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Dyspnea approach

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https://www.readbyqxmd.com/read/29665800/mda-5-associated-rapidly-progressive-interstitial-lung-disease-with-recurrent-pneumothoraces-a-case-report
#1
Safi Alqatari, Peter Riddell, Sinead Harney, Michael Henry, Grainne Murphy
BACKGROUND: Clinically hypomyopathic dermatomyositis is a rare disease that is important to recognize, investigate and treat early as it is associated with poor prognosis. In a proportion of patients, myositis specific antibodies could be negative, but with high clinical suspicion, myositis associated antibodies should be ordered. Anti-MDA-5 antibodies was reported in literature to be associated with severe and rapidly progressive interstitial lung disease, with few case reports of pneumothorax and/or pneumomediastinum...
April 17, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29657739/an-atypical-presentation-of-a-pericardial-cyst
#2
Dev R Sahni, Sonal G Vijayanagar, Rishi K Bala, Vipal K Sabharwal
A pericardial cyst is a benign and rare congenital anomaly. The presentation of pericardial cysts varies with the extent of mediastinal involvement. Complaints can include dyspnea, pleuritic chest pain and systemic symptoms; however, the majority are asymptomatic. Imaging modalities such as MRI, CT and X-ray can visualize the cysts. Treatment approach includes aspiration or surgical resection. We describe an atypical presentation of a pericardial cyst and subsequent treatment and recommendations for these rare anomalies...
November 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29642752/lupus-myocarditis-a-single-center-experience-and-a-comparative-analysis-of-observational-cohort-studies
#3
J Tanwani, K Tselios, D D Gladman, J Su, M B Urowitz
Background Lupus myocarditis (LM) is reported in 3-9% of patients with systemic lupus erythematosus (SLE) but limited evidence exists regarding optimal treatment and prognosis. This study aims to describe LM in a defined lupus cohort as compared with the existing literature. Patients and methods Patients with LM were identified from the University of Toronto Lupus Clinic database. Diagnosis was based on clinical manifestations and electrocardiographic, imaging, and biochemical criteria. Demographic, clinical, diagnostic and therapeutic variables and outcomes were collected in a standardized data retrieval form...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29619581/approach-to-undifferentiated-dyspnea-in-emergency-department-aids-in-rapid-clinical-decision-making
#4
Siva Nageswara Rao Guttikonda, Kiran Vadapalli
BACKGROUND: Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in emergency department (ED). A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The primary aim of our study is to assess a diagnostic strategy using multiorgan point of care ultrasonography (USG) to differentiate patients presenting with acute dyspnea to ED into different diagnostic categories for timely management in a resource-limited setting...
April 4, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29618325/chylopericardium-in-a-child-with-iga-nephropathy-a-case-report
#5
Yu-Lin Kang, Yun Cui, Ying Wu, Shen Hao, Xin-Yu Kuang, Yu-Cai Zhang, Wen-Yan Huang, Guang-Hua Zhu
BACKGROUND: Chylopericardium effusion is characterized by the accumulation of milky effusion in the pericardium. It is often idiopathic but it can be secondary to trauma, chest radiation, tuberculosis and malignancy. If cardiac tamponade ensues, it becomes life-threatening. Herein we describe chylopericardium tamponade in a child with IgA nephropathy. To the best of our knowledge, this is the first reported case of chylopericardium tamponade in IgA nephropathy. CASE PRESENTATION: A 6 years old boy with IgA nephropathy presented with dyspnea, orthopnea, pretibial pitting edema, ascites and fever...
April 5, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29595991/the-clinical-effects-of-manipulative-therapy-in-people-with-chronic-obstructive-pulmonary-disease
#6
Jayde Galletti, George Mcheileh, Andrew Hahne, Annemarie Louise Lee
OBJECTIVES: This study aimed to determine the effects of manipulative therapies (MT), including spinal manipulation, and diaphragmatic release techniques on lung function, exercise capacity, symptoms, and health-related quality of life (HRQOL) in people with chronic obstructive pulmonary disease (COPD). DESIGN: Systematic review. PARTICIPANTS: People diagnosed with COPD. INTERVENTION: Randomized controlled trials of MT (either with or without pulmonary rehabilitation [PR]) compared to other treatments (soft tissue [ST] therapy or sham therapy) applied in people with COPD were identified following the search of seven databases...
