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https://www.readbyqxmd.com/read/28749067/haemolysis-in-haemodialysis
#1
REVIEW
Dhakshayini Tharmaraj, Peter G Kerr
Haemolysis in haemodialysis, although rare in current times, is associated with significant mortality and morbidity. As such prompt recognition, treatment, analysis of root cause and correction of underlying causative factors is crucial. Dialysate, extracorporeal circuit and patient related factors all contribute to haemolysis risk. Haemolysis can manifest with non-specific signs and symptoms including but not restricted to hypertension, nausea, pain (abdominal, chest, back) and dyspnoea. It may present acutely during the dialysis session or may take a protracted course...
July 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28748625/multiple-risk-factor-counseling-to-promote-heart-healthy-lifestyles-in-the-chest-pain-observation-unit-pilot-randomized-controlled-trial
#2
David A Katz, Mark Graber, Patricia Lounsbury, Mark W Vander Weg, Emily K Phillips, Christina Clair, Phillip A Horwitz, Xueya Cai, Alan J Christensen
OBJECTIVE: Admission to the chest pain observation unit (CPOU) may be an advantageous time for patients to consider heart-healthy lifestyle changes while undergoing diagnostic evaluation to rule out myocardial ischemia. The aim of this pragmatic trial was to assess the effectiveness of a multiple risk factor intervention in changing CPOU patients' health beliefs and readiness to change health behaviors. A secondary aim was to obtain preliminary estimates of the intervention's effect on diet, physical activity, and smoking...
July 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28747944/impact-of-post-hospital-cardiac-rehabilitation-on-the-quality-of-life-of-patients-after-surgical-treatment-for-coronary-artery-disease
#3
Józefa Dąbek, Ewelina Pyka, Joanna Piotrkowicz, Krystian Stachoń, Grażyna Bonek-Wytrych
INTRODUCTION: The quality of life of cardiovascular patients is worse than that of healthy individuals. Pain, dyspnea, and fatigue impair daily activities, which in turn leads to decreased life satisfaction and emotional deterioration. The objective of comprehensive treatment, including early rehabilitation, is to reduce the risk of complications, progression, and recurrence of the disease, as well as to restore, maintain, or improve all aspects of the patient's quality of life to the greatest extent possible...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28747182/recurrent-primary-mediastinal-giant-cell-tumor-of-soft-tissue-with-radiological-findings-a-rare-case-report-and-literature-review
#4
Qiongjie Hu, Jian Peng, Liming Xia
BACKGROUND: Giant cell tumor of soft tissue (GCT-ST), which histologically resembles GCT of bone, is a rare tumor. Usually, it is located in the lower extremities and trunk. GCT-ST, occurring in mediastinum, is extremely rare. CASE PRESENTATION: We encountered an 18-year-old Chinese woman who had mild dull pain on the left side of back. The following chest computed tomography (CT) showed a heterogeneous mass deeply situated in the posterior mediastinum with compression of the lung and invasion of the adjacent rib...
July 26, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28746328/unresolving-pneumonia-with-pleural-effusion-pulmonary-paragonimiasis
#5
D Gaire, S Sharma, K Poudel, P Pant
Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. A 48 years, female presented at TUTH emergency with fever on and off for nine months, cough and shortness of breath for three months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28746222/the-use-of-tenoxicam-to-prevent-symptoms-of-discomfort-induced-by-vagotonia-during-uterus-manipulation-in-cesarean-sections
#6
Shih-Hong Chen, Shiou-Sheng Chen, Ching-Tao Chang, Chi-Hsiang Huang, Shou-Zen Fan, Li-Kuei Chen
PURPOSE: Symptoms such as nausea, vomiting, tightness of the chest, bradycardia, and shoulder or abdominal discomfort, caused by vagotonia occurring during uterus manipulation, have concerned healthcare professionals for some time. Patients sometimes report these symptoms when undergoing spinal anesthesia for cesarean sections (CSs). We designed a prospective, double-blind study to investigate the effectiveness of tenoxicam in preventing these symptoms of discomfort. METHODS: A total of 105 American Society of Anesthesiologists (ASA) class I-II nulliparous pregnant women, who were scheduled for a CS, were enrolled into this prospective, double-blind study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28744920/anti-myocardial-ischemia-effect-and-components-of-litchi-pericarp-extracts
#7
Yanfen Chen, Huanqing Li, Shu Zhang, Chaoyan Yang, Ziying Mai, Xueyan Hu, Zhenhu Gao, Hong Deng
Litchi (Litchi chinensis Sonn.) is a famous fruit in south China, and it is also effective for chest tightness or chest pain, irritability, flatulence, epigastric pain and neuralgic pain, hernia pain and testicular swelling, cough, etc. It is valued because a great amount of polyphenol was found in litchi pericarp. In this paper, we got litchi pericarp pure extract by a simple purification method, then evaluated its activity to clear oxygen free radicals in vitro, and evaluated its myocardial protection effect in vivo through acute myocardial ischemia rat model...
