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https://www.readbyqxmd.com/read/28329616/a-chronic-bleeding-and-painful-nodule-on-the-chest
#1
Isadore Tarantino, Garth Fraga, Ryan Fischer
An 81-year-old man presented to the dermatology clinic with a painful lesion on his chest. The nodule would occasionally bleed and leak serous fluid for 10 years. Physical examination revealed an unspecified nodule with two superimposed nodules. A deep shave biopsy of the lesion was obtained and expressed a solid-cystic dermal neoplasm that was comprised of an admixture of cell types. Through the presenting clinical and histological features seen, a final diagnosis of nodular hidradenoma was made.
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28327204/lung-adenocarcinoma-with-thyroid-metastasis-a-case-report
#2
A Dao, H Jabir, A Taleb, N Benchakroun, Z Bouchbika, T Nezha, H Jouhadi, S Sahraoui, A Benider
BACKGROUND: The metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases. CASE PRESENTATION: Three years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28325612/cost-effectiveness-of-high-sensitivity-troponin-compared-to-conventional-troponin-among-patients-presenting-with-undifferentiated-chest-pain-a-trial-based-analysis
#3
Billingsley Kaambwa, Julie Ratcliffe, Matthew Horsfall, Carolyn Astley, Jonathan Karnon, Penelope Coates, Margaret Arstall, Christopher Zeitz, Matthew Worthley, John Beltrame, Derek P Chew
BACKGROUND: Patients with low and intermediate risk chest pain features comprise the greatest proportion presenting to emergency services for evaluation of suspected acute coronary syndromes (ACS). The efficient and timely identification of patients with these features remains a major challenge within clinical practice. Troponin assays are increasingly being used for the determination of risk among patients presenting with chest pain potentially facilitating more appropriate care. To date, no economic evaluation comparing high-sensitivity troponin T (hs-TnT) reporting to standard troponin T (c-TnT) reporting in the routine management of suspected ACS and based on longer-term clinical outcomes has been conducted...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28323374/characteristics-of-short-stay-critical-care-admissions-from-emergency-departments-in-maryland
#4
Obiora O Chidi, Sarah M Perman, Adit A Ginde
OBJECTIVES: Critical care is an expensive and limited resource, and short stay critical care admissions may be treated in alternate, less costly settings. This study objective was to determine the proportion of critical care admissions with a short critical care length of stay and identify the clinical characteristics and diagnoses associated with high and low rates of short stay critical care admissions. METHODS: Secondary analysis of the 2011 Maryland State Inpatient Database...
March 21, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28321775/presence-and-extent-of-cardiac-computed-tomography-angiography-defined-coronary-artery-disease-in-patients-presenting-with-syncope
#5
S Altintas, T Dinh, N G H M Marcks, M Kok, A J J Aerts, B Weijs, Y Blaauw, J E Wildberger, M Das, B L J H Kietselaer, H J G M Crijns
BACKGROUND: In syncope patients, presence of coronary artery disease (CAD) is associated with poor prognosis. However, data concerning CAD prevalence in syncope patients without known cardiovascular disease are lacking. Therefore, the aim of this study was to investigate presence and extent of CAD in syncope patients. METHODS: We included 142 consecutive patients presenting with syncope at the outpatient cardiology clinic who underwent coronary computed tomography (CT) angiography...
March 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28321355/a-rare-presentation-of-sarcoidosis-as-a-pancreatic-head-mass
#6
Shruti Mony, Pradnya D Patil, Rebekah English, Ananya Das, Daniel A Culver, Tanmay S Panchabhai
Sarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very rare, especially when it is the presenting feature of sarcoidosis and can masquerade as pancreatic cancer. Tissue infiltration in pancreatic sarcoidosis can lead to either a diffuse nodular appearance or a mass-like lesion...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28320636/the-significance-of-equivocal-exercise-treadmill-ecg-for-intermediate-risk-chest-pain-assessment-insight-from-coronary-ct-angiography-data
#7
Gary T E Lau, Henry Wei, Jo Wickham, Andrew C Y To
BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#8
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#9
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28299808/pneumopericardium-as-a-rare-complication-after-esophagopericardial-fistula
#10
Hai-Qin Liao, Dan Zhou, Quan-Liang Shang, Yi-Fan Shi, Ming Zhang
Pneumopericardium is a rare clinical entity which is often complicated by trauma. Pneumoperdicardium resulting after esophagopericardial fistula is much rarer. We present a case of pneumopericardium as the complication of esophagopericardial fistula in a 53-year-old man. After undergoing radiotherapy for 26 times, the patient got a fever and an unspecified thoracic pain. Echocardiography showed the rectilinear echoes in the pericardium. Chest computed tomography revealed pneumopericardium, pericardial effusion, recurrence of lung cancer, and pneumonia in right lower and left lung...
