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https://www.readbyqxmd.com/read/27902957/giant-pedunclated-lipoma-of-the-esophagus-a-case-report
#1
Naohiro Taira, Hidenori Kawasaki, Akiko Koja, Tomonori Furugen, Yasuji Oshiro, Eriko Atsumi, Takaharu Ichi, Kazuaki Kushi, Tomofumi Yohena, Tsutomu Kawabata, Masanao Saio, Naoki Yoshimi
INTRODUCTION: Although Esophageal lipoma is extremely rare and pathologically benign, surgical excision of the lipoma is recommended when symptomatic or uncertain biological behavior. In general, some of the esophageal lipoma has a stalk. The pedunclated non-invasive tumor can be removed by stalk ligation, which is either endoscopic or surgical approache. Therefore, the preoperative evaluation is essential. We herein present a case of a huge esophageal lipoma. CASE REPORT: A 82-year-old man, with a wet cough and dyspnea for 6 months, who had the huge mass that almost completely occupied the esophageal lumen, was referred to our institution for the treatment...
November 21, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27891257/melas-syndrome-with-cardiac-involvement-a-multimodality-imaging-approach
#2
Sara Seitun, Laura Massobrio, Anna Rubegni, Claudia Nesti, Margherita Castiglione Morelli, Sara Boccalini, Athena Galletto Pregliasco, Irilda Budaj, Luca Deferrari, Gian Marco Rosa, Fabrizio Montecucco, Alberto Valbusa
A 49-year-old man presented with chest pain, dyspnea, and lactic acidosis. Left ventricular hypertrophy and myocardial fibrosis were detected. The sequencing of mitochondrial genome (mtDNA) revealed the presence of A to G mtDNA point mutation at position 3243 (m.3243A>G) in tRNA(Leu(UUR)) gene. Diagnosis of cardiac involvement in a patient with Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes syndrome (MELAS) was made. Due to increased risk of sudden cardiac death, cardioverter defibrillator was implanted...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27875096/paraesophageal-hernia-repair-techniques-for-success
#3
Tyler D Cohn, Nathaniel J Soper
With the introduction of laparoscopy, the outcomes of patients undergoing paraesophageal hernia repair have improved dramatically. When the fundamentals of a proper repair are followed, patients can expect to have improvement in gastroesophageal reflux symptoms, including heartburn, regurgitation, chest pain, dysphagia, and dyspnea. Adhering to these principles will alleviate patients' symptoms and avoid reoperation. This article describes the approach to paraesophageal hernia repair, including patient evaluation, operative technique, and postoperative management...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27874259/transcatheter-closure-of-calcified-patent-ductus-arteriosus-in-older-adult-patients-immediate-and-12-month-follow-up-results
#4
Xinghua Gu, Qiuwang Zhang, Hourong Sun, Jianchun Fei, Xiquan Zhang, Michael J Kutryk
OBJECTIVE: To present our experience in transcatheter closure of calcified patent ductus arteriosus (PDA) in older adult patients, which has rarely been reported. PATIENTS: From 2009 to 2014, a total of 16 patients (median age 58 years) with calcified PDA underwent transcatheter closure in our center. All patients were symptomatic with major symptoms being exertional dyspnea (in 12), palpitations (in 8), and fatigue (in 5). A continuous murmur was heard in all patients...
November 22, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27849304/biatrial-approach-provides-better-outcomes-in-the-surgical-treatment-of-cardiac-myxomas
#5
Ahmet Yüksel, Davit Saba, Yusuf Velioğlu, Serdar Ener, Hayati Özkan
Objective: We aimed to present clinical features, surgical approaches, importance of surgical technique and long-term outcomes of our patients with cardiac myxoma who underwent surgery. Methods: We retrospectively collected data of patients with cardiac myxoma who underwent surgical resection between February 1990 and November 2014. Biatrial approach is the preferred surgical method in a large proportion of patients that are operated due to left atrial myxoma because it provides wider exposure than the uniatrial approach...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27821828/-primary-spontaneous-pneumothorax-with-an-azygos-lobe
#6
Shoji Nakata, Shin Satake, Yoshitomo Okumura, Satoshi Hara, Kyongyob Min, Keiko Nakayama
A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Chest computed tomography revealed a collapsed lung and floating membrane, which was the lowermost part as a tear-shaped shadow. After the chest tube was inserted and surgical management was performed using a video-assisted thoracoscopic approach. At surgery, the visceral and parietal layers of pleura forming the mesoazygos were not fused, and azygos vein had a partial mobility. There was no adhesion between an upper lobe and visceral pleura...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27806818/delayed-presentation-of-forgotten-thyroid-goiter-25-years-after-thyroidectomy
#7
Fazal Wahab Khan, Ayesha Muhammad, Mohsin Abbas, Syed Usman Bin Mahmood, Benish Fatima, Saulat H Fatimi
Forgotten goiter is a rare occurrence (2 - 16% of retrosternal thyroid cases) that depicts recurrence of retrosternal thyroid mass due to growth of remnant thyroid tissue overlooked during an initial thyroidectomy. The patient is a 59-year female who presented with dyspnea and stridor 25 years after total thyroidectomy. She was diagnosed as having a mediastinal mass on radiographic imaging. There were only localized pressure symptoms due to mass effect. The mass was excised employing an extra-cervical approach and using a partial sternotomy...
