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https://www.readbyqxmd.com/read/29779296/the-assessment-and-management-of-chest-pain-in-primary-care-a-focus-on-acute-coronary-syndrome
#1
Richard Thomsett, Louise Cullen
BACKGROUND: Chest pain is a common presentation and diagnosis can be challenging. There are many causes for chest pain, including life-threatening conditions such as acute coronary syndrome (ACS), which can prove difficult to diagnose. OBJECTIVE: This article focuses on diagnosis and early management of patients with possible ACS. Key differentials and essential primary care investigations and management are outlined. Hospital-based risk stratification and management are described, providing an outline of what patients can expect if referred to hospital...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779091/two-years-of-maintenance-hemodialysis-has-a-pronounced-effect-on-arterial-stiffness-progression
#2
Agne Laucyte-Cibulskiene, Laurynas Rimsevicius, Liutauras Gumbys, Dileta Valanciene, Marius Miglinas
BACKGROUND: The change of aortic stiffness, but not the particular baseline value, plays a crucial role in estimating the patient risk with end-stage renal disease. Therefore, we aimed to analyze the evolution of central and peripheral arterial stiffness in hemodialysis population without previous cardiovascular events during a 2-year follow-up. METHODS: 60 hemodialysis patients (mean age 57.61 ± 13.01 years) were prospectively interviewed, and they underwent blood tests, chest X-ray for aortic calcification evaluation and pulse wave velocity (PWV) measurements at the baseline, after 6 months and after 2 years of observation period...
May 19, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29778994/heart-rate-changes-during-positive-pressure-ventilation-after-asphyxia-induced-bradycardia-in-a-porcine-model-of-neonatal-resuscitation
#3
Maria Liza Espinoza, Po-Yin Cheung, Tze-Fun Lee, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: The Neonatal Resuscitation Program (NRP) states that if adequate positive pressure ventilation (PPV) was given for a low heart rate (HR), the infant's HR should increase within the first 15 s of PPV. OBJECTIVE: To assess changes in HR in piglets with asphyxia-induced bradycardia. METHODS: Term newborn piglets (n=30) were anaesthetised, intubated, instrumented and exposed to 50 min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the tube until severe bradycardia (defined as HR at <u><</u>25% of baseline)...
May 19, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29778457/treatment-of-chronic-obstructive-pulmonary-disease-in-the-primary-care-setting-how-can-we-achieve-more-for-our-patients
#4
Barbara Yawn, Barry Make
Chronic obstructive pulmonary disease (COPD) is a debilitating and progressive disease that is both under-diagnosed and under-treated, affecting up to 1 in 10 older adults. Common symptoms, including dyspnea, productive cough, chest tightness, and fatigue, can reduce quality of life, ability to participate in all types of activities, and overall health status in patients. Minimizing the impact of symptoms on patients' quality of life should be a key goal for physicians and modest changes in current practice could make improvements in patients' lives...
May 17, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29778312/biomarker-signatures-of-sickle-cell-disease-severity
#5
Mengtian Du, Sarah Van Ness, Victor Gordeuk, Sayed M Nouraie, Sergei Nekhai, Mark Gladwin, Martin H Steinberg, Paola Sebastiani
Identifying sickle cell disease patients at high risk of complications could lead to personalized treatment and better prognosis but despite many advances prediction of the clinical course of these patients remains elusive. We propose a system-type approach to discover profiles of multiple, common biomarkers that correlate with morbidity and mortality in sickle cell disease. We used cluster analysis to discover 17 signatures of 17 common circulating biomarkers in 2320 participants of the Cooperative Study of Sickle Cell Disease, and evaluated the association of these signatures with risk for stroke, pain, leg ulceration, acute chest syndrome, avascular necrosis, seizure, death, and trend of fetal hemoglobin and hemolysis using longitudinally collected data...
