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https://www.readbyqxmd.com/read/28314525/intraoperative-electromagnetic-navigational-bronchoscopic-localization-of-small-deep-or-subsolid-pulmonary-nodules
#1
Abbas Abbas, Sagar Kadakia, Vishnu Ambur, Kimberly Muro, Larry Kaiser
BACKGROUND: Localizing small or deep pulmonary nodules or subsolid ground-glass opacities often is difficult during video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS). This can result in larger resections or conversion to thoracotomy. The goal of this study is to evaluate the role of electromagnetic navigational bronchoscopic localization (ENBL) as a safe and accurate intraoperative method to localize small, deep, or subsolid nodules. METHODS: This is a single-institution, single-surgeon retrospective study of all patients (51) who underwent combined ENBL and resection of 54 nodules between May 2013 and August 2015...
February 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28295515/two-cases-of-melanomas-paradoxically-metastasizing-to-the-intestinal-tract-during-nivolumab-therapy
#2
Hajime Miyazawa, Teruki Yanagi, Yasuyuki Yamaguchi, Keisuke Imafuku, Shinya Kitamura, Hiroo Hata, Jiro Uehara, Nobuki Ichikawa, Yosuke Ohno, Tadashi Yoshida, Shigenori Homma, Hideki Kawamura, Akinobu Taketomi, Hiroshi Shimizu
We report two cases of melanomas in patients who developed intestinal metastasis despite other metastatic sites responding to nivolumab and despite the patients having favorable findings such as vitiligo and normal lactate dehydrogenase. The first case is an 85-year-old man who had been administrated nivolumab for lung/cutaneous metastases. After 22 courses of nivolumab therapy, fever and anorexia had appeared and his bodyweight had decreased. An intussusception on the ileocecal valve was revealed by computed tomography, and emergency surgery revealed metastatic lesions on the colon...
March 11, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28295147/a-prospective-randomised-trial-of-pre-oxygenation-strategies-available-in-the-pre-hospital-environment
#3
C J Groombridge, E Ley, M Miller, T Konig
Pre-oxygenation before tracheal intubation aims to increase safe apnoea duration by denitrogenation of the functional residual capacity of the lungs, and increasing oxygen stores at the onset of apnoea. Pre-oxygenation options in the pre-hospital environment are limited due to oxygen availability and equipment portability. The aim of this study was to evaluate the effectiveness of strategies available in this setting. This was a prospective, randomised, crossover study of 30 healthy volunteers who underwent 3-min periods of pre-oxygenation by tidal volume breathing with a non-rebreather mask, a bag-valve-mask and a portable ventilator...
March 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28288638/aggregatibacter-actinomycetemcomitans-osteomyelitis-in-a-12%C3%A2-year-old-boy-case-report-emphasizing-the-importance-of-tissue-culture-and-review-of-literature
#4
Ketaki Sharma, Poonam Mudgil, John S Whitehall, Iain Gosbell
BACKGROUND: Aggregatibacter actinomycetemcomitans most commonly causes periodontitis but has been reported to infect heart valves, soft tissue, brain and lungs, and distal bones. Osteomyelitis distal to the jaw is rarely described. CASE PRESENTATION: We report an unusual and rare case of chronic osteomyelitis caused by A. actinomycetemcomitans in the toe of a paediatric patient, and review the available literature. The infection was managed with intravenous antibiotics followed by oral antibiotics...
March 14, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28270260/what-is-the-diagnostic-value-of-the-paediatric-exercise-tolerance-test-results-from-a-uk-centre
#5
Magdalena A Sajnach-Menke, Sarah C Walpole
Purpose The aim of this study was to determine whether the exercise tolerance test can provide diagnostic and prognostic information regarding children and young adults and help predict outcome. METHODS: A total of 87 patients, aged 7-29 years (median 13, mean 13.4) were selected retrospectively. They underwent exercise test at the Freeman Hospital from December, 2015 to May, 2016. There were two groups of patients - 46 had symptoms such as chest pain, palpitations, syncope, or dyspnoea on exertion and no cardiac diagnosis, and 40 patients had a cardiac diagnosis such as hypertrophic cardiomyopathy, transposition of the great arteries with post-arterial switch operation, aortic stenosis or regurgitation, tetralogy of Fallot, abnormal coronary arteries, Wolff-Parkinson-White syndrome, or supraventricular tachycardia...
March 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28258976/congenital-pulmonary-lymphangiectasia
#6
Shi-Min Yuan
Congenital pulmonary lymphangiectasia (CPL) is a rare but fatal disease, usually having an onset from the first few hours to days after birth. Inconsistent nomenclatures were used for CPL in the past decades. Patients often present with intractable respiratory failure, hydrops fetalis and even sudden death. The etiologies of CPL remain unclear. Previous hypotheses suggested that CPL might be caused by conditions preventing normal regression of the lymphatics after the 18th-20th week of gestation. Up-to-date biological studies on lymphatic development, lymphatic valve formation and occurrence of hydrops fetalis revealed possible causative relations with mutations of genes of the vascular endothelial growth factor receptor (VEGFR), RAS/MAPK, PI3K/AKT and NF-κB signaling pathways...
