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https://www.readbyqxmd.com/read/28087968/thymic-carcinoma-presenting-with-an-unusual-and-delayed-metastasis-to-the-neural-foramen-mimicking-thoracic-spinal-radiculopathy
#1
H M Low, C F Wong, M W H'ng
We report a case of metastatic thymic carcinoma which presented as an enhancing mass located in the neural foramen of the thoracic spine. More common tumours which arise in the neural foramen would include a neurogenic tumour or developmental anomalies such as a foregut duplication cyst. This case is singular firstly because the lesion present as radiculopathy which mimics a neurogenic tumour. Secondly, the presentation was unusually delayed as the patient presented to our centre more than a decade after the resection of the primary tumour in another institution...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#2
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28087132/practice-patterns-of-thoracic-radiotherapy-for-extensive-stage-small-cell-lung-cancer-survey-of-us-academic-thoracic-radiation-oncologists
#3
Carl M Post, Vivek Verma, Timur Mitin, Charles B Simone
PURPOSE: Despite the recent CREST trial demonstrating a survival benefit to thoracic radiotherapy (TRT) for patients with extensive-stage small-cell lung cancer (ES-SCLC) with response to chemotherapy, as well as endorsement by current National Comprehensive Cancer Network guidelines, TRT may not be uniformly delivered in clinical practice across all circumstances. METHODS AND MATERIALS: We surveyed US academic thoracic radiation oncologists regarding their practice patterns for TRT and assessed conditions in which withholding TRT could be warranted...
December 22, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28087062/timing-and-magnitude-of-lumbar-spine-contribution-to-trunk-forward-bending-and-backward-return-in-patients-with-acute-low-back-pain
#4
Iman Shojaei, Milad Vazirian, Elizabeth G Salt, Linda R Van Dillen, Babak Bazrgari
Alterations in the lumbo-pelvic coordination denote changes in neuromuscular control of trunk motion as well as load sharing between passive and active tissues in the lower back. Differences in timing and magnitude aspects of lumbo-pelvic coordination between patients with chronic low back pain (LBP) and asymptomatic individuals have been reported; yet, the literature on lumbo-pelvic coordination in patients with acute LBP is scant. A case-control study was conducted to explore the differences in timing and magnitude aspects of lumbo-pelvic coordination between females with (n=19) and without (n=19) acute LBP...
January 4, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28087049/-the-benefits-of-digital-chest-drainage-in-pleural-decortication-in-thoracic-empyema-prospective-randomized-control-trial
#5
José M Mier, Gildardo Cortés-Julián, Juan Berrios-Mejía, Zotés Víctor-Valdivia
BACKGROUND: Prolonged air leak after pleural decortication is one of the most frequent complications. OBJECTIVE: The aim of this study is to compare the effects of prolonged air leak between the digital chest drainage (DCD) system and the classic drainage system in patients with empyema class IIB or III (American Thoracic Society classification) in pleural decortication patients. MATERIAL AND METHODS: A total of 37 patients were enrolled in a prospective randomized control trial over one year, consisting of 2blinded groups, comparing prolonged air leak as a main outcome, the number of days until removal of chest drain, length of hospital stay and complications as secondary outcomes...
January 10, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28086989/correlation-between-the-ki-67-proliferation-index-and-response-to-radiation-therapy-in-small-cell-lung-cancer
#6
Naoya Ishibashi, Toshiya Maebayashi, Takuya Aizawa, Masakuni Sakaguchi, Haruna Nishimaki, Shinobu Masuda
BACKGROUND: In the breast cancer, the decision whether to administer adjuvant therapy is increasingly influenced by the Ki-67 proliferation index. In the present retrospective study, we investigated if this index could predict the therapeutic response to radiation therapy in small cell lung cancer (SCLC). METHODS: Data from 19 SCLC patients who received thoracic radiation therapy were included. Clinical staging was assessed using the TNM classification system (UICC, 2009; cstage IIA/IIB/IIIA/IIIB = 3/1/7/8)...
January 13, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28086896/fast-track-surgery-versus-conventional-perioperative-management-of-lung-cancer-associated-pneumonectomy-a-randomized-controlled-clinical-trial
#7
Qing Dong, Kai Zhang, Shouqiang Cao, Jian Cui
BACKGROUND: The aim of this study is to investigate the effects of fast-track surgery (FTS) on postoperative recovery, hospital stay, total medical costs, and the complications of pneumonectomy in patients with non-small cell lung cancer (NSCLC). METHODS: Studies were performed between June 2012 and March 2014 in 17 patients received FTS and 18 patients given conventional management (control) after pneumonectomy in the Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University...
