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https://www.readbyqxmd.com/read/28424565/invasive-pneumococcal-disease-still-lots-to-learn-and-a-need-for-standardized-data-collection-instruments
#1
T J Marrie, G J Tyrrell, Sumit R Majumdar, Dean T Eurich
Background. Large studies of invasive pneumococcal disease (IPD) are frequently lacking detailed clinical information. Methods. A population-based 15-year study of IPD in Northern Alberta. Results. 2435 patients with a mean age of 54.2 years formed the study group. Males outnumbered females and Aboriginal and homeless persons were overrepresented. High rates of smoking, excessive alcohol use, and illicit drug use were seen. Almost all (87%) had a major comorbidity and 15% had functional limitations prior to admission...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28400247/quality-of-life-dyspnea-and-functional-exercise-capacity-following-a-first-episode-of-pulmonary-embolism-results-of-the-elope-cohort-study
#2
Susan R Kahn, Arash Akaberi, John T Granton, David R Anderson, Philip S Wells, Marc A Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Chris Rush, Paul Hernandez, Shawn D Aaron, Andrew M Hirsch
BACKGROUND: We aimed to evaluate health-related quality of life (QOL), dyspnea and functional exercise capacity during the year following the diagnosis of a first episode of pulmonary embolism. METHODS: Prospective multicenter cohort study of 100 patients with acute pulmonary embolism recruited at 5 Canadian hospitals from 2010-2013. We measured the outcomes QOL (by SF-36 and PEmb-QOL measures), dyspnea (by the University of California San Diego Shortness of Breath Questionnaire (SOBQ)) and six-minute walk distance at Baseline, 1, 3, 6, and 12 months after acute pulmonary embolism...
April 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28348945/infective-endocarditis-in-a-patient-with-celiac-disease-after-central-venous-catheter-insertion
#3
Murtaza Sundhu, Suryanarayan Mohapatra, Salome Arobelidze, Parveen Gundelly, Anil Kumar Changarath Vijayan
There is an increasing incidence of infective endocarditis secondary to central venous catheters, which is termed as 'healthcare-associated infective endocarditis'. There is an increased risk of getting infective endocarditis in conditions with malnutrition and also if the tip of the central venous catheter is deep in the right atrium close to the tricuspid valve. We present a case of 31-year-old female who had all these risk factors. She was admitted to the hospital for the work up of the weight loss and was diagnosed with celiac disease...
February 13, 2017: Curēus
https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#4
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28302245/amniotic-fluid-embolism
#5
Tayyab Mohyuddin, Shahbaz Sarwar, Dawar Ayyaz
We report a case of 34-year patient who had uncomplicated elective caesarean-section. Postoperatively, she developed sudden hypotension, bradycardia, dyspnea and disseminated intravascular coagulation (DIC), all signs associated with amniotic fluid embolism (AFE). Echocardiogram showed signs of acutely increased right ventricular after load including McConell's sign, i.e. right ventricular dilatation, segmental hypokinesia (mid-right ventricular) and hypercontractile right ventricular apex and overall right ventricular dysfunction...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28265529/pulmonary-vein-thrombosis-a-recent-systematic-review
#6
REVIEW
Gerard Chaaya, Priya Vishnubhotla
The pulmonary veins (PVs) are the most proximal source of arterial thromboembolism. Pulmonary vein thrombosis (PVT) is a rare but potentially lethal disease; its incidence is unclear, as most of the literature includes case reports. It most commonly occurs as a complica-tion of malignancy, post lung surgery, or atrial fibrillation and can be idiopathic in some cases. Most patients with PVT are commonly asymptomatic or have nonspecific symptoms such as cough, hemoptysis, and dyspnea from pulmonary edema or infarction...
