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https://www.readbyqxmd.com/read/28222414/urinary-steroid-metabolites-in-a-case-of-florid-ectopic-cushing-s-syndrome-and-clinical-correlations
#1
Angelos Kyriacou, Karolina G Stepien, Basil Issa
A 51-year old woman was admitted with multiple cerebral, pulmonary and intra-abdominal abscesses. The combination of apparent immunosuppression, obesity, diabetes mellitus, hypertension, hypokalaemia, osteoporotic fractures and bilateral shoulder avascular necrosis led to a clinical diagnosis of Cushing's syndrome (CS). This was biochemically confirmed as follows: midnight serum cortisol 4275 nmol/L (60-250), non-suppressed overnight dexamethasone suppression test, raised salivary cortisol 716 nmol/L (5-46) and ACTH 639 ng/L (0-46)...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217316/subacute-right-heart-failure-revealing-three-simultaneous-causes-of-post-embolic-pulmonary-hypertension-in-metastatic-dissemination-of-breast-cancer
#2
Flavien Vincent, Nicolas Lamblin, Marion Classe, Guillaume Schurtz, Antoine Rauch, Marie Fertin, Pascal De Groote
A 72-year-old woman with history of breast cancer only treated surgically was referred to our department for pulmonary hypertension (PH) suspicion. Echocardiogram revealed elevated right ventricular systolic pressure. Computed tomography (CT) angiogram showed no pulmonary embolism (PE), but lung scan revealed two ventilation-perfusion mismatch areas. Right cardiac catheterization established precapillary PH. Despite treatment with PH specific therapy (sildenafil, ambrisentan, and epoprostenol), her condition worsened rapidly with acute right heart failure (RHF)...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28207279/angiotensin-converting-inhibitors-and-angiotensin-ii-receptor-blockers-and-longitudinal-change-in-percent-emphysema-on-computed-tomography-the-mesa-lung-study
#3
Megha A Parikh, Carrie P Aaron, Eric A Hoffman, Joseph E Schwartz, Jaime Madrigano, John H M Austin, Ravi Kalhan, Gina Lovasi, Karol Watson, Karen Hinckley Stukovsky, R Graham Barr
RATIONALE: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States. Emphysema on computed tomography (CT) is associated with increased morbidity and mortality in patients with and without spirometrically defined COPD but no available medications target emphysema.  Transforming growth factor beta (TGF-β) and endothelial dysfunction are implicated in emphysema pathogenesis, and angiotensin II receptor blockers (ARB) inhibit TGF-β, improve endothelial function and restore airspace architecture in murine models...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28191607/retrospective-study-of-the-clinical-characteristics-and-risk-factors-of-rheumatoid-arthritis-associated-interstitial-lung-disease
#4
Yongfeng Zhang, Hongbin Li, Nawei Wu, Xin Dong, Yi Zheng
This study aims to explore the clinical characteristics and risk factors of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD). This is a retrospective study of 550 patients with RA. All patients underwent chest high-resolution computed tomography (HRCT) scanning. (1) Two hundred thirty-seven out of five hundred fifty (43.1%) patients with RA were diagnose with ILD. 13.5% ILD occurred before RA onset, 69.6% ILD occurred within 10 years of RA onset, and 16.9% ILD occurred more than 10 years after RA onset...
February 12, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28157121/a-three-dimensional-approach-for%C3%A2-identifying-small-pulmonary-vessels%C3%A2-in%C3%A2-smokers
#5
Junchao Ma, Nan Yu, Cong Shen, Zhimin Wang, Taiping He, You-Min Guo
BACKGROUND: This study aims to develop a computerized scheme that utilizes a differential geometric approach to identify pulmonary vessels and then evaluate the performance of the scheme on the CT images of heavy smokers. METHODS: The scheme consists of two primary steps to segment entire lung vascular tree and identify the number of pulmonary vessels in a cross section. The scheme performance including accuracy, consistency, and efficiency was assessed using 102 chest CT scans...
