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https://www.readbyqxmd.com/read/29166342/important-considerations-for-performing-prepectoral-breast-reconstruction
#1
Hani Sbitany
Prepectoral breast reconstruction has emerged as an excellent technique for postmastectomy reconstruction, as it allows for full preservation of a patient's pectoralis major muscle and chest wall function. This reduces pain, eliminates animation deformity, and results in high patient satisfaction. Safely performed prepectoral breast reconstruction requires a careful patient selection process before committing to the procedure, taking into account comorbidities, radiation status, and oncologic criteria such as tumor location and breast cancer stage...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29163998/multifocal-pulmonary-granular-cell-tumor-presenting-with-postobstructive-pneumonia
#2
Samid M Farooqui, Muhammad S Khan, Laura Adhikari, Viral Doshi
Granular cell tumor (GCT) is a neoplasm of Schwann cell origin. Its presence in the aerodigestive tract is uncommon and becomes a diagnostic challenge on initial presentation. Our case is of a 59-year-old woman who presented to the emergency department with a history of productive cough and dyspnea associated with fever and chest pain. An initial chest X-ray (CXR) showed a right middle lobe consolidation with follow-up Computed Tomography (CT) scan showing a mass in the right bronchus. Bronchoscopy revealed a polypoid, sessile granular mass in the right bronchus intermedius with multiple white lesions in trachea, left main bronchus, and right upper bronchi...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29163951/coronary-artery-anomalies-unusually-high-incidence-of-anomalies-with-a-malignant-course-in-an-asian-population
#3
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/29162782/recurrent-early-coronary-stent-thrombosis-under-chronic-disseminated-intravascular-coagulation
#4
Yusuke Oba, Satoshi Hoshide, Tadayuki Mitama, Hajime Shinohara, Takahiro Komori, Tomoyuki Kabutoya, Yasushi Imai, Nobuhiko Ogata, Kazuomi Kario
A 62-year-old Japanese man presented with chest pain indicating that acute myocardial infarction had occurred. Eleven years earlier, he underwent a splenectomy due to idiopathic portal hypertension. Coronary angiography revealed diffuse stenosis, with calcification in the left anterior descending coronary artery (LAD). We performed a primary percutaneous coronary intervention (PCI). We deployed two drug-eluting stents with sufficient minimal cross-sectional stent area by intravascular ultrasound and thrombolysis in myocardial infarction (TIMI) 3 flow...
November 22, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29158999/recurrent-primary-suprahepatic-abscess-due-to-providencia-stuartii-a-rare-phenomenon
#5
Kyawzaw Lin, Aung Naing Lin, Sandar Linn, Madhavi Reddy, Anjali Bakshi
Gram-negative urease-producing bacilli, Providencia stuartii (P. stuartii), is reported in urinary tract infections, gastroenteritis, and bacteremia in humans but they rarely present with a hepatic abscess. We present a rare case of a recurrent suprahepatic cyst due to P. stuartii in a 45-year-old female, intravenous ( IV) heroin abuser with chronic hepatitis B and C. A 45-year-old female with 10 days status post right suprahepatic abscess drainage presented with recurrent, right, upper quadrant abdominal pain for one day...
September 16, 2017: Curēus
https://www.readbyqxmd.com/read/29158926/acquired-elliptocytosis-as-a-manifestation-of-myelodysplastic-syndrome-with-ring-sideroblasts-and-multilineage-dysplasia
#6
Jacob D Kjelland, Denis M Dwyre, Brian A Jonas
Acquired elliptocytosis is a known but rarely described abnormality in the myelodysplastic syndromes (MDS). Here we report the case of an elderly male who was admitted to the hospital with chest pain, dyspnea, and fatigue and was found to be anemic with an elliptocytosis that had only recently been noted on peripheral smears of his blood. After bone marrow biopsy he was diagnosed with MDS with ring sideroblasts and multilineage dysplasia and acquired elliptocytosis. Here we report a rare case of acquired elliptocytosis cooccurring with MDS with ring sideroblasts and multilineage dysplasia...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29158679/treatment-of-pulmonary-hypertension-with-left-heart-disease-a-concise-review
#7
REVIEW
Anish Desai, Shilpa A Desouza
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥ 25 mmHg, as determined by right heart catheterization. Pulmonary arterial hypertension (PAH) can no longer be considered an orphan disease given the increase in awareness and availability of new drugs. PH carries with it a dismal prognosis and leads to significant morbidity and mortality. Symptoms can range from dyspnea, fatigue and chest pain to right ventricular failure and death. PH is divided into five groups by the World Health Organization (WHO), based on etiology...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29158065/electrocardiographic-predictors-of-morbidity-and-mortality-in-patients-with-acute-myocarditis-the-importance-of-qrs-t-angle
#8
Shmuel Chen, Sarah Hoss, Vicki Zeniou, Ayelet Shauer, Dan Admon, Donna R Zwas, Chaim Lotan, Andre Keren, Israel Gotsman
BACKGROUND: Acute myocarditis carries a variable prognosis. We evaluated the morbidity and mortality rates in patients with acute myocarditis and admission electrocardiographic predictors of outcome. METHODS: Patients admitted to a tertiary hospital with a clinical diagnosis of acute myocarditis were evaluated. RESULTS: 193 patients were included. Median follow-up was 5.7 years; 82% were males, median age of 30 years (21-39). The most common clinical presentations were chest pain (77%) and fever (53%)...
