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https://www.readbyqxmd.com/read/29905897/patterns-of-injury-and-outcomes-in-the-elderly-patient-with-rib-fractures-a-multicenter-observational-study
#1
Mark G Van Vledder, Vicky Kwakernaak, Tjebbe Hagenaars, Esther M M Van Lieshout, Michiel H J Verhofstad
BACKGROUND: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. METHODS: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected...
June 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29904615/acute-pericarditis-as-a-presentation-of-adrenal-insufficiency
#2
Sukesh Manthri, Sindhura Bandaru, Abdisamad Ibrahim, Chaitanya K Mamillapalli
Acute pericarditis as a presenting sign of adrenal insufficiency is rarely reported. We present a rare case that highlights pericarditis as a clinical presentation of secondary adrenal insufficiency later complicated by cardiac tamponade. A 44-year-old lady who presented to the hospital with a one-day history of pleuritic chest pain and shortness of breath. In the emergency room, she had a blood pressure of 70/35 mmHg. Laboratory evaluation revealed white blood cell count of 16.08 k/cumm with neutrophilia, normal renal function and elevated troponin (0...
April 13, 2018: Curēus
https://www.readbyqxmd.com/read/29902195/theoretical-open-loop-model-of-respiratory-mechanics-in-the-extremely-preterm-infant
#3
Laura Ellwein Fix, Joseph Khoury, Russell R Moores, Lauren Linkous, Matthew Brandes, Henry J Rozycki
Non-invasive ventilation is increasingly used for respiratory support in preterm infants, and is associated with a lower risk of chronic lung disease. However, this mode is often not successful in the extremely preterm infant in part due to their markedly increased chest wall compliance that does not provide enough structure against which the forces of inhalation can generate sufficient pressure. To address the continued challenge of studying treatments in this fragile population, we developed a nonlinear lumped-parameter respiratory system mechanics model of the extremely preterm infant that incorporates nonlinear lung and chest wall compliances and lung volume parameters tuned to this population...
2018: PloS One
https://www.readbyqxmd.com/read/29901602/sudden-deaths-from-positional-asphyxia-a-case-report
#4
Sigitas Chmieliauskas, Eimantas Mundinas, Dmitrij Fomin, Gerda Andriuskeviciute, Sigitas Laima, Eleonora Jurolaic, Jurgita Stasiuniene, Algimantas Jasulaitis
RATIONALE: Positional asphyxia is a rare cause of sudden death and a difficult diagnosis, based mostly on the circumstances of the incident, along with particular external and internal findings, frequent in asphyxia (signs of sudden death). PATIENT CONCERNS: In this report, we are describing one case of adult who was found positioned in a way that led to eventual asphyxiation. DIAGNOSES: The final diagnosis of positional asphyxia was determined after the autopsy...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29896109/dan-lou-prescription-inhibits-foam-cell-formation-induced-by-ox-ldl-via-the-tlr4-nf-%C3%AE%C2%BAb-and-ppar%C3%AE-signaling-pathways
#5
Li-Na Gao, Xin Zhou, Yu-Ren Lu, Kefeng Li, Shan Gao, Chun-Quan Yu, Yuan-Lu Cui
Atherosclerosis is the major worldwide cause of mortality for patients with coronary heart disease. Many traditional Chinese medicine compound prescriptions for atherosclerosis treatment have been tried in patients. Dan-Lou prescription, which is improved from Gualou-Xiebai-Banxia decoction, has been used to treat chest discomfort (coronary atherosclerosis) for approximately 2,000 years in China. Although the anti-inflammatory activities of Dan-Lou prescription have been proposed previously, the mechanism remains to be explored...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29892226/blood-shift-during-cough-negligible-or-significant
#6
Antonella LoMauro, Andrea Aliverti
Rationale: It was reported how forceful rhythmic coughing can provide effective blood flow during ventricular fibrillation without direct chest compression. This mechanism of cough-assisted cardiopulmonary resuscitation constitutes a form of "cardiac massage" secondary to the intrathoracic and intra-abdominal pressure changes during cough. We have previously shown that significant blood shifts (BSs) occurs from the thorax to the extremities during expulsive maneuvers and that abdominal pressure controls the outflow of blood from the splanchnic vasculature...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29889952/management-of-suspected-tension-pneumothorax-in-tactical-combat-casualty-care-tccc-guidelines-change-17-02
#7
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29889749/clinical-variables-associated-with-adverse-maternal-outcomes-in-puerperal-group-a-streptococci-infection
