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https://www.readbyqxmd.com/read/28079399/safety-and-efficacy-of-tissue-plasminogen-activator-tpa-and-deoxyribonuclease-dnase-for-complicated-pleural-effusions-secondary-to-abdominal-pathology
#1
Adnan Majid, Sebastian Ochoa, Sumit Chatterji, Sebastian Fernandez-Bussy, Fayez Kheir, Estefania Rivera, George Cheng, Erik Folch
RATIONALE: Exudative pleural effusions may arise secondary to inflammation of intra-abdominal structures. Pleural space loculations can complicate these effusions, preventing adequate chest tube drainage and leading to consideration of surgical intervention. Previous studies have demonstrated that intrapleural administration of tissue plasminogen activator (tPA) combined with human recombinant deoxyribonuclease (DNase) can improve fluid drainage and reduce surgery for patients with loculated parapneumonic effusions; however, the efficacy of this treatment has not been evaluated for complicated pleural effusions attributed to intraabdominal inflammation...
January 12, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28077823/association-of-health-symptoms-with-low-level-exposure-to-organophosphates-dna-damage-ache-activity-and-occupational-knowledge-and-practice-among-rice-corn-and-double-crop-farmers
#2
Surat Hongsibsong, Nalin Sittitoon, Ratana Sapbamrer
OBJECTIVES: This study aims to determine (1) total dialkylphosphate (ΣDAP) levels, occupational knowledge and practice, DNA damage, AChE activity, and health symptoms in rice, corn, and double-crop farmers; (2) the association of health symptoms with ΣDAP levels, occupational knowledge and practice, DNA damage, and AChE activity in farmers; and (3) the prevalence of health symptoms between farmers and non-farmers. METHODS: A cross-sectional study was conducted by interviewing as well as analyzing urine and blood samples during July to August 2014...
January 11, 2017: Journal of Occupational Health
https://www.readbyqxmd.com/read/28075307/chronic-heart-failure-part-2-treatment-and-management
#3
Rebecca Brake, Ian David Jones
Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition...
January 11, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28062251/opioid-suppression-of-conditioned-anticipatory-brain-responses-to-breathlessness
#4
Anja Hayen, Vishvarani Wanigasekera, Olivia K Faull, Stewart F Campbell, Payashi S Garry, Simon J M Raby, Josephine Robertson, Ruth Webster, Richard G Wise, Mari Herigstad, Kyle T S Pattinson
Opioid painkillers are a promising treatment for chronic breathlessness, but are associated with potentially fatal side effects. In the treatment of breathlessness, their mechanisms of action are unclear. A better understanding might help to identify safer alternatives. Learned associations between previously neutral stimuli (e.g. stairs) and repeated breathlessness induce an anticipatory threat response that may worsen breathlessness, contributing to the downward spiral of decline seen in clinical populations...
January 3, 2017: NeuroImage
https://www.readbyqxmd.com/read/28050425/severe-left-ventricular-endomyocardial-fibrosis-presenting-as-biventricular-failure-in-a-young-adult-a-case-report
#5
Harpreet Singh Sandhu, Sampathkumar Mahadevappa Mahendrakar, Rajebali Ramzanali Pethani, Azizullah Hafizullah Khan, Yunus Shafi Loya
Endomyocardial Fibrosis (EMF) is a form of progressive restrictive cardiomyopathy of unclear aetiology prevalent in areas within 15(0) of equator including coastal areas of Kerala a few decades back. It inflicts young adults and carries a poor prognosis due to limited options for treatment. Fortunately, the incidence of cases is now declining due to improvement in health and hygiene standards. Here, we review the aetiology and pathogenesis of EMF and report a case of a young male from Mumbai (non-endemic area) presenting with progressively worsening breathlessness and signs of heart failure unresponsive to conventional medical treatment...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043958/fluctuating-drowsiness-following-cardiac-catheterisation-artery-of-percheron-ischaemic-stroke-causing-bilateral-thalamic-infarcts
#6
Daniel Hammersley, Ankur Arora, Madhava Dissanayake, Nabarun Sengupta
An 81-year-old man underwent cardiac catheterisation to investigate breathlessness and left ventricular impairment of unknown cause. He had unobstructed coronary arteries. Immediately following the procedure, he became suddenly unresponsive with vertical gaze palsy, anisocoria and bilateral upgoing plantar responses. He made a rapid recovery to his premorbid state 25 min later with no residual focal neurological signs. He then had multiple unresponsive episodes, interspaced with complete resolution of symptoms and neurological signs...
