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Dyspnea approach

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https://www.readbyqxmd.com/read/28345959/ventilatory-inefficiency-and-exertional-dyspnea-in-early-chronic-obstructive-pulmonary-disease
#1
J Alberto Neder, Danilo C Berton, Paulo de Tarso Müller, Amany F Elbehairy, Alcides Rocha, Paolo Palange, Denis E O'Donnell
Exertional dyspnea is present across the spectrum of chronic obstructive pulmonary disease (COPD) severity. However, without realizing it themselves, patients may decrease daily physical activity to avoid distressing respiratory sensations. Dyspnea also may be associated with deconditioning. Cardiopulmonary exercise testing can uncover exertional dyspnea and its physiological determinants in patients with preserved or only mildly-reduced FEV1. Dyspnea in mild COPD can largely be explained by increased "wasted" ventilation in the physiological dead space which heightens the drive to breathe and worsens the inspiratory mechanical constraints...
March 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28321811/interleukin-2-old-and-new-approaches-to-enhance-immune-therapeutic-efficacy
#2
Pooja Dhupkar, Nancy Gordon
Interleukin-2 (IL-2) is a very well-known cytokine that has been studied for the past 35 years. It plays a major role in the growth and proliferation of many immune cells such NK and T cells. It is an important immunotherapy cytokine for the treatment of various diseases including cancer. Systemic delivery of IL-2 has shown clinical benefit in renal cell carcinoma and melanoma patients. However, its use has been limited by the numerous toxicities encountered with the systemic delivery. Intravenous IL-2 causes the well-known "capillary leak syndrome," or the leakage of fluid from the circulatory system to the interstitial space resulting in hypotension (low blood pressure), edema, and dyspnea that can lead to circulatory shock and eventually cardiopulmonary collapse and multiple organ failure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28302292/short-term-effects-of-tolvaptan-in-patients%C3%A2-with-acute-heart-failure-and%C3%A2-volume-overload
#3
Marvin A Konstam, Michael Kiernan, Arthur Chandler, Ravi Dhingra, Freny Vaghaiwalla Mody, Howard Eisen, W Herbert Haught, Lynne Wagoner, Divya Gupta, Richard Patten, Paul Gordon, Kenneth Korr, Russell Fileccia, Susan J Pressler, Douglas Gregory, Patricia Wedge, Douglas Dowling, Matthew Romeling, Jeremy M Konstam, Joseph M Massaro, James E Udelson
BACKGROUND: In patients with acute heart failure (AHF), dyspnea relief is the most immediate goal. Renal dysfunction, diuretic resistance, and hyponatremia represent treatment impediments. OBJECTIVES: It was hypothesized that the addition of tolvaptan to a background diuretic improved dyspnea early in patients selected for an enhanced vasopressin antagonism response. METHODS: In a double-blind trial, patients were randomized to tolvaptan 30 mg/day or placebo...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28295572/dyspnea-following-thoracostomy-closure-after-right-pneumonectomy-an-uncommon-echocardiographic-diagnosis-and-therapeutic-approach
#4
Matteo Pernigo, Barbara Canneto, Davide Betta, Gionata Molinari, Flavio Ribichini, Guido Zannini, Corrado Vassanelli, Andrea Rossi
Dyspnea and hypoxemia are common postoperative problems after pneumonectomy. One of the rarer causes of respiratory distress after right pneumonectomy is the development of a significant right-to-left shunt across a patent foramen ovale (PFO), which can evolve at a variable interval of time after the operation. We report here our experience with a patient who underwent right pneumonectomy, followed by several complications, and who presented severe dyspnea 7 months later, after the closure of a right thoracostomy...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28290856/-chronic-heart-failure-with-preserved-systolic-function-and-reversible-dilatation-of-cardiac-chambers
#5
O V Blagova, S V Volkov, A V Nedostup, A O Korobkov, I V Mostovoy, N G Sergushina, N V Gagarina, E A Mershina
Diagnosis of dilation (D) cardiomyopathy (CMP) requires exclusion not only of inflammatory and genetically determined forms but also of some rare diseases. This 51 year old patient with history of moderate arterial hypertension approached a cardiologist because of new onset atrial fibrillation and dyspnea. Echocardiography detected dilation of all cardiac chambers with relatively preserved ejection fraction, causing suspicion of DCMP. Among conditions excluded were coronary atherosclerosis, congenital heart defect with left to right shunt, primary pulmonary hypertension, pulmonary embolism, hypertensive heart, tachycardia induced CMP, arrhythmogenic right ventricular dysplasia, noncompaction myocardium...
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28277858/pathophysiology-of-dyspnea-in-copd
#6
Antonio Anzueto, Marc Miravitlles
Dyspnea refers to the sensation of breathlessness, shortness of breath, or difficulty breathing that is commonly observed in patients with respiratory and cardiac disease. In the United States alone, dyspnea is reported in up to 4 million all-cause emergency room visits annually. Dyspnea can be a symptom of several different underlying physical conditions, typically involving the lung and heart. Indeed, it is an important symptom in chronic obstructive pulmonary disease (COPD), where it is associated with limited physical activity, increased anxiety and depression, decreased health-related quality of life (HRQoL), and reduced survival...
