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dyspnoea approach

Frantisek Nehaj, Juraj Sokol, Michal Mokan, Veronika Jankovicova, Frantisek Kovar, Marianna Kubaskova, Stanislav Mizera, Marian Mokan
The patient database at the First Department of Internal Medicine in Martin, the Central Slovak Institute for Cardiac and Vascular Diseases in Banska Bystrica, and the National Slovak Institute of Cardiovascular Diseases in Bratislava was searched to identify patients with benign tumors of the heart seen during the 5-year period between 2011 and 2016. Forty-one patients with primary cardiac myxomas were identified and their medical records were reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes...
2018: BioMed Research International
Christopher Mallow, Jeffrey Thiboutot, Roy Semaan, Margaret M Hayes, Russell Hales, Ashwin Ram, David Feller-Kopman, Hans Lee, Lonny Yarmus
BACKGROUND AND OBJECTIVE: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. METHODS: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed...
March 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Clément Medrinal, Guillaume Prieur, Yann Combret, Aurora Robledo Quesada, David Debeaumont, Tristan Bonnevie, Francis Edouard Gravier, Elise Dupuis Lozeron, Jean Quieffin, Olivier Contal, Bouchra Lamia
OBJECTIVE: To evaluate the effect of quadriceps Functional Electrical Stimulation (FES)-Cycling on exertional VO2 compared with Placebo FES-cycling in patients with COPD. DESIGN: A randomised, single-blind, placebo-controlled, cross-over trial SETTING: Pulmonary Rehabilitation Department PARTICIPANTS: 23 consecutive patients with COPD GOLD stage 2, 3 or 4 (mean FEV1 : 1.4±0.4 L (50.3% pred)) who had recently begun a respiratory rehabilitation program. INTERVENTION: Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-Cycling...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
Dario Buccheri, Paola Rosa Chirco, Salvatore Geraci, Giuseppe Caramanno, Bernardo Cortese
Coronary artery fistula (CAF) is a relatively rare anatomic abnormality of the coronary arteries that afflicts 0.002% of the general population and represents 14% of all the anomalies of coronary arteries. Its clinical relevance focusses mainly on the mechanism of "coronary steal phenomenon", causing myocardial functional ischaemia even in the absence of stenosis, hence common symptoms are angina or effort dyspnoea. The suggested diagnostic approach is guided by the patient's symptoms and consists of a number of instrumental examinations like ECG, treadmill test, echocardiography, computed tomography scan, cardiac magnetic resonance and coronary angiography...
February 9, 2018: Heart, Lung & Circulation
Hee Kong Fong, Obai Abdullah, Sandeep Gautam
A 59-year-old woman with paroxysmal atrial fibrillation (AF) presented with severe non-productive cough, malaise, low-grade fever and AF flare-up 3 weeks following pulmonary vein isolation with radiofrequency catheter ablation. She denied chest pain or dyspnoea. Patient was haemodynamically stable. There was no pulsus paradoxus. Laboratories showed leucocytosis and elevated C-reactive protein. ECG showed sinus tachycardia. CT abdomen and pelvis showed a large pericardial effusion (PE). Shortly after admission, she developed AF with rapid ventricular response, responsive to intravenous amiodarone...
February 5, 2018: BMJ Case Reports
J H Kauppila, A Johar, J A Gossage, A R Davies, J Zylstra, J Lagergren, P Lagergren
BACKGROUND: Transhiatal and transthoracic oesophagectomy in patients with oesophageal cancer have similar survival rates. Whether these approaches differ in health-related quality of life (HRQoL) is uncertain and was examined in this study. METHODS: Patients undergoing transhiatal or transthoracic surgery for lower-third oesophageal or gastro-oesophageal junctional cancer between 2011 and 2015 were selected from an institutional database. HRQoL outcomes were measured at 6 and 12 months after surgery using validated written questionnaires (European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25)...
February 2018: British Journal of Surgery
Anupam Kumar, Basem Abdelmalak, Yoshikazu Inoue, Daniel A Culver
Pulmonary alveolar proteinosis (PAP) is a diffuse lung disease that results from the accumulation of lipoproteinaceous material in the alveoli and alveolar macrophages due to abnormal surfactant homoeostasis. Identification of the granulocyte-macrophage colony-stimulating factor (GM-CSF) as an indispensable mediator of macrophage maturation and surfactant catabolism was the key discovery leading to the current understanding of the pathogenesis of most forms of PAP. Impaired GM-CSF bioavailability due to anti-GM-CSF autoimmunity is the cause of approximately 90% of adult PAP cases...
