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https://www.readbyqxmd.com/read/28314688/nivolumab-treatment-for-oesophageal-squamous-cell-carcinoma-an-open-label-multicentre-phase-2-trial
#1
Toshihiro Kudo, Yasuo Hamamoto, Ken Kato, Takashi Ura, Takashi Kojima, Takahiro Tsushima, Shuichi Hironaka, Hiroki Hara, Taroh Satoh, Satoru Iwasa, Kei Muro, Hirofumi Yasui, Keiko Minashi, Kensei Yamaguchi, Atsushi Ohtsu, Yuichiro Doki, Yuko Kitagawa
BACKGROUND: Nivolumab is a human monoclonal IgG4 antibody that inhibits programmed cell death protein 1 (PD-1) expressed on activated T cells. We investigated the safety and activity of nivolumab in patients with treatment-refractory oesophageal cancer. METHODS: We did an open-label, single-arm, multicentre phase 2 study. Eligible patients had advanced squamous-cell carcinoma, adenosquamous-cell carcinoma, or adenocarcinoma of the oesophagus refractory or intolerant to fluoropyrimidine-based, platinum-based, and taxane-based chemotherapy...
March 14, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28249882/a-rash-and-a-rare-cause-of-unilateral-diaphragmatic-paralysis
#2
Zakariye M Ashkir, George Tsaknis
A 61-year-old man who was an ex-heavy smoker presented to our ambulatory care centre with a 4-week history of dyspnoea on mild exertion. 2 weeks prior to his symptoms, he had developed right-sided cervical herpes zoster for which he was prescribed oral acyclovir by his general practitioner. On examination, a rash over the right C4-5 dermatomes was noted and dullness on percussion of the right mid and lower zones with markedly reduced air entry. His chest radiograph showed a raised right hemi-diaphragm with associated right middle and lower lobe collapse...
March 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28130325/concordance-of-barthel-index-ecog-ps-and-palliative-performance-scale-in-the-assessment-of-functional-status-in-patients-with-advanced-medical-diseases
#3
C Hernández-Quiles, M Bernabeu-Wittel, L M Pérez-Belmonte, P Macías-Mir, D Camacho-González, B Massa, M Maiz-Jiménez, M Ollero-Baturone
OBJECTIVE: Analysing most relevant clinical features and concordance between different functional scales in patients with advanced medical diseases (PAMD). METHODS: Cross-sectional multicentre study that included PAMD (heart, lung, kidney, liver, and neurological diseases) in hospital settings from February 2009 to October 2010. We analysed clinical, biological and functional features in performing activities of daily living (ADL) by medians of Barthel Index (BI); additionally we assessed their performance status by medians of Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) and Palliative Performance Scale (PPS) scores...
January 27, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28096283/laba-lama-combination-in-copd-a-meta-analysis-on-the-duration-of-treatment
#4
REVIEW
Luigino Calzetta, Paola Rogliani, Josuel Ora, Ermanno Puxeddu, Mario Cazzola, Maria Gabriella Matera
When there are no randomised clinical trials directly comparing all relevant treatment options, an indirect treatment comparison via meta-analysis of the available clinical evidence is an acceptable alternative. However, meta-analyses may be very misleading if not adequately performed. Here, we propose and validate a simple and effective approach to meta-analysis for exploring the effectiveness of long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed-dose combinations in chronic obstructive pulmonary disease...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28073631/-assessing-motivation-to-smoking-cessation-in-hospitalized-patients
#5
Juana María Sepúlveda-Sánchez, José Carlos Canca-Sánchez, Francisco Rivas-Ruiz, Mónica Martín-García, Celia Lorente Márquez, Eva María Timonet-Andreu
AIM: To assess motivation to quit smoking in patients admitted to an acute care hospital, determine predictors of readiness to change, and identify a risk group that requires targeted motivational interviewing. METHODS: A cross-sectional descriptive study. A retrospective study was performed on the medical records of 248 patients aged >18 years with smoking habits admitted to the medical and surgery units of a district hospital between May 2014 and April 2015...
