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https://www.readbyqxmd.com/read/28913877/minimal-important-difference-of-target-lobar-volume-reduction-after-endobronchial-valve-treatment-for-emphysema
#1
Jorrit B A Welling, Jorine E Hartman, Eva M van Rikxoort, Nick H T Ten Hacken, Huib A M Kerstjens, Karin Klooster, Dirk-Jan Slebos
BACKGROUND AND OBJECTIVE: Target lobar volume reduction (TLVR) is an important efficacy outcome measure for bronchoscopic lung volume reduction (BLVR) treatment using one-way endobronchial valves (EBV) in patients with severe emphysema. The commonly used cut-off value for TLVR that expresses a perceivable clinical benefit is -350 mL. However, a scientifically determined minimal important difference (MID) for TLVR never has been published. The objective of the present study was to determine the MID for TLVR on HRCT in patients who were treated with EBV...
September 15, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28912820/granulomatosis-with-polyangiitis-with-myocarditis-and-ventricular-tachycardia
#2
Ramy Magdy Hanna, Eduardo Lopez, James Wilson
Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a pulmonary-renal syndrome affecting small and medium sized blood vessels. The disease has a prevalence in studies ranging from 3 to 15.7 cases per 100,000, with a noted increasing incidence and prevalence in more recent studies. Pulmonary manifestations include hemorrhage, lung cavitary lesions, and pulmonary fibrosis. Within the kidney, GPA is known to cause rapidly progressive pauci-immune crescentic glomerulonephritis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28905517/the-prognostic-significance-of-tricuspid-valve-regurgitation-in-pulmonary-arterial-hypertension
#3
Libo Chen, Carolyn M Larsen, Rachel J Le, Heidi M Connolly, Sorin V Pislaru, Joseph G Murphy, Michael D McGoon, Robert P Frantz, Garvan C Kane
INTRODUCTION: Tricuspid valve regurgitation (TR) is a frequent finding in patients with pulmonary arterial hypertension (PAH). However, its prognostic significance and relation to PAH, while suspected, are poorly understood. We assessed 727 consecutive patients with newly diagnosed PAH who underwent transthoracic echocardiographic evaluation of tricuspid valve function. OBJECTIVES: The study objective was to determine the association of TR presence and severity with patient characteristics, pulmonary artery hemodynamics, and outcome...
September 14, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28902940/bacterial-translocation-and-mortality-on-rat-model-of-intestinal-ischemia-and-obstruction
#4
Rafael Izar Domingues da Costa, Roberto Rasslan, Marcia Kiyomi Koike, Edivaldo Massazo Utiyama, Edna Frasson de Souza Montero
Purpose: To develop an experimental model of intestinal ischemia and obstruction followed by surgical resection of the damaged segment and reestablishment of intestinal transit, looking at bacterial translocation and survival. Methods: After anesthesia, Wistar rats was subject to laparotomy, intestinal ischemia and obstruction through an ileal ligature 1.5cm of ileum cecal valve; and the mesenteric vessels that irrigate upstream of the obstruction site to approximately 7 to 10 cm were ligated...
August 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28898345/-endoscopic-lung-volume-reduction-in-advanced-pulmonary-emphysema-initial-experience-in-chile
#5
Sebastián Fernández-Bussy, Gonzalo Labarca, Iván Caviedes, Hiren J Mehta, Michael Jantz, Adnan Majid
Chronic obstructive pulmonary disease (COPD) has no curative treatment, and in moderate to advanced stages, functional parameters and quality of life are affected. Lung volume reduction improves respiratory parameters and quality of life of these patients. Endoscopic lung volume reduction is a minimally invasive procedure that uses endobronchial valves or coils. Valves are unidirectional, blocking the air from entering the target lobe during inspiration, allowing the exit of air and secretions during expiration...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28895301/early-leaflet-thrombosis-complicating-transcatheter-implantation-of-a-sapien-3-valve-in-a-native-right-ventricular-outflow-tract
#6
Mounir Riahi, Philipp Blanke, John Webb, Ronald G Carere
A 59-year-old female with Tetralogy of Fallot had a previous complete repair with RVOT patch enlargement. She developed subsequent severe symptomatic (NYHA III) pulmonary regurgitation with severe RV dilatation. She had a concomitant interstitial lung disease secondary to hypersensitivity pneumonitis that precluded her from cardiac surgery. After preprocedural assessment using computed tomography, echocardiography and invasive angiography we decided to implant a 29 mm Edwards Sapien 3 valve without pre-stenting...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28893830/assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-add-clinical-signs-to-echocardiographic-data
#7
Corstiaan A den Uil, Mihai Strachinaru, Ben van der Hoven, J Han J Meeder
A 62-year old male with pulmonary fibrosis and aortic valve stenosis underwent TAVI (Corevalve Evolut XL 34 mm) in the build-up for lung transplantation (LuTx). Following post-dilation for a large annular perimeter, moderate paravalvular aortic regurgitation (AR) was observed. After 6 weeks, he was admitted to the ICU with respiratory failure(A). TTE demonstrated residual mild AR (based on a small excentric paravalvular AR jet, <10% circumferential extent, pressure half-time was not reliably measured) and together with borderline elevated NT-pro-BNP, the consultant cardiologist authorized LuTx listing...
