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https://www.readbyqxmd.com/read/28527920/emerging-bronchoscopic-treatments-for-chronic-obstructive-pulmonary-disease
#1
REVIEW
Wouter H van Geffen, Huib A M Kerstjens, Dirk-Jan Slebos
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange. Treatment consists of lifestyle changes, lung rehabilitation and pharmacological therapies such as long acting beta-2-agonists (LABA) and long acting muscarinic antagonists (LAMA). More recently bronchoscopic treatments are emerging for COPD. Among them endobronchial valves(EBV) and endobronchial coils (EBC), next to endobronchial stents, sclerosing agents, targeted lung denervation and liquid nitrogen metered cryospray...
May 17, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28523177/systolic-anterior-motion-of-the-mitral-valve-the-mechanism-of-postural-hypotension-following-left-intrapericardial-pneumonectomy
#2
Javier D Lasala, January Tsai, Andrea Rodriguez-Restrepo, Scott Michael Atay, Boris Sepesi
Systolic anterior motion (SAM) is defined as displacement of the distal portion of the anterior leaflet of the mitral valve toward the left ventricular outflow tract obstruction. SAM can occur in patients without hypertrophic cardiomyopathy (HOCM) and is a well-recognized cause for unexplained sudden hypotension in perioperative settings. We present a case of persistent orthostatic hypotension caused by SAM following left intrapericardial pneumonectomy and mediastinal lymph node dissection for squamous cell carcinoma of the lung invading intrapericardial portion of the inferior pulmonary vein...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28512099/mitral-valve-vegetation-diagnosed-with-oesophageal-ultrasound-with-bronchoscope-eus-b
#3
Ajoe John Kattoor, Yogita M Rochlani, Kevin Kuriakose, Nikhil K Meena
Oesophageal ultrasound with bronchoscope (EUS-B) is designed to evaluate mediastinal structures. We describe a case of a 78-year-old woman who presented with altered mental status for 2 weeks. CT head revealed a subacute infarct in the right middle cerebral artery distribution. She was also found to have a lung mass on chest imaging. EUS-B-guided fine needle aspiration demonstrated the presence of adenocarcinoma in station 7 lymph node and in the mass. Immunohistochemistry confirmed it to be a lung primary as the Thyroid Transcription Factor-1 (TTF-1) was strongly positive...
May 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28495235/prenatal-detection-of-megacystis-not-always-an-adverse-prognostic-factor-experience-in-25-consecutive-cases-in-a-tertiary-referral-center-with-complete-neonatal-outcome-and-follow-up
#4
Marcella Pellegrino, Daniela Visconti, Vincenzo Davide Catania, Luisa D'Oria, Carlo Manzoni, Maria Giovanna Grella, Alessandro Caruso, Lucia Masini, Giuseppe Noia
INTRODUCTION: Megacystis is a condition of abnormal enlarged fetal bladder for gestational age, which is usually associated with urological malformations that may constitute a life-threatening condition for the baby. OBJECTIVE: The purpose of this study was to assess the prognostic and etiological criteria of fetal megacystis and to describe the neonatal outcome in a large series collected in a single tertiary center. STUDY DESIGN: A retrospective observational study was conducted between 2008 and 2012...
April 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28492181/coinfection-by-streptococcus-phocae-and-cetacean-morbillivirus-in-a-short-beaked-common-dolphin-delphinus-delphis
#5
J Díaz-Delgado, E Sierra, A I Vela, M Arbelo, D Zucca, K R Groch, A Fernández
We describe gross, histopathological, and immunohistochemical features of Streptococcus phocae and cetacean morbillivirus coinfection in a short-beaked common dolphin Delphinus delphis. Major gross findings were cutaneous purulent nodules in the tail fluke, vegetative mitral valve endocarditis, and presumed postpartum pyometra. Histologic examination revealed bacterial septicemia characterized by widespread intravascular coccoid bacterial emboli. These were associated with fibrinonecrotizing to pyogranulomatous dermatitis and panniculitis, embolic pneumonia, neutrophilic and lymphoplasmacytic meningochoroiditis, random neutrophilic hepatitis, lymphoplasmacytic myocarditis and epicarditis, necrotizing adrenalitis, suppurative endometritis, and multicentric reactive lymphadenopathy...
May 11, 2017: Diseases of Aquatic Organisms
https://www.readbyqxmd.com/read/28488348/pulmonary-artery-stiffness-in-chronic-obstructive-pulmonary-disease-copd-and-emphysema-the-multi-ethnic-study-of-atherosclerosis-mesa-copd-study
#6
Chia-Ying Liu, Megha Parikh, David A Bluemke, Pallavi Balte, James Carr, Stephen Dashnaw, Hooman D Poor, Antoinette S Gomes, Eric A Hoffman, Steven M Kawut, Joao A C Lima, David A McAllister, Martin A Prince, Jens Vogel-Claussen, R Graham Barr
PURPOSE: Chronic obstructive pulmonary disease (COPD) and particularly emphysema are characterized by stiffness of the aorta, due in part to accelerated elastin degradation in the lungs and aorta. Stiffness of the pulmonary arteries (PAs) may also be increased in COPD and emphysema, but data are lacking. We assessed PA stiffness using MRI in patients with COPD and related these measurements to COPD severity and percent emphysema. MATERIALS AND METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited 290 participants, age 50-79 years with 10 or more packyears and free of clinical cardiovascular disease...
