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Management of hemoptysis

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https://www.readbyqxmd.com/read/29465600/a-novel-endobronchial-approach-to-massive-hemoptysis-complicating-silicone-y-stent-placement-for-tracheobronchomalacia-a-case-report
#1
Changwan Ryu, Daniel Boffa, Kyle Bramley, Margaret Pisani, Jonathan Puchalski
RATIONALE: Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation. PATIENT CONCERNS: We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM. DIAGNOSES: An emergent bronchoscopy showed an actively bleeding, pulsatile vessel at the distal end of the left bronchial limb of the Y-stent...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29465555/two-cases-of-dieulafoy-lesions-of-the-bronchus-with-novel-comorbid-associations-and-endobronchial-ablative-management
#2
Hardik S Sheth, Fabien Maldonado, Robert J Lentz
RATIONALE: Dieulafoy lesions are aberrantly large submucosal arteries most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive hemoptysis. PATIENT CONCERNS: We present three episodes of massive hemoptysis in two patients, the first with comorbid Alagille syndrome including multiple cardiac and pulmonary vascular abnormalities and the second with thyroid cancer metastatic to the mediastinum...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29431404/hoarseness-in-adults
#3
Steven A House, Eric L Fisher
Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more serious systemic, neurologic, or cancerous conditions. Medication-induced hoarseness is common and should be considered. The initial evaluation begins with a targeted history and physical examination, while also looking for signs of potential systemic etiologies...
December 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29369193/fibrosing-mediastinitis-with-pulmonary-hypertension-as-a-complication-of-pulmonary-vein-stenosis-a-case-report-and-review-of-the-literature
#4
Yidan Li, Xiangli Meng, Yidan Wang, Yuanhua Yang, Xiuzhang Lu
INTRODUCTION: Fibrosingmediastinitis (FM) is caused by a proliferation of fibrous tissue in the mediastinum encasing the mediastinal viscera that results in compression of mediastinal bronchovascular structures. Pulmonary hypertension (PH) is a severe complication of FM caused by extrinsic compression of pulmonary blood vessels. CASE PRESENTATION: Here, we present the case of a 47-year-old man who presented with a 10-year history of progressive hemoptysis and a 2-year history of shortness of breath, in whom a diagnosis of FM was made...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29357402/sudden-death-from-cardiopulmonary-arrest-on-arrival-of-a-patient-with-pulmonary-tuberculosis-a-case-diagnosed-by-postmortem-ct-and-autopsy
#5
Daizo Yaguchi, Motoshi Ichikawa, Noriko Inoue, Daisuke Kobayashi, Masato Shizu, Naoyuki Imai, Kazuko Watanabe
Sudden death due to massive hemoptysis during management of tuberculosis occurs in a considerable number of patients. However, when massive airway hemorrhage occurs in a patient in whom tuberculosis has not been confirmed and a blood is not apparent externally on the face/body, it is difficult to immediately identify the cause of death as airway obstruction by tuberculous bleeding in the airway. We encountered an 83-year-old Japanese woman with her medical history included treatment of tuberculosis in her 20s who was in cardiopulmonary arrest on arrival (CPAOA), and the cause of sudden death could not initially be identified...
January 22, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29351111/novel-bronchoscopic-management-of-airway-bleeding-with-absorbable-gelatin-and-thrombin-slurry
#6
A Rolando Peralta, Mohit Chawla, Robert P Lee
BACKGROUND: Airway bleeding, either spontaneous or as a result of bronchoscopy, is associated with significant morbidity and mortality. Multiple bronchoscopic techniques are available to achieve complete hemostasis or as a bridge to definitive therapies. METHODS: We report our experience on the feasibility of endobronchial instillation of an absorbable gelatin and thrombin slurry (GTS) for the treatment of spontaneous hemoptysis and procedure-related bleeding. RESULTS: We identified 13 cases in which GTS was used for endobronchial hemostasis when standard bronchoscopic measures like cold saline, epinephrine, and in some cases balloon occlusion were not successful...
January 18, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29313654/lung-cancer-clinical-presentation-and-diagnosis
#7
Kelly M Latimer
In the absence of screening, most patients with lung cancer are not diagnosed until later stages, when the prognosis is poor. The most common symptoms are cough and dyspnea, but the most specific symptom is hemoptysis. Digital clubbing, though rare, is highly predictive of lung cancer. Symptoms can be caused by the local tumor, intrathoracic spread, distant metastases, or paraneoplastic syndromes. Clinicians should suspect lung cancer in symptomatic patients with risk factors. The initial study should be chest x-ray, but if results are negative and suspicion remains, the clinician should obtain a computed tomography scan with contrast...