January 7, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/27880064/a-randomised-controlled-feasibility-trial-of-group-cognitive-behavioural-therapy-for-people-with-severe-asthma
#6
Janelle Yorke, Pauline Adair, Anne-Marie Doyle, Linda Dubrow-Marshall, Sharon Fleming, Leanne Holmes, Andrew Menzies-Gow, Rob Niven, Mark Pilling, Caroline Shuldham
OBJECTIVES: Evidence for the efficacy of Cognitive Behavioural Therapy (CBT) in asthma is developing but it is not known if this translates to benefits in severe asthma or if a group approach is acceptable to this patient group. This study aimed to assess the feasibility and acceptability of Group-CBT in severe asthma. METHOD: This was a two-centre, randomised controlled parallel group feasibility study. Eligible participants (patients with severe asthma and a clinically significant diagnosis of anxiety and/or depression - Hospital Anxiety and Depression Scale (HAD) score greater than 8 for the anxiety or depression sub-scale) received Group-CBT in weekly sessions for eight consecutive weeks and usual care or usual care only...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27852660/massive-symptomatic-right-sided-bochdalek-hernia-in-an-adult-man
#7
Naman Kohli, Goran Mitreski, Cheng-Hon Yap, Matthew Leong
A 22-year-old man presented to a rural hospital in Australia with right-sided pleuritic chest pain, right shoulder pain and dyspnoea. The patient had been receiving chronic asthma therapy without improvement. CT of the chest was performed after an abnormal X-ray, incidentally revealing one of the largest documented right-sided diaphragmatic hernias, with left lung compression due to mediastinal shift. The patient was definitively managed with thoracotomy alone. The contents of the hernia sac included colon and multiple loops of small bowel with a 10 cm neck...
November 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27817814/exercise-induced-bronchoconstriction-in-athletes-a-qualitative-assessment-of-symptom-perception
#8
Oliver J Price, James H Hull, Les Ansley, Mike Thomas, Caroline Eyles
BACKGROUND: A poor relationship between perceived respiratory symptoms and objective evidence of exercise-induced bronchoconstriction (EIB) in athletes is often reported; however, the reasons for this disconnect remain unclear. The primary aim of this study was to utilise a qualitative-analytical approach to compare respiratory symptoms in athletes with and without objectively confirmed EIB. METHODS: Endurance athletes who had previously undergone bronchoprovocation test screening for EIB were divided into sub-groups, based on the presence or absence of EIB ± heightened self-report of dyspnoea: (i) EIB-Dys- (ii) EIB + Dys+ (iii) EIB + Dys- (iv) EIB-Dys+...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27807495/giant-mediastinal-germ-cell-tumour-an-enigma-of-surgical-consideration
#9
Firdaus Hayati, Nurayub Mohd Ali, Levin Kesu Belani, Nornazirah Azizan, Andee Dzulkarnaen Zakaria, Mohd Ramzisham Abdul Rahman
We present a case of 16-year-old male, who was referred from private centre for dyspnoea, fatigue, and orthopnea. The chest radiograph revealed complete opacification of left chest which was confirmed by computed tomography as a large left mediastinal mass measuring 14 × 15 × 18 cm. The diagnostic needle core biopsy revealed mixed germ cell tumour with possible combination of embryonal carcinoma, yolk sac, and teratoma. After 4 cycles of neoadjuvant BEP regime, there was initial response of tumour markers but not tumour bulk...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27797848/invasive-thymoma-presenting-as-classic-superior-vena-cava-syndrome-a-case-of-venous-spread-metastasis
#10
Prasan Kumar Panda, Naveet Wig, Sanjeev Kumar, Sudheer Arava
The approach to an intrinsic cause of superior vena cava syndrome (SVCS) is usually difficult but rewarding. We report a case of a middle-aged man who presented with progressive oedema of the upper half of the body, dyspnoea, cough and weight loss for a 1-year duration. He was a non-smoker without prior hospitalisation. Chest radiography showed right-sided pleural effusion with an apparent normal superior mediastinum. Contrast-enhanced CT of the chest revealed a right atrial mass extending and completely obliterating to superior vena cava...