May 10, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28481989/left-atrioventricular-valve-replacement-in-a-patient-with-hereditary-haemorrhagic-telangiectasia
#7
Yasunori Iida, Naritaka Kimura, Akinori Hirano, Hideyuki Shimizu
Hereditary haemorrhagic telangiectasia, or Osler-Rendu-Weber disease, is characterized by multiple arteriovenous malformations and telangiectasia which develop in the brain, lungs or liver. We report the case of a patient who had severe left atrioventricular valve regurgitation with atrial fibrillation after atrioventricular septal defect repair in her childhood and was diagnosed as having hereditary haemorrhagic telangiectasia by chance. The patient underwent successful left atrioventricular valve replacement and maze operation...
May 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28457372/lung-transplantation-from-donors-after-previous-cardiac-surgery-ideal-graft-in-marginal-donor
#8
A Palleschi, P Mendogni, D Tosi, M Montoli, R Carrinola, A V Mariolo, F Briganti, M Nosotti
Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28450164/a-novel-approach-to-study-the-pmdi-plume-using-an-infrared-camera-and-to-evaluate-the-aerodynamic-properties-after-varying-the-time-between-actuations
#9
Nitesh K Kunda, Julia Hautmann, Sebastián E Godoy, Patricia Marshik, Ramesh Chand, Sanjay Krishna, Pavan Muttil
Plume characteristics, such as temperature and velocity, emitted from pMDIs could significantly affect the dose delivered to the lung. Currently, high speed cameras and thermocouples are used separately to evaluate these parameters. We used a low-noise infrared camera to evaluate both the temperature and velocity of the emitted plume from pMDIs. Additionally, we investigated whether the fine particle fraction (FPF) is affected when time between actuations is varied. We tested three different albuterol sulfate pMDIs: ProAir(®) HFA, Proventil(®) HFA, and Ventolin(®) HFA...
April 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28446973/bronchoscopic-valves-for-prolonged-air-leak-current-status-and-technique
#10
REVIEW
Amit K Mahajan, Sandeep J Khandhar
Unidirectional airway valves are devices used for the treatment of persistent air leaks (PALs) secondary to alveolar-pleural fistulas (APF) or bronchopleural fistulas (BPFs). These valves were originally developed as a non-surgical alternative to lung volume reduction surgery (LVRS) for patients with chronic obstructive pulmonary disease (COPD). Randomized trials investigating the use of valves for bronchoscopic LVRS did not lead to the Federal Drug Administration (FDA) approval, but stemming from these studies a Humanitarian Device Exemption (HDE) was granted to Spiration intrabronchial valves (IBVs) for the treatment of PALs...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28444339/comparison-of-plethysmographic-and-helium-dilution-lung-volumes-in-patients-with-a-giant-emphysematous-bulla-as-selection-criteria-for-endobronchial-valve-implant%C3%A2
#11
Alfonso Fiorelli, Roberto Scaramuzzi, Matteo Pierdiluca, Elisabetta Frongillo, Gaetana Messina, Nicola Serra, Alberto De Felice, Mario Santini
OBJECTIVES: To assess whether the difference in lung volume measured with plethysmography and with the helium dilution technique could differentiate an open from a closed bulla in patients with a giant emphysematous bulla and could be used as a selection criterion for the positioning of an endobronchial valve. METHODS: We reviewed the data of 27 consecutive patients with a giant emphysematous bulla undergoing treatment with an endobronchial valve. In addition to standard functional and radiological examinations, total lung capacity and residual volume were measured with the plethysmographic and helium dilution technique...