January 2018: FP Essentials
https://www.readbyqxmd.com/read/29312703/isolated-unilateral-absence-of-pulmonary-artery-in-adulthood-a-clinical-analysis-of-65-cases-from-a-case-series-and-systematic-review
#8
Ping Wang, Ling Yuan, Juhong Shi, Zuojun Xu
Background: Isolated unilateral absence of pulmonary artery (UAPA) in adulthood is a rare congenital anomaly. Although some case reports exist, the clinical symptomatology, lung parenchymal features, collateral circulation and therapeutic approaches in adult patients with isolated UAPA remain unknown. The objectives of this study are to investigate the clinical characteristics, elucidate the correlation between clinical symptomatology and radiology, and summarize treatment of adult patients with isolated UAPA...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29240016/drainage-of-cerebrospinal-fluid-and-blood-pressure-augmentation-as-rescue-therapies-for-ischemic-myelitis-after-bronchial-embolization-a-case-report
#9
Pierre-Alexis Lépine, Jean-François Naud, Philippe Boisvert
A 62-year-old man presented to the emergency department with massive hemoptysis. After bronchial artery embolization, he developed ischemic myelitis, a rare complication in this setting for which no specific therapy is currently recommended. The symptoms were managed with lumbar drainage of cerebrospinal fluid and blood pressure augmentation therapy. To our knowledge, this is the first report of using lumbar drainage of cerebrospinal fluid and blood pressure augmentation in the treatment of anterior medullary ischemia after bronchial artery embolization for massive hemoptysis...
December 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29214066/a-systematic-approach-to-the-management-of-massive-hemoptysis
#10
REVIEW
Christopher Radchenko, Abdul Hamid Alraiyes, Samira Shojaee
Massive hemoptysis is regarded as a potentially lethal condition that requires immediate attention, and prompt action. Although minor hemoptysis is frequently encountered by most clinicians, massive hemoptysis in far less frequent and most physicians are not prepared to manage this time-sensitive clinical presentation in a systematic and timely fashion. Critical initial steps in management need to be implemented in an expedited fashion, such that patients may have a chance at a more definitive treatment. In this article, we review the definition, vascular anatomy, etiology, diagnostic evaluation, epidemiology and prognostic markers of massive hemoptysis...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29180555/the-diagnostic-value-of-the-patient-s-reason-for-encounter-for-diagnosing-cancer-in-primary-care
#11
Kees van Boven, Annemarie A Uijen, Nina van de Wiel, Sibo K Oskam, Henk J Schers, Willem J J Assendelft
PURPOSE: Family physicians (FPs) have to recognize alarm symptoms and estimate the probability of cancer to manage these symptoms correctly. Mostly, patients start the consultation with a spontaneous statement on why they visit the doctor. This is also called the reason for encounter (RFE). It precedes the interaction and interpretation by FPs and patients. The aim of this study is to investigate the predictive value of alarm symptoms as the RFE for diagnosing cancer in primary care. DESIGN AND SETTING: Retrospective cohort study in a Dutch practice-based research network (Family Medicine Network)...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29123846/two-cases-of-cryptogenic-life-threatening-hemoptysis-identification-and-management-of-bleeding-point
#12
Kazunori Okuda, Jun Tanaka, Jun Okamoto, Fumihisa Kishi, Junichiro Nakagawa, Hiroshi Hino, Satoru Chujoh, Kazuhisa Shimadzu, Masafumi Kishimoto, Noboru Kato, Shigeru Shiono
Cases: Case 1: A 63-year-old woman was referred for coughing blood. Although cardiorespiratory dynamics were stabilized by artificial respiration under sedation, severely poor ventilation developed from asphyxia associated with massive respiratory tract hemorrhage. One-lung ventilation was temporarily secured by endotracheal tube insertion into the left main bronchus just prior to cardiopulmonary arrest.Case 2: A 72-year-old man was referred for massive hemoptysis after coughing, then intubated and placed on a respirator...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29089735/role-of-tranexamic-acid-on-blood-loss-in-laparoscopic-cholecystectomy
#13
Paras Kumar Pandove, Rachan Lal Singla, Pallavi Mittal, Nikhil Mahajan, Ashwani Kumar
CONTEXT: Nonsurgical uses of tranexamic acid include the management of bleeding associated with leukemia, ocular bleeding, recurrent hemoptysis, menorrhagia, hereditary angioneurotic edema, and numerous other medical problems. However, there is hardly any documentation of the use of tranexamic acid in laparoscopic cholecystectomy. AIMS: This study was conducted to evaluate the role of tranexamic acid in limiting blood loss in laparoscopic cholecystectomy and to evaluate the effect of blood loss on morbidity in terms of hospital stay and mortality of the patient...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29073778/bronchial-artery-embolization-first-line-option-for-managing-massive-hemoptysis
#14
Yutaka Miyano, Masato Kanzaki, Takamasa Onuki
Background Today, treatment for hemoptysis is not limited to surgery, and among the various options, bronchial artery embolization is regarded as an effective approach. Methods In this retrospective study, 179 of 389 patients with massive hemoptysis were treated with bronchial artery embolization, without taking into account the underlying pathological lesions responsible (bronchiectasis in 41, aspergilloma in 29, lung cancer in 25, old tuberculosis in 23, pyothorax in 19, others in 23). Results Bronchial artery embolization failed in 12 cases...