January 31, 2018: Lancet Respiratory Medicine
W-F Su, M-C Lan, S-C Liu
A suture lateralisation (SL) instead of an endolaryngeal tissue ablation procedure under endoscopy has been utilised to treat bilateral vocal fold immobility (BVFI) since 1980. However, mechanical fixation (MF) of the cricoarytenoid joint (CAJ) has continually challenged the effectiveness of glottic dilatation both in the SL procedure and the tissue ablation procedure. From 2007 to 2015, a total of 38 patients with BVFI underwent 40 exo-endolaryngeal suture lateralisation (exoeSL) procedures and three were diagnosed with MF in our hospital...
January 31, 2018: Acta Otorhinolaryngologica Italica
Vratislav Sedlák, Vladimír Koblížek, Rastislav Šimek
Implementation of ultrasound into clinical medicine is current trend in many subspecialties of internal medicine. Remarkable development and use of this technology is currently present in intensive care and respiratory medicine. This review summarizes current knowledge and nomenclature of artefacts and findings in clinical chest ultrasound. It describes ultrasound-based approach in a differential diagnostic algorithm of acute severe dyspnoea. Chest ultrasound should be a standard knowledge of chest physician...
2018: Vnitr̆ní Lékar̆ství
Hayley Barnes, Anne E Holland, Glen P Westall, Nicole Sl Goh, Ian N Glaspole
BACKGROUND: Approximately one-third of individuals with interstitial lung disease (ILD) have associated connective tissue disease (CTD). The connective tissue disorders most commonly associated with ILD include scleroderma/systemic sclerosis (SSc), rheumatoid arthritis, polymyositis/dermatomyositis, and Sjögren's syndrome. Although many people with CTD-ILD do not develop progressive lung disease, a significant proportion do progress, leading to reduced physical function, decreased quality of life, and death...
January 3, 2018: Cochrane Database of Systematic Reviews
Leonel Avendaño-Perez, Nilda Espinola-Zavaleta
This is a case of a 37-year-old woman with uncorrected tetralogy of Fallot with the absence of pulmonary valve and history of heart murmur in childhood who did not have a medical approach. At 29 years of age she started with dyspnoea that in the last 7 months progressed to be of small effort and also referred increase of the abdominal perimeter.
March 2018: Cardiology in the Young
Pamela Bobadilla, Carlos Vigliano, Jose H Casabé, Eduardo Guevara, Fabián Salmo, José Abud, Eduardo Dulbecco, Roberto R Favaloro
Papillary ibroelastomas are small benign intracardiac tumors known for their embolic potential. Since the introduction of echocardiography with improved resolution and transesophageal imaging techniques, they are being increasingly detected in clinical practice. In recent series, papillary fibroelastoma is considered the most frequent benign tumor of the heart. Our objective was to analyze characteristics and midterm surgical outcome of histologically-confirmed cases of papillary fibroelastoma. We conducted a retrospective study on patients with cardiac tumors submitted to surgical excision between June 1992 and February 2017...
2017: Medicina
Doris Sau-Fung Yu, Polly Wai-Chi Li, Sherry On-Ki Chong
PURPOSE OF REVIEW: Assessment of symptom clustering is effective in enhancing care planning for symptom palliation in life-limiting disease. This review was aimed at identifying symptom cluster manifestation among advanced heart failure patients and to investigate the prognostic impact of the identified symptom clusters. RECENT FINDINGS: A systematic search of the literature identified 10 relevant articles. Two approaches were undertaken based on: correlations between symptoms and shared characteristics of patients' symptom profiles, to identify the symptom clusters...
March 2018: Current Opinion in Supportive and Palliative Care
Anahita Sanaei Dashti, Mohammad Rahim Kadivar, Abdolvahab Alborzi, Esmaeel Sadeghi, Gholam Reza Pouladfar, Neda Bagherian, Naser Honar, Masoomeh Khalifeh
The clinical manifestations of hydatidosis are various and related to anatomic location. Defining frequent symptoms and signs of the disease is imperative for early management of it. The aim of this report was to analyse the clinical features of infected children with hydatid cysts located in different organs. In this study, medical charts of 57 children between 3 and 16 years of age with hydatid cyst admitted to Pediatric Wards of Nemazee Hospital were evaluated over a 12 year period (from 2003 to 2014, prospectively)...