April 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28414678/what-the-eyes-don-t-see-the-heart-does-grieve-over
#12
M Sciaudone, M Dery
INTRODUCTION: A 71 year old Peruvian woman presented with blurry vision and bilateral eye pain and had evidence of bilateral endophthalmitis on eye examination. Her past medical history was notable for multiple abdominal surgeries within the preceding months, including an incarcerated inguinal hernia repair which required an ileostomy placement, and cholecystitis requiring cholecystostomy tube placement. Over her multiple long hospitalizations, she developed bacteremia and fungemia on several occasions, with organisms including Enterobacter cloacae, Klebsiella pneumoniae, Bacteroides fragilis, Pseudomonas aeruginosa, Enterococcus faecium, and Candida albicans...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414667/the-mysterious-case-of-dyspnea
#13
S Saad, N Turaga, J Grant, N Jain
INTRODUCTION: Dehiscence of a mitral valve annuloplasty ring is a rare occurrence that often manifests as mitral regurgitation and heart failure. We present a case of mitral ring dehiscence which was initially unrecognized by standard 2-dimensional transthoracic echocardiography (2D TTE); and 2-dimensional transesophageal echocardiography (2D TEE);. CASE: A 65-year-old woman was referred to Cardiology clinic for evaluation of dyspnea. Her history included tobacco abuse, atrial fibrillation status post pulmonary vein isolation, nonischemic cardiomyopathy, and prior mitral valve repair with annuloplasty ring for rheumatic valvular disease...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411422/ventilation-distribution-and-lung-recruitment-with-speaking-valve-use-in-tracheostomised-patient-weaning-from-mechanical-ventilation-in-intensive-care
#14
Anna-Liisa Sutt, Chris M Anstey, Lawrence R Caruana, Petrea L Cornwell, John F Fraser
PURPOSE: Speaking valves (SV) are used infrequently in tracheostomised ICU patients due to concerns regarding their putative effect on lung recruitment. A recent study in cardio-thoracic population demonstrated increased end-expiratory lung volumes during and post SV use without examining if the increase in end-expiratory lung impedance (EELI) resulted in alveolar recruitment or potential hyperinflation in discrete loci. MATERIALS AND METHODS: A secondary analysis of Electrical Impedance Tomography (EIT) data from a previous study was conducted...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28409042/nephrologists-hate-the-dialysis-catheters-a-systemic-review-of-dialysis-catheter-associated-infective-endocarditis
#15
Kalyana C Janga, Ankur Sinha, Sheldon Greenberg, Kavita Sharma
A 53-year-old Egyptian female with end stage renal disease, one month after start of hemodialysis via an internal jugular catheter, presented with fever and shortness of breath. She developed desquamating vesiculobullous lesions, widespread on her body. She was in profound septic shock and broad spectrum antibiotics were started with appropriate fluid replenishment. An echocardiogram revealed bulky leaflets of the mitral valve with a highly mobile vegetation about 2.3 cm long attached to the anterior leaflet...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28396860/aortic-valve-replacement-for-moderate-aortic-stenosis-with-severe-calcification-and-left-ventricualr-dysfunction-a-case-report-and-review-of-the-literature
#16
Nikhil Narang, Roberto M Lang, Vladimir M Liarski, Valluvan Jeevanandam, Marion A Hofmann Bowman
A 55-year-old man with a history of erosive, seropositive rheumatoid arthritis (RA), and interstitial lung disease presented with shortness of breath. Echocardiography showed new-onset severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 15% and moderately increased mean aortic valve gradient of 20 mmHg in a trileaflet aortic valve with severe sclero-calcific degeneration. Coronary angiography revealed no significant obstructive coronary disease. Invasive hemodynamic studies and dobutamine stress echocardiography were consistent with moderate aortic stenosis...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28378731/-right-ventricular-diastolic-function-in-patients-with-lung-diseases-in-the-absence-or-presence-of-pulmonary-hypertension
#17
A N Sumin, O G Arkhipov
AIM: To investigate the indicators of filling of the right ventricle (RV) in patients with chronic lung diseases with and without pulmonary hypertension (PH) compared to healthy individuals. SUBJECTS AND METHODS: 365 people (198 men); mean age 64.6±8.0 years) were examined and divided into a group of patients with respiratory pathology without and with PH (n=124 and n=138, respectively) and a comparison group that included individuals without cardiovascular and respiratory diseases (n=103)...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28370263/fetal-left-sided-cardiac-structural-dimensions-in-left-sided-congenital-diaphragmatic-hernia-association-with-severity-and-impact-on-postnatal-outcomes
#18
Joshua A Kailin, Gurpreet S Dhillon, Shiraz A Maskatia, Darrell L Cass, Alireza A Shamshirsaz, Amy R Mehollin-Ray, Christopher I Cassady, Nancy A Ayres, Yunfei Wang, Michael A Belfort, Oluyinka O Olutoye, Rodrigo Ruano
OBJECTIVES: Fetuses with congenital diaphragmatic hernia (CDH) demonstrate varying degrees of left heart hypoplasia. Our study assesses the relationship between fetal left-sided cardiac structural dimensions, lung size, percentage liver herniation, lung-to-head ratio, postnatal left-sided cardiac structural dimensions, and postnatal outcomes. METHODS: We performed a retrospective cohort study of fetuses with left-sided CDH who had prenatal echocardiographic, ultrasound, and magnetic resonance imaging examinations at our institution between January 2007 and March 2015...
March 31, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28355597/endobronchial-valve-used-as-salvage-therapy-in-a-mechanically-ventilated-patient-with-intractable-life-threatening-haemoptysis
#19
Usha Lalla, Brian W Allwood, Soumitra Sinha Roy, Elvis M Irusen, Coenraad F N Koegelenberg
Treatment options for intractable life-threatening haemoptysis in mechanically ventilated patients with structural lung disease who do not respond to bronchial artery embolisation (BAE) and who are deemed unfit for surgery are limited. A 26-year-old HIV-positive male with a poorly preserved CD4 count and active pulmonary tuberculosis was intubated and mechanically ventilated for persistent life-threatening haemoptysis. Two attempts at BAE failed, and life-threatening haemoptysis recurred daily for 14 days despite antituberculous therapy...
March 30, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28348945/infective-endocarditis-in-a-patient-with-celiac-disease-after-central-venous-catheter-insertion
#20
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
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