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https://www.readbyqxmd.com/read/28529261/clinical-implications-of-electrocardiograms-for-patients-with-type-a-acute-aortic-dissection
#1
Masami Kosuge, Kazuo Kimura, Keiji Uchida, Munetaka Masuda, Kouichi Tamura
Type A acute aortic dissection (AAD) is a serious cardiovascular emergency requiring urgent surgery. Timely accurate diagnosis is essential, but often challenging, because of the wide spectrum of clinical presentations. In patients with type A AAD, chest pain is the most common symptom; furthermore, ischemic ST-T changes such as ST-segment elevation or depression or negative T waves are frequently observed on presentation ECG. These clinical presentations of type A AAD are difficult to differentiate from those of acute coronary syndrome (ACS), which could lead to delayed diagnosis and treatment of type A AAD or misdiagnosis of ACS followed by inappropriate treatment...
May 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28522279/-stereotactic-lung-radiotherapy-technical-setting-up-on-novalis-tx-%C3%A2-and-single-centre-prospective-study-of-the-100-first-malignant-pulmonary-nodules-treated-at-centre-jean-perrin
#2
A Bellière-Calandry, G Dupic, F Magnier, V Chassin, V Dedieu, M Lapeyre
PURPOSE: Description of the treatment technique of stereotactic lung radiotherapy on Novalis Tx(®) and prospective study of the first 100 pulmonary nodules treated at centre Jean-Perrin (France). MATERIAL AND METHODS: From October 2012 to December 2015, 100 inoperable pulmonary nodules (62 stage I non-small-cell lung cancer and 38 metastases) of 90 patients with a mean age of 68.2 years (range: 46-89 years) were prospectively treated with dynamic arctherapy on Novalis Tx(®)...
May 15, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28520537/anomalous-origin-of-right-coronary-artery-from-left-coronary-sinus-13-cases-treated-with-the-reimplantation-technique
#3
Alain Cubero, Alejandro Crespo, Gadah Hamzeh, Andrés Cortes, Daniel Rivas, José Ignacio Aramendi
OBJECTIVES: Anomalous aortic origin of a coronary artery is uncommon but potentially clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe our experience with surgical reimplantation and results at midterm follow-up. METHODS: Between February 2003 and July 2016, a total of 13 patients with anomalous origin of the right coronary artery (RCA) from the left sinus underwent surgical reimplantation...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28515919/programmed-death-ligand-1-expression-is-associated-with-fibrosarcomatous-transformation-of-dermatofibrosarcoma-protuberans
#4
Kenji Tsuchihashi, Hitoshi Kusaba, Yuichi Yamada, Yuta Okumura, Hozumi Shimokawa, Masato Komoda, Keita Uchino, Tomoyasu Yoshihiro, Nobuhiro Tsuruta, Fumiyasu Hanamura, Kyoko Inadomi, Mamoru Ito, Kosuke Sagara, Michitaka Nakano, Kenta Nio, Shuji Arita, Hiroshi Ariyama, Kenichi Kohashi, Ryuji Tominaga, Yoshinao Oda, Koichi Akashi, Eishi Baba
Dermatofibrosarcoma protuberans (DFSP) is a locally invading tumor, characterized by the presence of the collagen type I α 1 (COL1A1)-platelet-derived growth factor (PDGF) β fusion gene. We herein report the case of a 31-year-old man with a history of resection of an abdominal wall DFSP. The patient presented with chest pain and a computed tomography scan revealed a large mass in the posterior mediastinum and another mass in the right lung. The mediastinal mass was a sarcomatous lesion expressing the COL1A1-PDGFβ fusion gene, suggesting that it represented a metastasis of the DFSP following fibrosarcomatous (FS) transformation...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28514823/-fulminant-course-of-a-clostridium-perfringens-infection-with-pathognomonic-ct-finding
#5
Christoph Alexander Stückle, Christopher Sonntag, Magdalena Kulik, Thorsten Nitschke
History and clinical findings A 74-year old woman was accepted by the emergency room with severe chest and abdominal pain. She complained about regurgitation after ingestion of food followed by sharp pain in her breast. Investigations A first examination of the patient showed a tachypnoea und tachycardia up to 122 beats per minute, the body temperature measured on admission was 38.7 °C. Due to hemolysis only a few of the requested parameters could be evaluated. CRP was increased with 8.32 mg/dl. The hemoglobin dropped from 12...