March 16, 2017: Echocardiography
https://www.readbyqxmd.com/read/28297814/-igg4-related-lung-disease-analysis-of-8-cases-and-literature-review
#11
G J Han, H Hu, D Mao, X Bai, D Y She, S F Zhao, Z L Wen, J Gao
Objective: To improve the understanding and treatment of IgG4-related lung disease (IgG4-RLD). Methods: The clinical characteristics, serum IgG4 levels, pathological features, chest CT, therapy and prognosis of 8 patients with IgG4-RLD were retrospectively analyzed. These patients were admitted to the People's Liberation Army General Hospital and the pathological diagnosis was made between December 2005 and March 2016. Relevant literatures were reviewed. Results: The 8 patients with IgG4-RLD included 4 men and 4 women, with an average age of (59±4) years (range, 37-74)...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#12
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#13
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28293403/hydroxycarbamine-from-an-old-drug-used-in-malignant-hemopathies-to-a-current-standard-in-sickle-cell-disease
#14
REVIEW
Giovanna Cannas, Solène Poutrel, Xavier Thomas
While hydroxycarbamide (hydroxyurea, HU) has less and fewer indications in malignant hemopathies, it represents the only widely used drug which modifies sickle cell disease pathogenesis. Clinical experience with HU for patients with sickle cell disease has been accumulated over the past 25 years in Western countries. The review of the literature provides increasing support for safety and efficacy in both children and adults for reducing acute vaso-occlusive events including pain episodes and acute chest syndrome...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28292858/predictive-value-of-age-and-sex-specific-nomograms-of-global-plaque-burden-on-coronary-computed-tomography-angiography-for-major-cardiac-events
#15
Christopher Naoum, Daniel S Berman, Amir Ahmadi, Philipp Blanke, Heidi Gransar, Jagat Narula, Leslee J Shaw, Leonard Kritharides, Stephan Achenbach, Mouaz H Al-Mallah, Daniele Andreini, Matthew J Budoff, Filippo Cademartiri, Tracy Q Callister, Hyuk-Jae Chang, Kavitha Chinnaiyan, Benjamin Chow, Ricardo C Cury, Augustin DeLago, Allison Dunning, Gudrun Feuchtner, Martin Hadamitzky, Joerg Hausleiter, Philipp A Kaufmann, Yong-Jin Kim, Erica Maffei, Hugo Marquez, Gianluca Pontone, Gilbert Raff, Ronen Rubinshtein, Todd C Villines, James Min, Jonathon Leipsic
BACKGROUND: Age-adjusted coronary artery disease (CAD) burden identified on coronary computed tomography angiography predicts major adverse cardiovascular event (MACE) risk; however, it seldom contributes to clinical decision making because of a lack of nomographic data. We aimed to develop clinically pragmatic age- and sex-specific nomograms of CAD burden using coronary computed tomography angiography and to validate their prognostic use. METHODS AND RESULTS: Patients prospectively enrolled in phase I of the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes) were included (derivation cohort: n=21,132; 46% female) to develop CAD nomograms based on age-sex percentiles of segment involvement score (SIS) at each year of life (40-79 years)...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28292305/possible-misdiagnosis-of-hiv-associated-lymphoma-as-tuberculosis-among-patients-attending-uganda-cancer-institute
#16
Paul Buyego, Lydia Nakiyingi, Henry Ddungu, Stephen Walimbwa, Damalie Nalwanga, Steven J Reynolds, Rosalind Parkes-Ratanshi
BACKGROUND: Early diagnosis of HIV associated lymphoma is challenging because the definitive diagnostic procedure of biopsy, requires skills and equipment that are not readily available. As a consequence, diagnosis may be delayed increasing the risk of mortality. We set out to determine the frequency and risk factors associated with the misdiagnosis of HIV associated lymphoma as tuberculosis (TB) among patients attending the Uganda Cancer Institute (UCI). METHODS: A retrospective cohort study design was used among HIV patients with associated lymphoma patients attending the UCI, Kampala, Uganda between February and March 2015...