May 16, 2018: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/29778090/massive-pericardial-effusion-without-cardiac-tamponade-due-to-subclinical-hypothyroidism-hashimoto-s-disease
#6
Panteleimon E Papakonstantinou, Nikolaos Gourniezakis, Christos Skiadas, Alexandros Patrianakos, Achilleas Gikas
CONTEXT: Hypothyroidism is a significant cause of pericardial effusion. However, large pericardial effusions due to hypothyroidism are extremely rare. Hormone replacement therapy is the cornerstone of treatment for hypothyroidism and regular follow-up of patients after initiation of the therapy is indicated. Herein, the case of a 70-year-old woman with a massive pericardial effusion due to Hashimoto's disease is presented. ISSUES: A 70-year-old female from a rural village on the island of Crete, Greece, was admitted to our hospital due to a urinary tract infection...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29778065/reliability-of-the-sub-components-of-the-instrumented-timed-up-and-go-test-in-ambulatory-children-with-traumatic-brain-injury-and-typically-developed-controls
#7
Mark A Newman, Mark A Hirsch, Richard D Peindl, Nahir A Habet, Tobias J Tsai, Michael S Runyon, Toan Huynh, Nigel Zheng
BACKGROUND: Studies have evaluated the test-re-test reliability of subcomponents of the timed up and-go test in adults by using body-worn inertial sensors. However, studies in children have not been reported in the literature. RESEARCH QUESTION: To evaluate the within-session reliability of subcomponents of a newly developed electronically augmented timed 'upand-go' test (EATUG) in ambulatory children with traumatic brain injury (TBI) and children with typical development (TD)...
May 16, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29777760/peripheral-intravenous-volume-assessment-piva-for-quantitating-volume-overload-in-patients-hospitalized-with-acute-decompensated-heart-failure-a-pilot-study
#8
Merrick Miles, Bret D Alvis, Kyle Hocking, Franz Baudenbacher, Christy Guth, JoAann Lindenfeld, Colleen Brophy, Susan Eagle
BACKGROUND: To determine the feasibility of Peripheral Intravenous Volume Assessment (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF). METHODS: Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis...
May 16, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29777243/comparison-of-formulae-for-orotracheal-intubation-depth-in-the-paediatric-population
#9
Jen Heng Pek, Elizabeth Mj Tan, Ying Hao, Gene Yk Ong
INTRODUCTION: Multiple formulae have been proposed for calculating orotracheal depth for paediatric intubation. However, literature on the validation of these formulae in the emergency department setting is limited. Three methods described in the local Advanced Paediatric Life Support curriculum include the Broselow tape, endotracheal tube (ETT) size x 3, and the age-based formula of age divided by 2, add 12. We aimed to determine their accuracy. MATERIALS AND METHODS: Patients with intubation performed in the Children's Emergency from 1 January 2009 to 31 December 2013 were included in this retrospective observational study...
April 2018: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/29777062/brock-malignancy-risk-calculator-for-pulmonary-nodules-validation-outside-a-lung-cancer-screening-population
#10
Kaman Chung, Onno M Mets, Paul K Gerke, Colin Jacobs, Annemarie M den Harder, Ernst T Scholten, Mathias Prokop, Pim A de Jong, Bram van Ginneken, Cornelia M Schaefer-Prokop
OBJECTIVE: To assess the performance of the Brock malignancy risk model for pulmonary nodules detected in routine clinical setting. METHODS: In two academic centres in the Netherlands, we established a list of patients aged ≥40 years who received a chest CT scan between 2004 and 2012, resulting in 16 850 and 23 454 eligible subjects. Subsequent diagnosis of lung cancer until the end of 2014 was established through linking with the National Cancer Registry...
May 18, 2018: Thorax
https://www.readbyqxmd.com/read/29776959/symptom-burden-of-atrial-fibrillation-and-its-relation-to-interventions-and-outcome-in-europe
#11
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776942/postpartum-pneumomediastinum-and-subcutaneous-emphysema
#12
Diaeddin Sagar, Trevor K Rogers, Aldrin Adeni
We present the case of a 22-year-old primigravida with symptoms of neck swelling and difficulty breathing 3 hours after uneventful vaginal delivery. On examination, there was surgical emphysema. A CT scan confirmed air in the subcutaneous tissues and also revealed pneumomediastinum. There was no evidence of pneumothorax and gastro-oesophageal endoscopy showed no signs of oesophageal rupture. The patient remained clinically stable throughout her admission and was discharged home after 48 hours of observation...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29776560/large-animal-model-of-acute-right-ventricular-failure-with-functional-tricuspid-regurgitation
#13
Marcin Malinowski, Alistair G Proudfoot, Lenora Eberhart, Hans Schubert, Jeremy Wodarek, David Langholz, Manuel K Rausch, Tomasz A Timek
