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https://www.readbyqxmd.com/read/28528430/risk-classification-of-highly-sensitive-troponin-i-predict-presence-of-vulnerable-plaque-assessed-by-dual-source-coronary-computed-tomography-angiography
#1
Ting Liu, Guan Wang, Peiling Li, Xu Dai
Patients presenting to the emergency department with acute chest pain, negative conventional troponin and electrocardiogram require serial testing to rule out acute coronary syndrome (ACS). We studied the association of highly sensitive troponin (hsTn) I with vulnerable plaque features as detected by coronary dual source computed tomography angiography (DSCTA) and determined whether hsTn I at the time of presentation combined with early DSCTA could improve classification of patients as high-risk or low risk for ACS...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528060/pulmonary-mucormycosis-treated-with-lobectomy
#2
Oluwatobi Afolayan, Hannah Copeland, Salman Zaheer, Jason M Wallen
A 57 year old man was referred from an outside facility for an unresolving pneumonia. Imaging of the chest demonstrated a right lung mass with a consolidation in the middle lobe, pleural effusion, and mediastinal lymphadenopathy. Cytologic examination of cultures from the bronchoscopy and thoracentesis did not yield a definitive diagnosis. Video-assisted thoracoscopic surgery (VATS) was performed because of a retained hemothorax and a suggestive lesion. Biopsy specimens obtained during VATS were consistent with mucormycosis...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528058/metachronous-germ-cell-tumors-of-the-mediastinum
#3
Shuhei Hakiri, Koji Kawaguchi, Takayuki Fukui, Koichi Fukumoto, Shota Nakamura, Kohei Yokoi
We report a rare case of mediastinal nonseminomatous germ cell tumor arising after 2 complete resections of mediastinal mature teratomas 18 and 10 years prior. After three cycles of chemotherapy for the mediastinal nonseminomatous germ cell tumor, the serum α-fetoprotein and β-human chorionic gonadotropin levels were normalized. However, chest radiography revealed that the mediastinal tumor had remarkably increased in size, and thus growing teratoma syndrome was diagnosed. The patient underwent urgent resection of the tumor, and a pathologic examination showed an encapsulated mature teratoma without any malignant viable cells...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528057/drains-and-blushes-a-case-of-impaired-venous-drainage-mimicking-pulmonary-torsion
#4
Nazia Alvi, Raju Z Abraham, Philip Alexander, Thomas Betlej, Arun Jagannathan
A 47-year-old woman underwent elective right upper lobectomy with pneumopexy for adenocarcinoma. On postoperative day 2, she had tachycardia, and her chest radiograph, bronchoscopy, and computed tomography chest scan were suspicious for pulmonary torsion. She underwent emergent thoracotomy, and the right middle lobe was not torsed; it was purple, engorged, and not ventilated. The patient did well after right middle lobectomy. We suspect compromised middle lobe pulmonary venous drainage due to angulation after compensatory expansion...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528054/surgical-management-of-simultaneous-left-coronary-atresia-and-anomalous-right-coronary-artery-origin
#5
Shyam Sathanandam, T K Susheel Kumar, Umar Boston, Christopher J Knott-Craig
A 9-year-old child presented with syncope during exercise. He received a diagnosis of congenital atresia of the left main coronary artery by angiography. He underwent successful coronary artery bypass grafting. On the third postoperative day, he experienced acute, precordial chest pain. An urgent computed tomographic scan showed an unrecognized anomalous origin of the right coronary artery (RCA) with a 1.5-cm intramural course. He was taken back to the operating room to undergo unroofing of the RCA. This case highlights the difficulty involved in making two rare diagnoses that can cause the same exact symptoms in a patient and the surgical challenges associated with it...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528050/novel-surgical-management-of%C3%A2-giant-aortic-arch-pseudoaneurysm
#6
Salah E Altarabsheh, Salil V Deo, Sakher M Alma'ayeh, Muhannad Jalookh, Ashraf O Alshabatat, Yagthan M Obeidat, Abeer Rababa'h, Fuad M Al-Azzam, Ashraf Fadel
