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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437337/axial-plane-deformity-of-the-shoulder-in-adolescent-idiopathic-scoliosis
#2
Venugopal K Menon, Naveen Tahasildar, Haroon M Pillay, Anbuselvam M
STUDY DESIGN: Prospective observational study. OBJECTIVE: To study axial plane deformation of the shoulder in adolescent idiopathic scoliosis (AIS) and try to correlate it with curve type and surgical correction. SUMMARY OF BACKGROUND DATA: It is established that AIS is a 3-dimensional deformity. The rib hump is the most common manifestation of axial plane deformations; the least common manifestation seems to be upper trunk and shoulder rotation, which has been hitherto undescribed...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437336/both-bilateral-breast-volume-discrepancy-and-asymmetric-anterior-chest-wall-shape-contribute-to-the-unsightly-breast-contour-in-female-right-thoracic-idiopathic-scoliosis
#3
Benlong Shi, Saihu Mao, Xu Sun, Leilei Xu, Feng Zhu, Zezhang Zhu, Bangping Qian, Weijun Wang, Yong Qiu
STUDY DESIGN: A retrospective radiographic study. OBJECTIVE: To evaluate the asymmetry of breast volume (BV) and shape in female adolescent idiopathic scoliosis (AIS) patients and to define their relationship with deformed components of the anterior chest wall and curved spine. SUMMARY OF BACKGROUND DATA: The higher incidence of asymmetric breast development in AIS was described by prior studies. However, the interplay between scoliosis curve magnitude and severity of breast asymmetry (BA) are unknown...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28436909/pulse-transit-time-measurement-using-seismocardiogram-photoplethysmogram-and-acoustic-recordings-evaluation-and-comparison
#4
Chenxi Yang, Negar Tavassolian
This work proposes a novel method of pulse transit time measurement. The proximal arterial location data is collected from seismocardiogram (SCG) recordings by placing a MEMS accelerometer on the chest wall. The distal arterial location data is recorded using an acoustic sensor placed inside the ear. The performance of distal location recordings is evaluated by comparing SCG-acoustic and SCG-Photoplethysmogram (PPG) measurements. PPG and acoustic performances under motion noise are also compared. Experimental results suggest comparable performances for the acoustic-based and PPG-based devices...
April 24, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28436741/deep-learning-at-chest-radiography-automated-classification-of-pulmonary-tuberculosis-by-using-convolutional-neural-networks
#5
Paras Lakhani, Baskaran Sundaram
Purpose To evaluate the efficacy of deep convolutional neural networks (DCNNs) for detecting tuberculosis (TB) on chest radiographs. Materials and Methods Four deidentified HIPAA-compliant datasets were used in this study that were exempted from review by the institutional review board, which consisted of 1007 posteroanterior chest radiographs. The datasets were split into training (68.0%), validation (17.1%), and test (14.9%). Two different DCNNs, AlexNet and GoogLeNet, were used to classify the images as having manifestations of pulmonary TB or as healthy...