July 26, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/28743479/integrating-heart-rate-variability-vital-signs-electrocardiogram-and-troponin-to-triage-chest-pain-patients-in-the-ed
#8
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Current triage methods for chest pain patients typically utilize symptoms, electrocardiogram (ECG), and vital sign data, requiring interpretation by dedicated triage clinicians. In contrast, we aimed to create a quickly obtainable model integrating the objective parameters of heart rate variability (HRV), troponin, ECG, and vital signs to improve accuracy and efficiency of triage for chest pain patients in the emergency department (ED). METHODS: Adult patients presenting to the ED with chest pain from September 2010 to July 2015 were conveniently recruited...
July 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28743323/teaching-diagnostic-reasoning-using-simulation-and-mixed-practice-to-build-competence
#9
Heather Murray, Tyson Savage, Louise Rang, David Messenger
The acquisition of competence in diagnostic reasoning is essential for medical trainees. Exposure to a variety of patient presentations helps develop the skills of diagnostic reasoning, but reliance on ad hoc clinical encounters is inefficient and does not guarantee timely exposure for all trainees. We present a novel teaching series led by emergency physicians that builds upon the existing medical education literature to teach diagnostic reasoning to preclinical (2nd year) medical students. The series used emergency department simulations involving patient actors and simulated vital signs to provide students with exposure to three acute care presentations: chest pain, abdominal pain, and headache...
July 26, 2017: CJEM
https://www.readbyqxmd.com/read/28742837/risk-factors-associated-with-posttraumatic-stress-disorder-in-us-veterans-a-cohort-study
#10
Jan Müller, Sarmila Ganeshamoorthy, Jonathan Myers
OBJECTIVE: To assess the association between clinical and exercise test factors and the development of posttraumatic stress disorder (PTSD) in US Veterans. PATIENTS AND METHODS: Exercise capacity, demographics and clinical variables were assessed in 5826 veterans (mean age 59.4 ± 11.5 years) from the Veterans Affairs Healthcare System in Palo Alto, CA. The study participants underwent routine clinical exercise testing between the years 1987 and 2011. The study end point was the development of PTSD...
2017: PloS One
https://www.readbyqxmd.com/read/28742646/comparison-of-3-symptom-classification-methods-to-standardize-the-history-component-of-the-heart-score
#11
Michael R Marchick, Michael L Setteducato, Jesse J Revenis, Matthew A Robinson, Emily C Weeks, Thomas F Payton, David E Winchester, Brandon R Allen
OBJECTIVES: The History, Electrocardiography, Age, Risk factors, Troponin (HEART) score enables rapid risk stratification of emergency department patients presenting with chest pain. However, the subjectivity in scoring introduced by the history component has been criticized by some clinicians. We examined the association of 3 objective scoring models with the results of noninvasive cardiac testing. METHODS: Medical records for all patients evaluated in the chest pain center of an academic medical center during a 1-year period were reviewed retrospectively...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742643/sensitive-troponin-i-and-stress-testing-in-the-emergency-department-for-the-early-management-of-chest-pain-using-2-hour-protocol
#12
Shahriar Dadkhah, Zakaria Almuwaqqat, Samian Sulaiman, Husein Husein, Quang Nguyen, Saad Ali, Tuncay Taskesen
BACKGROUND: Despite improvements in identifying high-risk patients with non-ST segment ACS (acute coronary syndrome), low risk patients presenting with atypical chest pain and non-diagnostic Electrocardiogram (ECG) continued to undergo unnecessary admissions and testing. Since 1992, our chest pain protocol included using 4-hour serial biomarkers from ED admission in combination with stress testing to evaluate these patients. Our study aimed at determining whether a new accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI) 2 hours after admission to the ED followed by stress testing is safe and effective in emergency settings, allowing for appropriate triage, earlier discharge and reducing costs...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742306/identifying-emergency-department-patients-with-chest-pain-who-are-at-low-risk-for-acute-coronary-syndromes-digest
#13
David Markel, Jeremy Kim
Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing...