March 29, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29592765/alternative-surgical-procedure-for-treating-superior-vena-cava-syndrome-in-a-hemodialysis-patient
#7
Chen L Yao, Zheng L Tan, Ran Tian, Peng Miao, Xin Chen, Zheng Y Yu
BACKGROUND: The incidence of superior vena cava syndrome has been increasing in hemodialysis patients with the widespread use of dialysis catheters. Although endovascular intervention remains the primary choice for treatment, the long-term patency rate is not optimistic. Occlusive lesions are often encountered that cannot be opened using this intervention. Therefore, we chose to present this case involving a pericardial patch used to reconstruct the superior vena cava in the treatment of catheter-associated chronic superior vena cava occlusion...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29579882/left-single-lung-transplantation-through-left-anterolateral-thoracotomy-with-longitudinal-partial-sternotomy-hemiclamshell-an-innovative-surgical-resource
#8
D A Murillo, F Cerezo, H D Gauman, F J Gonzalez, A Muñoz, P M Moreno, M J Ceballos, A Salvatierra
INTRODUCTION: Pulmonary fibrosis (PF) is one of the main indications for lung transplantation among end-stage respiratory diseases. PF represents a surgical challenge due to the pulmonary retraction, reduction of pleural space, and limitation for access of the lung hilum by elevation, specifically on the left lung. Unilateral sternothoracotomy, or hemiclamshell (HCS) approach, is the anterolateral thoracotomy with longitudinal partial sternotomy with possibility of cervical extension...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29567890/a-perplexing-primary-novel-hilar-lesion-remember-the-pneumonic-ppnhl
#9
Ketaki Utpat, Unnati D Desai, Gayathri Amonkar, Jyotsna M Joshi
A 60-year-old female presented with dyspnea, cough, and chest pain with a left hilar mass lesion. In our case, clinicoradiological correlation, bronchoscopy, and computed tomography-guided biopsy revealed the diagnosis of primary pulmonary non-Hodgkin's lymphoma (PPNHL) on histopathology and immunohistochemistry. We discuss the approach to hilar masses. PPNHL is a rare malignant lymphoma most common being mucosa-associated lymphoid tissue lymphoma. Various therapeutic options are available. The chemotherapy regimen consisting of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) is preferred...
January 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29556779/echocardiographic-evaluation-of-the-right-heart
#10
REVIEW
Matthias Schneider, Thomas Binder
Symptoms of right ventricular failure include dyspnea, a reduction in exercise capacity, and fluid retention. Right ventricular (dys)function strongly influences functional state and survival. The right ventricle is directly involved in a variety of diseases. A thorough analysis of right ventricular size and function, as well as estimation of pulmonary artery pressures is an important part of every echocardiographic examination. This review analyses the most commonly used parameters for quantification of right ventricular function...
March 19, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29554957/tension-pneumoperitoneum-after-surgery-for-endometrial-cancer-and-hernia-in-a-morbidly-obese-female-a-case-report
#11
Bing-Sheng Lin, Yan-Shen Shan, Wan-Chen Liu, Chin-Han Wu, Pei-Ying Wu, Keng-Fu Hsu
BACKGROUND: Obesity is a risk factor for the development of endometrial cancer and abdominal wall hernias. We report a case of tension pneumoperitoneum that developed after gynecological surgery and mesh repair of a ventral hernia. CASE PRESENTATION: A 57-year-old Asian Taiwanese woman with a body mass index of 52.9 (kg/m2 ) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy due to endometrial cancer, and ventral herniorrhaphy with mesh due to ventral hernia...