January 13, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28081314/cryptogenic-organizing-pneumonia-clinical-and-radiological-features-treatment-outcomes-of-17-patients-and-review-of-the-literature
#8
Elif Yelda Niksarlıoğlu, Gülcihan Zehra Özkan, Nur Dilek Bakan, Sibel Yurt, Lütfiye Kılıç, Güngör Çamsarı
BACKGROUND/AIM: We evaluated patients with cryptogenic organizing pneumonia (COP) who attended our clinic. MATERIALS AND METHODS: We retrospectively investigated the clinical and radiological findings, diagnostic methods, treatment, and follow-up outcomes of 17 patients who had been histopathologically diagnosed with COP. RESULTS: The mean age of the patients was 49.8 ± 10.4 years. The most common symptom was cough (n = 15; 88.2%) and the most common radiological finding (n = 10) was consolidation in the inferior lobes on thoracic computed tomography...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28081050/white-paper-of-the-society-of-computed-body-tomography-and-magnetic-resonance-on-dual-energy-ct-part-3-vascular-cardiac-pulmonary-and-musculoskeletal-applications
#9
Carlo N De Cecco, U Joseph Schoepf, Lynne Steinbach, Daniel T Boll, W Dennis Foley, Ravi K Kaza, David N Bolus, Desiree E Morgan, Dushyant V Sahani, William P Shuman, Marilyn J Siegel, Terri J Vrtiska, Benjamin M Yeh, Lincoln L Berland
This is the third of a series of 4 white papers that represent Expert Consensus Documents developed by the Society of Computed Body Tomography and Magnetic Resonance through its Task Force on dual-energy computed tomography. This paper, part 3, describes computed tomography angiography and thoracic, cardiac, vascular, and musculoskeletal clinical applications. At the end of the discussion of each application category (vascular, cardiac, pulmonary, and musculoskeletal), we present our consensus opinions on the current clinical utility of the application and opportunities for further research...
January 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28079847/relationship-between-abnormalities-on-high-resolution-computerized-tomography-pulmonary-function-and-bronchoalveolar-lavage-in-progressive-systemic-sclerosis
#10
Gulfidan Cakmak, Tuba Selcuk Can, Sule Gundogdu, Canan Akman, Hande Ikitimur, Benan Musellim, Gul Ongen
:  Introduction and aim: Progressive systemic sclerosis (pSS) is a multisystemic connective tissue disease characterized by fibrosis of the skin and internal organs including lung. The mechanisms that leads to progressive lung fibrosis in scleroderma remain obscure. In this study, we aimed to investigate the correlation between HRCT findings and patients' clinical and functional status and the degree of alveolitis based on the BAL resultsMaterials and methods: 65 patients with pSS were evaluated...
December 23, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/28079832/usefulness-of-low-dose-chest-ct-for-initial-evaluation-of-blunt-chest-trauma
#11
Sung Jung Kim, Anjali Basnyat Bista, Young Gi Min, Eun Young Kim, Kyung Joo Park, Doo Kyoung Kang, Joo Sung Sun
We aimed to compare the diagnostic performance and inter-observer consistency between low dose chest CT (LDCT) and standard dose chest CT (SDCT) in the patients with blunt chest trauma.A total of 69 patients who met criteria indicative of blunt chest trauma (77% of male; age range, 16-85) were enrolled. All patients underwent LDCT without intravenous (IV) contrast and SDCT with IV contrast using parameters as following: LDCT, 40 mAs with automatic tube current modulation (ATCM) and 100 kVp (BMI <25, n = 51) or 120 kVp (BMI>25, n = 18); SDCT, 180 mAs with ATCM and 120 kVp...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#12
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079662/recognition-of-a-thoracic-epidural-hematoma-in-the-setting-of-transient-paralysis-a-case-report
#13
Beth VanderWielen, Lindsay Rubenstein, Marc Shnider, Cindy Ku, Jason Wakakuwa
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079660/anesthetic-management-of-a-child-with-jeune-syndrome-for-tracheotomy-a-case-report
#14
Masakazu Kotoda, Tadahiko Ishiyama, Katsumi Okuyama, Takashi Matsukawa
Jeune syndrome is a rare autosomal-recessive skeletal disorder. Anesthetic management of these patients is often difficult because of thoracic and lung hypoplasia. A 5-month-old boy with Jeune syndrome was scheduled to undergo a tracheotomy. Despite 5-minute preoxygenation with continuous positive airway pressure, the patient's oxygen saturation rapidly dropped during the induction of anesthesia. The continuous positive airway pressure should have been titrated to effective tidal volume during preoxygenation to recruit the patient's functional residual capacity and to prevent desaturation...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079597/histologic-findings-of-severe-therapy-resistant-asthma-from-video-assisted-thoracoscopic-surgery-biopsies
#15
Humberto E Trejo Bittar, Daniel Doberer, Mitra Mehrad, Diane C Strollo, Joseph K Leader, Sally Wenzel, Samuel A Yousem
The histologic changes occurring in severe/therapy-resistant asthma (SA) as defined by the European Respiratory Society/American Thoracic Society guidelines, particularly at the level of the distal airways are unknown. This study describes the clinical, radiologic, and histologic characteristics of 29 SA patients who underwent video-assisted thoracoscopic surgery lung biopsy. Pathologic observations were correlated with clinical features, especially the presence of autoimmune disease (AID) (15/29, 51.7%). Ten biopsies (10/29, 34...
