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https://www.readbyqxmd.com/read/28324671/dose-de-escalation-of-intrapleural-tissue-plasminogen-activator-therapy-for-pleural-infection-the-adapt-project
#1
Natalia Popowicz, Oliver Bintcliffe, Duneesha De Fonseka, Kevin G Blyth, Nicola A Smith, Francesco Piccolo, Geoffrey Martin, Donny Wong, Anthony Edey, Nick Maskell, Y C Gary Lee
RATIONALE: Intrapleural therapy with a combination of tissue plasminogen activator (tPA) 10mg and deoxyribonuclease (DNase) 5mg administered twice daily has been shown in randomized and open-label studies to enable adequate drainage of over 90% of infected pleural effusions without surgery. Potential bleeding risks associated with intrapleural tPA and the drug costs remain important concerns. The ongoing ADAPT (Alteplase Dose Assessment for Pleural infection Therapy) project aims to investigate the efficacy and safety of dose de-escalation for intrapleural tPA...
March 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28319532/evaluation-of-a-protocol-for-same-day-discharge-after-radial-lounge-monitoring-in-a-southern-swiss-referral-percutaneous-coronary-intervention-centre
#2
Luigi Biasco, Giovanni B Pedrazzini, Marco Araco, Francesco Petracca, Daniele Del Monte, Daniel Sürder, Fulvio Bomio, Martina Boscolo Berto, Giulia Montrasio, Alessandro Del Bufalo, Elena Pasotti, Tiziano Moccetti, Marco Moccetti
AIMS: The aim of the study was to retrospectively evaluate safety and patient satisfaction of same-day discharge after elective radial coronary angiography/percutaneous coronary intervention (PCI) after the implementation of a radial lounge facility. METHODS: All patients admitted to our radial lounge with a planned same-day discharge after an uncomplicated coronary angiography/PCI, having a co-living caregiver, were day enrolled in the study. Rates of same-day discharge, unplanned overnight stay, and in-hospital and first complications [death, myocardial infarction (MI), unplanned coronary angiography, access site hematoma, bleedings requiring hospitalization] were analysed; satisfaction was also evaluated through a questionnaire...
March 17, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28319503/myocardial-infarction-in-a-patient-with-hypertrophic-cardiomyopathy-but-normal-coronary-arteries
#3
Shuheng Li, Xiaoxin Sun, Zongyao Zhang, Zuo-Xiang He
A 57-year-old man with a history of hypertrophic cardiomyopathy diagnosed by echocardiography experienced atypical chest pain and dyspnea for 6 months. A rest Tc-MIBI myocardial SPECT imaging and a F-FDG myocardial PET/CT imaging were performed, which showed multiple matched myocardial perfusion/metabolism defects in the left ventricle, indicating scar tissue. Surprisingly, subsequent contrast coronary angiography revealed no significant coronary artery stenosis.
March 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28319321/unrecognized-coronary-vasospasm-in-patients-referred-for-percutaneous-coronary-intervention-intracoronary-nitroglycerin-the-forgotten-stepchild-of-cardiovascular-guidelines
#4
Alec Vishnevsky, Howard M Julien, David L Fischman, Paul Walinsky, J David Ogilby, Nicholas J Ruggiero, Babu Jasti, Michael P Savage
OBJECTIVE: The goal of this study was to demonstrate the importance of intracoronary nitroglycerin (IC NTG) administration during diagnostic coronary angiography and prior to percutaneous coronary intervention (PCI). BACKGROUND: PCI has been a mainstay treatment for patients with symptomatic coronary artery disease. While current guidelines emphasize the importance of periprocedural antithrombotic medications, they fail to mention the use of nitroglycerin prior to PCI...
March 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28319162/risk-of-acute-myocardial-infarction-in-patients-with-gastroesophageal-reflux-disease-a-nationwide-population-based-study
#5
Wei-Yi Lei, Jen-Hung Wang, Shu-Hui Wen, Chih-Hsun Yi, Jui-Sheng Hung, Tso-Tsai Liu, William C Orr, Chien-Lin Chen
OBJECTIVE: Gastroesophageal reflux disease (GERD) is a common disease which can cause troublesome symptoms and affect quality of life. In addition to esophageal complications, GERD may also be a risk factor for extra-esophageal complications. Both GERD and coronary artery disease (CAD) can cause chest pain and frequently co-exist. However, the association between GERD and acute myocardial infarction (AMI) remain unclear. The purpose of the study was to compare the incidence of acute myocardial infarction in GERD patients with an age-, gender-, and comorbidity matched population free of GERD...
2017: PloS One
https://www.readbyqxmd.com/read/28318509/chest-pain-and-st-segment-elevation-in-an-18-year-old-man
#6
Mazen M Kawji, David Luke Glancy
An 18-year-old man came to the hospital because of 1 day of chest pain typical of pericarditis. He had had an upper respiratory infection 10 days earlier. His electrocardiograms indicated evolving pericarditis. His echocardiogram showed mild, diffuse left ventricular hypokinesia, and his troponin I level peaked at 47.5 ng/ml. Thus, he had myopericarditis.
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28317171/combination-of-change-in-hematological-parameters-with-exercise-stress-test-to-predict-coronary-artery-disease
#7
Ahmet Korkmaz, Abdulkadir Yıldız, Pınar Türker Duyuler, Serkan Duyuler, Samet Yılmaz, Funda Basyigit, Ozgul Ucar Elalmis, Umit Guray, Mehmet Ileri
OBJECTIVE: Treadmill exercise stress testing for identifying patients with a higher likelihood of coronary artery disease (CAD) before elective coronary angiography is recommended in the current guidelines. In this study, we aimed to evaluate the changes in the hematological parameters before and after exercise stress test in relation with the presence of CAD. METHODS: A total of 113 patients with chest pain who underwent treadmill exercise testing and coronary angiography were included in this study...
