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https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#1
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28079804/aquaporin-4-positive-neuromyelitis-optica-spectrum-disorders-secondary-to-thrombopenic-purpura-a-case-report
#2
Ying Wang, Qiaoyun Gong, Mingqin Zhu, Chao Lu, Li Sun, Jiachun Feng, Hongliang Zhang
RATIONALE: Neuromyelitis optica spectrum disorders (NMOSD) is considered as an immune-mediated disorder in the central nervous system (CNS). Numerous autoimmune diseases are frequently complicated with NMOSD and distinct clinical characteristics are noted in NMOSD patients with other autoimmune diseases. However, to our best knowledge, co-occurrence of NMOSD and thrombopenic purpura is rarely identified. PATIENT CONCERNS: We presented a rare case of a 72-year-old female with 6-year history of thrombopenic purpura, and 1-month history of blurred vision as well as chest zonethesia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079615/neuromuscular-weakness-in-chronic-obstructive-pulmonary-disease-chest-wall-diaphragm-and-peripheral-muscle-contributions
#3
Adam Alter, Loutfi S Aboussouan, Eduardo Mireles-Cabodevila
PURPOSE OF REVIEW: Chronic obstructive lung disease affects the lung parenchyma and airways leading to well described effects in respiratory function. This review describes the current knowledge and advances regarding neuromuscular function and chest wall mechanics, which are affected in chronic obstructive pulmonary disease (COPD). RECENT FINDINGS: In COPD, progressive lung hyperinflation becomes constrained by a chest wall with decreasing capacity to expand, resulting in respiratory muscle inefficiency...
January 11, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28077104/effects-of-treadmill-exercise-versus-flutter%C3%A2-on-respiratory-flow-and-sputum-properties-in-adults-with-cystic-fibrosis-a-randomised-controlled-cross-over-trial
#4
Tiffany J Dwyer, Rahizan Zainuldin, Evangelia Daviskas, Peter T P Bye, Jennifer A Alison
BACKGROUND: Treadmill exercise and airway clearance with the Flutter® device have previously been shown to improve mucus clearance mechanisms in people with cystic fibrosis (CF) but have not been compared. It is therefore not known if treadmill exercise is an adequate form of airway clearance that could replace established airway clearance techniques, such as the Flutter®. The aim of this study was to evaluate respiratory flow, sputum properties and subjective responses of treadmill exercise and Flutter® therapy, compared to resting breathing (control)...
January 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#5
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28066906/causes-and-mechanisms-of-death-in-fatal-water-buffalo-attacks
#6
Roger W Byard
Deaths due to buffalo attack have not been well described. A 72-year-old man was trampled by a water buffalo (Bubalus bubalis) while attempting to move the animal within an enclosed area at an abattoir. At autopsy, there were numerous injuries involving the chest, head, neck, and left upper arm. Blunt force injury had resulted in multiple rib fractures with a flail chest and fracture/dislocation of the mid-cervical vertebrae caused either by physical crushing by the animal against the walls of the enclosure or by stomping...
January 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28060255/a-model-of-cardiac-remodeling-through-constriction-of-the-abdominal-aorta-in-rats
#7
Hui-Chun Ku, Shih-Yi Lee, Yuan-Kun Aden Wu, Kai-Chien Yang, Ming-Jai Su
Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and fluid retention. Changes in myocardial structure, electrical conduction, and energy metabolism develop with heart failure, leading to contractile dysfunction, increased risk of arrhythmias, and sudden death. Hypertensive heart disease is one of the key contributing factors of cardiac remodeling associated with heart failure. The most commonly-used animal model mimicking hypertensive heart disease is created via surgical interventions, such as by narrowing the aorta...
