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Chest pain clinic

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https://www.readbyqxmd.com/read/27911474/is-chelation-therapy-efficient-for-the-treatment-of-intravenous-metallic-mercury-intoxication
#1
Daniela Pelclova, Stepanka Vlckova, Ondrej Bezdicek, Manuela Vaneckova, Pavel Urban, Petr Ridzon, Pavel Diblik, Tomas Navratil, Pavlina Klusackova, Kamil Vlcek, Olga Benesova, Pavel Trestik, Jiri Homolka, Sergey Zakharov
The efficacy of treatment for intravenous elemental mercury intoxication has not been fully studied with regard to clinical outcomes, and treatment recommendations vary. We treated a 41-year-old man with a history of drug abuse and depression who attempted suicide using 1 mL (13.53 g) metallic Hg i.v. He was admitted to the hospital two months later for dyspnoea and thoracic pain and was diagnosed with pneumonia. Hg deposits were seen in the lungs and extra-pulmonary organs. His blood level (372 μg/L) exceeded the population level of 5 μg/L by more than 70-fold...
December 2, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27899352/evaluation-of-computed-tomography-in-patients-with-atypical-angina-or-chest-pain-clinically-referred-for-invasive-coronary-angiography-randomised-controlled-trial
#2
(no author information available yet)
No abstract text is available yet for this article.
November 29, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27899323/comparison-of-endoscopic-submucosal-tunneling-dissection-and-thoracoscopic-enucleation-for-the-treatment-of-esophageal-submucosal-tumors
#3
Qing-Yuan Li, Yu-Yuan Xu, Wei Gong, Qiang Zang, Jian-Qun Cai, Haitao Qing, Zelong Han, Aimin Li, Si-de Liu, Yue Li
BACKGROUND: Endoscopic submucosal tunneling dissection (ESTD) has been proved to be safe and effective for removal of esophageal submucosal tumors (SMTs) and can maintain the mucosal integrity compared with other endoscopic methods. The aim of the study was to estimate the safety and efficacy of ESTD as well as compare its efficacy with thoracoscopic enucleation for esophageal SMTs, which is used increasingly as a minimally invasive approach. METHODS: We retrospectively collected the clinical data of the patients with esophageal SMTs smaller than 40 mm who underwent ESTD or thoracoscopic enucleation at Nanfang hospital between January 2008 and August 2016...
November 26, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27899132/cardiac-t1-mapping-and-extracellular-volume-ecv-in-clinical-practice-a-comprehensive-review
#4
REVIEW
Philip Haaf, Pankaj Garg, Daniel R Messroghli, David A Broadbent, John P Greenwood, Sven Plein
Cardiovascular Magnetic Resonance is increasingly used to differentiate the aetiology of cardiomyopathies. Late Gadolinium Enhancement (LGE) is the reference standard for non-invasive imaging of myocardial scar and focal fibrosis and is valuable in the differential diagnosis of ischaemic versus non-ischaemic cardiomyopathy. Diffuse fibrosis may go undetected on LGE imaging. Tissue characterisation with parametric mapping methods has the potential to detect and quantify both focal and diffuse alterations in myocardial structure not assessable by LGE...
November 30, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27896227/stress-first-single-photon-emission-computed-myocardial-perfusion-imaging
#5
C I Aquino, M Scarano, F Squame, G Casaburi, S L Nori, L Pace
BACKGROUND: Myocardial perfusion imaging (MPI) with single photon emission tomography (SPET) is widely used in coronary artery disease evaluation. Recently major dosimetric concerns have arisen. The aim of this study was to evaluate if a pre-test scoring system could predict the results of stress SPET MPI, thus avoiding two radionuclide injections. METHODS: All consecutive patients (n=309) undergoing SPET MPI during the first 6 months of 2014 constituted the study group...
November 2016: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/27894070/the-strategy-study-stress-cardiac-magnetic-resonance-versus-computed-tomography-coronary-angiography-for-the-management-of-symptomatic-revascularized-patients-resources-and-outcomes-impact
#6
Gianluca Pontone, Daniele Andreini, Andrea I Guaricci, Cristina Rota, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Virginia Beltrama, Laura Fusini, Anna Solbiati, Chiara Segurini, Edoardo Conte, Paola Gripari, Andrea Annoni, Alberto Formenti, Maria Petulla', Federico Lombardi, Giuseppe Muscogiuri, Antonio L Bartorelli, Mauro Pepi
BACKGROUND: Computed tomography coronary angiography (cTCA) and stress cardiac magnetic resonance (stress-CMR) are suitable tools for diagnosing obstructive coronary artery disease in symptomatic patients with previous history of revascularization. However, performance appraisal of noninvasive tests must take in account the consequent diagnostic testing, invasive procedures, clinical outcomes, radiation exposure, and cumulative costs rather than their diagnostic accuracy only. We aimed to compare an anatomic (cTCA) versus a functional (stress-CMR) strategy in symptomatic patients with previous myocardial revascularization procedures...