January 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28033197/impact-of-panic-attacks-on-bronchoconstriction-and-subjective-distress-in-asthma-patients-with-and-without-panic-disorder
#7
Maxine Boudreau, Simon L Bacon, Nicola J Paine, André Cartier, Barbara Trutschnigg, Alexandre Morizio, Kim L Lavoie
OBJECTIVES: Panic disorder (PD) is common among asthmatics and is associated with worse asthma outcomes. This may occur due to psychophysiological factors or to cognitive/affective factors. This study evaluated the impact of panic attacks (PAs) on bronchoconstriction and subjective distress in asthmatics with and without PD. METHODS: A total of 25 asthmatics (15 with PD who had a PA [PD/PA], 10 without PD who didn't have a PA [noPD/noPA]) were recruited from an outpatient clinic...
December 28, 2016: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28025597/clinical-profiles-of-dengue-infection-during-an-outbreak-in-northern-india
#8
Anish Laul, Poonam Laul, Vamsi Merugumala, Ravi Pathak, Urvashi Miglani, Pinkee Saxena
Introduction. Dengue fever is an arboviral disease, which is transmitted by mosquito vector and presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Unless we are aware of these presentations, diagnosis as well as early initiation of treatment becomes difficult. We studied the various clinical presentations of dengue infection during an outbreak of disease in 2015...
2016: Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28011247/health-status-of-patients-with-moderate-to-severe-copd-after-treatment-with-nebulized-arformoterol-tartrate-or-placebo-for-1-year
#9
James F Donohue, Vaidyanathan Ganapathy, Vamsi Bollu, Michael D Stensland, Lauren M Nelson
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a progressive disease that impairs both objectively measured lung function and patient-reported health status. In a randomized clinical trial of patients with moderate to severe COPD, we compared changes in health status after adding arformoterol tartrate or placebo to patients' treatment regimens. METHODS: In this multicenter, double-blind trial, patients were randomized to receive nebulized arformoterol 15 µg BID (n = 420) or matched placebo (n = 421)...
December 20, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27994452/copd-assessment-test-score-and-serum-c-reactive-protein-levels-in-stable-copd-patients
#10
Hyung Koo Kang, Kang Kim, Hyun Lee, Byeong-Ho Jeong, Won-Jung Koh, Hye Yun Park
BACKGROUND: An eight-item questionnaire of the COPD assessment test (CAT) is widely used to quantify the impact of COPD on the patient's health status. C-reactive protein (CRP) is associated with disease severity and adverse health outcomes of patients with COPD. This study aimed to evaluate the relationship between CAT score and serum CRP levels in stable COPD patients. METHODS: We evaluated the medical records of 226 patients with CAT and serum CRP measured within a week at Samsung Medical Center between October 2013 and October 2015...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27993297/young-child-with-breathlessness
#11
Marjolein Slaa, Nicole Dyer, Imke Zenker, Peter Ferguson, Simon Craig
No abstract text is available yet for this article.
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27981495/chronic-obstructive-pulmonary-disease-individualized-therapy-tailored-approach-to-symptom-management
#12
REVIEW
Dave Singh, Marc Miravitlles, Claus Vogelmeier
Chronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality. COPD is typified by persistent, progressive airflow limitation and a range of respiratory and systemic symptoms such as breathlessness, coughing, wheezing, depression, anxiety, general fatigue, and sleeping difficulties. Despite receiving treatment for COPD, many patients suffer from regular symptoms that affect their daily lives and lead to increased morbidity. These symptoms vary in severity, frequency, and type, and can occur at any time throughout the 24-h day, with over half of patients with COPD experiencing symptoms in the morning, during the day, and at nighttime...
December 15, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27965402/respiratory-symptoms-in-people-living-with-hiv-and-the-effect-of-antiretroviral-therapy-a-systematic-review-and-meta-analysis
#13
James Brown, Anjana Roy, Ross Harris, Sarah Filson, Margaret Johnson, Ibrahim Abubakar, Marc Lipman
BACKGROUND: Antiretroviral therapy (ART) has significantly altered the pattern of acute and chronic HIV-related disease. However, it is not clear what this means in terms of respiratory symptoms. We sought to investigate the association between HIV status and respiratory symptoms and how these have changed with the availability of ART. METHODS: We searched Cochrane, Medline and Embase databases for studies published between 1946 and August 2015 comparing the prevalence of respiratory symptoms in populations with and without HIV infection...
October 24, 2016: Thorax
https://www.readbyqxmd.com/read/27959351/fatal-haemorrhage-following-fine-needle-aspiration-of-the-thyroid
#14
M W Strachan, M Dalvi, R Ainsworth, F W Gibb, H Horsfall, D Patel
Fine needle aspiration is routinely performed as part of the assessment of thyroid nodules. It is generally regarded as a very safe procedure, though rarely significant bleeding can occur in its aftermath. A 79-year-old female was referred for assessment of an incidental thyroid nodule which had been identified on computed tomography of the chest and extended into the retrosternal space. The patient was referred for fine needle aspiration under ultrasound guidance. Three passes were made with a 25 gauge needle into the nodule; a haemorrhagic aspirate was obtained and sent for cytological examination...