October 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27797803/bronchial-schwannoma-a-singular-lesion-as-a-cause-of-obstructive-pneumonia
#11
Rui Caetano Oliveira, Tiago Nogueira, Vítor Sousa, Lina Carvalho
Bronchial schwannomas are very rare pulmonary lesions, but its awareness is important to reach correct diagnosis and decide proper intervention. Clinical and radiological characteristics are mainly unspecific and pathological examination usually provides the definite diagnosis. In small lesions, endoscopic approach may be sufficient, but in large lesions associated with organising pneumonia surgical intervention may be required. Prognosis is typically favourable. We describe a case of a woman, aged 66 years, with productive cough and sporadic haemoptysis, dyspnoea, anorexia, excessive sweating and weight loss with 2 months evolution...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27722910/niv-by-an-interdisciplinary-respiratory-care-team-in-severe-respiratory-failure-in-the-emergency-department-limited-to-day-time-hours
#12
Christian Michael Horvath, Martin Horvath Brutsche, Otto Dagobert Schoch, Bernarde Schillig, Florent Baty, Dieter vonOw, Jochen Julius Rüdiger
Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) would be feasible and could improve patient´s dyspnoea measured by respiratory rate and Borg visual dyspnea scale. NIV was set up by an interdisciplinary respiratory care team. Outside these predefined hours NIV was performed in the ICU...
October 8, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27623386/do-copd-patients-taught-pursed-lips-breathing-plb-for-dyspnoea-management-continue-to-use-the-technique-long-term-a-mixed-methodological-study
#13
S E Roberts, F M Schreuder, T Watson, M Stern
OBJECTIVE: To investigate whether COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term and, if so, their experience of this. DESIGN: A mixed methodological approach using semi-structured telephone interviews, a focus group and observation of current PLB technique was used. Qualitative analysis was based on grounded theory. SETTING: Participants were recruited from the two inner city London (UK) boroughs...
May 27, 2016: Physiotherapy
https://www.readbyqxmd.com/read/27621868/validation-of-eortc-and-calgb-prognostic-models-in-surgical-patients-submitted-to-diagnostic-palliative-or-curative-surgery-for-malignant-pleural-mesothelioma
#14
Alberto Sandri, Francesco Guerrera, Matteo Roffinella, Stefania Olivetti, Lorena Costardi, Alberto Oliaro, Pier Luigi Filosso, Paolo Olivo Lausi, Enrico Ruffini
BACKGROUND: To assess the trend of our surgical patients affected by malignant pleural mesothelioma (MPM) and submitted to diagnostic/palliative or curative surgical procedures and to validate the European Organisation for Research and Treatment of Cancer (EORTC) prognostic score in our patient population. METHODS: This is a cohort study of patients submitted to surgery for MPM from January 2007 to December 2013. Primary outcome was overall survival (OS). Univariate and multivariate-adjusted comparisons by EORTC prognostic score for OS were accomplished using Cox method...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27612548/is-personalised-medicine-the-key-to-heterogeneity-in-idiopathic-pulmonary-fibrosis
#15
REVIEW
Deborah L Clarke, Lynne A Murray, Bruno Crestani, Matthew A Sleeman
Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial pneumonia of unknown cause, characterised by progressive worsening in lung function and dyspnoea with an associated prognosis similar to or worse than many cancers. As a better understanding emerges around the pathogenesis and mechanisms driving disease pathology, a host of novel agents are being tested both pre-clinically and clinically. However even with this deeper understanding and positive pre-clinical supportive data, negative trial outcomes are frequently reported, highlighting the problems faced in treating such a heterogeneous disease with a varied clinical course...