April 24, 2017: Radiology
https://www.readbyqxmd.com/read/28436364/upper-pole-urologist-obtained-percutaneous-renal-access-for-pcnl-is-safe-and-efficacious
#6
Amar P Patel, Don Bui, John Pattaras, Kenneth Ogan
INTRODUCTION: Interventional radiologist may be hesitant to obtain upper pole access for percutaneous nephrolithotomy (PCNL) due to a higher complication rate. Renal access gained by urologists may achieve higher stone-free rates with similar complication rates. We evaluate our institution's contemporary results of percutaneous renal access in the upper pole for nephrolithotomy by urologists, which we believe both safe and efficacious. MATERIALS AND METHODS: This retrospective chart review included all PCNL's performed by fellowship-trained endourologists from 2003 to 2014 at a single institution...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436270/does-physiological-stress-slowdown-wound-healing-in-patients-with-diabetes
#7
Javad Razjouyan, Gurtej Singh Grewal, Talal K Talal, David G Armstrong, Joseph L Mills, Bijan Najafi
BACKGROUND: Poor healing is an important contributing factor to amputation among patients with diabetic foot ulcers (DFUs). Physiological stress may slow wound healing and increase susceptibility to infection. OBJECTIVES: The objective was to examine the association between heart rate variability (HRV) as an indicator of physiological stress response and healing speed (HealSpeed) among outpatients with active DFUs. DESIGN AND METHODS: Ambulatory patients with diabetes with DFUs (n = 25, age: 59...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28435786/mediastinal-liposarcoma-in-a-30-year-old-woman-with-dyspnea-and-chest-pain
#8
Ana Fernández-Tena, Francisco Julián López-González
Mediastinal liposarcoma (ML) is a rare mesenchymal tumor, accounting for less than 1% of mediastinal tumors. They have a slow growth, so they may not give symptoms for a long time, until the tumor produces compression of close structures. The treatment of choice is surgery, which can be combined with chemo-radiotherapy. We present a case in which the diagnosis of a ML was made in a 30-year-old woman with dyspnea and chest pain.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28435782/thoracic-ultrasound-what-non-radiologists-need-to-know
#9
REVIEW
Jonathan P Williamson, Chris Grainge, Ahilan Parameswaran, Scott H Twaddell
PURPOSE OF REVIEW: The aim of this review is to provide the theoretical and practical knowledge essential for non-radiologists to develop the skills necessary to apply thoracic ultrasound as an extension of clinical assessment and intervention. RECENT FINDINGS: Issues relating to training and competence are discussed and a library of thoracic ultrasound videos is provided to illustrate artefacts, pleural, parenchymal and pneumothorax pathology as well as important pitfalls to consider...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28435645/angiofibrolipoma-of-posterior-mediastinum-with-transforaminal-extension
#10
Monia Attia, Imen Megdiche, Henda Neji, Ameur Belhadj, Ines Baccouche, Soussen Hantous Zannad, Khaoula Ben Miled M'rad
Angiofibrolipoma is a histological variant of lipoma, which commonly occurs in subcutaneous tissues. In the present report we illustrate the case of an angiofibrolipoma of the posterior upper mediastinum in a 75-year-old man presented with progressive chest pain. Xray chest showed a homogeneous opacity vertically oriented along the right lateral aspect of thoracic vertebrae with an obtuse angle to the mediastinum. The upper extremity of the mass extended above the superior clavicle, suggestive of a posterior mediastinal lesion...
March 24, 2017: Rare Tumors
https://www.readbyqxmd.com/read/28435499/the-fast-and-the-furious-low-risk-chest-pain-and-the-rapid-rule-out-protocol
#11
REVIEW
Maite Anna Huis In 't Veld, Louise Cullen, Simon A Mahler, Barbra E Backus, Zachary D W Dezman, Amal Mattu
Accelerated diagnostic pathways (ADP) have been designed to identify low-risk chest pain patients in the emergency department. This review article discusses the Asia-Pacific Evaluation of Chest Pain Trial (ASPECT) score, the Accelerated Diagnostic Protocol for Chest Pain Trial (ADAPT) score, the Emergency Department Assessment of Chest Pain Score (EDACS), the HEARTScore and the HEART pathway. These ADPs have been validated in various studies and aid the emergency provider with identifying the low-risk chest pain patient who is appropriate for discharge home, while at the same time highlighting those patients who would benefit from further in-patient work up...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435496/-choosing-wisely-imaging-recommendations-initial-implementation-in-new-england-emergency-departments
#12
Ali S Raja, Arjun Venkatesh, Nathan Mick, Cristopher P Zabbo, Kohei Hasegawa, Janice A Espinola, Jane C Bittner, Carlos A Camargo
INTRODUCTION: In June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to "reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations." However, it is unknown whether New England emergency departments (ED) have already implemented evidence-based interventions to improve adherence to ACEP Choosing Wisely recommendations related to imaging after their initial release in 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#13
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434844/quality-and-value-of-subspecialty-reinterpretation-of-thoracic-ct-scans-of-patients-referred-to-a-tertiary-cancer%C3%A2-center
#14
Brett W Carter, Jeremy J Erasmus, Mylene T Truong, Jo-Anne O Shepard, Wayne Hofstetter, Ryan Clarke, Reginald F Munden, Joseph R Steele
INTRODUCTION: Patients referred to tertiary cancer centers often present with imaging studies performed and interpreted at other health care institutions. Although reinterpretation of imaging performed at another health care institution can reduce repeat imaging, unnecessary radiation dose, and cost, the benefit is uncertain. The purpose of this study is to evaluate the quality of initial imaging studies of patients seeking a second opinion at a tertiary cancer center, to compare the accuracy of initial interpretations to reinterpretations performed by subspecialty trained radiologists at a tertiary oncologic center, and to determine the potential impact on patient management...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28434625/prinzmetals-angina-presenting-with-non-critical-lesion-with-normal-ffr-to-stent-or-not-to-stent
#15
EDITORIAL
Deepak Kadeli, Keshava R, Magesh B, Krishnaprasath V
Variant angina also called Prinzmetals angina is an enigma characterized by transient circadian symptoms of chest pain associated with ECG changes. The patient is symptom free with normal ECG and echo during symptom free periods. We present a case associated with transient ST-segment elevation with non critical lesion with normal FFR.