Pseudoaneurysm of the aortic arch is a rare entity, usually seen after cardiac operations or chest trauma. Here we report a 32-year-old man who presented 10 years after blunt chest trauma with a giant aortic arch pseudoaneurysm. He finally underwent surgical intervention in which the pseudoaneurysm was closed from inside with use of an inlay patch method.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527963/clinical-significance-of-spontaneous-pneumomediastinum
#7
Brittany A Potz, Linda H Chao, Thomas T Ng, Ikenna C Okereke
BACKGROUND: Spontaneous pneumomediastinum (SPM) is classified as free air in the mediastinum in the absence of any precipitating cause. It is relatively uncommon, and the clinical significance and risk associated with SPM is not well understood and has not been widely documented in the literature. Our goals were to determine the outcomes of patients who presented with SPM and to determine predictors of severe pathology associated with SPM. METHODS: From 2004 through 2013, a retrospective review was conducted of patients who presented with SPM to our institution...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527170/oculo-otological-manifestations-in-a-case-of-granulomatosis-with-polyangiitis
#8
Archana Sonawale, Anjali Rajadhyaksha, Shreepriya Mangalgi
A 44 year old lady presented with acute onset of loss of vision in the right eye and cough with mucopurulent expectoration for two months. Ophthalmic examination revealed central retinal artery occlusion (CRAO). Chest radiograph showed multiple cavitatory nodules with fluid levels. Sputum was negative for AFB and ANCA was strongly positive suggestive of a diagnosis of Granulomatosis with Polyangiitis (GPA). Within the next few weeks the patient had rapid detenoration due to left eye CRAO, progressive bilateral hearing loss, facial palsy and retro orbital mass...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28526893/do-we-need-3d-tube-current-modulation-information-for-accurate-organ-dosimetry-in-chest-ct-protocols-dose-comparisons
#9
Xochitl Lopez-Rendon, Guozhi Zhang, Walter Coudyzer, Wim Develter, Hilde Bosmans, Federica Zanca
OBJECTIVES: To compare the lung and breast dose associated with three chest protocols: standard, organ-based tube current modulation (OBTCM) and fast-speed scanning; and to estimate the error associated with organ dose when modelling the longitudinal (z-) TCM versus the 3D-TCM in Monte Carlo simulations (MC) for these three protocols. METHOD: Five adult and three paediatric cadavers with different BMI were scanned. The CTDIvol of the OBTCM and the fast-speed protocols were matched to the patient-specific CTDIvol of the standard protocol...
May 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28526594/chest-compressions-in-infants
#10
Tomasz Klosiewicz, Radoslaw Zalewski, Agata Dabrowska, Adrian Maciejewski
No abstract text is available yet for this article.
May 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526539/diagnostic-accuracy-of-lung-subtraction-iodine-mapping-ct-for-the-evaluation-of-pulmonary-perfusion-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-correlation-with-perfusion-spect-ct
#11
Masashi Tamura, Yoshitake Yamada, Takashi Kawakami, Masaharu Kataoka, Yu Iwabuchi, Hiroaki Sugiura, Masahiro Hashimoto, Tadaki Nakahara, Shigeo Okuda, Seishi Nakatsuka, Fumiya Sano, Takayuki Abe, Yuichiro Maekawa, Keiichi Fukuda, Masahiro Jinzaki
BACKGROUND: For treatment of chronic thromboembolic pulmonary hypertension (CTEPH), the evaluation of segmental pulmonary perfusion is important. There are no previous reports about lung subtraction iodine mapping (LSIM) computed tomography (CT) for evaluation of segmental pulmonary perfusion in patients with CTEPH, using lung perfusion SPECT/CT (LPS) as the reference. METHODS: 50 patients (age, 60.7±16.7years) with known or suspected CTEPH were enrolled in this study...
May 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28526483/effects-of-air-stacking-maneuver-on-cough-peak-flow-and-chest-wall-compartmental-volumes-of-amyotrophic-lateral-sclerosis-subjects
#12
Antonio Sarmento, Vanessa Regiane Resqueti, Mario Emílio Teixeira Dourado-Júnior, Lailane Saturnino, Andrea Aliverti, Guilherme Augusto de Freitas Fregonezi, Armele de Fátima Dornelas de Andrade
OBJECTIVES: To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy controls positioned at 45° body inclination. DESIGN: Cross-sectional study with a matched-pair design. SETTING: University hospital. PARTICIPANTS: Twelve persons with ALS and twelve age-matched healthy. MAIN OUTCOMES: CPF, chest wall compartmental inspiratory capacity (ICCW), vital capacity (VCCW), tidal volume (VTCW) and operational volumes, breathing pattern and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography...
