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https://www.readbyqxmd.com/read/27922241/an-unusual-case-of-neuroblastoma-a-17-year-old-adolescent-presented-with-bilateral-diffuse-lung-metastasis-at-initial-diagnosis
#1
Çağlar Ödek, Tanıl Kendirli, Esra Pekpak, Ayhan Yaman, Başak Adaklı-Aksoy, Handan Dinçaslan, Nurdan Taçyıldız, Emel Ünal, Erdal İnce, Gülsan Yavuz
Neuroblastoma (NB) is the most frequently diagnosed neoplasm during infancy and its incidence declines within the first 3-5 years of life. It can be rarely diagnosed in adolescents and young adults. Adolescents have advanced stage of disease, higher frequency of uncommon metastatic sites such as lungs, and worse outcomes. Herein, we describe an unusual case of NB in a 17-year-old adolescent presented with lung metastasis at diagnosis. The patient was diagnosed with stage IV NB. Thorax high-resolution computed tomography (HRCT) scan revealed irregular septal thickening with ground glass opacity consistent with pulmonary parenchymal metastases...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27921112/-gastroenterological-diseases-as-triggers-of-chest-pain
#2
J Labenz, C Labenz
BACKGROUND: Non-cardiac chest pain is very common and gastroenterological diseases are one of the most important causes. The frequency distribution of the underlying causes depends on the sector of the healthcare system in which it is ascertained. In individual cases it must always be taken into consideration that detection of coronary heart disease, for example, does not exclude another origin of chest pain. OBJECTIVE: This article provides a systematic review of gastroenterological diseases that can cause chest pain...
December 5, 2016: Der Internist
https://www.readbyqxmd.com/read/27919348/hdl-function-is-impaired-in-acute-myocardial-infarction-independent-of-plasma-hdl-cholesterol-levels
#3
Wijtske Annema, Hendrik M Willemsen, Jan Freark de Boer, Arne Dikkers, Markus van der Giet, Wybe Nieuwland, Anneke C Muller Kobold, L Joost van Pelt, Riemer H J A Slart, Iwan C C van der Horst, Robin P F Dullaart, René A Tio, Uwe J F Tietge
BACKGROUND: High-density lipoproteins (HDLs) protect against the development of atherosclerotic cardiovascular disease. HDL function represents an emerging concept in cardiovascular research. OBJECTIVE: This study investigated the association between HDL functionality and acute myocardial infarction (MI) independent of HDL-cholesterol plasma levels. METHODS: Participants (non-ST-segment elevation MI, non-STEMI, n = 41; STEMI, n = 37; non-MI patients, n = 33) from a prospective follow-up study enrolling patients with acute chest pain were matched for age and plasma HDL cholesterol...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27919338/effects-of-ionizing-radiation-on-the-heart
#4
Marjan Boerma, Vijayalakshmi Sridharan, Xiao-Wen Mao, Gregory A Nelson, Amrita K Cheema, Igor Koturbash, Sharda P Singh, Alan J Tackett, Martin Hauer-Jensen
This article provides an overview of studies addressing effects of ionizing radiation on the heart. Clinical studies have identified early and late manifestations of radiation-induced heart disease, a side effect of radiation therapy to tumors in the chest when all or part of the heart is situated in the radiation field. Studies in preclinical animal models have contributed to our understanding of the mechanisms by which radiation may injure the heart. More recent observations in human subjects suggest that ionizing radiation may have cardiovascular effects at lower doses than was previously thought...
