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https://www.readbyqxmd.com/read/29228935/dosimetrically-administered-nebulized-morphine-for-breathlessness-in-very-severe-chronic-obstructive-pulmonary-disease-a-randomized-controlled-trial
#1
Piotr Janowiak, Małgorzata Krajnik, Zygmunt Podolec, Tomasz Bandurski, Iwona Damps-Konstańska, Piotr Sobański, David C Currow, Ewa Jassem
BACKGROUND: Systemic morphine has evidence to support its use for reducing breathlessness in patients with severe chronic obstructive pulmonary disease (COPD). The effectiveness of the nebulized route, however, has not yet been confirmed. Recent studies have shown that opioid receptors are localized within epithelium of human trachea and large bronchi, a target site for a dosimetric nebulizer. The aim of this study was to compare any clinical or statistical differences in breathlessness intensity between nebulized 2...
December 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29221328/uncontrolled-and-under-diagnosed-asthma-in-a-damascus-shelter-during-the-syrian-crisis
#2
Yousser Mohammad, Shaaban Rafea, Youssef Latifeh, Ali Khaddam, Bisher Sawaf, Mhd Ismael Zakaria, Mohammad Sadek Al Masalmeh, Yaser Fawaz, Abdoulraouf Allaham, Imad Almani, Hiba El-Tarcheh, Ayham Ghazal, Ali Zaher, Hala Rifai, Hamed Joumah, S Dresden Glockler-Lauf, Teresa To
Background: Studies have shown that poor shelter or dwelling conditions may lead to deteriorations in health. Those with asthma may be more susceptible to compromised living conditions and stress leading to a higher risk of asthma exacerbations. To describe the asthma control and quality of life of individuals with diagnosed asthma living in a shelter in Damascus, Syria and estimate the prevalence of respiratory symptoms in shelter dwellers without diagnosed asthma. Methods: In this cross-sectional study, all individuals 5 years and older living in Al-Herjalleh shelter with diagnosed asthma were recruited to complete a questionnaire, which included items related to their respiratory symptoms, asthma exacerbations, exposure to asthma triggers, medication use, and health-related quality of life before and since entering the shelter...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218227/lessons-learnt-from-a-case-of-missed-central-hypothyroidism
#3
Tessa Glyn, Beverley Harris, Kate Allen
We present the case of a 57-year-old lady who had a delayed diagnosis of central hypothyroidism on a background of Grave's thyrotoxicosis and a partial thyroidectomy. During the twenty years following her partial thyroidectomy, the patient developed a constellation of symptoms and new diagnoses, which were investigated by numerous specialists from various fields, namely rheumatology, renal and respiratory. She developed significantly impaired renal function and raised creatine kinase (CK). She was also referred to a tertiary neurology service for investigation of myositis, which resulted in inconclusive muscle biopsies...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29217721/insights-from-australians-with-respiratory-disease-living-in-the-community-with-experience-of-self-managing-through-an-emergency-department-near-miss-for-breathlessness-a-strengths-based-qualitative-study
#4
Tim Luckett, Jane Phillips, Miriam Johnson, Maja Garcia, Priyanka Bhattarai, Virginia Carrieri-Kohlman, Anne Hutchinson, Rebecca T Disler, David Currow, Meera Agar, Serra Ivynian, Richard Chye, Phillip J Newton, Patricia M Davidson
OBJECTIVES: Breathlessness 'crises' in people with chronic respiratory conditions are a common precipitant for emergency department (ED) presentations, many of which might be avoided through improved self-management and support. This study sought insights from people with experience of ED 'near misses' where they considered going to the ED but successfully self-managed instead. DESIGN AND METHODS: A qualitative approach was used with a phenomenological orientation...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29217598/phenotypes-of-symptomatic-airways-disease-in-china-and-new-zealand
#5
James Fingleton, Kewu Huang, Mark Weatherall, Yanfei Guo, Stefan Ivanov, Piet Bruijnzeel, Hong Zhang, Wei Wang, Richard Beasley, Chen Wang
It is uncertain whether phenotypes of asthma and chronic obstructive pulmonary disease (COPD) vary between populations with different genetic and environmental characteristics. Here, our objective was to compare the phenotypes of airways disease in two separate populations.This was a cross-sectional observational study in adult populations from New Zealand and China. Participants aged 40-75 years who reported wheeze and breathlessness in the last 12 months were randomly selected from the general population and underwent detailed characterisation...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29214821/-at-first-i-couldn-t-catch-my-breath-process-and-strategies-for-managing-chronic-obstructive-pulmonary-disease
#6
M Rebecca Genoe, Chantelle Zimmer
In this article, we describe the process and strategies that study participants living with chronic obstructive pulmonary disease in central Canada utilized to manage and live well with their illness and its associated symptoms. Drawing on interpretive phenomenology, we interviewed eight participants three times, followed by a member checking focus group and individual interviews. We analyzed interview transcripts using detailed line by line analysis. Our findings suggest participants engaged in a challenging process of recognizing that changes had occurred and then coming to terms with these changes by acknowledging the severity of their condition and the resulting limitations...