May 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28526472/-functional-respiratory-imaging-after-neostigmine-or-sugammadex-enhanced-recovery-from-neuromuscular-blockade-in-the-anesthetised-rat-a-randomised-controlled-pilot-study
#13
Tom Schepens, Guy Cammu, Sabine Maes, Benny Desmedt, Wim Vos, Kristof Deseure
OBJECTIVES: Reductions in diaphragm activity are associated with the postoperative development of atelectasis. Neostigmine reversal is also associated with increased atelectasis. We assessed the effects of neostigmine, sugammadex, and spontaneous reversal on regional lung ventilation and airway flow. METHODS: Six Sprague-Dawley rats were paralysed with rocuronium and mechanically ventilated until recovery of the train-of-four ratio to 0.5. We administered neostigmine (0...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28526464/-transient-horner-s-syndrome-after-single-shot-paravertebral-block
#14
Birzat Emre Gölboyu, Mürsel Ekinci, Pınar Karaca Baysal, Ayşe Nur Yeksan, Erkan Cem Çelik, Zeynep Bilgi, Murat Aksun
BACKGROUND: Thoracic paravertebral block can provide analgesia for unilateral chest surgery and is associated with a low complication rate. Horner syndrome also referred to as oculosympathetic paresis, is a classic neurologic constellation of ipsilateral blepharoptosis, pupillary miosis, and facial anhidrosis resulting from disruption of the sympathetic pathway supplying the head, eye, and neck. CASE REPORT: We present a patient with an ipsilateral transient Horner syndrome after ultrasound guided single shot of 15mL 0...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#15
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526193/effects-of-multiple-breath-hold-reproducibility-on-treatment-localization-and-dosimetric-accuracy-in-radiotherapy-of-left-sided-breast-cancer-with-voluntary-deep-inspiration-breath-hold-technique
#16
Mika Kapanen, Marko Laaksomaa, Jani Pehkonen, Mikko Haltamo, Helmi Luukkanen, Turkka Lehtonen, Simo Hyödynmaa, Pirkko-Liisa Kellokumpu-Lehtinen
The purpose of this study was to investigate the effects of breath hold reproducibility on positional and dosimetric errors in radiotherapy of patients with left-sided breast cancer (LSBC) treated with voluntary deep inspiration breath hold (vDIBH) technique. Clinical data from 2 groups of patients with LSBC were retrospectively investigated: (1) those irradiated for the whole breast only (WB group, n = 20) using typically from 3 to 5 breath holds per treatment session and (2) those irradiated simultaneously also for supraclavicular lymph nodes (WB + SLN group, n = 27) using from 7 to 9 breath holds per fraction...
May 16, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28526059/severe-polyserositis-induced-by-the-13-valent-pneumococcal-conjugate-vaccine-a-case-report
#17
Pierre Tawfik, Elie Gertner, Charlene E McEvoy
BACKGROUND: The United States Advisory Committee on Immunization Practices recommends administration of the 13-valent pneumococcal conjugate vaccine in series with the 23-valent pneumococcal polysaccharide vaccine for prevention of pneumonia in the elderly. Reports of autoimmune or auto-inflammatory diseases as a result of pneumococcal vaccination, especially pneumococcal conjugate vaccine, are extremely rare. CASE PRESENTATION: We present a case of severe serositis in a 75-year-old Caucasian woman complicated by pericardial and pleural effusions in the setting of recent 13-valent pneumococcal conjugate vaccine vaccination and no other obvious etiology...
May 20, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28525971/left-ventricular-mural-thrombus-and-dual-coronary-embolization-associated-with-hyperthyroid-cardiomyopathy-and-atrial-fibrillation-a-case-report
#18
Guohui Liu, Ping Yang, Yuquan He
BACKGROUND: The majority of acute myocardial infarction (AMI) events are caused by thrombotic occlusion of the coronary artery, secondary to atherosclerotic plaque erosion or rupture. However, coronary embolism (CE), while rare, is being increasingly recognized as an important cause of AMI. We present the case of a patient with multi-site coronary artery embolization associated with hyperthyroid-related cardiomyopathy and atrial fibrillation. CASE PRESENTATION: A 49-year-old female with a history of hyperthyroidism and atrial fibrillation (AF) was admitted to our hospital presenting with right upper limb pain and swelling...
May 19, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28525723/effectiveness-of-a-decision-aid-in-potentially-vulnerable-patients-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#19
Kristin L Rising, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Victor M Montori, Erik P Hess
BACKGROUND: We test the hypotheses that use of the Chest Pain Choice (CPC) decision aid (DA) would be similarly effective in potentially vulnerable subgroups but increase knowledge more in patients with higher education and trust in physicians more in patients from racial minority groups. METHODS: This was a secondary analysis of a multicenter randomized trial in adults with chest pain potentially due to acute coronary syndrome. The trial compared an intervention group engaged in shared decision making (SDM) using CPC to a control group receiving usual care (UC)...
May 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28525631/primary-leiomyosarcoma-of-inferior-vena-cava-adjacent-to-hepatic-veins-complete-off-pump-resection-and-inferior-vena-cava-graft-reconstruction-with-application-of-external-skin-surface-cooling
#20
Michael Malyshev, Sergey Zotov, Anton Malyshev, Andrey Rostovykh
OBJECTIVES: Resection of a leiomyosarcoma of the inferior vena cava (IVC) requires venovenous bypass, especially if IVC clamping above the hepatic veins is planned. This report describes the application of external skin surface cooling for off-pump resection of a primary IVC leiomyosarcoma adjacent to the hepatic veins with graft IVC reconstruction in conditions of suprahepatic caval clamping and uninterrupted Pringle's manoeuvre. METHODS: A 62-year-old woman presented with IVC leiomyosarcoma adjacent to the hepatic veins...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
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