September 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27942194/acute-undifferentiated-febrile-illness-in-patients-presenting-to-a-tertiary-care-hospital-in-south-india-clinical-spectrum-and-outcome
#15
Kundavaram Paul Prabhakar Abhilash, Jonathan Arul Jeevan, Shubhanker Mitra, Nirvin Paul, Thimiri Palani Murugan, Ajay Rangaraj, Sandeep David, Samuel George Hansdak, John Antony Jude Prakash, Asha Mary Abraham, Prakash Ramasami, Sowmya Sathyendra, Thambu David Sudarsanam, George M Varghese
BACKGROUND: Acute undifferentiated febrile illness (AUFI) may have similar clinical presentation, and the etiology is varied and region specific. MATERIALS AND METHODS: This prospective observational study was conducted in a tertiary hospital in South India. All adult patients presenting with AUFI of 3-14 days duration were evaluated for etiology, and the differences in presentation and outcome were analyzed. RESULTS: The study cohort included 1258 patients...
October 2016: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/27935345/using-health-psychology-techniques-to-manage-chronic-physical-symptoms
#16
Elizabeth Barley, Victoria Lawson
Chest pain and palpitations, non-malignant pain, breathlessness and fatigue often endure despite the receipt of appropriate nursing and medical care. This is distressing for patients, impacts on their quality of life and ability to function and is associated with high healthcare usage and costs. The cognitive behavioural approach offers nurses a model to understand how people's perceptions and beliefs and their emotional, behavioural and physiological reactions are linked. Common 'thinking errors' which can exacerbate symptom severity and impact are highlighted...
December 8, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27932629/breathlessness-during-daily-activity-the-psychometric-properties-of-the-london-chest-activity-of-daily-living-scale-in-patients-with-advanced-disease-and-refractory-breathlessness
#17
Charles C Reilly, Claudia Bausewein, Rachel Garrod, Caroline J Jolley, John Moxham, Irene J Higginson
BACKGROUND: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. AIM: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. DESIGN: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034)...
December 8, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27932338/meaning-of-living-with-severe-chronic-obstructive-lung-disease-a-qualitative-study
#18
Gabriella Marx, Maximilian Nasse, Henrikje Stanze, Sonja Owusu Boakye, Friedemann Nauck, Nils Schneider
OBJECTIVES: To explore what it means for patients to live with chronic obstructive pulmonary disease (COPD) as an incurable and constantly progressing disease. DESIGN: Qualitative longitudinal study using narrative and semistructured interviews. This paper presents findings of the initial interviews. Analysis using grounded theory. SETTING: Lung care clinics and community care in Lower Saxony, Germany. PARTICIPANTS: 17 patients with advanced-stage COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) III/IV)...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27929571/an-unusual-mediastinal-mass
#19
J Hardy, A R Jeyabalan, N Bhatt, A R Medford
We report a case of a mediastinal mass indenting the left lateral tracheal wall of a 35-year-old male who presented with weight loss, cough and breathlessness. Flow volume loop and thyroid function tests were normal and thyroid peroxidase antibodies were negative. Technetium scintigraphy and positron emission tomography both showed no uptake. Endobronchial ultrasound-guided fine needle aspiration confirmed ectopic mediastinal thyroid tissue. Mediastinal ectopic thyroid tissue is very rare. Most patients are asymptomatic and euthyroid with positive signals on scintigraphy...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27919937/primary-care-referral-for-echocardiogram-refer-in-heart-failure-a-diagnostic-accuracy-study
#20
Clare J Taylor, Andrea K Roalfe, Rachel Iles, Fd Richard Hobbs, Pelham Barton, Martin R Cowie, Russell C Davis, Jon Deeks, Jonathan Mant, Deborah McCahon, Theresa McDonagh, George Sutton, Lynda Tait
BACKGROUND: Symptoms of breathlessness, fatigue, and ankle swelling are common in general practice but deciding which patients are likely to have heart failure is challenging. AIM: To evaluate the performance of a clinical decision rule (CDR), with or without N-Terminal pro-B type natriuretic peptide (NT-proBNP) assay, for identifying heart failure. DESIGN AND SETTING: Prospective, observational, diagnostic validation study of patients aged >55 years, presenting with shortness of breath, lethargy, or ankle oedema, from 28 general practices in England...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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