December 2017: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
Andrea Legati, Aurelio Reyes, Camilla Ceccatelli Berti, Oliver Stehling, Silvia Marchet, Costanza Lamperti, Alberto Ferrari, Alan J Robinson, Ulrich Mühlenhoff, Roland Lill, Massimo Zeviani, Paola Goffrini, Daniele Ghezzi
BACKGROUND: Hereditary myopathy with lactic acidosis and myopathy with deficiency of succinate dehydrogenase and aconitase are variants of a recessive disorder characterised by childhood-onset early fatigue, dyspnoea and palpitations on trivial exercise. The disease is non-progressive, but life-threatening episodes of widespread weakness, metabolic acidosis and rhabdomyolysis may occur. So far, this disease has been molecularly defined only in Swedish patients, all homozygous for a deep intronic splicing affecting mutation in ISCU encoding a scaffold protein for the assembly of iron-sulfur (Fe-S) clusters...
October 27, 2017: Journal of Medical Genetics
Fernando J Martinez, Harold R Collard, Annie Pardo, Ganesh Raghu, Luca Richeldi, Moises Selman, Jeffrey J Swigris, Hiroyuki Taniguchi, Athol U Wells
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease characterized by progressive lung scarring and the histological picture of usual interstitial pneumonia (UIP). It is associated with increasing cough and dyspnoea and impaired quality of life. IPF affects ∼3 million people worldwide, with incidence increasing dramatically with age. The diagnostic approach includes the exclusion of other interstitial lung diseases or overlapping conditions and depends on the identification of the UIP pattern, usually with high-resolution CT; lung biopsy might be required in some patients...
October 20, 2017: Nature Reviews. Disease Primers
Udo Abah, Gianluca Casali, Timothy James Peacock Batchelor, Eveline Internullo, Rakesh Krishnadas, Natasha Joshi, Samson Egbulonu, Frances Warden, Vito Domenico Bruno, Douglas George West
OBJECTIVES: As the practice of video-assisted thoracoscopic surgery (VATS) lobectomy gains widespread acceptance, the complexity of procedures attempted increases and the stage of tumour that may be safely approached remains controversial. We examined the impact of nodal involvement with respect to perioperative outcomes after VATS lobectomy. METHODS: All patients listed for VATS lobectomy for non-small-cell lung cancer at our institution from 2012 to 2016 were analysed...
August 29, 2017: European Journal of Cardio-thoracic Surgery
Guillaume Noell, Borja G Cosío, Rosa Faner, Eduard Monsó, German Peces-Barba, Alfredo de Diego, Cristobal Esteban, Joaquim Gea, Robert Rodriguez-Roisin, Marian Garcia-Nuñez, Francisco Pozo-Rodriguez, Susana G Kalko, Alvar Agustí
Patients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation (ECOPD) that impact negatively the course of their disease. ECOPD are heterogeneous events of unclear pathobiology and non-specific diagnosis. Network analysis is a novel research approach that can help unravelling complex biological systems. We hypothesised that the comparison of multi-level (i.e., clinical, physiological, biological, imaging and microbiological) correlation networks determined during ECOPD and convalescence can yield novel patho-biologic information...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Yasuhiro Kondoh, Vincent Cottin, Kevin K Brown
Recognising recent advances, the definition and diagnostic criteria for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) have been updated by an international working group. The new definition describes any acute, clinically significant respiratory deterioration (both idiopathic and triggered events) characterised by evidence of new widespread alveolar abnormality. The new criteria require a previous or concurrent diagnosis of IPF, an acute worsening or development of dyspnoea typically less than 1 month in duration, chest imaging evidence on computed tomography (CT) of new bilateral ground-glass opacity and/or consolidation superimposed on a background imaging pattern of usual interstitial pneumonia not fully explained by cardiac failure or fluid overload...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
Mara Lelii, Maria Francesca Patria, Raffaella Pinzani, Rossana Tenconi, Alessandro Mori, Nicola Bonelli, Nicola Principi, Susanna Esposito
Background: Chronic interstitial lung diseases in children (chILD) are a heterogeneous group of disorders that can represent a clinical challenge for pediatric pneumologists. Among them, neuroendocrine cell hyperplasia of infancy (NEHI) is a diffuse lung disease prevalent in the first years of life that spontaneously improves over time. The clinical presentation of NEHI is indistinguishable from other interstitial lung diseases, so a correct and non-invasive diagnosis by chest computed tomography (CT) without lung biopsy might not be simple...
September 25, 2017: International Journal of Environmental Research and Public Health
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