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https://www.readbyqxmd.com/read/28936949/-clinical-practice-guidelines-of-hap-vap-in-2016-the-updates
#1
Meizhu Lu, Yan Kang
Hospital acquired pneumonia (HAP) and ventilatorassociated pneumonia (VAP) are common hospital-acquired infections with higher mortality, longer hospital stay and more hospitalization expenses. With the latest research results and evidence-based guideline methodology, Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) have collaborated to create updated guidelines for the diagnosis and treatment of HAP and VAP in 2016. It is worth critically reading and thinking that most recommendations are supported by low-quality or very-low quality evidence and some strong recommendations is different from the actual clinical work in China...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936559/posterior-column-reconstruction-improves-fusion-rates-at-the-level-of-osteotomy-in-three-column-posterior-based-osteotomies
#2
Stephen J Lewis, Chandan Mohanty, Aaron M Gazendam, So Kato, Sam G Keshen, Noah D Lewis, Sofia P Magana, David Perlmutter, Jennifer Cape
PURPOSE: To determine the incidence of pseudarthrosis at the osteotomy site after three-column spinal osteotomies (3-COs) with posterior column reconstruction. METHODS: 82 consecutive adult 3-COs (66 patients) with a minimum of 2-year follow-up were retrospectively reviewed. All cases underwent posterior 3-COs with two-rod constructs. The inferior facets of the proximal level were reduced to the superior facets of the distal level. If that was not possible, a structural piece of bone graft either from the local resection or a local rib was slotted in the posterior column defect to re-establish continual structural posterior bone across the lateral margins of the resection...
September 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28935963/differentially-expressed-genes-and-canonical-pathways-in-the-ascending-thoracic-aortic-aneurysm-the-tampere-vascular-study
#3
Miska Sulkava, Emma Raitoharju, Ari Mennander, Mari Levula, Ilkka Seppälä, Leo-Pekka Lyytikäinen, Otso Järvinen, Thomas Illig, Norman Klopp, Nina Mononen, Reijo Laaksonen, Mika Kähönen, Niku Oksala, Terho Lehtimäki
Ascending thoracic aortic aneurysm (ATAA) is a multifactorial disease with a strong inflammatory component. Surgery is often required to prevent aortic rupture and dissection. We performed gene expression analysis (Illumina HumanHT-12 version 3 Expression BeadChip) for 32 samples from ATAA (26 without/6 with dissection), and 28 left internal thoracic arteries (controls) collected in Tampere Vascular study. We compared expression profiles and conducted pathway analysis using Ingenuity Pathway Analysis (IPA) to reveal differences between ATAA and a healthy artery wall...
September 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28934935/treatment-and-outcomes-of-tumor-induced-osteomalacia-associated-with-phosphaturic-mesenchymal-tumors-retrospective-review-of-12-patients
#4
Qing-Yao Zuo, Hong Wang, Wei Li, Xiao-Hui Niu, Yan-Hong Huang, Jia Chen, Yu-Hua You, Bao-Yue Liu, Ai-Min Cui, Wei Deng
BACKGROUND: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by severe hypophosphatemia and osteomalacia. Nonspecific symptoms make the diagnosis elusive. In addition, locating the responsible tumor(s) is challenging. The aim of this study was to investigate the clinical management and outcomes of TIO. METHODS: The clinical features, diagnostic procedures, treatment, and outcomes of 12 patients were reviewed retrospectively. RESULTS: The cohort comprised six men and six women (mean age 45...
September 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28933101/-discussion-on-relevant-theories-of-qi-blood-shen-and-formula-implication-of-guan-xin-jing-capsule
#5
Rui-Ping Li, Guo-Hua Yu, Jun-Fang Li, Shi-Huan Tang
In the field of traditional Chinese medicine(TCM),the definition of "Shen" contains a broad concept and a narrow concept. Broad "Shen" is the dominator and administrator of human vital movement,while narrow "Shen" means spirit, consciousness, thinking and emotions of human. "Shen" originates from innate essence of parents, and survives on acquired essence of water and food as well as the nutrition of its metaplastic Qi-Blood-Body fluid. Qi-Blood,the most precious asset of human body, is a quite important section of one person and the central material basis of "Shen-Zhi"...