BACKGROUND: Functional tricuspid regurgitation (FTR) commonly arises secondary to conditions affecting the left heart and is associated with right ventricular dysfunction and tricuspid annular dilatation. We set out to establish an animal model of acute RV failure (RVF) with FTR resembling the clinical features. METHODS: Ten adult sheep had pressure sensors placed in the LV, RV, and right atrium while sonomicrometry crystals were implanted around tricuspid annulus and on the RV...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29775966/an-enigmatic-case-presentation-of-budd-chiari-syndrome-with-pulmonary-embolism-an-unusual-syndrome-with-an-uncommon-complication
#14
A M Al-Sharydah, A H Al-Abdulwahhab, H A Abu AlOla
INTRODUCTION: In patients with a hypercoagulable state, such as patients with pulmonary embolism and/or Budd-Chiari syndrome, the complications from multiple gene mutations are more numerous than those from a single mutation. The authors present a woman with no major prior medical history who presented with pulmonary embolism and Budd-Chiari syndrome; this enigmatic co-occurrence has never been solely reported without underlying aetiology in a patient without prior medical conditions...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29775663/free-breathing-ultrashort-echo-time-lung-magnetic-resonance-imaging-using-stack-of-spirals-acquisition-a-feasibility-study-in-oncology-patients
#15
Min Jae Cha, Hyun Jeong Park, Mun Young Paek, Alto Stemmer, Eun Sun Lee, Sung Bin Park, Yang Soo Kim
OBJECTIVES: To investigate the diagnostic accuracy of lung magnetic resonance imaging (MRI) with a free-breathing three-dimensional ultrashort echo time spoiled gradient echo sequence using a stack-of-spirals acquisition (spiral 3D UTE) for pulmonary nodule detection at 3 T in oncology patients. METHODS: The institutional review board approved this retrospective study. Between June and September of 2017, 32 oncology patients underwent both free-breathing spiral 3D UTE of the lungs and thin-section chest computed tomography (CT) for pulmonary metastasis workups...
May 15, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#16
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29775084/health-state-utilities-in-patients-with-advanced-non-small-cell-lung-cancer-in-china
#17
Yunjie Shen, Bin Wu, Xiaohui Wang, Jun Zhu
AIM: Non-small-cell lung cancer (NSCLC) is a leading global health threat that impairs patient health outcomes. Health state utilities are fundamental values in economic evaluation and significantly vary across countries. Given the scarce data on the Chinese population, the current study measured utility values in the Chinese patients with NSCLC. METHODS: This study was conducted as a cross-sectional survey of patients with advanced NSCLC at the Shanghai Chest Hospital...
May 18, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29774980/edwards-sapien-xt%C3%A2-pulmonic-valve-compression-after-resuscitation-and-successful-redilatation
#18
Anja Lehner, Marinos Kantzis, Nikolaus A Haas
Despite the increasing use of percutaenous valves, little is known about valve performance after external chest compression. We report a case of a compressed pulmonary Edwards Sapien® XT valve after resuscitation. With the patient on ECMO, successful redilatation was performed with unimpaired postprocedural valve function. We aim to increase the awareness for valve distortion after external chest compression with increasing numbers of transcatheter valvulations. We suggest that immediate re-evaluation of the implanted device via biplane fluoroscopy is mandatory after resuscitation in such cases...
May 18, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29774196/common-carotid-artery-dissection-in-multiple-extracranial-injury-a-case-report
#19
Jin Sang Kil, Mi Kyung Lee, Ki Seong Eom
Traumatic common carotid artery dissection (CCAD) is rare. To our knowledge, only 14 case reports have described traumatic CCAD previously. Here, we report a case of CCAD in a patient with severe trauma. A 50-year-old man was lying on the road after drinking alcohol when a car drove over him. Computed tomography (CT) revealed multiple rib fractures with hemopneumothorax, lung contusion, flail chest, large amount of hematoma with bladder rupture, and fractures on the C6 spinous process, sacral ala, iliac bone, and pubic ramus...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773665/hypersensitivity-pneumonitis-and-acute-respiratory-distress-syndrome-from-e-cigarette-use
#20
Casey G Sommerfeld, Daniel J Weiner, Andrew Nowalk, Allyson Larkin
Electronic cigarette (e-cigarette) use, or "vaping," is gaining widespread popularity as an alternative to conventional cigarettes among adolescents. Little is known of the health risks of e-cigarette use, especially in children and adolescents. We present a Case Report of a previously healthy 18-year-old woman who presented with dyspnea, cough, and pleuritic chest pain after e-cigarette use. She developed respiratory failure with hypoxia and was intubated, and ultimately met diagnostic criteria for acute respiratory distress syndrome...
May 17, 2018: Pediatrics
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