March 4, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28258452/pathophysiology-of-gastroesophageal-reflux-disease
#7
Mariano A Menezes, Fernando A M Herbella
Gastroesophageal reflux disease pathophysiology is multifactorial and linked to a misbalance between the aggressiveness of the refluxate into the esophagus or adjacent organs and the failure of protective mechanisms associate or not to a defective valvular mechanism at the level of the esophagogastric junction incapable of dealing with a transdiaphragmatic pressure gradient. Antireflux mechanisms include the lower esophageal sphincter and abdominal esophagus, the diaphragm, the angle of His, the Gubaroff valve, and the phrenoesophageal membrane...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28243777/blood-pooling-in-extrathoracic-veins-after-glossopharyngeal-insufflation
#8
Tanja Mijacika, Daria Frestad, Kasper Kyhl, Otto Barak, Ivan Drvis, Niels H Secher, Ante Buca, Ante Obad, Zeljko Dujic, Per Lav Madsen
PURPOSE: Trained breath-hold divers hyperinflate their lungs by glossopharyngeal insufflation (GPI) to prolong submersion time and withstand lung collapse at depths. Pulmonary hyperinflation leads to profound hemodynamic changes. METHODS: Thirteen divers performed preparatory breath-holds followed by apnea with GPI. Filling of extrathoracic veins was determined by ultrasound and magnetic resonance imaging and peripheral extravasation of fluid was assessed by electrical impedance...
February 27, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28242132/abducens-nerve-palsy-due-to-inferior-petrosal-sinus-thrombosis
#9
Shivam Om Mittal, Junaid Siddiqui, Bashar Katirji
Isolated unilateral abducens nerve palsy is usually due to ischemia, trauma or neoplasm. Dorello's canal is the space between the petrous apex and superolateral portion of the clivus, bound superiorly by Gruber's ligament. The abducens nerve travels with inferior petrosal sinus (IPS) though the Dorello's canal before entering the cavernous sinus. A 31-year-old man presented with neck pain, and binocular horizontal diplopia, worse looking towards left and at distance. He had a history of intravenous drug abuse but no history of hypertension or diabetes...
February 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28230230/bronchoscopic-lung-volume-reduction-procedures-for-chronic-obstructive-pulmonary-disease
#10
REVIEW
Joseph Em van Agteren, Khin Hnin, Dion Grosser, Kristin V Carson, Brian J Smith
BACKGROUND: In the recent years, a variety of bronchoscopic lung volume reduction (BLVR) procedures have emerged that may provide a treatment option to participants suffering from moderate to severe chronic obstructive pulmonary disease (COPD). OBJECTIVES: To assess the effects of BLVR on the short- and long-term health outcomes in participants with moderate to severe COPD and determine the effectiveness and cost-effectiveness of each individual technique. SEARCH METHODS: Studies were identified from the Cochrane Airways Group Specialised Register (CAGR) and by handsearching of respiratory journals and meeting abstracts...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28221172/interventional-pulmonology-in-chronic-obstructive-pulmonary-disease
#11
Daniela Gompelmann, Nilab Sarmand, Felix J F Herth
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and emphysema are widespread diseases associated with progressive dyspnea because of airflow limitation and hyperinflation. Fundamental therapeutic strategies consist of pulmonary rehabilitation, pharmacotherapy, long-term oxygen therapy, noninvasive ventilation, and surgical therapeutic approaches. RECENT FINDINGS: In the last 14 years, endoscopic therapeutic modalities emerged as a substantial part of severe COPD and emphysema treatment...
February 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28219569/intrabronchial-pneumonectomy-for-vanishing%C3%A2-lung-syndrome-first-reported-case
#12
Nicholas Ballay, Brent Soder, Jeremiah Smith, Ashley Miller, James R Headrick
Vanishing lung syndrome is a clinical presentation of giant bullous emphysema associated with significant morbidity and mortality. We present a case of a 50-year-old white woman with vanishing lung syndrome who presented with a spontaneous secondary pneumothorax and an uncontrolled bronchopleural fistula. The large bronchopleural fistula was initially controlled with a double-lumen endotracheal tube and a tube thoracostomy. After surgical efforts failed, complete left lung isolation was performed with multiple intrabronchial valves...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216473/five-year-results-from-a-prospective-multicentre-study-of-percutaneous-pulmonary-valve-implantation-demonstrate-sustained-removal-of-significant-pulmonary-regurgitation-improved-right-ventricular-outflow-tract-obstruction-and-improved-quality-of-life
#13
Alfred Hager, Stephan Schubert, Peter Ewert, Lars Søndergaard, Maarten Witsenburg, Paolo Guccione, Lee N Benson, José Suárez de Lezo, Te-Hsin Lung, John Hess, Andreas Eicken, Felix Berger
AIMS: Percutaneous pulmonary valve implantation (PPVI) is used to treat patients with dysfunctional pulmonary valve conduits. Short- and longer-term results from multiple trials have outlined haemodynamic improvements. Our aim was to report the long-term results, including quality of life, from a multicentre trial in Europe and Canada. METHODS AND RESULTS: From October 2007 to April 2009, 71 patients (24 female; median age 19.0 [IQR: 14.0 to 25.0] years) were enrolled in a prospective cohort study...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#14
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28191267/single-cell-digital-polymerase-chain-reaction-on-self-priming-compartmentalization-chip
#15
Qiangyuan Zhu, Lin Qiu, Yanan Xu, Guang Li, Ying Mu
Single cell analysis provides a new framework for understanding biology and disease, however, an absolute quantification of single cell gene expression still faces many challenges. Microfluidic digital polymerase chain reaction (PCR) provides a unique method to absolutely quantify the single cell gene expression, but only limited devices are developed to analyze a single cell with detection variation. This paper describes a self-priming compartmentalization (SPC) microfluidic digital polymerase chain reaction chip being capable of performing single molecule amplification from single cell...