November 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28932577/how-to-design-a-randomized-clinical-trial-tips-and-tricks-for-conduct-a-successful-study-in-thoracic-disease-domain
#6
Francesco Guerrera, Stéphane Renaud, Fabrizio Tabbò, Pier Luigi Filosso
Randomized controlled trials (RCTs) are considered one of the highest level of evidence in clinical practice, due to their strong confidence and robustness in producing data. The "randomization" (e.g., allocating patients randomly in each group of the study) allows eliminating many pre-analytical differences that might bias the entire study. Nevertheless, RCTs aren't free of internal pitfalls that might make them not easy to be developed or utilized. Our objective is to explain RCT management difficulties and suggest certain tips useful for the design of a RCT in thoracic disease domain...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932560/cost-and-effectiveness-of-lung-lobectomy-by-video-assisted-thoracic-surgery-for-lung-cancer
#7
Juan J Mafé, Beatriz Planelles, Santos Asensio, Jorge Cerezal, María-Del-Mar Inda, Javier Lacueva, Maria-Dolores Esteban, Luis Hernández, Concepción Martín, Benno Baschwitz, Ana M Peiró
BACKGROUND: Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. METHODS: A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932555/does-bioglue-contribute-to-anastomotic-pseudoaneurysm-after-thoracic-aortic-surgery
#8
Wei-Guo Ma, Bulat A Ziganshin, Chang-Fa Guo, Mohammad A Zafar, Richard S Sieller, Maryann Tranquilli, John A Elefteriades
BACKGROUND: Although bovine serum albumin-glutaraldehyde glue (BioGlue®) has been successfully used as a hemostatic adjunct in aortic surgical procedures, there are reports that it may lead to anastomotic pseudoaneurysm formation. We seek to examine if the use of BioGlue is associated with a high incidence of anastomotic pseudoaneurysm formation following surgical repair of thoracic aortic disease. METHODS: We reviewed the medical records and follow-up computed tomography (CT) scans of patients from 2001 to 2015 in whom BioGlue was used during surgical repair of thoracic aortic disease to detect postoperative anastomotic pseudoaneurysm formation...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931915/non-tuberculous-mycobacteria-isolated-from-pulmonary-samples-in-sub-saharan-africa-a-systematic-review-and-meta-analyses
#9
Catherine Okoi, Suzanne T B Anderson, Martin Antonio, Sarah N Mulwa, Florian Gehre, Ifedayo M O Adetifa
Pulmonary non-tuberculous mycobacterial (NTM) disease epidemiology in sub-Saharan Africa is not as well described as for pulmonary tuberculosis. Earlier reviews of global NTM epidemiology only included subject-level data from one sub-Saharan Africa country. We systematically reviewed the literature and searched PubMed, Embase, Popline, OVID and Africa Wide Information for articles on prevalence and clinical relevance of NTM detection in pulmonary samples in sub-Saharan Africa. We applied the American Thoracic Society/Infectious Disease Society of America criteria to differentiate between colonisation and disease...
September 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28931767/musical-instrument-associated-health-issues-and-their-management
#10
Kae Okoshi, Taro Minami, Masahiro Kikuchi, Yasuko Tomizawa
Playing musical instruments can bring joy to people, but can also cause a wide variety of health issues that range from mild disorders to potentially fatal conditions. Although sports medicine is an established medical subspecialty, relatively few studies have investigated the health issues associated with musical instruments. Here we present an overview of these health issues. These include infections due to microorganisms, allergic reactions, as well as mechanical injuries from sustained high pressures within the oral, mediastinal, thoracic, and abdominal cavities...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28931720/ph-control-in-the-midgut-of-aedesaegypti-under-different-nutritional-conditions
#11
Denise Barguil Nepomuceno, Vânia Cristina Santos, Ricardo Nascimento Araújo, Marcos Horácio Pereira, Maurício Roberto Sant'Anna, Luciano Andrade Moreira, Nelder Figueiredo Gontijo
Aedes aegypti is one of the most important disease vectors in the world. Because their gut is the first site of interaction with pathogens, it is important to understand A. aegypti gut physiology. In this study, we investigated the mechanisms of pH control in the midgut of A. aegypti females under different nutritional conditions. We found that unfed females have an acidic midgut (pH ∼6). The midgut of unfed insects is actively maintained at pH 6 regardless of the ingestion of either alkaline or acidic buffered solutions...
September 15, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28929388/fiber-reinforced-computational-model-of-the-aortic-root-incorporating-thoracic-aorta-and-coronary-structures
#12
Hossein Mohammadi, Raymond Cartier, Rosaire Mongrain
Cardiovascular diseases are still the leading causes of death in the developed world. The decline in the mortality associated with circulatory system diseases is accredited to development of new diagnostic and prognostic tools. It is well known that there is an inter relationship between the aortic valve impairment and pathologies of the aorta and coronary vessels. However, due to the limitations of the current tools, the possible link is not fully elucidated. Following our previous model of the aortic root including the coronaries, in this study, we have further developed the global aspect of the model by incorporating the anatomical structure of the thoracic aorta...
September 19, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28929251/risk-reduction-of-long-term-major-adverse-cardiovascular-events-after-endoscopic-thoracic-sympathectomy-in-palmar-hyperhidrosis
#13
Chun-An Cheng, Chun-Gu Cheng, Hsin Chu, Hung-Che Lin, Chi-Hsiang Chung, Hung-Wen Chiu, Wu-Chien Chien
PURPOSE: Palmar hyperhidrosis (PH) is excessive sweating of the palms resulting from sympathetic overactivity, and patients who undergo endoscopic thoracic sympathectomy (ETS) show reduced cardiac demand after 1 year and improved cerebral perfusion within 2-4 weeks. However, the long-term risks of major adverse cardiovascular events (MACE) following ETS remain unclear. METHODS: We searched the Longitudinal National Health Insurance Database in Taiwan and identified PH patients (International Classification of Disease, Ninth Revision, Clinical Modification diagnostic code 708...
