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Lung, stroke,

Vera Spatenkova, Pavlina Krejzarova, Jaroslav Jedlicka
Introduction: Dysphagia is a risk factor for aspiration pneumonia and acute respiratory failure in acute stroke patients. Dysphagia lusoria is caused by compression on the esophagus from artery lusoria, when the aberrant right subclavian artery arises from the descending aortic arch. We present a rare case report of pre-stroke undiagnosed dysphagia lusoria as a cause of aspiration pneumonia with acute respiratory failure in a 67-year-old female patient admitted with a minor left intracerebral hemorrhage in the left basal ganglia...
2018: SAGE Open Medical Case Reports
Georges Al-Helou, Nardos Temesgen, Jonathan Gwizdala, Jalil Ahari
Our patient is a 69-year-old man who presented to the emergency department with left-sided hemiparesis that started 4 hours prior to presentation. Brain CT showed right basal ganglia and internal capsule haemorrhagic strokes. MRI revealed multiple brain lesions suspicious for metastases. Further workup revealed a 5 cm lung mass and a 1 cm pancreatic nodule. Biopsy of both pulmonary and pancreatic lesions was consistent with melanoma and was similar histologically. The patient underwent cyberknife stereotactic radiosurgery to the brain metastases followed by immunotherapy with pembrolizumab, and then by nivolumab and ipilimumab...
March 15, 2018: BMJ Case Reports
Marta Trapero-Bertran, Celia Muñoz, Kathryn Coyle, Doug Coyle, Adam Lester-George, Reiner Leidl, Bertalan Németh, Kei-Long Cheung, Subhash Pokhrel, Ángel Lopez-Nicolás
AIMS: To assess the cost-effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). DESIGN: We used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov-based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self-helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion...
March 13, 2018: Addiction
Marta Trapero-Bertran, Reiner Leidl, Celia Muñoz, Puttarin Kulchaitanaroaj, Kathryn Coyle, Maximilian Präger, Judit Józwiak-Hagymásy, Kei Long Cheung, Mickael Hiligsmann, Subhash Pokhrel
BACKGROUND AND AIMS: Modelling return on investment (ROI) from smoking cessation interventions requires estimates of their costs and benefits. This paper describes a standardized method developed to source both economic costs of tobacco smoking and costs of implementing cessation interventions for a Europe-wide ROI model [European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD)]. DESIGN: Focused search of administrative and published data...
March 13, 2018: Addiction
Fabian Kording, Jin Yamamura, Manuela Tavares de Sousa, Christian Ruprecht, Erik Hedström, Anthony H Aletras, P Ellen Grant, Andrew J Powell, Kai Fehrs, Gerhard Adam, Hendrik Kooijman, Bjoern P Schoennagel
BACKGROUND: Fetal cardiovascular magnetic resonance (CMR) imaging may provide a valuable adjunct to fetal echocardiography in the evaluation of congenital cardiovascular pathologies. However, dynamic fetal CMR is difficult due to the lack of direct in-utero cardiac gating. The aim of this study was to investigate the effectiveness of a newly developed Doppler ultrasound (DUS) device in humans for fetal CMR gating. METHODS: Fifteen fetuses (gestational age 30-39 weeks) were examined using 1...
March 12, 2018: Journal of Cardiovascular Magnetic Resonance
Smita Kaushik, Warren J Gasper, Bala Ramanan, Shant M Vartanian, Linda M Reilly, Timothy A M Chuter, Jade S Hiramoto
OBJECTIVE: The purpose of this study was to evaluate the impact of prior aortic surgery on outcomes after multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAAs). METHODS: From July 2005 to October 2016, there were 153 patients who underwent elective endovascular repair of TAAA and PRAA using multibranched stent grafts. Data on demographics, procedural details, and outcomes were collected prospectively...
March 6, 2018: Journal of Vascular Surgery
Diego Milani, Megan C Bakeberg, Jane L Cross, Vince W Clark, Ryan S Anderton, David J Blacker, Neville W Knuckey, Bruno P Meloni
We have previously demonstrated that arginine-rich and poly-arginine peptides possess potent neuroprotective properties, with poly-arginine peptide R18 identified as being highly effective at reducing infarct volume following middle cerebral artery occlusion (MCAO) in the Sprague Dawley rat. Since peptides synthesised using D-isoform amino acids have greater stability than L-isoform peptides due to increased resistance to proteolytic degradation, they represent potentially more effective peptide therapeutics...