October 2016: Mutation Research
https://www.readbyqxmd.com/read/27918847/left-ventricular-compressions-improve-hemodynamics-in-a-swine-model-of-out-of-hospital-cardiac-arrest
#5
Kenton L Anderson, Maria G Castaneda, Susan M Boudreau, Danny J Sharon, Vikhyat S Bebarta
INTRODUCTION: We hypothesized that chest compressions located directly over the left ventricle (LV) would improve hemodynamics, including coronary perfusion pressure (CPP), and return of spontaneous circulation (ROSC) in a swine model of cardiac arrest. METHODS: Transthoracic echocardiography (echo) was used to mark the location of the aortic root and the center of the left ventricle on animals (n = 26) which were randomized to receive chest compressions in one of the two locations...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918754/interventions-to-improve-rates-of-successful-extubation-in-preterm-infants-a-systematic-review-and-meta-analysis
#6
Kristin N Ferguson, Calum T Roberts, Brett J Manley, Peter G Davis
Importance: Clinicians aim to extubate preterm infants as early as possible, to minimize the risks of mechanical ventilation. Extubation is often unsuccessful owing to lung disease or inadequate respiratory drive. Objective: To conduct a systematic review and meta-analysis of interventions to improve rates of successful extubation in preterm infants. Data Sources: Searches were undertaken in PubMed and The Cochrane Library. Study Selection: The review was conducted using the methods of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
December 5, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#7
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904536/a-review-on-human-respiratory-modeling
#8
REVIEW
Pardis Ghafarian, Hamidreza Jamaati, Seyed Mohammadreza Hashemian
Input impedance of the respiratory system is measured by forced oscillation technique (FOT). Multiple prior studies have attempted to match the electromechanical models of the respiratory system to impedance data. Since the mechanical behavior of airways and the respiratory system as a whole are similar to an electrical circuit in a combination of series and parallel formats some theories were introduced according to this issue. It should be noted that, the number of elements used in these models might be less than those required due to the complexity of the pulmonary-chest wall anatomy...
2016: Tanaffos
https://www.readbyqxmd.com/read/27899069/gastric-dilatation-and-intestinal-obstruction-mimicking-acute-coronary-syndrome-with-dynamic-electrocardiographic-changes
#9
H M M T B Herath, Anne Thushara Matthias, B S D P Keragala, W A E Udeshika, Aruna Kulatunga
BACKGROUND: ST elevation myocardial infarction is a medical emergency and the electrocardiogram is a part of the mainstay in the initial diagnosis. A variety of non-cardiac conditions have been known to mimic the electrocardiographic changes seen in acute coronary syndrome. We present a patient presenting with acute partial intestinal obstruction causing gastric distension and intestinal dilatation who also had dynamic electrocardiographic changes, mimicking anterior ST elevation myocardial infarction...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27889372/-non-invasive-ventilation-in-children-do-we-need-more-evidence
#10
G Mortamet, G Emeriaud, P Jouvet, B Fauroux, S Essouri
Respiratory failure is the leading cause of hospital admissions in the pediatric intensive care unit (PICU) and is associated with significant morbidity and mortality. Mechanical ventilation, preferentially delivered by a non-invasive route (NIV), is currently the first-line treatment for respiratory failure since it is associated with a reduction in the intubation rate. This ventilatory support is increasingly used in the PICU, but its wider use contrasts with the paucity of studies in this field. This review aims to describe the main indications of NIV in acute settings: (i) bronchiolitis; (ii) postextubation respiratory failure; (iii) acute respiratory distress syndrome; (iv) pneumonia; (v) status asthmaticus; (vi) acute chest syndrome; (vii) left heart failure; (viii) exacerbation of chronic respiratory failure; (ix) upper airway obstruction and (x) end-of-life care...