December 2, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28057053/a-pig-model-of-acute-right-ventricular-afterload-increase-by-hypoxic-pulmonary-vasoconstriction
#8
Kathrine Knai, Nils Kristian Skjaervold
BACKGROUND: The aim of this study was to construct a non-invasive model for acute right ventricular afterload increase by hypoxic pulmonary vasoconstriction. Intact animal models are vital to improving our understanding of the pathophysiology of acute right ventricular failure. Acute right ventricular failure is caused by increased afterload of the right ventricle by chronic or acute pulmonary hypertension combined with regionally or globally reduced right ventricular contractile capacity...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28050776/enlarged-mediastinal-air-cyst-in-a-patient-with-bronchial-diverticula-localized-in-the-left-main-bronchus-a-case-report-with-surgical-and-bronchoscopic-findings
#9
Hideo Ichimura, Yuichiro Ozawa, Masanari Shiigai, Seiji Shiotani, Kazunori Kikuchi, Yukio Sato
BACKGROUND: A mediastinal air cyst is a rare computed tomography (CT) finding. Once the lesion is identified, it is difficult to diagnose and treat. Meanwhile, bronchial diverticula have been reported as a CT finding observed in certain pulmonary pathologic conditions. We encountered the case of an enlarged mediastinal air cyst accompanied with bronchial diverticula and upper lobe-dominant fibrous changes of the lung. CASE PRESENTATION: A 69-year-old man with a chronic cough who had regularly visited a chest physician for upper lobe-dominant pulmonary fibrosis was referred to our hospital for the examination of an enlarged mediastinal air cyst...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28046510/th-ab-207a-01-contrast-enhanced-ct-correlation-of-radiation-dose-and-biological-effect
#10
E Abadi, J Sanders, G Agasthya, P Segars, E Samei
PURPOSE: The potential risk from CT is generally characterized in terms of radiation dose. The presence of iodinated-contrast medium increases radiation dose. However, it is unclear how much of this increase is biologically relevant. The purpose of this study was to establish the contribution of dose increase from iodine to biological effect. METHODS: Radiation organ dose was estimated in 58 human (XCAT) phantoms "undergoing" chest CT examination (120 kVp, 9 mGy CTDI) on a simulated CT system (Definition Flash, Siemens) with and without iodinated-contrast agent (62...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28040384/circulatory-collapse-right-ventricular-dilatation-and-alveolar-dead-space-a-triad-for-the-rapid-diagnosis-of-massive-pulmonary-embolism
#11
Raúl J Gazmuri, Dimple J Patel, Rom Stevens, Shani Smith
A triad of circulatory collapse, right ventricular dilatation, and large alveolar dead space is proposed for the rapid diagnosis and treatment of massive pulmonary embolism. A 17year-old female on oral contraceptives collapsed at home becoming incoherent with shallow breathing. Paramedics initiated mechanical chest compression and transported the patient to our emergency department, arriving minimally responsive with undetectable blood pressure but having positive corneal reflexes and bradycardia with wide QRS...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28033290/sudden-death-due-to-ventricular-double-rupture-as-a-complication-of-inferior-acute-myocardial-infarction-a-case-report
#12
Shi-Jian Chen, Chen Zhang, Qing-Tao Meng, Yong Peng, Mao Chen
RATIONALE: Ventricular double rupture (VDR) is a rare but lethal mechanical complication of acute myocardial infarction (AMI). The early identification and timely treatment of VDR remain challenging problems. We present a case of AMI with VDR and briefly review the characteristics and prognosis of this life-threatening disease. PATIENT CONCERNS AND DIAGNOSES: A 77-year-old male presented to our hospital with a 4-day history of severe dizziness, mild chest tightness, and dyspnea...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28030506/rib-fracture-fixation-in-the-65-year-and-older-population-a-paradigm-shift-in-management-strategy-at-a-level-i-trauma-center
#13
Michael T Fitzgerald, DennisW Ashley, Hesham Abukhdeir, D Benjamin Christie