January 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27607886/-lung-volume-reduction-surgery-state-of-the-art-2016
#16
C Caviezel, D Franzen, I Inci, W Weder
In a number of large case series in the mid-1990s, lung volume reduction surgery (LVRS) was shown to reduce dyspnoea and improve pulmonary function and quality of life in patients with advanced pulmonary emphysema. The large randomised National Emphysema Treatment Trial (NETT) confirmed this in the early 2000s and also demonstrated that selected patients live longer after surgery. Patient selection is crucial to the success of the procedure and should be performed at a specialised experienced centre with a multidisciplinary team approach on emphysema treatment...
September 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27589227/chronic-obstructive-pulmonary-disease-and-cardiac-diseases-an-urgent-need-for-integrated-care
#17
Sara Roversi, Leonardo M Fabbri, Don D Sin, Nathaniel M Hawkins, Alvar Agustí
Chronic obstructive pulmonary disease (COPD) is a global health issue with high social and economic costs. Concomitant chronic cardiac disorders are frequent in patients with COPD, likely owing to shared risk factors (e.g., aging, cigarette smoke, inactivity, persistent low-grade pulmonary and systemic inflammation) and add to the overall morbidity and mortality of patients with COPD. The prevalence and incidence of cardiac comorbidities are higher in patients with COPD than in matched control subjects, although estimates of prevalence vary widely...
December 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27585597/end-of-life-care-in-patients-with-advanced-lung-cancer
#18
REVIEW
Richard B L Lim
Despite advances in the detection, pathological diagnosis and therapeutics of lung cancer, many patients still develop advanced, incurable and progressively fatal disease. As physicians, the duties to cure sometimes, relieve often and comfort always should be a constant reminder to us of the needs that must be met when caring for a patient with lung cancer. Four key areas of end-of-life care in advanced lung cancer begin with first recognizing 'when a patient is approaching the end of life'. The clinician should be able to recognize when the focus of care needs to shift from an aggressive life-sustaining approach to an approach that helps prepare and support a patient and family members through a period of progressive, inevitable decline...
October 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27440802/comparison-of-early-and-late-quality-of-life-between-left-anterior-thoracotomy-and-median-sternotomy-off-pump-coronary-artery-bypass-surgery
#19
COMPARATIVE STUDY
Julian J Nesbitt, George Mori, Charlotte Mason-Apps, George Asimakopoulos
OBJECTIVE: Minimally invasive coronary artery bypass surgery performed through a left thoracotomy has potential benefits over conventional sternotomy, including reduced surgical trauma, faster recovery and potential improvement in quality of life. This study is a prospective assessment of quality of life in patients undergoing off-pump coronary bypass by median sternotomy and left anterior thoracotomy. METHODS: Quality of life was assessed by the EuroQoL questionnaire, with additional questions on dyspnoea, angina, wound pain and scar aesthetics...
January 2017: Perfusion
https://www.readbyqxmd.com/read/27437262/gender-based-differences-in-risk-factor-profile-and-coronary-angiography-of-patients-presenting-with-acute-myocardial-infarction-in-north-indian-population
#20
Supriya Bajaj, Vijay Mahajan, Sumit Grover, Amit Mahajan, Nipun Mahajan
INTRODUCTION: Coronary Artery Disease (CAD) among women presents atypically with atypical chest pain, neck pain, nausea, fatigue and dyspnoea. Co-existing co-morbidities such as Diabetes Mellitus (DM) and hypertension along with difference in risk factor prevalence makes it necessary to have a gender specific approach. AIM: To study gender specific differences in diagnosing and treating Acute Myocardial Infarction (AMI) in North Indian population. MATERIALS AND METHODS: Fifty consecutive men and women presenting with AMI were studied...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
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