October 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27803752/body-mass-index-airflow-obstruction-and-dyspnea-and-body-mass-index-airflow-obstruction-dyspnea-scores-age-and-pack-years-predictive-properties-of-new-multidimensional-prognostic-indices-of-chronic-obstructive-pulmonary-disease-in-primary-care
#8
Khalid Ansari, Niall Keaney, Andrea Kay, Monica Price, Joan Munby, Andrew Billett, Sharon Haggerty, Ian K Taylor, Hajed Al Otaibi
BACKGROUND: The assessment of the severity of chronic obstructive pulmonary disease (COPD) should involve a multidimensional approach that is now clearly shown to be better than using spirometric impairment alone. The aim of this study is to validate and compare novel tools without an exercise test and to extend prognostic value to patients with less severe impairment of Forced expiratory volume 1 s. METHODS: A prospective, observational, primary care cohort study identified 458 eligible patients recruited from the primary care clinics in the northeast of England in 1999-2002...
October 2016: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/27790495/acute-right-heart-failure-in-a-patient-with-right-heart-thrombus-and-pulmonary-thromboembolism
#9
Mohammad Mostafa Ansari-Ramandi, Samaneh Ansari-Ramandi, Nasim Naderi
Right Heart Thrombus (RiHT) management is really controversial, and appropriate guidelines are not present for the management. In patients referring with RiHT and Pulmonary Embolism (PE), there are three ways of managing these patients. Out of the three, one is thrombectomy, which is with high risk taking in mind the comorbidities these patients have. The other is using thrombolytic which, in many cases is contraindicated or with high risk. The other less effective way is full anticoagulation. It is really controversial to choose between these ways of management and no clear approach is present...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27765845/the-reservoir-wave-approach-to-characterize-pulmonary-vascular-right-ventricular-interactions-in-man
#10
Anukul Ghimire, Mads Andersen, Lindsay M Burrowes, James Christopher Bouwmeester, Andrew D Grant, Israel Belenkie, Nowell M Fine, Barry A Borlaug, John V Tyberg
Using the reservoir-wave approach (RWA) we previously characterized pulmonary vasculature mechanics in a normal canine model. We found reflected backward-travelling waves that decrease pressure and increase flow in the proximal pulmonary artery (PA). These waves decrease right ventricular (RV) afterload and facilitate RV ejection. With pathological alterations to the pulmonary vasculature, these waves may change and impact RV performance. Our objective in this study was to characterize PA wave reflection and the alterations in RV performance in cardiac patients, using the RWA...
October 20, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27758996/crohn-s-disease-associated-interstitial-lung-disease-mimicking-sarcoidosis-a-case-report-and-review-of-the-literature
#11
Choua Thao, Amir Lagstein, Tadashi Allen, Huseyin Erhan Dincer, Hyun Joo Kim
Respiratory involvement in Crohn's disease (CD) is a rare manifestation known to involve the large and small airways, lung parenchyma, and pleura. The clinical presentation is nonspecific, and diagnostic tests can mimic other pulmonary diseases, posing a diagnostic challenge and delay in treatment. We report a case of a 60-year-old female with a history of CD and psoriatic arthritis who presented with dyspnea, fever, and cough with abnormal radiological findings. Diagnostic testing revealed an elevated CD4:CD8 ratio in the bronchoalveolar lavage fluid, and cryoprobe lung biopsy results showed non-necrotizing granulomatous inflammation...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27758995/pulmonary-stenting-for-the-treatment-of-sarcoid-induced-pulmonary-vascular-stenosis
#12
Jose F Condado, Vasilis Babaliaros, Travis S Henry, Brian Kaebnick, Dennis Kim, Gerald W Staton
BACKGROUND: The best treatment of patients with external pulmonary vascular compression due to advanced sarcoidosis is unknown. OBJECTIVES: To report a single-center experience of percutaneous treatment for pulmonary vascular stenosis caused by external compression due to advanced sarcoidosis. METHODS: We report a case series of 5 patients with biopsy confirmed advanced sarcoidosis, seen at our academic institution with worsening dyspnea despite increase of immunosuppressive therapy...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27758984/clinical-features-of-sarcoidosis-in-oman-a-report-from-the-middle-east-region
#13
B Jayakrishnan, Nasser Al-Busaidi, Ahsan Al-Lawati, Jojy George, Omar A Al-Rawas, Yaqoub Al-Mahrouqi, Nabil Al-Lawati
BACKGROUND: Though clinical features of sarcoidosis follow a similar pattern, some heterogeneity is seen in different ethnic and racial groups. OBJECTIVES: To describe for the first time the clinical characteristics of sarcoidosis patients in the Sultanate of Oman. METHODS: The data on all cases of sarcoidosis followed up in the two tertiary hospitals in Oman were retrieved retrospectively. RESULTS: Of the 92 patients, for representing the ethnic data only Omani patients (n=83) were included...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27751189/treatment-after-acute-coronary-syndrome-analysis-of-patient-s-priorities-with-analytic-hierarchy-process
#14
Axel C Mühlbacher, Susanne Bethge, Anika Kaczynski
BACKGROUND: Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS. METHODS: To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted...