#8
Jennifer E Kaiser, Amanda V Bakian, Robert M Silver, Erin A S Clark
OBJECTIVE: To identify clinical variables associated with increased risk of composite adverse outcome in a cohort of women with puerperal group A streptococci infection. METHODS: Our prospective case registry enrolled patients between 1991 and 2017. Chart abstraction was conducted for admission demographic and clinical data in patients with culture-proven puerperal group A streptococci infection. We created a composite variable of signs of capillary leakage including pulmonary edema, pleural effusion, ascites, and abdominal distention...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29888560/-correlation-between-referred-pain-region-and-sensitized-acupoints-in-patients-with-stable-angina-pectoris-and-distribution-of-sensitized-spots-in-rats-with-myocardial-ischemia
#9
Jing Shi, Jian Wang, Yuan Wang, Kun Liu, Yong Fu, Jian-Hua Sun, Ji-Ping Zhao, Xiao-Mei Shao, Si-Feng Feng, You-Wei Yang, Jie Li, Qian-An Cao, Xun He, Mei-Fang Liu, Lu Chen, Xiang Cui, Jiang-Yun Wu, Yuan-Yuan Wu, Xin-Yan Gao, Bing Zhu
OBJECTIVE: To observe the correlation between the referred pain regions of stable angina pectoris (SAP) and the acupoints in coronary heart disease (CHD) patients and to investigate the rule of regional sensitized point distribution in rats. METHODS: A total of 1 046 CHD patients with SAP from 8 hospitals in China were recruited in the present study. The tenderness was palpated along the left and right chest, back, shoulder, upper limb, etc. by a specially-assigned researcher in each hospital...
May 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29885664/zumba-induced-takotsubo-cardiomyopathy-a-case-report
#10
Sana Chams, Skye El Sayegh, Mulham Hamdon, Sarwan Kumar, Zain Kulairi
BACKGROUND: Takotsubo cardiomyopathy or stress cardiomyopathy is characterized by transient left ventricular apical ballooning in the absence of coronary occlusion. The underlying pathophysiological mechanism is still unclear but possible causes have been proposed mainly catecholamine cardiotoxicity, followed by metabolic disturbance, coronary microvascular impairment, and multivessel epicardial coronary artery vasospasm. Takotsubo cardiomyopathy accounts for 1-2% of patients presenting with acute coronary syndrome with the majority of patients diagnosed with Takotsubo cardiomyopathy being women > 55 years of age...
June 10, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29883602/hunting-for-treasure-chests-in-microbial-defense-islands
#11
Eugene V Koonin
Microbes exist in a constant struggle with viruses and have evolved multiple defense mechanisms. Some of these, such as restriction endonucleases and CRISPR-Cas, have revolutionized genome editing methodology. A systematic strategy combining computation and experiment led to discovery of ten new defense systems that remain to be characterized mechanistically.
June 7, 2018: Molecular Cell
https://www.readbyqxmd.com/read/29880022/a-case-report-of-pseudoaneurysm-of-left-sinus-of-valsalva-invaded-into-the-left-ventricle-with-severe-aortic-regurgitation
#12
Hyun Oh Park, Joung Hun Byun, Seong Ho Moon, Jong Woo Kim, Sung Hwan Kim, Ki Nyun Kim, Jae Jun Jung, Dong Hoon Kang, Jun Young Choi, Jun Ho Yang, In Seok Jang, Chung Eun Lee
BACKGROUND: The pseudoaneurysms of sinus of Valsalva is an uncommon and serious complication of an infection, trauma, or after cardiac surgery or procedure. Pseudoaneurysms of sinus of Valsalva from left is rare. We describe a case of pseudoaneurysm of the left coronary sinus of Valsalva invaded into the left ventricle (LV) diagnosed by transthoracic echocardiography (TTE), transesophageal ecoccardiography (TEE), and multiple detector computed tomography (MDCT). CASE PRESENTATION: A 44-year-old male patient had New York Heart Association (NYHA) class II / III dyspnea during 4 months...
June 7, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29879852/predictors-of-extubation-failure-after-open-chest-cardiac-surgery-based-on-routinely-collected-data-the-importance-of-a-shared-interprofessional-clinical-assessment
#13
Gianfranco Sanson, Massimiliano Sartori, Lorella Dreas, Roberta Ciraolo, Adam Fabiani
BACKGROUND: Extubation failure (ExtF) is associated with prolonged hospital length of stay and mortality in adult cardiac surgery patients postoperatively. In this population, ExtF-related variables such as the arterial partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2 /FiO2 ), rapid shallow breathing index, cough strength, endotracheal secretions and neurological function have been sparsely researched. AIM: To identify variables that are predictive of ExtF and related outcomes...