BACKGROUND: Rib fractures after chest wall trauma are a common injury, however carry a significant morbidity and mortality risk. The impact of rib fractures in the ≥ 65yo patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients ≥ 65yo receiving rib plating have decreased mortality, complication rates, and an accelerated return to normal functional states when compared to controls. METHODS: With IRB approval, a retrospective review analyzed patients ≥ 65yo with rib fractures admitted from 2009-2015 receiving rib plating(RP group)(n=23) compared to non-operative, injury-matched controls admitted from 2003-2008(NO group)(n=50)...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#14
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28028415/scapular-fractures-in-blunt-chest-trauma-self-experience-study
#15
Tabet A Al-Sadek, Desislav Niklev, Ahmed Al-Sadek, Lina Al-Sadek
AIM: The aim of this retrospective study was to report the scapular fractures in patients with blunt chest trauma and to present the type and the frequency of associated thoracic injuries. MATERIAL AND METHODS: Nine patients with fractures of the scapula were included in the study. The mechanisms of the injury, the type of scapular fractures and associated thoracic injuries were analysed. RESULTS: Scapular fractures were caused by high-energy blunt chest trauma...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28028308/metastatic-squamous-cell-carcinoma-of-the-pleura-a-rare-complication-of-hidradenitis-suppurativa
#16
Kiran Joglekar, Christopher Jackson, Dipen Kadaria, Amik Sodhi
BACKGROUND Squamous cell carcinoma (SCC), also known as Marjolin ulcer, is a rare complication of hidradenitis suppurativa (HS). Metastatic SCC from HS typically involves the axial skeleton or abdominopelvic viscera. Metastatic disease to the lungs is a rare phenomenon with only three reported cases of lung parenchyma. We present a biopsy proven case of metastatic SCC to the pleura from gluteal HS. CASE REPORT A 46-year-old male with a history of recently diagnosed Marjolin ulcer secondary to gluteal HS was transferred to our intensive care unit for acute hypoxemic respiratory failure secondary to recurrent pleural effusion...
December 28, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#17
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28012492/guidelines-concordant-empiric-antimicrobial-therapy-and-mortality-in-patients-with-severe-community-acquired-pneumonia-requiring-mechanical-ventilation
#18
Yukiyo Sakamoto, Yasuhiro Yamauchi, Hideo Yasunaga, Hideyuki Takeshima, Wakae Hasegawa, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Takahide Nagase
BACKGROUND: Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan...
January 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28011953/hyperventilation-assists-proarrhythmia-development-during-delayed-repolarization-in-clofilium-treated-anaesthetized-mechanically-ventilated-rabbits
#19
H Papp, A Sarusi, A S Farkas, H Takacs, P Kui, D Vincze, E Ivany, A Varro, J G Papp, T Forster, A Farkas
Hyperventilation reduces partial pressure of CO2 (PCO2) in the blood, which results in hypokalaemia. Hypokalaemia helps the development of the life-threatening torsades de pointes type ventricular arrhythmia (TdP) evoked by repolarization delaying drugs. This implies that hyperventilation may assist the development of proarrhythmic events. Therefore, this study experimentally investigated the effect of hyperventilation on proarrhythmia development during delayed repolarization. Phenylephrine (an α1-adrenoceptor agonist) and clofilium (as a representative repolarization delaying agent inhibiting the rapid component of the delayed rectifier potassium current, IKr) were administered intravenously to pentobarbital-anaesthetized, mechanically ventilated, open chest rabbits...
October 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28007867/chest-wall-stabilization-in-ventilator-dependent-traumatic-flail-chest-patients-who-benefits-%C3%A2
#20
Gregor J Kocher, Siamak Sharafi, Luis Filipe Azenha, Ralph A Schmid
OBJECTIVES: Traumatic flail chest is a potentially life threatening injury, often associated with prolonged invasive mechanical ventilation and intensive care unit stay. This study evaluates the usefulness and cost-effectiveness of surgical rib stabilization in patients with flail chest resulting in ventilator dependent respiratory insufficiency. METHODS: A retrospective study on a consecutive series of patients with flail chest with the need for mechanical ventilation was performed...
December 22, 2016: European Journal of Cardio-thoracic Surgery
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