February 3, 2017: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/28154579/rare-presentation-of-left-lower-lobe-pulmonary-artery-dissection
#6
René Hako, Ján Fedačko, Štefan Tóth, Radoslav Morochovič, Pavol Kristian, Tímea Pekárová, Petri Tuomainen, Daniel Pella
Background. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. Case Presentation. We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28152279/pulmonary-vein-stenosis-of-ex-premature-infants-with-pulmonary-hypertension-and-bronchopulmonary-dysplasia-epidemiology-and-survival-from-a-multicenter-cohort
#7
Linda Mahgoub, Tarek Kaddoura, A Rebecca Kameny, Paloma Lopez Ortego, Rachel D Vanderlaan, Ashok Kakadekar, Frank Dicke, Ivan Rebeyka, Christopher A Calderone, Andrew Redington, Maria Jesus Del Cerro, Jeff Fineman, Ian Adatia
BACKGROUND: Pulmonary vein stenosis is emerging as an important clinical problem in ex-premature infants. METHODS: We sought to describe the epidemiology of pulmonary vein stenosis affecting ex-premature infants by a multicenter retrospective cohort study of patients from seven children's hospitals diagnosed between 2000-2014. RESULTS: We identified 39 ex-premature patients (26 males, median gestational age 28 weeks range 22-36 weeks, birth weight 1...
February 2, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28127435/dementia-gait-disturbance-and-urinary-incontinence-in-a-patient-with-pulmonary-sarcoidosis
#8
Gonzalo Labarca, Romina Ramirez, Ximena Monsalve, Isabel Mira-Avendano
Hydrocephalus is an uncommon presentation of neurosarcoidosis. We discuss the case of a 67-year-old woman with a prior diagnosis of hypothyroidism, systemic hypertension, and lung sarcoidosis who presented with a 1-month history of progressive impairment of consciousness leading to prostration and loss of sphincter control. At admission, patient was febrile with altered speech and without focalization. Laboratory results showed leucocytosis and mild anaemia. Cerebrospinal fluid (CSF) analysis was characterized by mild elevated protein level, increased cell count, normal glucose and adenosine deaminase (ADA), negative cytology, and no bacterial isolations...
September 2016: Respirology Case Reports
https://www.readbyqxmd.com/read/28120560/vegf-promoter-polymorphism-confers-an-increased-risk-of-pulmonary-arterial-hypertension-in-a-chinese-population
#9
Yufeng Zhuo, Qingchun Zeng, Peng Zhang, Guoyang Li, Qiang Xie, Ying Cheng
PURPOSE: Evidence on the contribution of genes to the hereditary predisposition to pulmonary arterial hypertension (PAH) is limited. MATERIALS AND METHODS: In this study, we hypothesized that single nucleotide variants in vascular endothelial growth factor (VEGF) gene may alter gene function and expression and may be associated with PAH risk. Five putatively functional loci (rs699947C>A and rs833061T>C in the promoter, rs3025040C>T, rs10434G>A and rs3025053G>A in the 3'-UTR) in the VEGF gene were genotyped and analyzed in a retrospective study of 587 patients with PAH and 736 healthy subjects from southern China...
March 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28091982/death-from-pulmonary-embolism-of-cyanoacrylate-glue-following-gastric-varix-endoscopic-injection
#10
Michael Philip Burke, Chris O'Donnell, Yeliena Baber
We present the case of a 25 year old woman with a complex past medical history including Crigler-Najjar syndrome (Type 1) with a liver transplant in 1993 and subsequent development of cirrhosis with portal hypertension in the transplanted liver. The deceased presented to hospital with hematemesis and investigations showed a large gastric varix. The varix was injected with cyanoacrylate glue. Within 30 min of injection the patient became acutely hypoxic. Urgent chest X-ray demonstrated radio opaque glue within the pulmonary arteries...