June 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29878942/intraoperative-hemodynamic-and-echocardiographic-measurements-associated-with-severe-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#14
Michael D Gudejko, Brian R Gebhardt, Farhad Zahedi, Ankit Jain, Janis L Breeze, Matthew R Lawrence, Stanton K Shernan, Navin K Kapur, Michael S Kiernan, Greg Couper, Frederick C Cobey
BACKGROUND: Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF. METHODS: A review of LVAD patients between March 2013 and March 2016 was performed. Severe RVF was defined by the need for a right ventricular mechanical support device, inotropic, and/or inhaled pulmonary vasodilator requirements for >14 days...
June 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29877960/the-effects-of-vasoconstriction-and-volume-expansion-on-veno-arterial-ecmo-flow
#15
Per W Moller, Anisa Hana, Paul Philipp Heinisch, Shengchen Liu, Siamak Djafarzadeh, Matthias Haenggi, Andreas Bloch, Jukka Takala, Stephan M Jakob, David Berger
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is gaining widespread use in the treatment of severe cardiorespiratory failure. Blood volume expansion is commonly used to increase ECMO flow (QECMO), with risk of positive fluid balance and worsening prognosis. We studied the effects of vasoconstriction on recruitment of blood volume as an alternative for increasing QECMO, based on the concepts of venous return. METHODS: In a closed chest, centrally cannulated porcine preparation (n = 9) in ventricular fibrillation and VA-ECMO with vented left atrium, mean systemic filling pressure (MSFP) and venous return driving pressure (VRdP) were determined in Euvolemia, during Vasoconstriction (norepinephrine 0...
June 5, 2018: Shock
https://www.readbyqxmd.com/read/29874954/prolonged-use-of-eptifibatide-as-a-bridge-to-maintain-drug-eluting-stent-patency-in-a-patient-receiving-extracorporeal-membrane-oxygenation
#16
Payal K Gurnani, Allison Bohlmann, Robert J March
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used as a bridge to cardiac recovery in patients following a major cardiac event. There is a lack of literature surrounding prolonged use of eptifibatide and optimal dosing during ECMO. This case report describes our experience with extended durations and standard dosing of eptifibatide in the setting of ECMO. CASE: A 40-year-old male with a history of Marfan's syndrome, aortic root and ascending aortic aneurysm status post a modified Bentall with a St...
June 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29873642/-lung-and-heart-interaction-chronic-obstructive-pulmonary-disease-and-ischemic-heart-disease
#17
Sara Roversi, Leonardo M Fabbri
The interaction between the lung and the heart is a vast, complex, and fascinating topic and, from a clinical point of view, disorders of the one often influence and promote disorders of the other. This is especially true for chronic diseases, with chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) representing a classic example. Epidemiologic data indicate that cardiovascular diseases are frequent in patients with COPD, and vice versa. Accordingly, rates of IHD in COPD vary from 4% up to 60%, while, on the other hand, COPD has been reported in up to 30% of patients with coronary artery disease...
March 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29872631/bilateral-spontaneous-pneumothoraces-with-spontaneous-pneumomediastinum-an-intravenous-methamphetamine-complication
#18
Daniel Guck, Ryan Munyon
Objective: To present an unusual case and proposed mechanism of bilateral spontaneous pneumothoraces with pneumomediastinum in a patient with intravenous methamphetamine use. Case report: Thin white man presented with confusion and chest pain after intravenous methamphetamine use. Initial workup found bilateral pneumothoraces with pneumomediastinum. Conservative management was initiated and subsequent radiographs and physical examination revealed subsequent improvement in pneumothoraces and pneumomediastinum...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29866125/the-associations-between-psychological-distress-and-healthcare-use-in-patients-with-non-cardiac-chest-pain-does-a-history-of-cardiac-disease-matter
#19
Ghassan Mourad, Tiny Jaarsma, Anna Strömberg, Erland Svensson, Peter Johansson
BACKGROUND: Psychological distress such as somatization, fear of body sensations, cardiac anxiety and depressive symptoms is common among patients with non-cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i...
June 5, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29864630/guidelines-risk-assessment-recommendations-for-venous-thromboembolism-prophylaxis-a-comparison-and-implementability-appraisal
#20
M J Moesker, N L Damen, E E Volmeijer, D Dreesens, E M de Loos, R Vink, M Coppens, M J Kruip, K Meijer, M Langelaan, M C de Bruijne, C Wagner
INTRODUCTION: Venous thromboembolism (VTE) prophylaxis guidelines for non-surgical patients recommend VTE- and bleeding risk assessment to guide prophylactic strategies. These recommendations differ between guidelines and implementation is suboptimal. Assessing a guideline's implementability characteristics helps predicting the ease of implementation and reveals barriers. OBJECTIVES: We aimed to compare guidelines' risk assessment recommendations and critically appraise the implementability characteristics...
May 26, 2018: Thrombosis Research
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