September 11, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28893026/superior-vena-cava-as-gateway-to-heart-metastatic-breast-carcinoma-causing-ball-in-a-loop-metastasis-to-right-atrium
#8
Harpreet Singh Sandhu, Sampath Kumar Mahadevappa Mahendrakar, Sulaiman Sadruddin Ladhani, Azizullah Hafizullah Khan, Yunus Shafi Loya
Breast carcinoma is the most common invasive cancer in women worldwide. It metastasizes commonly to bone, lungs, regional lymph nodes and brain. Cardiac metastasis of lung and breast cancers is a known but rare complication of advanced disease with tumour metastasising to pericardium via the locoregional lymphatic system. Here we present a case of 59-year-old female presenting with right upper limb oedema, facial puffiness and features of Superior Vena Cava (SVC) syndrome 15 years after mastectomy and adjuvant chemotherapy, radiotherapy for carcinoma of the right breast...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28886850/transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-lower-surgical-risk-patients-with-chronic-obstructive-pulmonary-disease
#9
Vincent Auffret, Victor Becerra Munoz, Aurélie Loirat, Eric Dumont, Hervé Le Breton, Jean-Michel Paradis, Daniel Doyle, Robert De Larochellière, Siamak Mohammadi, Jean-Philippe Verhoye, François Dagenais, Marc Bedossa, Dominique Boulmier, Guillaume Leurent, Lluis Asmarats, Ander Regueiro, Chekrallah Chamandi, Tania Rodriguez-Gabella, Emile Voisine, Anne-Sophie Moisan, Martin Thoenes, Mélanie Côté, Rishi Puri, Pierre Voisine, Josep Rodés-Cabau
Respiratory complications are a major factor contributing to postoperative morbidity and mortality, especially in patients with chronic obstructive pulmonary disease (COPD). Our objective was to compare the rate of respiratory complications in patients with COPD with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR). Low-to-intermediate surgical-risk patients with moderate or severe COPD who underwent TAVI or SAVR at 2 tertiary centers were included in this study...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28885054/a-multicenter-rct-of-zephyr%C3%A2-endobronchial-valve-treatment-in-heterogeneous-emphysema-transform
#10
Samuel V Kemp, Dirk-Jan Slebos, Alan Kirk, Malgorzata Kornaszewska, Kris Carron, Lars Ek, Gustav Broman, Gunnar Hillerdal, Herve Mal, Christophe Pison, Amandine Briault, Nicola Downer, Kaid Darwiche, Jagan Rao, Ralf-Harto Hübner, Christof Ruwwe-Glosenkamp, Valéry Trosini-Desert, Ralf Eberhardt, Felix J Herth, Eric Derom, Thomas Malfait, Pallav L Shah, Justin L Garner, Nick H Ten Hacken, Hazem Fallouh, Sylvie Leroy, Charles H Marquette
RATIONALE: Single-center RCTs of Zephyr Endobronchial Valve (EBV) treatment have demonstrated benefit in severe heterogeneous emphysema. This is the first multicenter study evaluating this treatment approach. OBJECTIVES: To evaluate the efficacy and safety of Zephyr EBVs in patients with heterogeneous emphysema and absence of collateral ventilation. METHODS: Prospective, multicenter 2:1 RCT of EBVs plus standard of care or standard of care (SoC) alone...