November 17, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29156231/acute-organoaxial-gastric-volvulus-a-massive-problem-with-a-twist-case-report
#9
Fadi Al Daoud, Gul Sachwani Daswani, Vinu Perinjelil, Tina Nigam
INTRODUCTION: Gastric volvulus (GV) is a rare and life threatening condition if not treated promptly or wrongly diagnosed. The main complication of gastric volvulus is foregut obstruction. The extreme rotation can cut off blood supply to the stomach and even distal organs, which can lead to ischemia and necrosis of the affected area. PRESENTATION OF CASE: We report a case of a 41yo female that complained of severe abdominal pain, nausea and vomiting for approximately 3days after eating a large meal...
November 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29154424/acute-fulminant-necrotizing-eosinophilic-myocarditis-early-diagnosis-and-treatment
#10
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/29153816/a-decreased-preload-due-to-a-loaded-stomach-a-rare-presentation-of-a-paraesophageal-hernia
#11
Rens A van der Linde, Seilenna S Lases, Thomas J Buist, Henderik L van Westreenen, Vincent B Nieuwenhuijs
A hiatal hernia is a condition in which intraabdominal content herniates into the intrathoracic cavity. On rare occasions, a hiatal hernia can lead to cardiorespiratory compromise. We report a case of chest pain followed by cardiac arrest in a patient not known to have hiatal hernia, and without preliminary symptoms. The patient was suspected of having cardiac ischemia; however, angiography did not reveal any abnormalities. Chest tomography revealed a large paraesophageal hernia with compression of the right ventricle causing decreased preload and cardiac output...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29153814/surgical-management-of-medically-refractory-tietze-syndrome
#12
Rebecca Gologorsky, Benjamin Hornik, Jeffrey Velotta
Tietze syndrome is a rare and benign cause of chest pain that may be confused with life-threatening conditions. Characteristic findings are painful, localized inflammation of the costosternal, sternoclavicular, or costochondral joints typically of the second and third ribs. We present a patient with severe, medically refractory symptoms consistent with Tietze syndrome. Although surgical management is not the typical treatment course, symptomatic control was eventually achieved with complete resection of the involved cartilage and adjacent rib...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29152856/treatment-associated-symptoms-and-coping-of-postoperative-patients-with-lung-cancer-in-japan-development-of-a-model-of-factors-influencing-hope
#13
Takae Bando, Chiemi Onishi, Yoshie Imai
AIM: Postoperative patients with lung cancer have a high recurrence rate and poor prognosis; hence, it was aimed to identify the factors affecting hope to develop a care-oriented perspective that focuses on the levels of hope of postoperative patients with lung cancer. METHODS: In the study, postoperative patients with lung cancer were included and data were collected for treatment-related symptoms, coping, and support-related factors as the primary variables. The Herth Hope Index, Quality of Life Questionnaire Lung Cancer Module of the European Organization for Research and Treatment of Cancer, Japanese version of the Coping Inventory for Stressful Situations, and Social Support Scale for Cancer Patients were used...
November 20, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/29152209/case-control-study-hyperbaric-oxygen-treatment-of-mild-traumatic-brain-injury-persistent-post-concussion-syndrome-and-post-traumatic-stress-disorder
#14
Paul G Harch, Susan R Andrews, Edward F Fogarty, Juliette Lucarini, Keith W Van Meter
Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18-65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied...