October 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27892881/comparison-of-visual-assessment-of-coronary-stenosis-with-independent-quantitative-coronary-angiography-findings-from-the-prospective-multicenter-imaging-study-for-evaluation-of-chest-pain-promise-trial
#7
Rohan Shah, Eric Yow, William Schuyler Jones, Louis P Kohl, Andrzej S Kosinski, Udo Hoffmann, Kerry L Lee, Christopher B Fordyce, Daniel B Mark, Alicia Lowe, Pamela S Douglas, Manesh R Patel
: The outcomes in patients by visual assessment and quantitative coronary angiography (QCA) for obstructive coronary artery disease (CAD) are not known. Our objectives were to compare visual and QCA estimates of obstructive CAD and to assess their relationship to outcomes in stable patients with symptoms of CAD. METHODS: The PROMISE trial randomized 10,003 patients with CAD symptoms to anatomical or functional testing. Site reports of invasive angiography detailing visual stenosis and independent, blinded QCA were performed for obstructive CAD (≥50% stenosis)...
October 26, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892622/changes-in-physician-practice-patterns-after-implementation-of-a-communication-and-resolution-program
#8
Lorens A Helmchen, Bruce L Lambert, Timothy B McDonald
OBJECTIVE: To test if a 2006 communication-and-resolution program to address unexpected adverse outcomes was associated with changes in cost and use trajectories. DATA SOURCE: Records of patients discharged with a principal diagnosis of chest pain from 44 nonfederal general hospitals in Cook County, Illinois, between January 2002 and December 2009. STUDY DESIGN: Propensity-score matched discharges from the intervention and comparison hospitals before computing difference-in-differences estimates of quarterly growth rates...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27890699/ayurvedic-management-of-spondyloepiphyseal-dysplasia-tarda-a-rare-hereditary-disorder
#9
Sarvesh Kumar Singh, Kshipra Rajoria
Spondyloepiphyseal dysplasia tarda (SEDT) is a rare genetic disease in which patient suffers from short stature, short trunk and neck with disproportionately long arms, coxa vara, skeletal features such as barrel shaped chest, kyphosis, scoliosis and early arthropathy. Only limited medical and surgical management is available in modern medicine. A 15 years old male suffering from SEDT and diagnosed as Vata vyadhi was treated with Panchakarma therapy and selected Ayurvedic oral medicines. Ayurvedic treatment was directed to ameliorate the orthopaedic clinical conditions in this case...
November 25, 2016: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/27889211/takotsubo-cardiomyopathy-associated-with-epinephrine-use-a-systematic-review-and-meta-analysis
#10
Salik Nazir, Saroj Lohani, Niranjan Tachamo, Sushil Ghimire, Dilli Ram Poudel, Anthony Donato
BACKGROUND: Takotsubo cardiomyopathy is a syndrome of transient cardiac dysfunction that is frequently associated with sudden emotional or physical stress. Epinephrine use has been implicated in precipitating Takotsubo cardiomyopathy in multiple case reports and case series. We sought to systematically review the current English literature on this association. METHODS: We searched relevant articles on Takotsubo cardiomyopathy associated with epinephrine administration and extracted data on demographic characteristics, clinical features, investigations and clinical outcomes...
November 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#11
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27887648/the-potential-hazard-of-drug-eluting-stent-induced-coronary-vasospasm-causing-subacute-stent-thrombosis-a-case-report
#12
Hiroki Shibutani, Yuzo Akita, Yumie Matsui, Masahiro Yoshinaga, Masahiro Karakawa
BACKGROUND: Drug-eluting stent (DES) -induced coronary vasospasm is a well known phenomenon after stent implantation; however, the extent of this risk is still unknown. We report a case in which DES-induced severe coronary vasospasm was clinically suspected as a cause of subacute stent thrombosis (ST). CASE PRESENTATION: A 67-year-old man came to our hospital due to chest pain with mild exercise. He was diagnosed with effort angina by coronary angiography and underwent DES implantation in the mid-left ascending artery (LAD) after the administration of dual anti-platelet therapy...
November 25, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27885658/early-skin-to-skin-contact-for-mothers-and-their-healthy-newborn-infants
#13
REVIEW
Elizabeth R Moore, Nils Bergman, Gene C Anderson, Nancy Medley
BACKGROUND: Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27884628/skirt-followed-by-trouser-stenting-technique-true-anatomical-preservation-of-coronary-y-shaped-bifurcation-lesions-while-using-vanishing-bioresorbable-scaffolds-a-report-of-two-cases
#14
Wael Elabbassi, Arif Al Nooryani
We report on two cases in which Y-shaped coronary bifurcations were treated with the use of Bioresorbable scaffolds. The first case was of a 50-year-old man with NSTEMI. Coronary angiography showed stenosis involving a Y-shaped bifurcation of proximal to mid LAD and diagonal. The lesion was wired using two 0.14 BMW guide wires, followed by serial pre-dilatation of LAD and Diagonal branch. The stent into proximal LAD was deployed first as a skirt (3.5 × 12 BVS). Stent was post-dilated. A second 2.5 × 28 BVS was deployed into diagonal branch, protruding backwards; along with a 2...