September 19, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28928619/percutaneous-management-of-complex-acquired-aortic-coarctation-in-an-adult-with-tetralogy-of-fallot-and-pulmonary-atresia
#14
Michael D Seckeler, Emily Lawson, Brent J Barber, Scott E Klewer
We present the case of a female adult with complex cyanotic congenital heart disease who had long-standing thoracic aortic obstruction due to scarring from earlier surgical procedures. She was symptomatic but felt to be too high risk for surgical intervention. With careful planning, she was able to undergo successful stenting of her aorta with subsequent clinical improvement. This case highlights some of the complexities of caring for adults with congenital heart disease and the importance of a thorough understanding of their anatomy and physiology and prior interventions before undertaking interventions...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28925275/-catamenial-pneumothorax-case-reports-and-literature-review
#15
E Voláková, V Kolek, J Kufa, J Zatloukal, J Chudáček, M Szkorupa, R Pilka
AIM: Catamenial pneumothorax is menstrual cycle dependent and represents the most common form of thoracic endometriosis syndrome. Recurrences are very common even after surgical resection. DESIGN: Case reports and literature overview. SETTING: Department of Respiratory Medicine, Department of Surgery I, Department of Obstetrics and Gynecology, University Hospital, Palacky University, Olomouc. CASE REPORT: Two cases of catamenial pneumothorax are presented with repeated recurrences of right-sided pneumothorax even after surgical treatment...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28924111/synovitis-acne-pustulosis-hyperostosis-osteitis-sapho-syndrome-with-significant-bilateral-pleural-effusions
#16
Shoichi Hasegawa, Hiroki Yabe, Naoya Kaneko, Eri Watanabe, Takahisa Gono, Chihiro Terai
We herein report a rare case of a 66-year-old woman who had synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome with marked sternal osteitis and bilateral pleural effusions. SAPHO syndrome was diagnosed based on the characteristic features of a hyperostotic sternum and thoracic spine. The inflammatory changes of sternal osteitis and involvement of the adjacent soft tissue were assumed to be the cause of the pleural effusions. The effusions decreased during the natural course of the disease and resolved after methotrexate therapy...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28923146/cannon-ball-diagnosis-and-management-in-a-flight-attendant-candidate
#17
Meryem Zerrik, Houda Echchachoui, Zakaria Iloughmane, Choukri El'mhadi, Salaheddine Elkhader, Laila Benaissa, Mohamed Chemsi
BACKGROUND: ''Cannon ball'' opacities on chest X-rays are a common manifestation of hematogenous dissemination of a malignant tumor in the lungs. They indicate an advanced stage of disease with a very grim prognosis in terms of cure and survival. In aerospace medicine, this aspect means the patient is unfit for flight duties. Nonmetastatic etiologies of pulmonary nodules are rare. We report a case of cannon ball opacities discovered fortuitously during an admission visit. CASE REPORT: A 23-yr-old flight attendant candidate came to the Aeromedical Expertise Center of the Military Hospital in Rabat for medical evaluation...
October 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28922454/surgery-for-t4-lung-cancer-invading-the-thoracic-aorta-do-we-push-the-limits
#18
Giuseppe Marulli, Erino A Rendina, Walter Klepetko, Reinhold Perkmann, Davide Zampieri, Giulio Maurizi, Thomas Klikovits, Francesco Zaraca, Federico Venuta, Egle Perissinotto, Federico Rea
BACKGROUND: Few investigators have described en bloc resection of non-small cell lung cancer (NSCLC) invading the aorta. AIM OF STUDY: Analysis of outcome and prognostic factors for en bloc resections of NSCLC invading the aorta. METHODS: Thirty-five patients (27 males, 8 females; mean age 63 ± 8.6 years) were operated between 1994 and 2015 in four European Centers. HISTOLOGY: 12 (34.3%) squamous cell carcinoma, and 6 (17...
September 18, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28922191/acr-spr-str-practice-parameter-for-the-performance-of-cardiac-positron-emission-tomography-computed-tomography-pet-ct-imaging
#19
Rathan M Subramaniam, Warren R Janowitz, Geoffrey B Johnson, Martin A Lodge, Marguerite T Parisi, Mark R Ferguson, Jeffrey C Hellinger, Gregory W Gladish, Narainder K Gupta
This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death...
September 15, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28920536/pleural-lymphocyte-rich-transudates-in-cats
#20
Monica Probo, Valentina Valenti, Luigi Venco, Saverio Paltrinieri, Emme Lavergne, Catherine Trumel, Walter Bertazzolo
Objectives Non-chylous lymphorrhagic pleural effusions are transudative effusions with a predominance of lymphocytes; however, they do not contain chylomicrons and therefore do not have the classical milky aspect of true chylous effusion. This type of effusion has been anecdotally associated with cardiac diseases in cats, but studies are lacking. The aim of this study was to investigate the association between this type of effusion and the primary disease. Methods In this study, feline non-chylous lymphorrhagic pleural effusions were retrospectively selected from the database of the authors' institutions over a 3 year period...
September 1, 2017: Journal of Feline Medicine and Surgery
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