July 2017: Medical Gas Research
https://www.readbyqxmd.com/read/29151495/acute-pericarditis-following-acute-pulmonary-thromboembolism
#15
Akio Nakata, Isao Aburadani, Koichirou Kontani, Satoshi Hirota
We describe the case of a 45-year-old Japanese man who developed acute pericarditis following an acute pulmonary thromboembolism. He had developed shortness of breath 7 days prior to hospitalization and was admitted with severe dyspnea. Echocardiography and laboratory results were compatible with acute pulmonary thromboembolism, which was confirmed by contrast-enhanced chest computed tomography. On the third hospital day, he experienced chest pain exacerbated by inspiration. On the fourth hospital day, his body temperature increased to 39°C and echocardiography revealed circumferential pericardial effusion...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29150126/hypertrophic-cardiomyopathy
#16
REVIEW
Juan José Santos Mateo, María Sabater Molina, Juan Ramón Gimeno Blanes
Hypertrophic cardiomyopathy is the most common inherited cardiovascular disease. It is characterized by increased ventricular wall thickness and is highly complex due to its heterogeneous clinical presentation, several phenotypes, large number of associated causal mutations and broad spectrum of complications. It is caused by mutations in sarcomeric proteins, which are identified in up to 60% of cases of the disease. Clinical manifestations of Hypertrophic Cardiomyopathy include shortness of breath, chest pain, palpitations and syncope, which are related to the onset of diastolic dysfunction, left ventricular outflow tract obstruction, ischemia, atrial fibrillation and abnormal vascular responses...
November 14, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29148415/exacerbation-of-beh%C3%A3-et-s-syndrome-and-familial-mediterranean-fever-with-menstruation
#17
Gul Guzelant, Yesim Ozguler, Sinem Nihal Esatoglu, Guzin Karatemiz, Huri Ozdogan, Sebahattin Yurdakul, Hasan Yazici, Emire Seyahi
OBECTIVES: Menstruation triggers several conditions such as migraine, recurrent aphthous stomatitis and acne vulgaris in healthy individuals. There is evidence that Behçet's syndrome (BS) and familial Mediterranean fever (FMF) may exacerbate during menstruation. The aim is to assess whether BS and FMF patients experience menstrual flares. METHODS: Females of reproductive age with BS and FMF seen consecutively at the outpatient clinic of Cerrahpasa Medical Faculty at Istanbul, as well as apparently healthy hospital workers were studied using a standardised questionnaire...
October 24, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29147480/a-rare-case-of-late-onset-saphenous-vein-graft-spasm
#18
Nirmal Guragai, Upamanyu Rampal, Rahul Vasudev, Hiten Patel, Meherwan B Joshi, Fayez Shamoon
Spasm following coronary artery bypass graft surgery has been well established in arterial grafts, especially in grafts utilizing the internal mammary. Venous graft spasms are uncommon and are only observed in vein grafts during or soon after the coronary artery bypass surgery. It is exceedingly rare to see spasm of venous graft beyond one year of surgery. We report a 72-year-old female who had coronary artery bypass graft three years ago and presented with new onset chest pain for one month. The coronary angiogram revealed severe spasm of the proximal aspect of a patent saphenous venous graft which was relieved by intracoronary nitroglycerine...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147478/abdominal-pain-with-a-twist-a-rare-presentation-of-acute-gastric-volvulus
#19
David P Chen, Saqib Walayat, Imran L Balouch, Daniel K Martin, Teresa J Lynch
Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146682/magnitude-of-soluble-st2-as-a-novel-biomarker-for-acute-aortic-dissection
#20
Yuan Wang, Xin Tan, Hai Gao, Hui Yuan, Rong Hu, Lixin Jia, Junming Zhu, Lizhong Sun, Hongjia Zhang, Lianjun Huang, Dong Zhao, Pei Gao, Jie Du
Background -Misdiagnosis of acute aortic dissection (AAD) can lead to significant morbidity and death. Soluble ST2 (sST2) is a cardiovascular injury-related biomarker. The extent to which sST2 is elevated in AAD and whether sST2 can discriminate AAD from other causes of sudden-onset severe chest pain is unknown. Methods -We measured plasma concentrations of sST2 (R&D systems assay) in 1360 patients, including 1027 participants in the retrospective discovery set and 333 patients with initial suspicion of AAD enrolled in the prospective validation cohort...
November 16, 2017: Circulation
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