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Interventional pulmonary

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https://www.readbyqxmd.com/read/29156141/one-year-unsupervised-individualized-exercise-training-intervention-enhances-cardiorespiratory-fitness-but-not-muscle-deoxygenation-or-glycemic-control-in-adults-with-type-1-diabetes
#1
Antti-Pekka E Rissanen, Heikki O Tikkanen, Anne S Koponen, Jyrki M Aho, Juha E Peltonen
Adaptations to long-term exercise training in type 1 diabetes are sparsely studied. We examined the effects of a 1-year individualized training intervention on cardiorespiratory fitness, exercise-induced active muscle deoxygenation, and glycemic control in adults with and without type 1 diabetes. Eight men with type 1 diabetes (T1D) and eight healthy men (CON) matched for age, anthropometry, and peak pulmonary O2 uptake (V̇O2peak), completed a 1-year individualized training intervention in an unsupervised real-world setting...
November 20, 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29156069/the-role-of-intraoperative-intermittent-pneumatic-compression-devices-in-venous-thromboembolism-prophylaxis-in-total-hip-and-total-knee-arthroplasty
#2
Vineet Tyagi, Paul Tomaszewski, Adam Lukasiewicz, Shahana Theriault, Richard Pelker
Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) and total knee arthroplasty (TKA), occurring in up to 85% of patients who are not treated with prophylaxis. The initiation of VTE development may occur intraoperatively. This study investigated whether this gap in VTE prophylaxis can be addressed by the use of intraoperative intermittent pneumatic compression devices (IPCDs) and if intraoperative IPCDs have a meaningful benefit in preventing symptomatic VTE. The authors defined symptomatic VTE as deep venous thrombosis in either lower extremity or a pulmonary embolism...
November 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29156017/early-and-late-outcomes-after-surgical-repair-of-congenital-supravalvular-aortic-stenosis-a-european-congenital-heart-surgeons-association-multicentric-study
#3
Massimo A Padalino, Anna Chiara Frigo, Marina Comisso, Martin Kostolny, Ikenna Omeje, Christian Schreiber, Jelena Pabst von Ohain, Julie Cleuziou, David J Barron, Bart Meyns, Viktor Hraska, Bohdan Maruszewski, Michal Kozlowski, Luca A Vricella, Narutoshi Hibino, Sarah Collica, Hakan Berggren, Mats Synnergren, Stojan Lazarov, David Kalfa, Emile Bacha, Christian Pizarro, Mark Hazekamp, Vlado Sojak, Jeffrey P Jacobs, Matej Nosal, Jose Fragata, Sertac Cicek, George E Sarris, Panayotis Zografos, Vladimiro L Vida, Giovanni Stellin
OBJECTIVES: Our goal was to evaluate the early and late results of the surgical management of congenital supravalvular aortic stenosis (SVAS). METHODS: We performed a retrospective, multicentre study using data from the European Congenital Heart Surgeons Association. Exclusion criteria were age >18 years, operation before 1990 and redo supravalvular aortic stenosis operations. Multivariate Cox regression analysis was performed to detect independent predictors of adverse events...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29153847/effect-of-incentive-payments-on-chronic-disease-management-and-health-services-use-in-british-columbia-canada-interrupted-time-series-analysis
#4
M Ruth Lavergne, Michael R Law, Sandra Peterson, Scott Garrison, Jeremiah Hurley, Lucy Cheng, Kimberlyn McGrail
We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29153115/prevalence-and-medical-costs-of-chronic-diseases-among-adult-medicaid-beneficiaries
#5
John M Chapel, Matthew D Ritchey, Donglan Zhang, Guijing Wang
INTRODUCTION: This review summarizes the current literature for the prevalence and medical costs of noncommunicable chronic diseases among adult Medicaid beneficiaries to inform future program design. METHODS: The databases MEDLINE and CINAHL were searched in August 2016 using keywords, including Medicaid, health status, and healthcare cost, to identify original studies that were published during 2000-2016, examined Medicaid as an independent population group, examined prevalence or medical costs of chronic conditions, and included adults within the age group 18-64 years...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#6
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
November 17, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29145831/copd-online-rehabilitation-versus-conventional-copd-rehabilitation-rationale-and-design-for-a-multicenter-randomized-controlled-trial-study-protocol-core-trial
#7
Henrik Hansen, Theresa Bieler, Nina Beyer, Nina Godtfredsen, Thomas Kallemose, Anne Frølich
BACKGROUND: Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program and 30-50% drop-out before completion. The main reasons are severe symptoms, inflexible accessibility and necessity for transportation. Currently there are no well-established and evident rehabilitation alternatives...