April 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28275353/advances-in-the-evaluation-of-respiratory-pathophysiology-during-exercise-in-chronic-lung-diseases
#7
REVIEW
Denis E O'Donnell, Amany F Elbehairy, Danilo C Berton, Nicolle J Domnik, J Alberto Neder
Dyspnea and exercise limitation are among the most common symptoms experienced by patients with various chronic lung diseases and are linked to poor quality of life. Our understanding of the source and nature of perceived respiratory discomfort and exercise intolerance in chronic lung diseases has increased substantially in recent years. These new mechanistic insights are the primary focus of the current review. Cardiopulmonary exercise testing (CPET) provides a unique opportunity to objectively evaluate the ability of the respiratory system to respond to imposed incremental physiological stress...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#8
David B Auyong, Stanley C Yuan, Daniel S Choi, Joshuel A Pahang, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: Continuous brachial plexus blocks at the interscalene level are associated with known diaphragm dysfunction from phrenic nerve paresis. More distal blocks along the brachial plexus may provide postsurgical analgesia while potentially having less effect on diaphragm function. Continuous interscalene, continuous supraclavicular, and continuous suprascapular nerve blocks were evaluated for respiratory function and analgesia after total shoulder arthroplasty. METHODS: After ethics board approval, subjects presenting for total shoulder arthroplasty were planned for randomization in a 1:1:1 ratio of a continuous interscalene, supraclavicular, or suprascapular block...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28272203/sarcoidosis-associated-with-infliximab-therapy-in-ulcerative-colitis-a-case-report
#9
Georgiana-Emmanuela Gîlcă, Smaranda Diaconescu, Gheorghe Gh Bălan, Oana Timofte, Gabriela Ştefănescu
RATIONALE: Although immunomodulatory therapy has been clearly stated as an important landmark in treatment of ulcerative colitis, significantly improving the quality of life for patients with inflammatory bowel disease, there are several aspects to be considered regarding the possible side-effects of anti-TNF alpha agents. In spite of a good safety profile, biologic TNF antagonists may induce paradoxical inflammation, which can manifest as sarcoid-like granulomatosis, consisting of noncaseating granulomas in the affected organs...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28254561/extracorporeal-ige-immunoadsorption-in-allergic-asthma-safety-and-efficacy
#10
Christian Lupinek, Kurt Derfler, Silvia Lee, Thomas Prikoszovich, Oliver Movadat, Eva Wollmann, Carolin Cornelius, Milena Weber, Renate Fröschl, Regina Selb, Katharina Blatt, Dubravka Smiljkovic, Volker Schoder, René Cervenka, Thomas Plaichner, Gottfried Stegfellner, Hans Huber, Rainer Henning, Justyna Kozik-Jaromin, Thomas Perkmann, Verena Niederberger, Ventzislav Petkov, Peter Valent, Adelheid Gauly, Hans Peter Leinenbach, Ingrid Uhlenbusch-Koerwer, Rudolf Valenta
BACKGROUND: Prevention of IgE-binding to cellular IgE-receptors by anti-IgE (Omalizumab) is clinically effective in allergic asthma, but limited by IgE threshold-levels. To overcome this limitation, we developed a single-use IgE immunoadsorber column (IgEnio). IgEnio is based on a recombinant, IgE-specific antibody fragment and can be used for the specific extracorporeal desorption of IgE. OBJECTIVE: To study safety and efficacy of IgEnio regarding the selective depletion of IgE in a randomized, open-label, controlled pilot trial in patients with allergic asthma and to investigate if IgEnio can bind IgE-Omalizumab immune complexes...
February 12, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28251961/-anticytokine-therapy-of-allergic-asthma
#11
I P Shilovskiy, D V Eroshkina, A A Babakhin, M R Khaitov
Bronchial asthma is a chronic inflammatory disease of the airways that is characterized by episodes of shortness of breath, expiratory dyspnea, cough, wheezing, and pulmonary emphysema. At the present time, asthma is a global public health problem and affects about 5% of the worldwide population. Although a wide range of anti-inflammatory drugs is available, uncontrolled or poorly controlled asthma is still a problem, requiring the development of novel therapeutic approaches. Intense studies of the molecular mechanisms of asthma in transgenic animals performed since the 1990s implicated cytokines, such as IL-4, IL-5, and IL-13, and their receptors in the initiation and maintenance of asthma...
January 2017: Molekuliarnaia Biologiia
https://www.readbyqxmd.com/read/28239910/adverse-symptoms-of-immunosuppressants-a-survey-of-canadian-transplant-clinicians
#12
J J Harrison, H Mansell, T Blydt-Hansen
Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients, however standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician-dependent, clinician views remain largely unexplored. We surveyed Canadian Society of Transplantation members on their perceptions of ASI including frequency, perceived QOL impact, causal attribution, management strategies and success. Sixty-one clinicians participated in the survey of 12 ASI (tremor, diarrhea, nausea, constipation, dyspnea, insomnia, edema, dyspnea, arthralgia, acne, mouth sores, paresthesias), for a 22% response rate...