January 1, 2017: International Journal of Aging & Human Development
https://www.readbyqxmd.com/read/29200670/clinico-radiological-and-pathological-characteristics-of-inflammatory-myofibroblastic-tumors-in-children-a-retrospective-study
#7
Mohamad Hussain Mir, Waseem Dar, Sheikh Aejaz Aziz, Gul Mohamad, Burhan Wani
Purpose: Inflammatory myofibroblastic tumors (IMTs) are rare, benign lesions most often seen in the lung of young adults but can occur in children, in various sites. They mimic, clinically and radiologically, malignant tumors - especially sarcomas and lymphomas. The aim was to review the clinical, radiological, and pathological data of children with a diagnosis of IMT referred to our department. Materials and Methods: This retrospective study was conducted at the Department of Medical and Paediatric Oncology, Regional Cancer Centre, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India from January 2014 to December 2015...
July 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29197835/kombucha-is-a-cup-of-tea-good-for-you
#8
Ailsa Holbourn, Judith Hurdman
A 54-year-old asthmatic woman presented to hospital with a 10-day history of breathlessness. On examination, she was tachypnoeic with mild wheeze. She had preserved peak flows and was saturating at 100% on room air. Investigations revealed severe metabolic lactic acidosis. On further questioning, it transpired that she drank kombucha tea, which has been linked to lactic acidosis. She made a full recovery with supportive management and cessation of the tea.
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29193381/experiences-of-older-people-following-an-acute-exacerbation-of-copd-a-phenomenological-study
#9
Francesca Rosa, Annamaria Bagnasco, Luca Ghirotto, Gennaro Rocco, Gianluca Catania, Giuseppe Aleo, Milko Zanini, Nicoletta Dasso, Mark Hayter, Loredana Sasso
AIMS AND OBJECTIVES: To explore the experience of patients affected by COPD following hospitalization due to an acute exacerbation event. BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched - especially amongst people with COPD recovering from an acute event and facing a return home...
November 29, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29191220/type-iv-dual-left-anterior-descending-coronary-artery-a-case-report
#10
Sahela Nasrin, Fathima Aaysha Cader, M Maksumul Haq, Masuma Jannat Shafi
BACKGROUND: Dual left anterior descending (LAD) artery or duplication of LAD is a rarely reported coronary anomaly, consisting of two branches supplying the usual distribution of the LAD. Type IV dual LAD, in which a short LAD arises from the left main coronary artery and a long LAD arises from the right coronary artery is remarkably rare, and has not been reported in a Bangladeshi subject. CASE PRESENTATION: We describe the case of a 70-year old Bangladeshi male who presented with breathlessness in the background of a prior inferior myocardial infarction...