March 20, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29550338/mechanism-of-cardiovascular-toxicity-by-proteasome-inhibitors-new-paradigm-derived-from-clinical-and-pre-clinical-evidence
#12
REVIEW
Mara Gavazzoni, Enrico Vizzardi, Elio Gorga, Ivano Bonadei, Laura Rossi, Angelo Belotti, Giuseppe Rossi, Rossella Ribolla, Marco Metra, Riccardo Raddino
Proteasome Inhibitors (PI) have now become the cornerstone of treatment of multiple myeloma (MM). Carfilzomib has been demonstrated to cause more frequent cardiovascular side effects such as dyspnea, hypertension, and heart failure. Recent pre-clinical studies have investigated the effects of proteasome on myocardial and vascular cells, but the pathogenic mechanism underlying the effects of proteasome inhibition on these cells is poorly understood. We reviewed the evidence from clinical trials, post-hoc analysis and small observational studies currently available and summarized the data from experimental, focusing on the pathogenic mechanisms potentially implicated in the cardiovascular toxicity of proteasome inhibitor, particularly of carfilzomib that is most responsible for cardiovascular side effects...
March 15, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29535876/ultrasound-guided-interscalene-catheter-complicated-by-persistent-phrenic-nerve-palsy
#13
Andrew T Koogler, Michael Kushelev
A 76-year-old male presented for reverse total shoulder arthroplasty (TSA) in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Three weeks postoperatively, the patient reported worsening dyspnea with a subsequent chest X-ray demonstrating an elevated right hemidiaphragm. Pulmonary function testing revealed worsening deficit from presurgical values consistent with phrenic nerve palsy...
2018: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29533692/comparing-the-effect-of-pulmonary-rehabilitation-in-patients-with-uncontrolled-and-partially-controlled-asthma
#14
Hulya Sahin, Ilknur Naz
OBJECTIVE: Pulmonary rehabilitation (PR) is an important therapeutic approach in asthmatic patients. Lack of asthma control is associated with high morbidity, poor health outcomes, and decrease in quality of life (QOL). However, there is no clear information about the effectiveness of PR in patients with differing levels of asthma control. This study aimed to compare the efficacy of PR in patients with uncontrolled and partially controlled asthma. METHODS: Before undergoing an 8-week outpatient PR program, patients were classified according to the asthma control test (ACT) as having partially controlled asthma or uncontrolled asthma...
March 13, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29524398/functional-electrical-stimulation-a-new-therapeutic-approach-to-enhance-exercise-intensity-in-chronic-obstructive-pulmonary-disease-patients-a-randomised-controlled-cross-over-trial
#15
Clément Medrinal, Guillaume Prieur, Yann Combret, Aurora Robledo Quesada, David Debeaumont, Tristan Bonnevie, Francis Edouard Gravier, Elise Dupuis Lozeron, Jean Quieffin, Olivier Contal, Bouchra Lamia
OBJECTIVE: To evaluate the effect of quadriceps Functional Electrical Stimulation (FES)-Cycling on exertional VO2 compared with Placebo FES-cycling in patients with COPD. DESIGN: A randomised, single-blind, placebo-controlled, cross-over trial SETTING: Pulmonary Rehabilitation Department PARTICIPANTS: 23 consecutive patients with COPD GOLD stage 2, 3 or 4 (mean FEV1 : 1.4±0.4 L (50.3% pred)) who had recently begun a respiratory rehabilitation program. INTERVENTION: Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-Cycling...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29522655/assessment-of-left-atrial-size-in-addition-to-focused-cardiopulmonary-ultrasound-improves-diagnostic-accuracy-of-acute-heart-failure-in-the-emergency-department
#16
Maria Viviana Carlino, Fiorella Paladino, Alfonso Sforza, Claudia Serra, Filomena Liccardi, Giovanni de Simone, Costantino Mancusi
BACKGROUND: Acute dyspnea is one of the main reasons for admission to Emergency Department (ED). Availability of ultraminiaturized pocket ultrasound devices (PUD) adds diagnostic power to the clinical examination. The aim of this study was to identify an integrated ultrasound approach for diagnosis of acute heart failure (acute HF), using PUD and combining evaluation from lung, heart and inferior vena cava (IVC). METHODS: We included 102 patients presenting to the ED of "Antonio Cardarelli" Hospital in Naples (Italy) for acute dyspnea (AD)...