April 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#16
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433452/the-timing-of-chest-compressions-and-artificial-ventilation-a-re-appraisal
#17
Ignacy Baumberg, David Baker, Przemysław Wołoszyn, Janusz Andres, Wojciech Kopacki, Paweł Krawczyk, Wojciech Gaszyński
No abstract text is available yet for this article.
April 9, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433225/adjuvant-chemotherapy-is-associated-with-improved-survival-in-locally-invasive-node-negative-non-small-cell-lung-cancer
#18
Usman Ahmad, Traves D Crabtree, Aalok P Patel, Daniel Morgensztern, Cliff G Robinson, A Sasha Krupnick, Daniel Kreisel, David R Jones, G Alexander Patterson, Bryan F Meyers, Varun Puri
BACKGROUND: The objectives of this study are to explore factors that are associated with use of adjuvant chemotherapy and to evaluate its impact on overall survival in node-negative patients who undergo lung and chest wall resection for non-small cell lung cancer (NSCLC). METHODS: Patients who underwent concomitant lung and chest wall resection for NSCLC were abstracted from the National Cancer Database. Clinical, pathologic, treatment, and follow-up data were obtained...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433201/humoral-primary-immunodeficiency-diseases-clinical-overview-and-chest-high-resolution-computed-tomography-hrct-features-in-the-adult-population
#19
REVIEW
L Cereser, R Girometti, P d'Angelo, M De Carli, A De Pellegrin, C Zuiani
Humoral primary immunodeficiency diseases (hPIDs) are a heterogeneous group of hereditary disorders resulting in abnormal susceptibility to infections of the sinopulmonary tract. Some of these conditions (e.g., common variable immunodeficiency disorders [CVID]) imply a number of non-infectious thoracic complications such as non-infectious airway disorders, diffuse lung parenchymal diseases, and neoplasms. Chest high-resolution computed tomography (HRCT) is a key imaging tool to characterise and quantify the extent of underlying thoracic involvement, as well as to direct and monitor treatment...
April 19, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28432730/assessment-of-voluntary-deep-inspiration-breath-hold-with-cine-imaging-for-breast-radiotherapy
#20
Reuben Patrick Estoesta, Lani Attwood, Diana Naehrig, Elizabeth Claridge-Mackonis, David Odgers, Darren Martin, Melissa Pham, Joanne Toohey, Susan Carroll
Deep Inspiration Breath-Hold (DIBH) techniques for breast cancer radiation therapy (RT) have reduced cardiac dose compared to Free Breathing (FB). Recently, a voluntary deep inspiration breath-hold (vDIBH) technique was established using in-room lasers and skin tattoos to monitor breath-hold. An in-house quality assessment of positional reproducibility during RT delivery with vDIBH in patients with left-sided breast cancer was evaluated. The electronic portal imaging device (EPID) was used in cinematographic (CINE) mode to capture a sequence of images during beam delivery...
April 22, 2017: Journal of Medical Imaging and Radiation Oncology
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