December 1, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#11
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29184398/the-role-of-pain-in-pulmonary-rehabilitation-a-qualitative-study
#12
Samantha L Harrison, Annemarie L Lee, Helene L Elliott-Button, Rebecca Shea, Roger S Goldstein, Dina Brooks, Cormac G Ryan, Denis J Martin
Introduction: One third of individuals with chronic obstructive pulmonary disease (COPD) report pain. To help inform a COPD-specific pain intervention, we explored the views of health care providers (HCPs) and individuals with COPD on pain during pulmonary rehabilitation (PR). Methods: This is a qualitative study using inductive thematic analysis. Eighteen HCPs familiar with PR and 19 patients enrolled in PR participated in semi-structured interviews. Demographic data were recorded, and the patients completed the Brief Pain Inventory (Short Form)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29179573/the-value-of-rehabilitation-medicine-for-patients-receiving-palliative-care
#13
Sarah A Wittry, Ny-Ying Lam, Thomas McNalley
BACKGROUND: Rehabilitation medicine is a multidisciplinary field aimed at improving patients' quality of life by improving function. Patients receiving palliative care frequently share common symptoms including fatigue, decreased functional independence, mood disorders, pain, and breathlessness. Many rehabilitation interventions can improve these symptoms. OBJECTIVE: To evaluate the scope and effectiveness of rehabilitation interventions and exercise programs in improving quality of life and distressing symptoms in patients receiving palliative care...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29167300/respiratory-adverse-effects-of-opioids-for-breathlessness-a-systematic-review-and-meta-analysis
#14
Cindy A Verberkt, Marieke H J van den Beuken-van Everdingen, Jos M G A Schols, Sushma Datla, Carmen D Dirksen, Miriam J Johnson, Sander M J van Kuijk, Emiel F M Wouters, Daisy J A Janssen
Previous studies have shown that opioids can reduce chronic breathlessness in advanced disease. However, physicians remain reluctant to prescribe opioids for these patients, commonly due to fear of respiratory adverse effects. The aim of this study was to systematically review reported respiratory adverse effects of opioids in patients with advanced disease and chronic breathlessness.PubMed, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, ClinicalTrials.gov and the reference lists of relevant systematic reviews were searched...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29167117/effect-of-6-weeks-of-high-intensity-one-legged-cycling-on-functional-sympatholysis-and-atp-signaling-in-patients-with-heart-failure
#15
Gregers Wibe Munch, Ulrik Winning Iepsen, Camilla Koch Ryrsø, Jaya Birgitte Rosenmeier, Bente Klarlund Pedersen, Stefan P Mortensen
Breathlessness during daily activities is the primary symptom in patients with heart failure (HF). Poor correlation between the hemodynamic parameters of left ventricular performance and perceived symptoms suggests that other factors such as skeletal muscle function plays a role in determining exercise capacity. We investigated the effect of six weeks of high-intensity one-legged cycling (HIC; 8x4 at 90% one-legged cycling max) on: 1) the ability to override sympathetic vasoconstriction (arterial infusion of tyramine) during one-legged knee-extensor exercise (KEE); 2) vascular function (arterial infusion of ACh, SNP, tyramine and ATP); 3) exercise capacity in HF patients with reduced ejection fraction (n=8) compared with healthy individuals (n=6)...
November 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29164255/effect-of-an-indwelling-pleural-catheter-vs-talc-pleurodesis-on-hospitalization-days-in-patients-with-malignant-pleural-effusion-the-ample-randomized-clinical-trial
#16
RANDOMIZED CONTROLLED TRIAL
Rajesh Thomas, Edward T H Fysh, Nicola A Smith, Pyng Lee, Benjamin C H Kwan, Elaine Yap, Fiona C Horwood, Francesco Piccolo, David C L Lam, Luke A Garske, Ranjan Shrestha, Christopher Kosky, Catherine A Read, Kevin Murray, Y C Gary Lee
Importance: Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis. Objective: To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant pleural effusion. Design, Setting, and Participants: This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015)...
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29163951/coronary-artery-anomalies-unusually-high-incidence-of-anomalies-with-a-malignant-course-in-an-asian-population
#17
Abdulaziz M Alkhulaifi, Nidheesh Chooriyil, Maryam Alkuwari, Abdelnasser N Ghareep, Cornelia Carr
Objectives: Coronary artery anomalies are uncommon, but important cardiac malformations, representing the second commonest cause of death in young athletes. Methods: We utilized computerized tomographic angiography to screen and precisely delineate coronary artery anomalies in patients with minimal cardiac symptoms. Results: During 3.5-year period, we performed 2888 computerized tomographic angiographies. A total of 33 (1.1%; 95% confidence interval = 0...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29154424/acute-fulminant-necrotizing-eosinophilic-myocarditis-early-diagnosis-and-treatment
#18
Paul David Callan, Aigul Baltabaeva, Mohammed Kamal, Joyce Wong, Rebecca Lane, Jan Lukas Robertus, Nicholas R Banner
Necrotizing eosinophilic myocarditis is a rare but potentially fatal condition that requires prompt recognition and treatment. We describe a case of a young athlete presenting with chest pain and breathlessness, with evidence of rapidly deteriorating cardiac function. The condition was successfully treated with corticosteroids, with no evidence of residual myocardial damage. This is the first reported case to demonstrate the utility of cardiac magnetic resonance imaging for diagnosis and monitoring response to treatment...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#19
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29097402/renal-transplant-previous-breast-cancer-and-progressive-breathlessness
#20
Subramanian Nachiappan, David C Howlett
No abstract text is available yet for this article.
November 2, 2017: BMJ: British Medical Journal
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