September 8, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28882284/harmony-feasibility-trial-acute-and-short-term-outcomes-with-a-self-expanding-transcatheter-pulmonary-valve
#11
Lisa Bergersen, Lee N Benson, Matthew J Gillespie, Sharon L Cheatham, Andrew M Crean, Kan N Hor, Eric M Horlick, Te-Hsin Lung, Brian T McHenry, Mark D Osten, Andrew J Powell, John P Cheatham
OBJECTIVES: This study sought to obtain in vivo data to confirm assumptions on device loading conditions and assess procedural feasibility, safety, and valve performance. BACKGROUND: The Harmony transcatheter pulmonary valve (Medtronic, Minneapolis, Minnesota) was designed for patients with severe pulmonary regurgitation who require pulmonary valve replacement. METHODS: Three sites participated in this first Food and Drug Administration-approved early feasibility study using an innovative device design to accommodate the complex anatomy of the right ventricular outflow tract...
September 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28864682/mtor-kinase-inhibition-effectively-decreases-progression-of-a-subset-of-neuroendocrine-tumors-that-progress-on-rapalog-therapy-and-delays-cardiac-impairment
#12
Melissa A Orr-Asman, Zhengtao Chu, Min Jiang, Mariah Worley, Kathleen LaSance, Sheryl E Koch, Vinicius S Carreira, Hanan M Dahche, David R Plas, Kakajan Komurov, Xiaoyang Qi, Carol A Mercer, Lowell B Anthony, Jack Rubinstein, Hala Elnakat Thomas
Inhibition of mTOR signaling using the rapalog everolimus is an FDA-approved targeted therapy for patients with lung and gastroenteropancreatic neuroendocrine tumors (NETs). However, patients eventually progress on treatment, highlighting the need for additional therapies. We focused on pancreatic NETs (pNETs) and reasoned that treatment of these tumors upon progression on rapalog therapy, with an mTOR kinase inhibitor (mTORKi) such as CC-223 could overcome a number of resistance mechanisms in tumors and delay cardiac carcinoid disease...
September 1, 2017: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/28863023/evaluation-of-the-augmented-infant-resuscitator-a-monitoring-device-for-neonatal-bag-valve-mask-resuscitation
#13
Desmond J Bennett, Taiga Itagaki, Christopher T Chenelle, Edward A Bittner, Robert M Kacmarek
BACKGROUND: Annually, 6 million newborns require bag-valve-mask resuscitation, and providing live feedback has the potential to improve the quality of resuscitation. The Augmented Infant Resuscitator (AIR), a real-time feedback device, has been designed to identify leaks, obstructions, and inappropriate breath rates during bag-valve-mask resuscitation. However, its function has not been evaluated. METHODS: The resistance of the AIR was measured by attaching it between a ventilator and a ventilator tester...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28835891/patient-experience-of-lung-volume-reduction-procedures-for-emphysema-a-qualitative-service-improvement-project
#14
Sara Buttery, Adam Lewis, Inger Oey, Joanne Hargrave, David Waller, Michael Steiner, Pallav L Shah, Samuel V Kemp, Simon Jordan, Nicholas S Hopkinson
The aim of this service improvement project was to gain understanding of the patient experience of lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement, from referral through to post-discharge care. Focus group interviews were carried out in two tertiary centres in London and Leicester, UK. Sixteen patients who had undergone lung volume reduction surgery (LVRS), endobronchial valve (EBV) placement, or both, were recruited. Prior to participation in each focus group, participants completed a questionnaire to guide and focus discussion...
July 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28833552/a-rare-complication-of-mechanical-aortic-valve-replacement-separation-in-the-region-of-the-mitral-aortic-intervalvular-fibrosa
#15
Mehmet Celik, Ahmet Güner, Alev Kılıçgedik, Sabahattin Gunduz, Abdulrahman Naser, Elif Eroglu Büyüköner, Muzaffer Kahyaoglu, Cagatay Onal, Gokhan Kahveci
A 28-year-old man was admitted to our emergency service with a shortness of breath and palpitation. On admission, his blood pressure was high and he was in hypertensive pulmonary edema. His physical examination showed rales in both lungs and pansystolic murmur at mitral focus. His medical history included aortic valve replacement (AVR) because of native aortic valve infective endocarditis. Transthoracic echocardiography (TTE) showed normal functional aortic valve. Color flow imaging demonstrated severe mitral regurgitation with posterior eccentric jet...