March 14, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28291726/change-in-angiogram-derived-management-strategy-of-patients-with-chest-pain-when-some-ffr-data-are-available-how-consistent-is-the-effect
#17
Vinayak Nagaraja, Mamas Mamas, Michael Mahmoudi, Campbell Rogers, Nick Curzen
BACKGROUND: The assessment of patients presenting with angina using invasive angiography alone is imperfect. By contrast, fractional flow reserve (FFR) allows for assessment of lesion-specific ischemia, which is predictive of clinical outcome. A series of studies has demonstrated that the availability of FFR data at the time of diagnostic angiography leads to significant differences in the management of those patients. HYPOTHESIS: The objective of this paper is to describe assess the consistency in the difference in management resulting from an FFR-directed versus and angiogram-directed strategy in appropriate observational and randomized trials...
February 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28290973/total-artificial-heart-implantation-as-a-bridge-to-heart-transplantation-in-an-active-duty-service-member-with-amyloid-cardiomyopathy
#18
Michael S Scully, Dylan E Wessman, James M McKee, Gregory M Francisco, Keshav R Nayak, Jon A Kobashigawa
INTRODUCTION: Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290782/prognostic-value-of-combined-ct-angiography-and-myocardial-perfusion-imaging-versus-invasive-coronary-angiography-and-nuclear-stress-perfusion-imaging-in-the-prediction-of-major-adverse-cardiovascular-events-the-core320-multicenter-study
#19
Marcus Y Chen, Carlos E Rochitte, Armin Arbab-Zadeh, Marc Dewey, Richard T George, Julie M Miller, Hiroyuki Niinuma, Kunihiro Yoshioka, Kakuya Kitagawa, Hajime Sakuma, Roger Laham, Andrea L Vavere, Rodrigo J Cerci, Vishal C Mehra, Cesar Nomura, Klaus F Kofoed, Masahiro Jinzaki, Sachio Kuribayashi, Arthur J Scholte, Michael Laule, Swee Yaw Tan, John Hoe, Narinder Paul, Frank J Rybicki, Jeffrey A Brinker, Andrew E Arai, Matthew B Matheson, Christopher Cox, Melvin E Clouse, Marcelo F Di Carli, João A C Lima
Purpose To compare the prognostic importance (time to major adverse cardiovascular event [MACE]) of combined computed tomography (CT) angiography and CT myocardial stress perfusion imaging with that of combined invasive coronary angiography (ICA) and stress single photon emission CT myocardial perfusion imaging. Materials and Methods This study was approved by all institutional review boards, and written informed consent was obtained. Between November 2009 and July 2011, 381 participants clinically referred for ICA and aged 45-85 years were enrolled in the Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Row Computed Tomography (CORE320) prospective multicenter diagnostic study...
March 14, 2017: Radiology
https://www.readbyqxmd.com/read/28289555/gender-differences-in-post-traumatic-stress
#20
Maria Grazia Modena, Daniele Pettorelli, Giulia Lauria, Elisa Giubertoni, Erminio Mauro, Valentina Martinotti
Acute stress can trigger cardiovascular events and disease. The earthquake is an "ideal" natural experiment for acute and chronic stress, with impact mainly on the cardiovascular system. On May 20th and 29th, 2012, two earthquakes of magnitude 5.9° to 6.4° on the Richter scale, hit the province of Modena and Reggio Emilia, an area of the north-center of Italy never considered at seismic risk. The purpose of our study was to assess whether there were gender-specific differences in stress-induced incidence of cardiovascular events and age of patients who arrived at the Emergency Departments (ED) of the three main teaching hospitals of the University of Modena and Reggio Emilia...
2017: BioResearch Open Access
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