November 23, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27886777/characteristics-of-patients-who-are-not-resuscitated-in-out-of-hospital-cardiac-arrests-and-opportunities-to-improve-community-response-to-cardiac-arrest
#11
S Rajagopal, C R Kaye, R Lall, C D Deakin, S Gates, H Pocock, T Quinn, N Rees, M Smyth, G D Perkins
AIM: This study explores why resuscitation is withheld when emergency medical staff arrive at the scene of a cardiac arrest and identifies modifiable factors associated with this decision. METHODS: This is a secondary analysis of unselected patients who sustained an out of hospital cardiac arrest attended by ambulance vehicles participating in a randomized controlled trial of a mechanical chest compression device (PARAMEDIC trial). Patients were categorized as 'non-resuscitation' patients if there was a do-not-attempt-cardiopulmonary-resuscitation (DNACPR) order, signs unequivocally associated with death or resuscitation was deemed futile (15min had elapsed since collapse with no bystander-CPR and asystole recorded on EMS arrival)...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27886421/pathophysiology-of-dyspnoea-in-acute-pulmonary-embolism-a-cross-sectional-evaluation
#12
Olivier Sanchez, Aurore Caumont-Prim, Elisabeth Riant, Laurent Plantier, Martin Dres, Bruno Louis, Marie-Anne Collignon, Benoit Diebold, Guy Meyer, Claudine Peiffer, Christophe Delclaux
BACKGROUND AND OBJECTIVE: Dyspnoea in pulmonary embolism (PE) remains poorly characterized. Little is known about how to measure intensity or about the underlying mechanisms that may be related to ventilatory abnormalities, alveolar dead space ventilation or modulating factors such as psychological modulate. We hypothesized that dyspnoea would mainly be associated with pulmonary vascular obstruction and its pathophysiological consequences, while the sensory-affective domain of dyspnoea would be influenced by other factors...
November 25, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27876330/pneumomediastinum-pneumothorax-and-subcutaneous-emphysema-caused-by-colonoscopic-perforation-a-report-of-two-cases
#13
Pyong Wha Choi
BACKGROUND: Although colonoscopy is generally a safe procedure, lethal complications can occur. Colonoscopic perforation is one of the most serious complications, and it can present with various clinical symptoms and signs. Aggravating abdominal pain and free air on simple radiography are representative clinical manifestations of colonoscopic perforation. However, unusual symptoms and signs, such as dyspnea and subcutaneous emphysema, which are less likely to be related with complicating colonoscopy, may obscure correct clinical diagnosis...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876089/rapid-onset-obesity-hypoventilation-hypothalamic-dysfunction-autonomic-dysregulation-and-neuroendocrine-tumor-syndrome-with-a-homogenous-enlargement-of-the-pituitary-gland-a-case-report
#14
Lama Aljabban, Lina Kassab, Nour Alhuda Bakoura, Mohammad Fayez Alsalka, Ismaeil Maksoud
BACKGROUND: Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome is a rare pediatric disorder with a variable sequence of clinical presentations, undefined etiology, and high risk of mortality. Our patient presented an unusual course of the disease accompanied by a homogenous mild enlargement of her pituitary gland with an intact pituitary-endocrine axis which, to the best of our knowledge, represents a new finding in rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome...
November 22, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27875408/diagnosing-acute-respiratory-distress-syndrome-in-resource-limited-settings-the-kigali-modification-of-the-berlin-definition
#15
Elisabeth D Riviello, Egide Buregeya, Theogene Twagirumugabe
PURPOSE OF REVIEW: The acute respiratory distress syndrome (ARDS) was re-defined by a panel of experts in Berlin in 2012. Although the Berlin criteria improved upon the validity and reliability of the definition, it did not make diagnosis of ARDS in resource limited settings possible. Mechanical ventilation, arterial blood gas measurements, and chest radiographs are not feasible in many regions of the world. In 2014, we proposed and applied the Kigali modification of the Berlin definition in a hospital in Rwanda...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27873512/antimicrobial-resistance-and-clinical-outcomes-in-nursing-home-acquired-pneumonia-compared-to-community-acquired-pneumonia
#16