November 3, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27881012/elevated-aspartate-aminotransferase-and-monocyte-counts-predict-unfavorable-prognosis-in-patients-with-malignant-pleural-mesothelioma
#15
A Zhang, S Cao, S Jin, J Cao, J Shen, B Pan, R Zhu, Y Yu
Limited biomarkers predicting prognosis of malignant pleural mesothelioma (MPM) have been identified. The present study aims to assess potential laboratory prognostic factors of MPM. We retrospectively reviewed the clinical data of 105 patients with MPM. The overall survival and prognostic factors were assessed by Kaplan-Meier curves and Cox regression analysis. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values. The mean age of the 105 patients (62 men, 43 women) was 56...
November 24, 2016: Neoplasma
https://www.readbyqxmd.com/read/27880056/bronchial-biopsy-and-reactivity-in-patients-with-chest-tightness-relieved-with-bronchodilator
#16
Hirokazu Taniguchi, Hideaki Furuse, Yuko Nakanishi, Takeshi Tsuda, Kiyoto Totsuka, Yasuaki Masaki, Kensuke Suzuki, Shin Ishizawa, Hideki Miyazawa
OBJECTIVE: It has been hypothesized that some patients with chest tightness of unknown origin can be successfully treated with a bronchodilator and that they should be diagnosed with chest pain variant asthma. We conducted a prospective study to characterize newly diagnosed patients with chest tightness relieved with bronchodilator use and without characteristic bronchial asthma attacks. METHODS: Eleven patients were registered following recurrent positive responses of chest tightness to inhalation of a ß2-agonist...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27879583/breast-tissue-expanders-with-magnetic-ports-clinical-experience-at-1-5-t
#17
Nanda Deepa Thimmappa, Martin R Prince, Kari L Colen, Christina Y Ahn, Silvina P Dutruel, Srikanth R Boddu, David T Greenspun, Julie V Vasile, Constance M Chen, Hakan Usal, Christine H Rohde, Jeremiah S Redstone, Maria M LoTempio, Oren Z Lerman, Anik K Nath, Robert J Allen, Joshua L Levine
BACKGROUND: The purpose of this study was to evaluate breast tissue expanders with magnetic ports for safety in patients undergoing abdominal/pelvic magnetic resonance angiography before autologous breast reconstruction. METHODS: Magnetic resonance angiography of the abdomen and pelvis at 1.5 T was performed in 71 patients in prone position with tissue expanders with magnetic ports labeled "MR Unsafe" from July of 2012 to May of 2014. Patients were monitored during magnetic resonance angiography for tissue expander-related symptoms, and the chest wall tissue adjacent to the tissue expander was examined for injury at the time of tissue expander removal for breast reconstruction...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27879464/severe-pleuropulmonary-paragonimiasis-caused-by-paragonimus-mexicanus-treated-as-tuberculosis-in-ecuador
#18
Manuel Calvopina, Daniel Romero-Alvarez, Rubén Macias, Hiromu Sugiyama
A 30-year-old male, from a subtropical region of Ecuador, was hospitalized with a 5-year history of persistent cough with rusty brown sputum, chest pain, and progressive dyspnea. The patient underwent thoracic surgery 3 years ago for pleural effusion and subsequently received a 9-month regimen treatment of tuberculosis. However, there was no clinical resolution and symptoms became progressively worse. A chest radiograph and computerized tomography scan showed several small nodules in both lungs. Eggs of Paragonimus spp...
November 22, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27876330/pneumomediastinum-pneumothorax-and-subcutaneous-emphysema-caused-by-colonoscopic-perforation-a-report-of-two-cases
#19
Pyong Wha Choi
BACKGROUND: Although colonoscopy is generally a safe procedure, lethal complications can occur. Colonoscopic perforation is one of the most serious complications, and it can present with various clinical symptoms and signs. Aggravating abdominal pain and free air on simple radiography are representative clinical manifestations of colonoscopic perforation. However, unusual symptoms and signs, such as dyspnea and subcutaneous emphysema, which are less likely to be related with complicating colonoscopy, may obscure correct clinical diagnosis...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27875728/exercise-induced-pulmonary-hypertension-by-stress-echocardiography-prevalence-and-correlation-with-right-heart-hemodynamics
#20
Deepika Misra, Ante Kendes, Roxana Sulica, Blase Carabello
OBJECTIVES: The aim of this study was to determine the prevalence of exercise-induced pulmonary hypertension (EIPH) in consecutive subjects referred for stress echocardiography for chest pain or shortness of breath and correlate echocardiographic diagnosis of EIPH with hemodynamics at right heart catheterization (RHC). BACKGROUND: Elevated pulmonary pressure can lead to significant morbidity and mortality. EIPH by ehocardiography has been described in patients with connective tissue disease...
November 9, 2016: International Journal of Cardiology
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