May 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28512745/implementation-of-multi-disciplinary-care-reduces-maternal-mortality-in-women-with-sickle-cell-disease-living-in-low-resource-setting
#6
Eugenia Vicky Asare, Edeghonghon Olayemi, Theodore Boafor, Yvonne Dei-Adomakoh, Enoch Mensah, Harriet Ghansah, Yvonne Osei-Bonsu, Selina Crabbe, Latif Musah, Charles Hayfron-Benjamin, Brittany Covert, Adetola A Kassim, Andra James, Mark Rodeghier, Michael R DeBaun, Samuel A Oppong
Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic...
May 16, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#7
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28501373/evaluating-appropriate-use-of-pediatric-echocardiograms-for-chest-pain-in-outpatient-clinics
#8
Reid C Chamberlain, Jonathan H Pelletier, Sarah Blanchard, Christoph P Hornik, Kevin D Hill, Michael J Campbell
BACKGROUND: Echocardiography is often used in the evaluation of pediatric chest pain, but the incidence of cardiac pathology is low. In 2014, the American College of Cardiology published appropriate use criteria (AUC) for echocardiography including recommendations for pediatric chest pain. We evaluated the frequency and diagnostic yield of echocardiograms performed for each AUC indication and cost associated with echocardiograms performed for indications meeting the "rarely appropriate" criteria...
May 10, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28500860/interventions-for-preventing-silent-cerebral-infarcts-in-people-with-sickle-cell-disease
#9
REVIEW
Lise J Estcourt, Patricia M Fortin, Sally Hopewell, Marialena Trivella, Carolyn Doree, Miguel R Abboud
BACKGROUND: Sickle cell disease (SCD) is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. SCD can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Silent cerebral infarcts are the commonest neurological complication in children and probably adults with SCD. Silent cerebral infarcts also affect academic performance, increase cognitive deficits and may lower intelligence quotient...
May 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#10
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28499844/inconclusive-exercise-stress-echocardiography-in-patients-with-chest-pain-prevalence-and-clinical-determinants
#11
Pedro J Flores-Blanco, Francisco Cambronero, Miguel García-Navarro, Gonzalo de la Morena, Mariano Valdés, Sergio Manzano-Fernández
No abstract text is available yet for this article.
May 9, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28499407/early-neurosyphilis-presenting-with-facial-palsy-and-an-oral-ulcer-in-a-patient-who-is-human-immunodeficiency-virus-positive-a-case-report
#12
Evangeline Njiru, Jamil Abdulkadir, Zipporah Kamuren, Gabriel Kigen
BACKGROUND: Neurosyphilis is the tertiary stage of Treponema pallidum infection that involves the central nervous system, which occurs within days or weeks after an initial syphilis infection, especially in immunocompromised patients. The diagnosis of neurosyphilis is quite challenging as it is uncommon and often presents with obscure symptoms since any organ system may be involved. CASE PRESENTATION: We describe a case of a 40-year-old African man who is human immunodeficiency virus positive with early neurosyphilis who presented with a stiff neck, headache, confusion, restlessness, and a left-sided chest pain; he did not respond to an empiric treatment of ceftriaxone and fluconazole for meningitis, and tramadol for headache...
May 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28497381/deep-benign-fibrous-histiocytoma-of-the-anterior-mediastinum-mimicking-malignancy
#13
Angelica Puopolo, William Newmarch, Brian Casserly
The following report describes the case of a 43-year-old male smoker that was referred to the rapid access lung clinic with haemoptysis, chest pain, and axillary lymphadenopathy-a clinical picture that raised concern for a possible underlying malignancy. Preliminary investigations revealed elevated D-dimers, low-volume haemoptysis, and a normal chest X-ray, which lowered the index of suspicion. However, computed tomography (CT) pulmonary angiogram identified a right hilar mass, several parenchymal cysts, and a large mediastinal mass...
May 11, 2017: Lung
https://www.readbyqxmd.com/read/28496094/apical-hypertrophic-cardiomyopathy-case-report-and-literature-review
#14
Tanya Doctorian, William J Mosley, Bao Do
BACKGROUND Apical hypertrophic cardiomyopathy (ApHCM) is a relatively rare form of hypertrophic cardiomyopathy that predominantly affects the apex of the left ventricle and typically has a nonobstructive physiology. Its variable presentation and clinical course render ApHCM a commonly delayed or missed diagnosis. CASE REPORT A 53-year-old Caucasian woman presented with chronic progressive chest pain. She was initially started on treatment for acute coronary syndrome. Diagnosis of ApHCM was initially missed on echocardiography, but made on subsequent cardiac catheterization and cardiac MRI...
