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Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
Kpp Abhilash, P R Mannam, K Rajendran, R A John, P Ramasami
BACKGROUND AND RATIONALE: Respiratory system involvement in scrub typhus is seen in 20-72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. MATERIALS AND METHODS: Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed...
October 2016: Journal of Postgraduate Medicine
Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
Hilal Altınöz, Cengiz Çelikkalkan, Gönül Dinç Horasan, Fatih Hamşioğlu, Nalan Cengiz, Hikmet Orbay
AIM: Pneumoconiosis is caused by inhaling dust. The aim of the study was to analyze 208 cases of workers' pneumoconiosis. METHOD: Patients' files were used for the descriptive study. RESULTS: All patients were male aged 38.82±13 years. The most important symptom was breathlessness. Patients were denim sandblasters (50.5%), dental technicians (12%), coal miners (6.7%), and others. The mean exposure time before pneumoconiosis occurred was shorter in denim sandblasters and teflon kitchenware producers compared to other occupations (5...
September 2016: Central European Journal of Public Health
R Dawar, D Nagarjuna, R Gupta, N P Ghonge, R Sardana
A 62-year-old man with asthma sought care for intermittent fever, cough with expectoration, breathlessness and orthopnoea with grunting. Computed tomography revealed clusters of centrilobular nodules on both sides with a tree-in-bud appearance and mild diffuse bronchial wall thickening. Sputum sample grew pure colonies of Actinobacillus ureae which was confirmed by MALDI-TOF and 16SrRNA gene sequencing. A. ureae may be an additional bacteriologic causative agent of the tree-in-bud pattern on computed tomographic scan...
November 2016: New Microbes and New Infections
Sarah Jones, William D-C Man, Wei Gao, Irene J Higginson, Andrew Wilcock, Matthew Maddocks
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews Issue 1, 2013 on Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease.Patients with advanced progressive disease often experience muscle weakness, which can impact adversely on their ability to be independent and their quality of life. In those patients who are unable or unwilling to undertake whole-body exercise, neuromuscular electrical stimulation (NMES) may be an alternative treatment to enhance lower limb muscle strength...
October 17, 2016: Cochrane Database of Systematic Reviews
Carol A Kelly, Dave Lynes, Mary R O'Brien, Ben Shaw
BACKGROUND: Despite emerging evidence and guidelines, poor prescribing and administration of oxygen therapy persists. This study aimed to explore healthcare professionals' (HCPs) and patients' perceptions of oxygen. DESIGN: Semi-structured interviews with 28 patients and 34 HCPs. FINDINGS: Three master themes uncovered: oxygen as a panacea, the burden of oxygen, and antecedents to beliefs. Patients used oxygen for breathlessness and as an enabler; they were grateful to oxygen and accepted it as part of the disease...
October 12, 2016: Clinical Respiratory Journal
Helen Walthall, Crispin Jenkinson, Mary Boulton
AIMS: To explore how patients with CHF describe their experiences of breathlessness, the pattern of their breathlessness, how daily life is affected and how they adjust to and manage these symptoms. BACKGROUND: Chronic Heart Failure (CHF) is a highly prevalent syndrome often with poor outcomes and in a patient group who are predominately elderly. Breathlessness is the main symptom experienced by patients and often relates to decompensation and hospitalisation, yet subtle changes described by patients are often not discussed with health care professionals...
October 12, 2016: Journal of Clinical Nursing
Avas Chandra Ray, Subhra Aditya, Pulak Kumar Jana, Apratim Chatterjee, Anup Sarkar, Jay Mehta, Jotideb Mukhopadhyay
A young male labourer developed pain at the site of blunt trauma over back of chest followed by fever, cough with expectoration, breathlessness and hemorrhagic pleural effusion in the side of injury. What could have been passed as a sequel of trauma turned out to be the consequences of an underlying rare and aggressive malignant tumor of the chest wall known as Askin tumor or Primitive Neuroectodermal Tumor (PNET). CT thorax with guided FNAC, debulking operation, histopathological examination followed by immunohistochemistry of the tumor tissue led to the final diagnosis...