November 16, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29144886/comparative-effectiveness-of-proactive-tobacco-treatment-among-smokers-with-and-without-chronic-lower-respiratory-disease
#8
Anne C Melzer, Barbara Clothier, Sandra J Japuntich, Siamak Noorbaloochi, Patrick Hammett, Diana J Burgess, Anne M Joseph, Steven S Fu
RATIONALE: Adults with chronic lower respiratory disease (CLRD) differ in their barriers to smoking cessation, but also suffer from tobacco related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without CLRD. OBJECTIVE: We examined the effectiveness of a proactive outreach program for cessation among smokers with and without CLRD. METHODS: Subgroup analysis of the Veterans VICTORY Over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared to usual care...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29144103/effects-of-home-based-superimposed-neuromuscular-electrical-stimulation-in-severe-chronic-obstructive-pulmonary-disease-patients-a-randomized-controlled-clinical-trial
#9
Marie C Valenza, Irene Torres-Sánchez, Laura López-López, Irene Cabrera-Martos, Araceli Ortiz-Rubio, Gerald Valenza-Demet
BACKGROUND: COPD patients experience a sustained deterioration of several capacities. Those with severe COPD undergo a considerable decline in their physical and functional capacities, but pulmonary rehabilitation (PR) is used to reduce the weakness of such patients. To date, neuromuscular electrical stimulation (NMES) has been used in acute COPD patients but NMES superimposed onto voluntary muscular contraction has not been tested in COPD patients. AIM: The aim of this study was to evaluate the effects of superimposed NMES on the cardiorespiratory performance and functionality of severe COPD patients undergoing a home-based rehabilitation program...
November 16, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#10
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29141890/british-thoracic-society-clinical-statement-on-pulmonary-arteriovenous-malformations
#11
Claire L Shovlin, Robin Condliffe, James W Donaldson, David G Kiely, Stephen J Wort
Pulmonary arteriovenous malformations (PAVMs) are structurally abnormal vascular communications that provide a continuous right-to-left shunt between pulmonary arteries and veins. Their importance stems from the risks they pose (>1 in 4 patients will have a paradoxical embolic stroke, abscess or myocardial infarction while life-threatening haemorrhage affects 1 in 100 women in pregnancy), opportunities for risk prevention, surprisingly high prevalence and under-appreciation, thus representing a challenging condition for practising healthcare professionals...
December 2017: Thorax
https://www.readbyqxmd.com/read/29140963/when-the-momentum-has-gone-what-will-be-the-role-of-extracorporeal-lung-support-in-the-future
#12
Darryl Abrams, Matthew Bacchetta, Daniel Brodie
PURPOSE OF REVIEW: There has been expanding interest in and use of extracorporeal support in respiratory failure concurrent with technological advances and predominantly observational data demonstrating improved outcomes. However, until there is more available data from rigorous, high-quality randomized studies, the future of extracorporeal support remains uncertain. RECENT FINDINGS: Outcomes for patients supported with extracorporeal devices continue to show favorable trends...
November 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#13
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29133351/efficacy-and-safety-outcomes-of-recanalisation-procedures-in-patients-with-acute-symptomatic-pulmonary-embolism-systematic-review-and-network-meta-analysis
#14
David Jimenez, Carlos Martin-Saborido, Alfonso Muriel, Javier Zamora, Raquel Morillo, Deisy Barrios, Frederikus A Klok, Menno V Huisman, Victor Tapson, Roger D Yusen
BACKGROUND: We aimed to review the efficacy and safety of recanalisation procedures for the treatment of PE. METHODS: We searched PubMed, the Cochrane Library, EMBASE, EBSCO, Web of Science and CINAHL databases from inception through 31 July 2015 and included randomised clinical trials that compared the effect of a recanalisation procedure versus each other or anticoagulant therapy in patients diagnosed with PE. We used network meta-analysis and multivariate random-effects meta-regression to estimate pooled differences between each intervention and meta-regression to assess the association between trial characteristics and the reported effects of recanalisation procedures versus anticoagulation...