Yun Seong Kang, Soo Ryeong Ryoo, Seung Joo Byun, Yun Jeong Jeong, Jin Young Oh, Young Soon Yoon
PURPOSE: Patients with nursing home-acquired pneumonia (NHAP) should be treated as hospital-acquired pneumonia (HAP) according to guidelines published in 2005. However, controversy still exists on whether the high mortality of NHAP results from multidrug resistant pathogens or underlying disease. We aimed to outline differences and factors contributing to mortality between NHAP and community-acquired pneumonia (CAP) patients. MATERIALS AND METHODS: We retrospectively evaluated patients aged 65 years or older with either CAP or NHAP from 2008 to 2014...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27867587/acute-chest-pain-in-a-triathlete-rupture-of-the-noncoronary-sinus-of-valsalva-into-the-right-ventricle
#17
Ernan Zhu, Ralf Westenfeld, Mareike Gastl, Florian Bönner, Alexander Assmann, Amir M Nia, Malte Kelm, Christian Jung
Sinus of Valsalva (SoV) aneurysm is a rare cardiac disease which can be congenital or acquired. A ruptured SoV aneurysm presents a clinical emergency and can lead to progressively deteriorating heart failure. Therefore, appropriate treatment requires prompt and accurate diagnosis. Most ruptured or nonruptured SoV aneurysms are diagnosed by the means of echocardiography. However, cardiovascular magnetic resonance (CMR) can provide information on precise anatomy and mechanisms due to its excellent soft tissue contrast and high resolution, and thereby allows for optimized preoperative planning of the repair strategy...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27863743/in-vitro-and-in-silico-approaches-to-quantify-the-effects-of-the-mitraclip-%C3%A2-system-on-mitral-valve-function
#18
Francesco Sturla, Riccardo Vismara, Michal Jaworek, Emiliano Votta, Paolo Romitelli, Omar A Pappalardo, Federico Lucherini, Carlo Antona, Gianfranco B Fiore, Alberto Redaelli
Mitraclip(®) implantation is widely used as a valid alternative to conventional open-chest surgery in high-risk patients with severe mitral valve (MV) regurgitation. Although effective in reducing mitral regurgitation (MR) in the majority of cases, the clip implantation produces a double-orifice area that can result in altered MV biomechanics, particularly in term of hemodynamics and mechanical stress distribution on the leaflets. In this scenario, we combined the consistency of in vitro experimental platforms with the versatility of numerical simulations to investigate clip impact on MV functioning...
November 10, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27853071/a-destabilized-case-of-stable-effort-angina-pectoris-induced-by-low-dose-adenosine-triphosphate
#19
Daisuke Sueta, Sunao Kojima, Yasuhiro Izumiya, Megumi Yamamuro, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa
A 79-year-old man was diagnosed with sudden deafness. He had previously experienced a suspected episode of angina pectoris. At a local hospital, after 500 mg of hydrocortisone and 80 mg adenosine triphosphate (ATP) were administered, he became aware of chest discomfort. An electrocardiogram revealed serious ST-segment depressions. He was diagnosed with a non-ST elevated myocardial infarction (NSTEMI). Emergency coronary angiography revealed triple vessel disease, and the lesion was successfully stented. The mechanisms whereby the stable effort angina pectoris destabilized in this case were thought to include a reduction of the local blood flow because of an ATP product and probable thrombus formation in response to the administered steroids...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27852713/effects-of-increased-positive-end-expiratory-pressure-on-intracranial-pressure-in-acute-respiratory-distress-syndrome-a-protocol-of-a-prospective-physiological-study
#20
Han Chen, Ming Xu, Yan-Lin Yang, Kai Chen, Jing-Qing Xu, Ying-Rui Zhang, Rong-Guo Yu, Jian-Xin Zhou
INTRODUCTION: There are concerns that the use of positive end-expiratory pressure (PEEP) in patients with brain injury may potentially elevate intracranial pressure (ICP). However, the transmission of PEEP into the thoracic cavity depends on the properties of the lungs and the chest wall. When chest wall elastance is high, PEEP can significantly increase pleural pressure. In the present study, we investigate the different effects of PEEP on the pleural pressure and ICP in different respiratory mechanics...
November 15, 2016: BMJ Open
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