July 21, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28741863/development-of-quality-metrics-for-ambulatory-pediatric-cardiology-infection-prevention
#14
Jonathan N Johnson, Cindy S Barrett, Wayne H Franklin, Eric M Graham, Nancy J Halnon, Brandy A Hattendorf, Catherine D Krawczeski, James J McGovern, Matthew J O'Connor, Amy H Schultz, Jeffrey M Vinocur, Devyani Chowdhury, Jeffrey B Anderson
INTRODUCTION: In 2012, the American College of Cardiology's (ACC) Adult Congenital and Pediatric Cardiology Council established a program to develop quality metrics to guide ambulatory practices for pediatric cardiology. The council chose five areas on which to focus their efforts; chest pain, Kawasaki Disease, tetralogy of Fallot, transposition of the great arteries after arterial switch, and infection prevention. Here, we sought to describe the process, evaluation, and results of the Infection Prevention Committee's metric design process...
July 25, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28740997/guidelines-for-bystander-first-aid-2016
#15
Jen Heng Pek
Cardiac life support is a form of first aid for cardiac emergencies. However, research and evidence in this field is lacking compared with other forms of first aid. Having identified the common emergencies that are encountered in the hospital, based on the available evidence, we have put together what could be an evidence-based approach to the first aid management of some of these common emergencies, viz. breathlessness, chest pain, allergies, stroke, heat injury, poisoning, unconsciousness, seizures, and trauma situations such as bleeding, wounds, contusions, head injury, burns and fractures...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740696/uniportal-video-assisted-thoracoscopic-thymectomy-and-resection-of-a-giant-thymoma-in-a-patient-witness-of-jehova
#16
Diego Gonzalez-Rivas, Ching Feng Wu, Mercedes de la Torre
A rare case of a giant thymoma in a patient witness of Jehova treated by single port thoracoscopic resection is reported. A 78-year-old man with chest pain and mild dyspnea had been previously diagnosed with giant thymoma went to our hospital and asked for second opinion of operation. Computed tomography showed a 12.5 cm × 9.5 cm × 10 cm mass in the anterior mediastinum. Under the request of this patient, he is only willing to receive minimal invasive surgery without blood transfusion. Thirty-six hours after surgical resection, the patient safely discharged from our hospital without complication...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740693/disease-flare-after-discontinuing-gefitinib-in-a-patient-with-lung-adenocarcinoma-and-concomitant-epithelial-growth-factor-receptor-mutation-and-anaplastic-lymphoma-kinase-translocation
#17
Eun Hye Park, Hwa Young Lee, Jin Woo Kim, Chang Dong Yeo
We report on a patient with lung adenocarcinoma and a concomitant epithelial growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) translocation who developed a disease flare after discontinuing gefitinib. A 63-year-old woman with lung adenocarcinoma and a concomitant activating EGFR mutation and ALK translocation was treated with first-line gefitinib. After 4 months, she discontinued the gefitinib due to disease progression. She was admitted to the emergency room complaining of severe dyspnea and back pain 22 days after discontinuing gefitinib...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#18
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740629/comparison-of-coronary-artery-disease-guidelines-with-extracted-knowledge-from-data-mining
#19
Peyman Rezaei-Hachesu, Azadeh Oliyaee, Naser Safaie, Reza Ferdousi
Introduction: Coronary artery disease (CAD) is one of the major causes of disability and death in the world. Accordingly utilizing from a national and update guideline in heart-related disease are essential. Finding interesting rules from CAD data and comparison with guidelines was the objectives of this study. Methods: In this study 1993 valid and completed records related to patients (from 2009 to 2014) who had suffered from CAD were recruited and analyzed. Total of 25 variable including a target variable (CAD) and 24 inputs or predictor variables were used for knowledge discovery...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28739614/apical-ballooning-takotsubo-syndrome-with-concurrent-st-segment-elevation-myocardial-infarction
#20
Mohsin A Hussain, Andrew T Cox, Rachel Bastiaenen, Abhiram Prasad
We present the case of a 61-year-old woman admitted with chest pain and an ECG demonstrating ST-segment elevation in the lateral leads. Emergency coronary angiography demonstrated an occluded obtuse marginal branch. Percutaneous intervention was unsuccessful as the lesion could not be crossed with a wire. Left ventriculography and transthoracic echocardiography demonstrated hypokinesis of the entire apex but preserved contractility of the basal segments, consistent with a diagnosis of apical ballooning syndrome (ABS)...
July 24, 2017: BMJ Case Reports
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