February 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28223673/-a-case-of-meningeal-carcinomatosis-and-small-cell-lung-carcinoma-effectively-treated-using-a-multidisciplinary-approach
#13
Kota Hikima, Mikie Nagayama, Takashi Sato, Takashi Inoue, Mutsumi Nagai
A 65-year-old man visited our hospital with dyspnea and cough. He was diagnosed with small cell lung carcinoma (cT4N2M1b, Stage IV). The disease partially responded to systemic chemotherapy. However, it was progressive and metastasized to the brain 3 months after 6 courses of chemotherapy. Therefore, whole brain irradiation was performed. Subsequently, weakness of the lower extremities and vesicorectal disturbances appeared. Meningeal carcinomatosis was diagnosed by enhanced magnetic resonance imaging and liquid examination...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28221172/interventional-pulmonology-in-chronic-obstructive-pulmonary-disease
#14
Daniela Gompelmann, Nilab Sarmand, Felix J F Herth
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and emphysema are widespread diseases associated with progressive dyspnea because of airflow limitation and hyperinflation. Fundamental therapeutic strategies consist of pulmonary rehabilitation, pharmacotherapy, long-term oxygen therapy, noninvasive ventilation, and surgical therapeutic approaches. RECENT FINDINGS: In the last 14 years, endoscopic therapeutic modalities emerged as a substantial part of severe COPD and emphysema treatment...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28217685/right-ventricular-metastatic-tumor-from-a-primary-carcinoma-of-uterine-cervix-a-cause-of-pulmonary-embolism
#15
Gwan Hee Han, Do Youn Kwon, Roshani Ulak, Kyung Do Ki, Jong-Min Lee, Seon-Kyung Lee
The presence of intracavitary cardiac metastasis from squamous cell carcinoma of the uterine cervix is extremely rare. The diagnosis is made almost exclusively postmortem. Apart from causing intracardiac obstruction, it can present as pulmonary emboli and the prognosis is extremely poor. It is important to suspect this diagnosis in patient with recurrent pulmonary emboli. Due to the rarity of this condition it is very difficult to standardize care for these patients. However, it is possible that aggressive therapy may lengthen patients' survival and quality of life...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#16
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28205183/large-primary-pleural-synovial-sarcoma-with-severe-dyspnea-a-case-report
#17
Minoru Yamaki, Shuji Yonehara, Toshio Noriyuki
BACKGROUND: Synovial sarcoma is a malignant neoplasm of soft tissues. It occurs mainly in the extremities and is closely related to tendons, tendon sheaths, and bursal structures. Primary synovial sarcoma of the pleura and lungs is extremely rare. CASE PRESENTATION: We present the case of a 62-year-old man with a large synovial sarcoma of the left pleura. He presented with general fatigue and severe dyspnea. Chest computed tomography (CT) revealed a 20-cm tumor in the left thoracic cavity...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28196638/japanese-guidelines-for-adult-asthma-2017
#18
REVIEW
Masakazu Ichinose, Hisatoshi Sugiura, Hiroyuki Nagase, Masao Yamaguchi, Hiromasa Inoue, Hironori Sagara, Jun Tamaoki, Yuji Tohda, Mitsuru Munakata, Kohei Yamauchi, Ken Ohta
Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms...
February 11, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28186686/combined-bone-marrow-derived-mesenchymal-stromal-cell-therapy-and-one-way-endobronchial-valve-placement-in-patients-with-pulmonary-emphysema-a-phase-i-clinical-trial
#19
Hugo Goulart de Oliveira, Fernanda Ferreira Cruz, Mariana Alves Antunes, Amarilio Vieira de Macedo Neto, Guilherme Augusto Oliveira, Fabio Munhoz Svartman, Tamara Borgonovo, Carmen Lucia Kuniyoshi Rebelatto, Daniel J Weiss, Paulo Roberto Slud Brofman, Marcelo Marcos Morales, José Roberto Lapa E Silva, Patricia Rieken Macedo Rocco
One-way endobronchial valves (EBV) insertion to reduce pulmonary air trapping has been used as therapy for chronic obstructive pulmonary disease (COPD) patients. However, local inflammation may result and can contribute to worsening of clinical status in these patients. We hypothesized that combined EBV insertion and intrabronchial administration of mesenchymal stromal cells (MSCs) would decrease the inflammatory process, thus mitigating EBV complications in severe COPD patients. This initial study sought to investigate the safety of this approach...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28181709/combination-therapy-of-over-the-scope-clip-and-covered-metallic-stent-for-refractory-multiple-esophagobronchial-fistulae-and-stenosis
#20
Hirohito Mori, Asadur Rahman, Tsutomu Masaki
Many reports have indicated efficacy of Over-The-Scope-Clip (OTSC) regarding closure of perforation [1, 2]. However, closure of esophagobronchial fistula still remains difficult even by OTSC due to hard tissue of bronchial wall [3]. Combination approaches of OTSC and covered stent were performed to reduce intolerable symptoms. A 59-year-old man was diagnosed with advanced lung cancer with severe dyspnea and massive sputum. This article is protected by copyright. All rights reserved.
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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