2018: PloS One
Oliver T Mytton, Christopher Jackson, Arno Steinacher, Anna Goodman, Claudia Langenberg, Simon Griffin, Nick Wareham, James Woodcock
BACKGROUND: The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation...
March 2018: PLoS Medicine
Peter N Lee
BACKGROUND: Opinions differ on the relationship between tar level and risk of smoking-related disease. However, except for lung cancer, few reviews have evaluated the epidemiological evidence. Here the relationship of tar level to risk of the four main smoking-related diseases is considered. METHODS: Papers comparing risk of lung cancer, COPD, heart disease or stroke in smokers of lower and higher tar yield cigarettes were identified from reviews and searches, relative risk estimates being extracted comparing the lowest and highest tar groups...
February 28, 2018: Inhalation Toxicology
Jonathan R Weir-McCall, Patrick Sk Liu-Shiu-Cheong, Allan D Struthers, Brian J Lipworth, J Graeme Houston
BACKGROUND: Pulmonary pulse wave velocity (PWV) allows the non-invasive measurement of pulmonary arterial stiffening, but has not previously been assessed in COPD. The aim of the current study was to assess PWV in COPD and its association with right ventricular (RV) remodelling. METHODS: Fifty-eight participants with COPD underwent pulmonary function tests, 6-min walk test and cardiac MRI, while 21 healthy controls (HCs) underwent cardiac MRI. Thirty-two COPD patients underwent a follow-up MRI to assess for longitudinal changes in RV metrics...
February 27, 2018: European Radiology
Amrish Deshmukh, Ankit Bhatia, Emeka Anyanwu, Takeyoshi Ota, Valluvan Jeevanandam, Nir Uriel, Roderick Tung, Cevher Ozcan
This study sought to determine the incidence, predictors, and outcomes of postoperative atrial fibrillation (POAF) in patients undergoing implantation of left ventricular assist devices (LVADs). A retrospective analysis of all patients who underwent LVAD implantation from 2013 to 2014 was conducted. Postoperative AF, survival, and thrombotic complications were evaluated after surgery. A total of 47 patients (mean age, 56.4 ± 12.5 years; 33 male) were included and followed for a median of 331 days. Within 30 days of surgery, 13 (28%) patients developed POAF at mean 7...
February 24, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
María Lema Tome, Francisco Andrés De la Gala, Patricia Piñeiro, Luis Olmedilla, Ignacio Garutti
INTRODUCTION: In last few years, emphasis was placed in goal-directed therapy in order to optimize patient's hemodynamic status and improve their prognosis. Parameters based on the interaction between heart and lungs have been questioned in situations like low tidal volume and open chest surgery. The goal of the study was to analyze the changes that one-lung ventilation can produce over stroke volume variation and to assess the possible impact of airway pressures and lung compliance over stroke volume variation...
February 21, 2018: Revista Brasileira de Anestesiologia
Bob Smit, Yvo M Smulders, Johannes C van der Wouden, Heleen M Oudemans-van Straaten, Angelique M E Spoelstra-de Man
BACKGROUND: In clinical practice, oxygen is generally administered to patients with the intention of increasing oxygen delivery. Supplemental oxygen may, however, cause arterial hyperoxia, which is associated with hemodynamic alterations. We performed a systematic review and meta-analysis of the literature to determine the effect of hyperoxia on central hemodynamics and oxygen delivery in healthy volunteers and cardiovascular-compromised patients. METHODS: PubMed and EMBASE were searched up to March 2017...