March 2016: Journal of the Association of Physicians of India
Charles C Reilly, Caroline J Jolley, Caroline Elston, John Moxham, Gerrard F Rafferty
The electromyogram recorded from the diaphragm (EMGdi) and parasternal intercostal muscle using surface electrodes (sEMGpara) provides a measure of neural respiratory drive (NRD), the magnitude of which reflects lung disease severity in stable cystic fibrosis. The aim of this study was to explore perception of NRD and breathlessness in both healthy individuals and patients with cystic fibrosis. Given chronic respiratory loading and increased NRD in cystic fibrosis, often in the absence of breathlessness at rest, we hypothesised that patients with cystic fibrosis would be able to tolerate higher levels of NRD for a given level of breathlessness compared to healthy individuals during exercise...
January 2016: ERJ Open Research
Sau Nga Fu, Wai Cho Yu, Carlos King-Ho Wong, Margaret Choi-Hing Lam
PURPOSE: The purpose of this study was to define the prevalence of undiagnosed airflow obstruction (AO) among subjects with a history of smoking but no previous diagnosis of chronic lung disease. The finding of AO likely represents diagnosis of chronic obstructive pulmonary disease. PATIENTS: People aged ≥30 years with a history of smoking who attended public outpatient clinics for primary care services were included in this study. METHODS: A cross-sectional survey in five clinics in Hong Kong using the Breathlessness, Cough, and Sputum Scale, the Lung Function Questionnaire, and office spirometry was conducted...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Win Wah, Pin Pin Pek, Andrew Fu Wah Ho, Stephanie Fook-Chong, Huili Zheng, En Yun Loy, Terrance Siang Jin Chua, Tian Hai Koh, Khuan Yew Chow, Arul Earnest, Junxiong Pang, Marcus Eng Hock Ong
OBJECTIVES: Symptom-to-door time (S2D) is one of the important components of ischaemic time, which might affect the infarct size and outcomes of acute myocardial infarction. The aim of the present study was to identify patients' characteristics associated with delayed symptom-onset-to-arrival at EDs in ST-segment elevation myocardial infarction (STEMI) patients in Singapore. METHODS: Retrospective data of STEMI patients presenting to the ED of all public hospitals with onsite primary percutaneous coronary intervention facilities between 2010 and 2012 were obtained from the Singapore Myocardial Infarction Registry...
October 11, 2016: Emergency Medicine Australasia: EMA
Gail Ewing, Clarissa Penfold, John Benson, Ravi Mahadeva, Sophie Howson, Julie Burkin, Sara Booth, Roberta Lovick, David Gilligan, Christopher Todd, Morag Farquhar
CONTEXT: Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease which focus on symptoms are scarce and absent for breathlessness. OBJECTIVES: To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness and relevant outcomes for a future randomised controlled trial (RCT) of an educational intervention for carers...
October 7, 2016: Journal of Pain and Symptom Management
Jing-Yu Tan, Janelle Yorke, Amelie Harle, Jacky Smith, Fiona Blackhall, Mark Pilling, Alex Molassiotis
CONTENT: The Dyspnoea-12 (D-12) is a well validated instrument in respiratory illnesses for breathlessness assessment, but its psychometric properties have not been tested in lung cancer. OBJECTIVES: To demonstrate the psychometric properties of the D-12 in lung cancer patients. METHODS: Baseline data from a lung cancer feasibility trial were adopted for this analysis. D-12 and a series of patient-reported tools including five Numeric Rating Scales (NRS), the Hospital Anxiety and Depression Scale (HADS) and the Lung Cancer Symptom Scale (LCSS) were employed for the psychometric assessment...