November 13, 2017: Thorax
https://www.readbyqxmd.com/read/29133320/effect-of-an-intensive-3-week-preoperative-home-rehabilitation-programme-in-patients-with-chronic-obstructive-pulmonary-disease-eligible-for-lung-cancer-surgery-a-multicentre-randomised-controlled-trial
#15
Hélène Laurent, Géraud Galvaing, Emilie Thivat, Emmanuel Coudeyre, Sylvie Aubreton, Ruddy Richard, Fabrice Kwiatkowski, Frederic Costes, Marc Filaire
INTRODUCTION: Surgery is the standard curative treatment for lung cancer but is only possible in patients with local tumour and preserved exercise capacity. Improving fitness before surgery can reduce postoperative complications and mortality. However, preoperative rehabilitation remains difficult to implement for several reasons. We aim to investigate the effectiveness of an intensive 3-week home-based preoperative exercise training programme on hospital discharge ability, postoperative complications and physical performance in patients with chronic obstructive pulmonary disease (COPD) who are eligible for lung cancer surgery...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132736/clinical-effects-of-probiotics-in-cystic-fibrosis-patients-a-systematic-review
#16
Stephanie Van Biervliet, Dimitri Declercq, Shawn Somerset
Cystic fibrosis (CF) is characterised by a build-up of thick, intransient mucus linings of the digestive and respiratory mucosa, which disrupts digestive system functioning and microbiota composition. In view of the potential for probiotics to enhance microbiota composition in other contexts, this study investigated the current evidence for probiotics as an adjunct to usual therapy for CF. Electronic clinical databases were interrogated for human randomised, controlled, intervention trials (1985-2015) testing the effects of probiotics on clinical endpoints in CF were reviewed...
April 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29132697/treatment-of-postsurgical-chylothorax
#17
Janani S Reisenauer, Carlos A Puig, Chris J Reisenauer, Mark S Allen, Emily Bendel, Stephen D Cassivi, Francis C Nichols, Rob K Shen, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: Postoperative chylothorax can be managed by any or all of observation, parenteral nutrition, surgical duct ligation, pleurodesis, or thoracic duct embolization. The objective of this study was to determine the efficacy of standard therapies, such as surgical duct ligation and observation, compared with newer treatment methods (thoracic duct embolization). METHODS: A prospectively maintained database at a single institution was used to identify and review patients with postoperative chylothorax from 2008 to 2015...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132514/ventilator-strategies-for-chronic-obstructive-pulmonary-disease-and-acute-respiratory-distress-syndrome
#18
REVIEW
Nathan T Mowery
The management of the ventilator in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS) has a dramatic effect on the overall outcome. The incidence of COPD is increasing as the US population grows older. The most effective means to deal with pulmonary complications is to avoid them, but both COPD and ARDS have evidence-based interventions that have been shown to improve outcomes. Pulmonary complications affect up to 40% of patients, and their occurrence is associated with an increased duration of hospital stay, and an increased mortality...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29131765/comprehensive-cross-sectional-imaging-of-the-pulmonary-veins
#19
Cameron Hassani, Farhood Saremi
The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward function. The anatomy of the pulmonary veins is variable among patients, with several noteworthy variant and anomalous patterns, including supernumerary pulmonary veins, a common ostium, anomalous pulmonary venous return, and levoatriocardinal veins. Differences in pulmonary vein anatomy and the presence of variant or anomalous anatomy can be of critical importance, especially for preoperative planning of pulmonary and cardiac surgery...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29131284/usefulness-of-cutting-balloon-angioplasty-for-the-treatment-of-congenital-heart-defects
#20
Jacek Kusa, Magdalena Mazurak, Agnieszka Skierska, Leslaw Szydlowski, Pawel Czesniewicz, Lukasz Manka
BACKGROUND: Patients with complex congenital heart defects may have different hemodynamic problems which require a variety of interventional procedures including angioplasty which involves using high-pressure balloons. After failure of conventional balloon angioplasty cutting balloon angioplasty is the next treatment option available. The purpose of this study was to evaluate the safety and efficacy of cutting balloon angioplasty in children with different types of congenital heart defects...
November 13, 2017: Cardiology Journal
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