March 20, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28306672/radiotherapy-chemotherapy-and-atherosclerosis
#8
San S Min, Anthony S Wierzbicki
PURPOSE OF REVIEW: This article reviews the effects of radiotherapy and chemotherapy in promoting the progression of atherosclerosis in patients with cancer. RECENT FINDINGS: Radiotherapy is associated with an increase in the incidence of atherosclerosis with the effects being related to the site of irradiation and dose of radiotherapy. Cranial irradiation is associated with dyslipidaemia and the metabolic syndrome secondary to effect on growth hormone secretion...
March 16, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28306584/serratus-anterior-plane-block-to-address-post-thoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#9
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#10
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28302732/an-unusual-cause-of-chest-pain-in-a-teenage-girl
#11
Ben McNaughten, Andrew Thompson, Dara O'Donoghue
No abstract text is available yet for this article.
March 16, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28302232/giant-ganglioneuroma-in-a-5-year-child
#12
Fazal Wahab Khan, Saulat Hasnain Fatimi, Hamza Abdur Rahim Khan
We report a 5-year boy presenting with pain in the lower chest and upper abdomen. On evaluation with computed tomography scan of the chest, he was found to have a large 16 x 14 cm posterior mediastinal mass compressing the inferior vena cava and liver, and shifting the heart to the opposite side. Tumor was approached via right postero-lateral thoracotomy and dissected off from esophagus, heart, inferior vena cava and lungs. The entire tumor was resected without any complications. Postoperative course was unremarkable...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#13
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28299808/pneumopericardium-as-a-rare-complication-after-esophagopericardial-fistula
#14
Hai-Qin Liao, Dan Zhou, Quan-Liang Shang, Yi-Fan Shi, Ming Zhang
Pneumopericardium is a rare clinical entity which is often complicated by trauma. Pneumoperdicardium resulting after esophagopericardial fistula is much rarer. We present a case of pneumopericardium as the complication of esophagopericardial fistula in a 53-year-old man. After undergoing radiotherapy for 26 times, the patient got a fever and an unspecified thoracic pain. Echocardiography showed the rectilinear echoes in the pericardium. Chest computed tomography revealed pneumopericardium, pericardial effusion, recurrence of lung cancer, and pneumonia in right lower and left lung...
March 16, 2017: Echocardiography
https://www.readbyqxmd.com/read/28298766/comparison-of-perioperative-thoracic-epidural-fentanyl-with-bupivacaine-and-intravenous-fentanyl-for-analgesia-in-patients-undergoing-coronary-artery-bypass-grafting-surgery
#15
Amitabh Chanchal Sen, Sunil Rajan, Rakhi Balachandran, Lakshmi Kumar, Suresh Gangadharan Nair
CONTEXT: Two-thirds of patients undergoing coronary artery bypass grafting (CABG) surgery report moderate to severe pain, particularly with ambulatory or respiratory effort. AIMS: The aim of this study is to compare the analgesic effect of perioperative thoracic epidural fentanyl with bupivacaine and intravenous fentanyl in patients undergoing CABG surgery. SETTINGS AND DESIGN: The study was a prospective, randomized, nonblinded comparative study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298050/intra-articular-steroid-injection-for-frozen-shoulder
#16
Yaying Sun, Peng Zhang, Shaohua Liu, Hong Li, Jia Jiang, Shiyi Chen, Jiwu Chen
BACKGROUND: Intra-articular steroid injection is a common intervention for frozen shoulder (FS). PURPOSE: This review aimed to illustrate the effects of intra-articular steroid injection for FS. STUDY DESIGN: Systematic review and meta-analysis. METHODS: PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) comparing intra-articular steroid injection with no injection or sham injections for FS...
October 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28297814/-igg4-related-lung-disease-analysis-of-8-cases-and-literature-review
#17
G J Han, H Hu, D Mao, X Bai, D Y She, S F Zhao, Z L Wen, J Gao
Objective: To improve the understanding and treatment of IgG4-related lung disease (IgG4-RLD). Methods: The clinical characteristics, serum IgG4 levels, pathological features, chest CT, therapy and prognosis of 8 patients with IgG4-RLD were retrospectively analyzed. These patients were admitted to the People's Liberation Army General Hospital and the pathological diagnosis was made between December 2005 and March 2016. Relevant literatures were reviewed. Results: The 8 patients with IgG4-RLD included 4 men and 4 women, with an average age of (59±4) years (range, 37-74)...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#18
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#19
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28295517/a-giant-aneurysm-of-noncoronary-sinus-of-valsalva-concomitant-with-aortic-regurgitation-and-mitral-regurgitation
#20
Yi Luo, Zhi Fang, Wei Meng
Aneurysms of the sinus of Valsalva (ASV) are rare, with an incidence ranging from 0.1% to 3.5% of all congenital cardiac defects and a prevalence of 0.009% in an autopsy series.ASVs occur much more frequently in the right coronary sinus of Valsalva. Previous reports, based on necropsy and cardiac surgery findings, estimated that 20% of ASVs are unruptured. Patients with an unruptured ASV may remain asymptomatic for a long period of time until rupture. They may also presented with dyspnea, palpitation, and angina-like chest pain...
March 14, 2017: Echocardiography
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