March 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28070489/acute-disseminated-histoplasmosis-with-atypical-lymphocytosis-in-an-immunocompetent-host
#11
Ayman Elbadawi, Hamdy M A Ahmed, Hussain Adly, Mohamed A Elkhouly, Samar Abohamed, Ann R Falsey
65 year-old-male presented with a one-week history of high grade fever, fatigue and confusion which began abruptly two days after a cystoscopy procedure. Past medical history included pulmonary sarcoidosis diagnosed by mediastinal lymph biopsy, diabetes and hypertension. On admission he was febrile and confused with stable vital signs. Initial workup included negative Head CT and lumbar puncture. Blood work revealed normal metabolic and liver function tests with progressive anemia, thrombocytopenia and atypical lymphocytosis of 15-20%...
2017: IDCases
https://www.readbyqxmd.com/read/28063199/diagnostic-accuracy-of-echocardiography-combined-with-chest-ct-in-pulmonary-hypertension
#12
Adil Shujaat, Abubakr A Bajwa, Farah Al-Saffar, Jason Bellardini, Lisa Jones, James D Cury
BACKGROUND: Transthoracic echocardiography (TTE) and computerized axial tomography (CT) are complementary imaging techniques. It is possible that a combination of the two may offer a better way of identifying pulmonary hypertension (PH) than either one alone. OBJECTIVES: To determine the diagnostic accuracy of TTE combined with chest CT in pulmonary hypertension. METHODS: We performed a retrospective review of consecutive patients who had undergone TTE, CT and right heart catheterization (RHC) between 7/1/2008 and 6/30/2012...
January 7, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28062433/rivaroxaban-lessens-the-number-of-thrombi-in-the-left-atrium-and-right-lower-pulmonary-vein-as-illustrated-by-transoesophageal-echocardiography-but-not-80-mdct
#13
Hidekazu Takeuchi
Stroke is a clinically important problem. A left atrial thrombus is known as a cause of ischaemic stroke. A pulmonary vein thrombus (PVT) is thought to be rare; however, PVT is common in elderly patients. Additionally, images of PVT with transoesophageal echocardiography (TEE) following treatment have not been well contrasted with that from either 64 or 80-slice multidetector CT (80-MDCT). The images of such changes depicted by TEE remain unknown. An 87-year-old man with hypertension was examined by 80-MDCT and TEE to check the cardiac thrombus...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28060193/imaging-in-chronic-thromboembolic-pulmonary-hypertension
#14
Rahul D Renapurkar, Sankaran Shrikanthan, Gustavo A Heresi, Charles T Lau, Deepa Gopalan
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the potentially curable causes of pulmonary hypertension and is definitively treated with pulmonary thromboendartectomy. CTEPH can be overlooked, as its symptoms are nonspecific and can be mimicked by a wide range of diseases that can cause pulmonary hypertension. Early diagnosis of CTEPH and prompt evaluation for surgical candidacy are paramount factors in determining future outcomes. Imaging plays a central role in the diagnosis of CTEPH and patient selection for pulmonary thromboendartectomy and balloon pulmonary angioplasty...
January 2, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28043611/usefulness-of-pulmonary-artery-diameter-in-diagnosing-pulmonary-hypertension-in-patients-admitted-to-tuberculosis-intensive-care-unit
#15
Armin Nowroozpoor, Seyed Mohammadreza Hshemian, Majid Malekmohammad, Majid Marjani, Payam Tabarsi, Hamidreza Jamaati, Batoul Khoundabi, Afshin Moniri
OBJECTIVE/BACKGROUND: Pulmonary hypertension (PH) can be a complication of patients with severe pulmonary tuberculosis (TB). We aimed to study the correlation between pulmonary artery (PA) diameter (PAD) as measured by computed tomography (CT) and mean PA pressure (mPAP) as measured by echocardiography. We also aimed to determine the accuracy of PAD in diagnosing PH in patients with pulmonary TB. METHODS: We retrospectively investigated the correlation between PAD measured using CT and mPAP measured using echocardiography in 132 patients with TB and PH, and 68 patients with TB but without PH, admitted to the TB intensive care unit at Masih Daneshvari Hospital in Tehran, Iran...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28034568/efficacy-and-safety-of-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension-guided-by-cone-beam-computed-tomography-and-electrocardiogram-gated-area-detector-computed-tomography
#16
Takeshi Ogo, Tetsuya Fukuda, Akihiro Tsuji, Shigefumi Fukui, Jin Ueda, Yoshihiro Sanda, Yoshiaki Morita, Ryotaro Asano, Nao Konagai, Satoshi Yasuda
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. METHODS: We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment...