March 9, 2018: Echocardiography
https://www.readbyqxmd.com/read/29521676/another-strategy-for-the-treatment-of-thyroglossal-duct-cyst-totally-endoscopic-surgery-by-breast-approach
#17
Rui Qu, Cunchuan Wang, Zhiyong Dong, Jinyi Li, Daosheng Liu
OBJECTIVE: Open surgery is the most common treatment of thyroglossal duct cyst (TGDC), but it leaves obvious neck scarring. This study aimed to explore the feasibility and strategy of total endoscopic procedure by breast approach to avoid such scarring on the neck. MATERIALS AND METHODS: This study reviewed 13 patients who underwent endoscopic resection of TGDC and 15 patients who underwent open resection of TGDC. We compared and analyzed factors including operative time, estimated blood loss, postoperative hospitalization, complications, and cosmetic effect...
March 7, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29508899/patient-reported-outcomes-from-a-phase-3-randomized-controlled-trial-of-inotuzumab-ozogamicin-versus-standard-therapy-for-relapsed-refractory-acute-lymphoblastic-leukemia
#18
Hagop M Kantarjian, Yun Su, Elias J Jabbour, Helen Bhattacharyya, Eric Yan, Joseph C Cappelleri, David I Marks
BACKGROUND: Inotuzumab ozogamicin (InO), an anti-CD22 antibody-calicheamicin conjugate, demonstrated superior clinical activity versus standard-of-care (SOC) chemotherapies for relapsed/refractory B-cell acute lymphoblastic leukemia in the phase 3 randomized controlled INO-VATE trial. The authors assessed patient-reported outcomes (PROs) from that study. METHODS: Patients were randomized to receive either InO (1.8 mg/m2 per cycle for ≤6 cycles) or SOC (fludarabine/cytarabine [ara-C]/granulocyte colony-stimulating factor, or ara-C plus mitoxantrone, or high-dose ara-C for ≤4 cycles) and completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the EuroQoL 5 Dimensions Questionnaires at baseline, on day 1 of each cycle, and at the end of treatment...
March 6, 2018: Cancer
https://www.readbyqxmd.com/read/29501297/tracheal-paraganglioma-presenting-as-stridor-in-a-pediatric-patient-case-report-and-literature-review
#19
Amy L Dimachkieh, Allison Dobbie, Damon R Olson, Mark A Lovell, Jeremy D Prager
OBJECTIVE: To review tracheal paragangliomas and describe the clinical presentation, radiologic findings, operative management, and histologic findings of a pediatric patient who presented with stridor refractory to traditional asthma therapy. METHODS: Chart review of an 8-year-old male who presented to a tertiary care pediatric hospital and literature review of tracheal paragangliomas. RESULTS: We present the case of an 8-year-old male who presented with new-onset of wheezing and dyspnea on exertion...
April 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29495970/large-scale-external-validation-and-comparison-of-prognostic-models-an-application-to-chronic-obstructive-pulmonary-disease
#20
Beniamino Guerra, Sarah R Haile, Bernd Lamprecht, Ana S Ramírez, Pablo Martinez-Camblor, Bernhard Kaiser, Inmaculada Alfageme, Pere Almagro, Ciro Casanova, Cristóbal Esteban-González, Juan J Soler-Cataluña, Juan P de-Torres, Marc Miravitlles, Bartolome R Celli, Jose M Marin, Gerben Ter Riet, Patricia Sobradillo, Peter Lange, Judith Garcia-Aymerich, Josep M Antó, Alice M Turner, Meilan K Han, Arnulf Langhammer, Linda Leivseth, Per Bakke, Ane Johannessen, Toru Oga, Borja Cosio, Julio Ancochea-Bermúdez, Andres Echazarreta, Nicolas Roche, Pierre-Régis Burgel, Don D Sin, Joan B Soriano, Milo A Puhan
BACKGROUND: External validations and comparisons of prognostic models or scores are a prerequisite for their use in routine clinical care but are lacking in most medical fields including chronic obstructive pulmonary disease (COPD). Our aim was to externally validate and concurrently compare prognostic scores for 3-year all-cause mortality in mostly multimorbid patients with COPD. METHODS: We relied on 24 cohort studies of the COPD Cohorts Collaborative International Assessment consortium, corresponding to primary, secondary, and tertiary care in Europe, the Americas, and Japan...
March 2, 2018: BMC Medicine
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