October 5, 2016: Journal of Pain and Symptom Management
Jan Y Verbakel, Marieke B Lemiengre, Tine De Burghgraeve, An De Sutter, Bert Aertgeerts, Bethany Shinkins, Rafael Perera, David Mant, Ann Van den Bruel, Frank Buntinx
BACKGROUND: Point-of-care blood C-reactive protein (CRP) testing has diagnostic value in helping clinicians rule out the possibility of serious infection. We investigated whether it should be offered to all acutely ill children in primary care or restricted to those identified as at risk on clinical assessment. METHODS: Cluster randomised controlled trial involving acutely ill children presenting to 133 general practitioners (GPs) at 78 GP practices in Belgium. Practices were randomised to undertake point-of-care CRP testing in all children (1730 episodes) or restricted to children identified as at clinical risk (1417 episodes)...
October 6, 2016: BMC Medicine
Lone Schaadt, Robin Christensen, Lars Erik Kristensen, Marius Henriksen
INTRODUCTION: Intensity of exercise is believed to be a key determinant of response to chronic obstructive pulmonary disease (COPD) rehabilitation. We hypothesized that a higher intensity of exercise, in combination with physiotherapist-led instructions and education in management of breathlessness, would lead to better self-management, possibly delaying calls to the emergency service and preventing hospitalization. OBJECTIVE: We aimed to test this hypothesis in a subsequent randomized trial, and in order to test study processes and estimate hospitalization rates, we did a small preliminary prospective cohort study on severe COPD patients referred to outpatient rehabilitation...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Sebastiano Mercadante, Flavio Fusco, Amanda Caruselli, Claudio Cartoni, Francesco Masedu, Marco Valenti, Federica Aielli
BACKGROUND: The aim of this study was to assess the phenomenon of episodic breathlessness in advanced cancer patients followed by palliative care services at home. METHODS: A consecutive sample of patients with advanced cancer admitted to home care for a period of six months, was surveyed. The presence of background breathlessness and episodic breathlessness, their intensity, and drugs used for its treatment were collected. Factors inducing episodic breathlessness, and its influence on daily activities were investigated...
October 6, 2016: Current Medical Research and Opinion
Kevin O'Gallagher, Evelyn Chou, Swarna Jeyabraba, Aish Sinha, Daniel Robb, Jonathan Byrne
An 80-year-old female presented with progressive breathlessness, worse on sitting or standing and relieved by lying flat. Subsequent investigations identified a patent foramen ovale (PFO) with right-to-left flow across the interatrial septum (IAS). A diagnosis of platypnoea orthodeoxia syndrome secondary to inter-atrial shunting was made. Technical features precluded a percutaneous PFO closure so an open surgical repair was performed with complete resolution of symptoms. We discuss the pathophysiology and management of platypnoea orthodeoxia syndrome...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Atsushi Hayata, Yoshiaki Minakata, Kazuto Matsunaga, Masanori Nakanishi, Nobuyuki Yamamoto
BACKGROUND: Physical activity (PA) is impaired from the early stages of COPD, is associated with a worsening of disease prognosis, and causes COPD patients to restrict their daily activities in order to avoid breathlessness. The development of a simple tool to estimate physical activity level (PAL) could be useful for the management of COPD. OBJECTIVES: We investigated the differences in PA according to the modified Medical Research Council (mMRC) grade in patients with COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Steffen T Simon, Marianne Kloke, Bernd Alt-Epping, Jan Gärtner, Martin Hellmich, Rebecca Hein, Maren Piel, Oliver A Cornely, Friedemann Nauck, Raymond Voltz
CONTEXT: Episodic breathlessness is a frequent and burdensome symptom in cancer patients but pharmacological treatment is limited. OBJECTIVES: To determine time to onset, efficacy, feasibility and safety of transmucosal fentanyl in comparison to immediate-release morphine (IRM) for the relief of episodic breathlessness. METHODS: Phase II, investigator initiated, multicenter, open-label, randomized, morphine-controlled, crossover trial with open-label titration of fentanyl buccal tablet (FBT) in inpatients with incurable cancer...
September 29, 2016: Journal of Pain and Symptom Management
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