January 23, 2017: Curēus
https://www.readbyqxmd.com/read/28246560/saddle-pulmonary-embolism-with-thrombus-in-transit-across-a-patent-foramen-ovale
#7
Fitzgerald Shepherd, Ashley White-Stern, Oloruntobi Rahaman, Damian Kurian, Karen Simon
This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mildly increased troponin. On further investigation he was found to have a saddle pulmonary embolism with massive clot burden...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28228310/comparison-of-pesi-echocardiogram-ctpa-and-nt-probnp-as-risk-stratification-tools-in-patients-with-acute-pulmonary-embolism
#8
A Vamsidhar, D Rajasekhar, V Vanajakshamma, A Y Lakshmi, K Latheef, C Siva Sankara, G Obul Reddy
OBJECTIVE: The aim of this study is to prospectively assess the diagnostic accuracy of pulmonary embolism severity index, echocardiogram, computed tomography pulmonary angiogram (CTPA), and N-terminal pro b-type natriuretic peptide (NT-proBNP) for predicting adverse events in acute pulmonary embolism patients. METHODS: Thirty consecutive acute pulmonary embolism patients were included in this study. Combined adverse events consisted of in-hospital death or use of escalation of care including cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, or secondary thrombolysis during hospital stay...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28217685/right-ventricular-metastatic-tumor-from-a-primary-carcinoma-of-uterine-cervix-a-cause-of-pulmonary-embolism
#9
Gwan Hee Han, Do Youn Kwon, Roshani Ulak, Kyung Do Ki, Jong-Min Lee, Seon-Kyung Lee
The presence of intracavitary cardiac metastasis from squamous cell carcinoma of the uterine cervix is extremely rare. The diagnosis is made almost exclusively postmortem. Apart from causing intracardiac obstruction, it can present as pulmonary emboli and the prognosis is extremely poor. It is important to suspect this diagnosis in patient with recurrent pulmonary emboli. Due to the rarity of this condition it is very difficult to standardize care for these patients. However, it is possible that aggressive therapy may lengthen patients' survival and quality of life...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28217316/subacute-right-heart-failure-revealing-three-simultaneous-causes-of-post-embolic-pulmonary-hypertension-in-metastatic-dissemination-of-breast-cancer
#10
Flavien Vincent, Nicolas Lamblin, Marion Classe, Guillaume Schurtz, Antoine Rauch, Marie Fertin, Pascal De Groote
A 72-year-old woman with history of breast cancer only treated surgically was referred to our department for pulmonary hypertension (PH) suspicion. Echocardiogram revealed elevated right ventricular systolic pressure. Computed tomography (CT) angiogram showed no pulmonary embolism (PE), but lung scan revealed two ventilation-perfusion mismatch areas. Right cardiac catheterization established precapillary PH. Despite treatment with PH specific therapy (sildenafil, ambrisentan, and epoprostenol), her condition worsened rapidly with acute right heart failure (RHF)...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28179706/massive-pulmonary-embolism-presenting-as-seizures
#11
Shahrukh Hashmani, Fateh Ali Tipoo Sultan, Murtaza Kazmi, Ammarah Yasmeen
Pulmonary embolism can present in various ways, though seizure activity has been rarely reported. We report a 38 years old male who had met a road traffic accident, underwent surgery, presented a month later with seizures, chest pain, shortness of breath and low blood pressure. Massive pulmonary embolism was diagnosed on CTPA, with classical features on ECG and echocardiogram and the patient was successfully managed with thrombolysis. Massive pulmonary embolism (MPE) should be kept in mind in patients who present with seizures, chest pain and haemodynamic instability...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28133551/large-left-ventricular-thrombus-in-a-patient-with-systemic-and-venous-thromboembolism-secondary-to-protein-c-and-s-deficiency
#12
Mohit Pahuja, Bujji Ainapurapu, Aiden Abidov
58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28054894/a-rare-case-of-a-pedicled-mobile-thrombus-in-right-atrium
#13
Xiaodong Li, Liping Chen, Xiumei Duan, Xiaocong Wang
Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well...
December 2, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27932051/functional-and-exercise-limitations-after-a-first-episode-of-pulmonary-embolism-results-of-the-elope-prospective-cohort-study
#14
Susan R Kahn, Andrew M Hirsch, Arash Akaberi, Paul Hernandez, David R Anderson, Philip S Wells, Marc Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Christopher Rush, William H Geerts, Shawn D Aaron, John T Granton
BACKGROUND: We aimed to determine the frequency and predictors of exercise limitation after pulmonary embolism (PE), and to assess its association with health-related quality of life (HRQOL) and dyspnea. METHODS: 100 patients with acute PE were recruited at five Canadian hospitals from 2010-2013. Cardiopulmonary exercise testing (CPET) was performed at 1 and 12 months. Quality of life, dyspnea, six-minute walk distance (6MWD), residual clot burden (perfusion (Q) scan; CT pulmonary angiography (CTPA)), cardiac function (echocardiogram) and pulmonary function tests (PFT) were measured during follow-up...