January 2016: International Journal of Technology Assessment in Health Care
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
#15
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/27710876/bilateral-simultaneous-vats-for-complete-resection-of-bilateral-posterior-mediastinal-bronchogenic-cyst-a-case-report
#16
Dario Amore, Francesco S Cerqua, Fabio Perrotta, Antonio Cennamo, Carlo Curcio
INTRODUCTION: The mediastinal bronchogenic cysts represents 50%-60% of mediastinal cysts and rarely occurs in the posterior mediastinum. The final surgical resection is indicated for symptomatic patients and is recommended for some asymptomatic patients in order to establish the diagnosis and to avoid any subsequent complications. CASE PRESENTATION: We report a case of 17 years-old male suffering from bronchogenic cysts of the mediastinum. The patient was admitted to our hospital complaining with dry chough and dyspnea; CT scan showed a cystic mass in posterior mediastinum...
September 23, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27703365/long-term-safety-of-tiotropium-delivered-by-respimat-%C3%A2-softmist%C3%A2-inhaler-patient-selection-and-special-considerations
#17
Ching Kuo Tan, Gui Quan Say, James B Geake
Tiotropium bromide is a long-acting inhaled muscarinic antagonist used in patients with chronic respiratory disease. It has been available since 2002 as a single-dose dry powder formulation via the HandiHaler(®) dry powder inhaler (DPI) device, and since 2007 as the Respimat(®) SoftMist™ Inhaler (SMI). The latter is a novel method of medication delivery that utilizes a multidose aqueous solution to deliver the drug as a fine mist. Potential benefits include more efficient drug deposition throughout the respiratory tract, reduced systemic exposure, and greater ease of use and patient satisfaction compared with the use of HandiHaler DPI...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27659741/a-multidisciplinary-telehealth-program-in-patients-with-combined-chronic-obstructive-pulmonary-disease-and-chronic-heart-failure-study-protocol-for-a-randomized-controlled-trial
#18
Palmira Bernocchi, Simonetta Scalvini, Tiziana Galli, Mara Paneroni, Doriana Baratti, Ottavia Turla, Maria Teresa La Rovere, Maurizio Volterrani, Michele Vitacca
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist, significantly reducing patients' quality of life and increasing morbidity and mortality. For either single disease, a multidisciplinary disease-management approach supported by telecommunication technologies offers the best outcome in terms of prolonged survival and reduced hospital readmissions. However, no data exist in patients with combined COPD/CHF. We planned a randomized controlled trial to investigate the feasibility and efficacy of an integrated, home-based, medical/nursing intervention plus a rehabilitation program versus conventional care in patients with coexisting COPD/CHF...
2016: Trials
https://www.readbyqxmd.com/read/27648273/an-unusual-cause-of-dyspnea-and-tachycardia
#19
Ian S Reynolds, Peter Coyle, Michael Murray, Ronan Waldron, Kevin Barry
Diaphragmatic hernias are typically congenital or caused by trauma. Delayed presentation is not uncommon. Repair can be undertaken through an open or minimally invasive abdominal or thoracic approach. Small defects can be repaired with sutures, while larger defects require a mesh repair. This patient's comorbidities precluded him from surgery.
September 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27638064/vestibular-symptoms-and-history-taking
#20
A Bisdorff
History taking is an essential part in the diagnostic process of vestibular disorders. The approach to focus strongly on the quality of symptoms, like vertigo, dizziness, or unsteadiness, is not that useful as these symptoms often coexist and are all nonspecific, as each of them may arise from vestibular and nonvestibular diseases (like cardiovascular disease) and do not permit to distinguish potentially dangerous from benign causes. Instead, patients should be categorized if they have an acute, episodic, or chronic vestibular syndrome (AVS, EVS, or CVS) to narrow down the spectrum of differential diagnosis...
2016: Handbook of Clinical Neurology
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