August 2017: Echocardiography
https://www.readbyqxmd.com/read/28831765/validation-of-transpulmonary-thermodilution-variables-in-hemodynamically-stable-patients-with-heart-diseases
#16
Matthias Peter Hilty, Daniel Peter Franzen, Christophe Wyss, Patric Biaggi, Marco Maggiorini
BACKGROUND: Transpulmonary thermodilution is recommended in the treatment of critically ill patients presenting with complex shock. However, so far it has not been validated in hemodynamically stable patients with heart disease. METHODS: We assessed the validity of cardiac output, global end-diastolic volume index (GEDVI), an established marker of preload thought to reflect the volume of all four heart chambers, global ejection fraction (GEF) and cardiac function index (CFI) as variables of cardiac function, and extravascular lung water index (EVLWI) as indicator of pulmonary edema in 29 patients undergoing elective left and right heart catheterization including left ventricular angiography with stable coronary heart disease and normal cardiac function (controls, n = 11), moderate-to-severe aortic valve stenosis (AS, n = 10), or dilated cardiomyopathy (DCM, n = 8)...
August 22, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28831197/a-pulsed-air-model-of-blue-whale-b-call-vocalizations
#17
R P Dziak, J H Haxel, T-K Lau, S Heimlich, J Caplan-Auerbach, D K Mellinger, H Matsumoto, B Mate
Blue whale sound production has been thought to occur by Helmholtz resonance via air flowing from the lungs into the upper respiratory spaces. This implies that the frequency of blue whale vocalizations might be directly proportional to the size of their sound-producing organs. Here we present a sound production mechanism where the fundamental and overtone frequencies of blue whale B calls can be well modeled using a series of short-duration (<1 s) wavelets. We propose that the likely source of these wavelets are pneumatic pulses caused by opening and closing of respiratory valves during air recirculation between the lungs and laryngeal sac...
August 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28817821/endoscopic-lung-volume-reduction-an-expert-panel-recommendation-update-2017
#18
Felix J F Herth, Dirk-Jan Slebos, Gerard J Criner, Pallav L Shah
Interest in endoscopic lung volume reduction (ELVR) technologies for emphysema is consistently growing. In the last couple of months, several endoscopic options (e.g., endo- or intrabronchial valves, coil implants, and thermal vapor ablation) that have been evaluated in randomized controlled trials have been reported with the ultimate goal of improving respiratory mechanics and alleviating chronic dyspnea. Patients presenting with severe air trapping and thoracic hyperinflation have the greatest potential to derive benefit from ELVR procedures...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28814849/tiotropium-bromide-exerts-anti-inflammatory-effects-during-resistive-breathing-an-experimental-model-of-severe-airway-obstruction
#19
Dimitrios Toumpanakis, Konstantinos Loverdos, Vassiliki Tzouda, Vyronia Vassilakopoulou, Eleni Litsiou, Christina Magkou, Vassiliki Karavana, Michael Pieper, Theodoros Vassilakopoulos
INTRODUCTION: Resistive breathing (RB), a hallmark of obstructive airway diseases, is characterized by strenuous contractions of the inspiratory muscles that impose increased mechanical stress on the lung. RB is shown to induce pulmonary inflammation in previous healthy animals. Tiotropium bromide, an anticholinergic bronchodilator, is also shown to exert anti-inflammatory effects. The effect of tiotropium on RB-induced pulmonary inflammation is unknown. METHODS: Adult rats were anesthetized, tracheostomized and breathed spontaneously through a two-way non-rebreathing valve...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28802510/aortic-dilatation-associated-with-bicuspid-aortic-valve-relation-to-sex-hemodynamics-and-valve-morphology-the-national-heart-lung-and-blood-institute-sponsored-national-registry-of-genetically-triggered-thoracic-aortic-aneurysms-and-cardiovascular-conditions
#20
MULTICENTER STUDY
Mary J Roman, Norma L Pugh, Richard B Devereux, Kim A Eagle, Kathryn Holmes, Scott A LeMaire, Rita K Milewski, Shaine A Morris, Siddharth K Prakash, Reed E Pyeritz, William J Ravekes, Ralph V Shohet, Howard K Song, Federico M Asch
This study analyzed the impact of sex, hemodynamic profile, and valve fusion pattern on aortopathy associated with bicuspid aortic valve (BAV). The National Heart Lung and Blood Institute-sponsored National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) provided comprehensive information on a large population of well-characterized patients with BAV. Of 969 enrolled patients with BAV, 551 (57%, 77% male) had already undergone valvular and/or aortic surgery...
October 1, 2017: American Journal of Cardiology
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