February 25, 2018: Critical Care: the Official Journal of the Critical Care Forum
Sasan Faridi, Mansour Shamsipour, Michal Krzyzanowski, Nino Künzli, Heresh Amini, Faramarz Azimi, Mazen Malkawi, Fatemeh Momeniha, Akbar Gholampour, Mohammad Sadegh Hassanvand, Kazem Naddafi
The main objectives of this study were (1) investigation of the temporal variations of ambient fine particulate matter (PM2.5 ) and ground level ozone (O3 ) concentrations in Tehran megacity, the capital and most populous city in Iran, over a 10-year period from 2006 to 2015, and (2) estimation of their long-term health effects including all-cause and cause-specific mortality. For the first goal, the data of PM2.5 and O3 concentrations, measured at 21 regulatory monitoring network stations in Tehran, were obtained and the temporal trends were investigated...
February 21, 2018: Environment International
V K Zafiraki, E D Kosmachyeva, L V Shulzhenko, D M Ramazanov, A A Omarov, I V Pershukov
OBJECTIVE: to assess the effect of lung hyperinflation (LHI) in patients with chronic obstructive pulmonary disease (COPD) on longterm outcomes of percutaneous coronary intervention (PCI). MATERIALS AND METHODS: Patients with COPD who suffered stable ischemic heart disease and underwent PCI (n=135) were included in a prospective cohort study. LHI was found in 60 patients, while 75 patients had no LHI. Evaluation included comparing the frequency of major adverse cardiac events (MACE) (cardiac death, myocardial infarcпункtion [MI], stroke, repeat revascularization) and Kaplan-Mayer curves between groups of patients with and without LHI...
January 2018: Kardiologiia
Ryan A Orizondo, Guy Gino, Garret Sultzbach, Shalv P Madhani, Brian J Frankowski, William J Federspiel
Gas transfer through hollow fiber membranes (HFMs) can be increased via fiber oscillation. Prior work, however, does not directly translate to present-day, full-scale artificial lungs. This in vitro study characterized the effects of HFM oscillations on oxygenation and hemolysis for a pediatric-sized HFM bundle. Effects of oscillation stroke length (2-10 mm) and frequency (1-25 Hz) on oxygen transfer were measured according to established standards. The normalized index of hemolysis was measured for select conditions...
February 20, 2018: Annals of Biomedical Engineering
Carol H Christensen, Brian Rostron, Candace Cosgrove, Sean F Altekruse, Anne M Hartman, James T Gibson, Benjamin Apelberg, Maki Inoue-Choi, Neal D Freedman
Importance: Tobacco products have changed in recent years. Contemporary mortality risk estimates of combustible tobacco product use are needed. Objective: To investigate the mortality risks associated with current and former use of cigars, pipes, and cigarettes. Design, Setting, and Participants: The National Longitudinal Mortality Study is a longitudinal population-based, nationally representative health survey with mortality follow-up that includes demographic and other information from the Current Population Survey, tobacco product use information from the Tobacco Use Supplement, and mortality data from the National Death Index...
February 19, 2018: JAMA Internal Medicine
Nakul Katyal, Amanda Korzep, Christopher Newey
Central venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed...
January 2018: Journal of Neurosciences in Rural Practice
Sang-Lim Kim, Byoung-Hee Lee
Background: This study was to evaluate the effects of weight-bearing-based mobilization with movement (WBBMWM) on balance and gait in stroke patients. Methods: Thirty stroke patients participated in this study. All individuals were randomly assigned to either WBMWM group ( n = 15) or weight-bearing with placebo mobilization with movement group (control, n = 15). Individuals in the WBMWM group were trained for 10 glides of 5 sets a day, 5 times a week during 4 weeks...
January 2018: Journal of Neurosciences in Rural Practice
Adam Leigh, John W McEvoy, Parveen Garg, J Jeffrey Carr, Veit Sandfort, Elizabeth C Oelsner, Matthew Budoff, David Herrington, Joseph Yeboah
OBJECTIVES: This study assessed the utility of the pooled cohort equation (PCE) and/or coronary artery calcium (CAC) for atherosclerotic cardiovascular disease (ASCVD) risk assessment in smokers, especially those who were lung cancer screening eligible (LCSE). BACKGROUND: The U.S. Preventive Services Task Force recommended and the Centers for Medicare & Medicaid Services currently pays for annual screening for lung cancer with low-dose computed tomography scans in a specified group of cigarette smokers...
February 9, 2018: JACC. Cardiovascular Imaging
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