May 12, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28490326/the-clinical-epidemiology-of-fatigue-in-newly-diagnosed-heart-failure
#15
Brent A Williams
BACKGROUND: Fatigue is a common and distressing but poorly understood symptom among patients with heart failure (HF). This study sought to evaluate the prevalence, predictors, and prognostic value of clinically documented fatigue in newly diagnosed HF patients from the community. METHODS: This retrospective cohort study consisted of 12,285 newly diagnosed HF patients receiving health care services through the Geisinger Health System, with passive data collection through electronic medical records (EMR)...
May 11, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28489923/differences-of-microparticle-patterns-between-sickle-cell-anemia-and-hemoglobin-sc-patients
#16
Yohann Garnier, Séverine Ferdinand, Maryse Etienne-Julan, Gisèle Elana, Marie Petras, Lydia Doumdo, Benoit Tressières, Marie-Laure Lalanne-Mistrih, Marie-Dominique Hardy-Dessources, Philippe Connes, Marc Romana
Sickle cell anemia (SCA) and hemoglobin SC (HbSC) disease are the two most common forms of sickle cell disease (SCD), a frequent hemoglobinopathy which exhibits a highly variable clinical course. Although high levels of microparticles (MPs) have been consistently reported in SCA and evidence of their harmful impact on the SCA complication occurrences have been provided, no data on MP pattern in HbSC patients has been reported so far. In this study, we determined and compared the MP patterns of 84 HbSC and 96 SCA children, all at steady-state, using flow cytometry...
2017: PloS One
https://www.readbyqxmd.com/read/28489009/-vanishing-lungs-a-case-report
#17
Thorunn Halldora Thordardottir, Arni Jon Geirsson, Sif Hansdottir
A 55 year old female with rheumatoid arthritis who was repeatedly admitted to internal medicine for fever, shortness of breath and pleuritic chest pain. Laboratory work up showed normal WBC but elevated CRP and sedimentatation rate. Cultures were negative. Imaging studies revealed elevated diaphragms, bilateral atelectasis and pleural fluid but normal lung parenchyma. Lung function testing showed restriction. Anti-dsDNA and anti-Ro/SSA were elevated. A clinical diagnosis of anti-TNF-induced lupus secondary to infliximab and shrinking lung syndrome was made...
May 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28487318/impact-of-coronary-calcification-on-clinical-management-in-patients-with-acute-chest-pain
#18
Daniel O Bittner, Thomas Mayrhofer, Fabian Bamberg, Travis R Hallett, Sumbal Janjua, Daniel Addison, John T Nagurney, James E Udelson, Michael T Lu, Quynh A Truong, Pamela K Woodard, Judd E Hollander, Chadwick Miller, Anna Marie Chang, Harjit Singh, Harold Litt, Udo Hoffmann, Maros Ferencik
BACKGROUND: Coronary artery calcification (CAC) may impair diagnostic assessment of coronary computed tomography angiography (CTA). We determined whether CAC affects efficiency of coronary CTA in patients with suspected acute coronary syndrome (ACS). METHODS AND RESULTS: This is a pooled analysis of ACRIN-PA (American College of Radiology Imaging Network-Pennsylvania) 4005 and the ROMICAT-II trial (Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography) comparing an initial coronary CTA strategy to standard of care in acute chest pain patients...
May 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28484658/thermal-esophageal-injury-following-ingestion-of-boiling-mushroom-water
#19
Allison Prevost, Adam Talley, Emily Klepper, Elizabeth McDonough
Thermal esophageal and gastric damage from ingestion of hot liquids is poorly studied in pediatrics. Limited case reports exist in the literature. Many cases presented with chest pain, dysphagia, and odynophagia. Variable histologic findings were reported. No definitive management guidelines exist for such injuries. We provide a report of the acute assessment and management of an obvious thermal esophageal injury and contribute to what is known about this presentation. A 16-year-old male presented with odynophagia, dysphagia, and hematemesis following ingestion of "nearly boiling" mushroom water...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28483595/mefv-mutations-and-their-relation-to-major-clinical-symptoms-of-familial-mediterranean-fever
#20
Nilgun Cekin, Murat Eser Akyurek, Ergun Pinarbasi, Filiz Ozen
Familial Mediterranean fever is a common hereditary disease in Turkey. To date, different mutational spectrum of MEFV gene was observed in studies carried out in different regions of Turkey but in most of these studies association of clinical symptoms of FMF to mutant genotypes have not been investigated in details. Here we report the MEFV gene variations in exons 2, 3, 5 and 10 and their relations to major clinical symptoms of FMF in 514 unrelated (245 males and 269 females) Turkish patients. MEFV mutations were found in 45% (n=230) of patients and 55% (n=284) of patients did not have any mutations...
May 5, 2017: Gene
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