November 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29021475/successful-pulmonary-artery-embolization-for-the-management-of-hemoptysis-in-a-patient-with-eisenmenger-syndrome-caused-by-patent-ductus-arteriosus
#15
Naoki Tamada, Kazuhiko Nakayama, Yuto Shinkura, Ken-Ichi Yanaka, Naoto Katayama, Takuya Okada, Masato Yamaguchi, Kensuke Matsumoto, Hidekazu Tanaka, Toshiro Shinke, Noriaki Emoto, Ken-Ichi Hirata
The patient was a 19-year-old woman who was diagnosed with patent ductus arteriosus complicating Eisenmenger syndrome at a previous medical institution. She was referred to our hospital and arranged for lung transplantation. She developed hemoptysis after the introduction of i.v. epoprostenol, which was administered as a bridging treatment while the patient awaited lung transplantation. She continued to suffer from recurrent hemoptysis, even after switching from i.v. epoprostenol to i.v. treprostinil. Angiography of the systemic and pulmonary arteries revealed the vessel responsible for the recurrent hemoptysis and pulmonary artery embolization was successfully performed...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28941051/no-added-value-of-the-age-adjusted-d-dimer-cut-off-to-the-years-algorithm-in-patients-with-suspected-pulmonary-embolism
#16
L M van der Pol, T van der Hulle, Y W Cheung, A T A Mairuhu, C G Schaar, L M Faber, M Ten Wolde, H M A Hofstee, M M C Hovens, M Nijkeuter, R C J van Klink, M J H A Kruip, S Middeldorp, M V Huisman, F A Klok
Essentials Imaging is warranted in the majority of patients to confirm or rule out pulmonary embolism (PE). The age-adjusted D-dimer (ADJUST) reduced the number of required imaging tests in patients ≥ 50 years. The YEARS algorithm was designed to improve the efficiency in patients with suspected PE. There was no added value of implementing ADJUST in the YEARS algorithm in our cohort. SUMMARY: Background The YEARS algorithm was designed to simplify the diagnostic work-up of pulmonary embolism (PE) and to reduce the number of necessary computed tomography pulmonary angiography (CTPA) scans...
December 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28904677/-pulmonary-nocardiosis-in-immunocompetent-patients-about-2-cases
#17
Yasmina Rhofir, Rachida Zahraoui, Nabil Tiress, Hicham Naji-Amrani, Mouna Soualhi, Jamal Eddine Bourkadi
Nocardiosis is a rare but severe infection caused by bacteria of the genus nocardia, which belong to the order actinomycetales. If they can affect immunocompetent adult, nocardioses are pathologies affecting the individuals with weakened immune system. Pulmonary involvement is the most common manifestation, its correct management is based on diagnosis, which is often delayed due to non-specific symptoms and inconclusive specimens. We here report two cases of nocardiosis in immunocompetent patients. The first case concerns a 24-year old man with a history of smoking and alcoholism, hospitalized for chest pain and hemoptysis of low abundance evolving for two months, associated with the occurrence of dorsal subcutaneous fistulized abscess...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28894382/apatinib-in-the-treatment-of-advanced-lung-adenocarcinoma-with-kras-mutation
#18
Da-Xiong Zeng, Chang-Guo Wang, Jian-An Huang, Jun-Hong Jiang
Activating KRAS mutations in lung adenocarcinoma are characterized with treatment resistance and poor prognosis. As a small molecule inhibitor of vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase, apatinib has been proven successful in advanced gastric cancer and breast cancer. In this study, we show the result of apatinib as salvage treatment in lung adenocarcinoma patients with KRAS mutation. Four advanced lung adenocarcinoma patients with KRAS mutation were orally administered apatinib (250 mg/d) after second-line treatment...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28868316/a-rare-and-late-complication-after-left-ventricular-assist-device-explantation
#19
George Gradinariu, André R Simon, Jullien Gaer
Late complications can arise after explantation of a left ventricular assist device. We report the case of a patient who presented at the age of 19 years with peri-partum cardiomyopathy and was initially managed with a biventricular support device, which was subsequently upgraded to an ambulatory left ventricular assist device. This was successfully explanted after myocardial recovery via a minimally invasive approach 7 months later. The patient re-presented 5 years following explantation with hemoptysis. At redo sternotomy, a 10-cm remnant of the outflow graft was found to be eroding the surface of the right lung...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28852580/incidental-finding-of-dual-ectopic-thyroid-on-computed-tomography-angiography
#20
Antonio Pierro, Savino Cilla, Pietro Modugno, Giuseppina Sallustio
The presence of simultaneous two ectopic foci of thyroid tissue (dual ectopic thyroid) is rare, and few cases have been reported in the literature. The ectopic thyroid tissue is an extremely uncommon embryological aberration due to the alterations occurring during the embryological development with incomplete migration of thyroid precursors. Commonly ectopic thyroid tissue is a midline structures, but the lateral location is possible but very rare. Ectopic thyroid is common in women and can vary in size from a microscopic focus to a few centimeters...
2017: Journal of Clinical Imaging Science
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