February 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28078376/ipsilateral-dual-site-same-sitting-percutaneous-lung-biopsy-a-feasibility-study
#16
Joseph Barnett, Aniket N Tavare, Sajid Khan, Ashish Saini, Dean D Creer, Samanjit S Hare
PURPOSE: Patients with thoracic malignancies often have more than one site of pulmonary, nodal or pleural disease within one hemithorax. In addition, large heterogeneous lesions may comprise distinct, mixed pathological entities. Histological analysis of these lesions can alter tumour staging and treatment options. We investigated the feasibility, safety and benefit of performing image-guided percutaneous lung biopsy (PLB) of two lesions in the same hemithorax at a single sitting. MATERIALS AND METHODS: Ten consecutive outpatients with two or more potential disease foci within the same hemithorax were analysed over a 15-month period...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28078076/sex-dependent-alteration-of-cardiac-cytochrome-p450-gene-expression-by-doxorubicin-in-c57bl-6-mice
#17
Marianne K O Grant, Davis M Seelig, Leslie C Sharkey, Beshay N Zordoky
BACKGROUND: There is inconclusive evidence about the role of sex as a risk factor for doxorubicin (DOX)-induced cardiotoxicity. Recent experimental studies have shown that adult female rats are protected against DOX-induced cardiotoxicity. However, the mechanisms of this sexual dimorphism are not fully elucidated. We have previously demonstrated that DOX alters the expression of several cytochrome P450 (CYP) enzymes in the hearts of male rats. Nevertheless, the sex-dependent effect of DOX on the expression of CYP enzymes is still not known...
2017: Biology of Sex Differences
https://www.readbyqxmd.com/read/28077537/chronic-postsurgical-pain-in-children-prevalence-and-risk-factors-a-prospective-observational-study
#18
H Batoz, F Semjen, M Bordes-Demolis, A Bénard, K Nouette-Gaulain
BACKGROUND: Chronic postsurgical pain (CPSP) is well known in adults, with prevalence rates ranging from 10 to 50%. Little is known about the epidemiology of CPSP in children. The aim of this prospective observational study was to evaluate the prevalence of CPSP after surgery in children. METHODS: After informed consent, children aged six to18 yr were included. Characteristics and risk factors for CPSP were recorded. Exclusion criteria included ambulatory surgery, refusal, inability to understand and change of address...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077503/european-association-for-cardio-thoracic-surgery-expert-consensus-statement-on-the-prevention-and-management-of-mediastinitis
#19
Yasir Abu-Omar, Gregor J Kocher, Paolo Bosco, Cristina Barbero, David Waller, Tomas Gudbjartsson, Miguel Sousa-Uva, Peter B Licht, Joel Dunning, Ralph A Schmid, Giuseppe Cardillo
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28077473/a-joint-ers-ats-policy-statement-what-constitutes-an-adverse-health-effect-of-air-pollution-an-analytical-framework
#20
George D Thurston, Howard Kipen, Isabella Annesi-Maesano, John Balmes, Robert D Brook, Kevin Cromar, Sara De Matteis, Francesco Forastiere, Bertil Forsberg, Mark W Frampton, Jonathan Grigg, Dick Heederik, Frank J Kelly, Nino Kuenzli, Robert Laumbach, Annette Peters, Sanjay T Rajagopalan, David Rich, Beate Ritz, Jonathan M Samet, Thomas Sandstrom, Torben Sigsgaard, Jordi Sunyer, Bert Brunekreef
The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies...
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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