January 2017: Biomicrofluidics
https://www.readbyqxmd.com/read/28186686/combined-bone-marrow-derived-mesenchymal-stromal-cell-therapy-and-one-way-endobronchial-valve-placement-in-patients-with-pulmonary-emphysema-a-phase-i-clinical-trial
#16
Hugo Goulart de Oliveira, Fernanda Ferreira Cruz, Mariana Alves Antunes, Amarilio Vieira de Macedo Neto, Guilherme Augusto Oliveira, Fabio Munhoz Svartman, Tamara Borgonovo, Carmen Lucia Kuniyoshi Rebelatto, Daniel J Weiss, Paulo Roberto Slud Brofman, Marcelo Marcos Morales, José Roberto Lapa E Silva, Patricia Rieken Macedo Rocco
One-way endobronchial valves (EBV) insertion to reduce pulmonary air trapping has been used as therapy for chronic obstructive pulmonary disease (COPD) patients. However, local inflammation may result and can contribute to worsening of clinical status in these patients. We hypothesized that combined EBV insertion and intrabronchial administration of mesenchymal stromal cells (MSCs) would decrease the inflammatory process, thus mitigating EBV complications in severe COPD patients. This initial study sought to investigate the safety of this approach...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28146260/quality-of-life-outcomes-after-transcatheter-aortic-valve-replacement-in-an-unselected-population-a-report-from-the-sts-acc-transcatheter-valve-therapy-registry
#17
Suzanne V Arnold, John A Spertus, Sreekanth Vemulapalli, Zhuokai Li, Roland A Matsouaka, Suzanne J Baron, Amit N Vora, Michael J Mack, Matthew R Reynolds, John S Rumsfeld, David J Cohen
Importance: In clinical trials, transcatheter aortic valve replacement (TAVR) has been shown to improve symptoms and quality of life. As this technology moves into general clinical practice, evaluation of the health status outcomes among unselected patients treated with TAVR is of critical importance. Objective: To examine the short- and long-term health status outcomes of surviving patients after TAVR in the context of an unselected population. Design, Setting, and Participants: This observational cohort study included patients with severe aortic stenosis who underwent TAVR in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry from November 1, 2011, to March 31, 2016, at more than 450 clinical sites...
February 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28144064/re-discovering-the-heimlich-valve-old-wine-in-a-new-bottle
#18
Ajay Narasimhan, Shivanraj Ayyanathan, Late Rajavenkatesh Krishnamoorthy
A 14-year-old boy came to our outpatient department with pleuritic chest pain and dyspnea. He was found to have a loculated empyema on the right side. He was taken up for surgery and decortication was done. He developed air leak in the postoperative period. When the air leak did not settle until the 10(th) day, we decided to attach the atrium Pneumostat(™), a modified version of the Heimlich valve to his Intercostal drainage tube and sent him home. On further follow-up, his lung expanded, and ICD could be removed...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#19
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28078376/ipsilateral-dual-site-same-sitting-percutaneous-lung-biopsy-a-feasibility-study
#20
Joseph Barnett, Aniket N Tavare, Sajid Khan, Ashish Saini, Dean D Creer, Samanjit S Hare
PURPOSE: Patients with thoracic malignancies often have more than one site of pulmonary, nodal or pleural disease within one hemithorax. In addition, large heterogeneous lesions may comprise distinct, mixed pathological entities. Histological analysis of these lesions can alter tumour staging and treatment options. We investigated the feasibility, safety and benefit of performing image-guided percutaneous lung biopsy (PLB) of two lesions in the same hemithorax at a single sitting. MATERIALS AND METHODS: Ten consecutive outpatients with two or more potential disease foci within the same hemithorax were analysed over a 15-month period...
January 11, 2017: Cardiovascular and Interventional Radiology
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