meticulous review of his CT imaging showed that he had subcarinal calcification on his prior CT scans, which had decreased in size and now multiple new small areas of calcifications were seen in the right lower lobe lesion. An esophago-pulmonary fistula due to migration of mediastinal calcifications was suspected which was identified on careful review of the CT chest and confirmed by esophagogastroduodenoscopy...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28635200/unusual-symptomatic-late-onset-presentation-of-aberrant-right-subclavian-artery-report-of-two-cases-and-short-literature-review
#13
Yannis Dimitroglou, Ioannis Loulakas, Maria Chounti, Michail Megalakakis, Eleni Karavana, Panagiotis Hountis
Aberrant subclavian arteries are congenital vascular anomalies that usually do not cause any symptoms. When symptomatic they are considered as a rare cause of dysphagia. This presentation is known as dysphagia lusoria. They are diagnosed by barium swallow or contrast-enhanced computed tomography, although it may be an incidental finding. Management varies from life modifications and drug therapy to surgical intervention. We report two cases of the unusual form of late onset symptomatic presentation because of the presence of aberrant right subclavian artery...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634559/malignant-pleural-mesothelioma-with-marked-lymphatic-involvement-a-report-of-two-autopsy-cases
#14
Reiko Ideguchi, Kazuto Ashizawa, Saori Akashi, Michiko Shindo, Kazunori Minami, Toshio Fukuda, Junji Irie, Minoru Fukuda, Masataka Uetani
We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28634555/a-rare-case-of-pneumopericardium-in-the-setting-of-tuberculous-constrictive-pericarditis
#15
Lauro L Abrahan Iv, Stephanie Martha O Obillos, Jaime Alfonso M Aherrera, Jose Donato A Magno, Celia Catherine C Uy-Agbayani, Ulysses King G Gopez, Jobelle Joyce Anne R Baldonado
A 28-year-old Filipino male was admitted due to high-grade fevers and dyspnea on a background of chronic cough and weight loss. Due to clinical and echocardiographic signs of cardiac tamponade, emergency pericardiocentesis was performed on his first hospital day. Five days after, chest radiographs showed new pockets of radiolucency within the cardiac shadow, indicative of pneumopericardium. On repeat echo, air microbubbles admixed with loculated effusion were visualized in the anterior pericardial space. Constrictive physiology was also supported by a thickened pericardium, septal bounce, exaggerated respiratory variation in AV valve inflow, and IVC plethora...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28634529/duodenal-diverticulum-incidental-finding-with-potentially-dangerous-outcomes
#16
Stephen Melnick, Shoaib Fareedy, David Gish, Salik Nazir
We present the case of an 83-year-old woman with a past medical history significant for schizoaffective disorder, presenting to our emergency department with the complaint of 'pain'. Given the non-specific complaint and the limited history obtained, CT imaging was performed on her chest and abdomen which incidentally found a large duodenal diverticulum. This manuscript discusses the incidence of duodenal diverticula and the potential associated complications.
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28632657/role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#17
Melissa A Bent, William L Hennrikus, Johan E Latorre, Douglas G Armstrong, Brian Shaw, Kerwyn C Jones, Lee S Segal
OBJECTIVES: To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures. DESIGN: Retrospective Chart Review. SETTING: Level-1 Pediatric Trauma Center. PATIENTS/PARTICIPANTS: Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan. MAIN OUTCOME MEASUREMENTS: Fleiss Kappa coefficient to compare interreliability...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28631022/risk-analysis-and-outcomes-of-bronchopulmonary-sequestrations
#18
Chun Hong, Gang Yu, Jing Tang, QianLi Liu, Bo Xia
BACKGROUND: Researched and discussed the risks and outcomes of bronchopulmonary sequestrations, especially the intralobar type. METHODS: A retrospective review of our experiences with bronchopulmonary sequestrations from January 2012 to April 2015 is reported. The present study researched and discusses the risks and outcomes of bronchopulmonary sequestrations, especially the intralobar type, compared with other types of bronchopulmonary sequestrations in symptoms, surgery, pathology, and excretion...
June 19, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#19
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630775/a-rare-case-of-paraneoplastic-aortitis-associated-with-chronic-myelomonocytic-leukemia
#20
Sylwia Sasinowska, Pamela Traisak, Michael McCormack, Hala Eid
Aortitis is a broad term describing inflammation of the aorta. The most common causes of aortitis are the large-vessel vasculitides giant cell arteritis and Takayasu arteritis. Other etiologies include aortitis associated with other autoimmune disorders, infectious causes, and paraneoplastic and idiopathic cases. We describe a rare case of a large-vessel arteritis occurring in association with chronic myelomonocytic leukemia (CMML). A 68-year-old female with recent diagnosis of CMML presented to our office for evaluation of abnormal chest computed tomography (CT) that showed inflammation surrounding the entirety of thoracic and abdominal aorta, consistent with aortitis...
2017: Case Reports in Hematology
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