December 21, 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/28011890/idiopathic-myelofibrosis-with-disseminated-hepatosplenic-mesenteric-renal-and-pulmonary-extramedullary-haematopoeisis-portal-hypertension-and-tuberculosis-initial-presentation-and-2%C3%A2-years-follow-up
#17
Ananya Panda, Sheragaru Hanumanthappa Chandrashekhara, Aruna Nambirajan, Pravas Mishra
A 35-year-old man with a 12-year history of idiopathic myelofibrosis (IMF) presented in 2014 with fatigue and abdominal distension. CT scan revealed massive hepatosplenomegaly with focal splenic lesions, soft tissue around renal pelvis, mesenteric masses compressing bowel loops and perilymphatic nodules in lungs. There was portal hypertension, ascites, pleural effusion, bilateral psoas abscesses and necrotic retroperitoneal lymphadenopathy. MRI additionally revealed hypointense periportal infiltrative lesions in liver, not seen on CT scan...
December 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/28009778/left-atrium-maximal-axial-cross-sectional-area-is-a-specific-computed-tomographic-imaging-biomarker-of-world-health-organization-group-2-pulmonary-hypertension
#18
Khalil Jivraj, Arash Bedayat, Yon K Sung, Roham T Zamanian, Francois Haddad, Ann N C Leung, Jarrett Rosenberg, H Henry Guo
PURPOSE: Left heart disease is associated with left atrial enlargement and is a common cause of pulmonary hypertension (PH). We investigated the relationship between left atrium maximal axial cross-sectional area (LA-MACSA), as measured on chest computed tomography (CT), and PH due to left heart disease (World Health Organization group 2) in patients with right heart catheterization-proven PH. MATERIALS AND METHODS: A total of 165 patients with PH who had undergone right heart catheterization with pulmonary artery pressure and pulmonary capillary wedge pressure (PCWP) measurements and nongated chest CTs were included...
December 22, 2016: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/27987279/falsely-elevated-troponin-rare-occurrence-or-future-problem
#19
James Nguyen, Rosy Thachil, Neil Vyas, Thomas Marino
INTRODUCTION: Troponins are known to be released in response to cardiac damage and therefore are the biomarkers of choice for the early diagnosis of acute myocardial infarction (AMI), improving outcome in patients presenting with chest pain. However, false results can occur due to interference from other substances in the blood. CASE: A 52-year-old male with a past medical history of alcohol abuse, hypertension, and coronary artery bypass graft at age 34 with normal stress test 2 years before presented to the emergency department (ED) complaining of 1 day of non-exertional chest pain with radiation to the neck and left arm...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27979575/the-right-atrium-and-tricuspid-annulus-are-cardinal-structures-in-tricuspid-regurgitation-with-or-without-pulmonary-hypertension
#20
Naohiko Nemoto, Jonathan G Schwartz, John R Lesser, Wesley D Pedersen, Paul Sorajja, Ross Garberich, Erin M Spinner, Robert S Schwartz
BACKGROUND: Right heart structural abnormalities occur in both tricuspid regurgitation (TR) and pulmonary hypertension (PH). They may occur independently or together, but their joint effects on cardiac structure are incompletely described. This study examined the interactions of TR severity and PH on right heart structural changes. METHODS: The study evaluated 455 patients undergoing both echocardiography and CT angiography (CTA). Cases were divided into 3 groups by TR severity: trace (n=217), mild (n=174), and significant (moderate or severe, n=64)...
March 1, 2017: International Journal of Cardiology
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