December 5, 2016: Chest
https://www.readbyqxmd.com/read/27920693/capecitabine-induced-coronary-vasospasm
#15
Danish Henry, Francine Rudzik, Allison Butts, Aju Mathew
Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is approved for early-stage and advanced colorectal cancer and metastatic breast cancer. Cardiotoxicity of 5-FU is well described in the literature. However, cardiac adverse effects of capecitabine are poorly described. We report a case of coronary vasospasm induced by capecitabine. A 41-year-old female with metastatic breast cancer presented with chest pain 3 days after starting capecitabine. The chest pain was relieved by rest and exacerbated by exertion...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27912200/is-cha2ds2-vasc-appropriate-for-hyperthyroid-patients-with-atrial-fibrillation-implications-of-adding-a-transesophageal-echocardiography-evaluation
#16
Marcus Vinicius Leitão de Souza, Patricia de Fátima Dos Santos Teixeira, Mario Vaisman, Sergio Salles Xavier
BACKGROUND: Anticoagulation remains a controversial issue among hyperthyroid patients with atrial fibrillation (AF). We aimed to evaluate the prevalence of the thrombogenic milieu (TM), detected using transesophageal echocardiography (TEE), among patients with AF related to hyperthyroidism, and to correlate these findings with the clinical embolic risk classification (CHA2DS2-VASc). METHODS: CHA2DS2-VASc score, thyroid hormonal status, time since hyperthyroidism diagnosis, transthoracic echocardiography (TTE) and TEE were assessed in 47 consecutive patients aged between 18 and 65years with AF related to hyperthyroidism...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27873765/extensive-biatrial-thrombus-straddling-the-patent-foramen-ovale-and-traversing-into-the-left-and-right-ventricle
#17
Adil Sattar, Theingi Tiffany Win, Alex Schevchuck, Abinash Achrekar
We report an extremely rare case of an extensive biatrial thrombus straddling a patent foramen ovale (PFO) extending into the bilateral ventricles in a patient presenting with an acute embolic stroke. Our patient further developed a massive saddle pulmonary embolus (PE) with haemodynamic instability during the course of his hospitalisation. The risks of pharmacological thrombolysis or surgical thrombectomy for PE in a haemodynamically unstable patient with recent embolic stroke posed a significant therapeutic dilemma...
November 21, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27812780/pulmonary-arteriovenous-malformations-embolized-using-a-micro-vascular-plug-system-technical-note-on-a-preliminary-experience
#18
Emanuele Boatta, Christine Jahn, Matthieu Canuet, Julien Garnon, Nitin Ramamurthy, Roberto Luigi Cazzato, Afshin Gangi
AIM: To report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT). MATERIALS AND METHODS: Four consecutive female patients (mean age 38.0 years; range 25-55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization...
February 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27793505/emergency-physician-performed-tricuspid-annular-plane-systolic-excursion-in-the-evaluation-of-suspected-pulmonary-embolism
#19
James Daley, John Grotberg, Joseph Pare, Amanda Medoro, Rachel Liu, Michael Kennedy Hall, Andrew Taylor, Christopher L Moore
OBJECTIVES: The primary objectives were to describe the diagnostic characteristics tricuspid annular plane systolic excursion (TAPSE) for pulmonary embolism (PE) and to optimize the measurement cutoff of TAPSE for the diagnosis of PE. Secondary objectives included assessment of interrater reliability and the quantitative visual estimation of TAPSE. METHODS: This is a prospective observational cohort study involving a convenience sample of patients at an urban academic emergency department...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27793158/clinical-and-echocardiographic-predictors-of-mortality-in-acute-pulmonary-embolism
#20
Talal Dahhan, Irfan Siddiqui, Victor F Tapson, Eric J Velazquez, Stephanie Sun, Clemontina A Davenport, Zainab Samad, Sudarshan Rajagopal
PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a diagnosis of acute PE, based on a positive ventilation perfusion scan or computed tomography (CT) chest angiogram, were identified using the Duke University Hospital Database. Of these, 69 had echocardiograms within 24-48 h of the diagnosis that were suitable for offline analysis...
October 28, 2016: Cardiovascular Ultrasound
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