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Dyspnea approach

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https://www.readbyqxmd.com/read/28223673/-a-case-of-meningeal-carcinomatosis-and-small-cell-lung-carcinoma-effectively-treated-using-a-multidisciplinary-approach
#1
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
#2
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...
February 17, 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
#3
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
#4
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
#5
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
#6
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
#7
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...
December 9, 2016: 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
#8
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
https://www.readbyqxmd.com/read/28164609/anti-cytoplasmic-autoantibodies-in-hodgkin-s-lymphoma
#9
Joachim Sennekamp, Hans-Peter Seelig
BACKGROUND: A 42-year old male patient with anamnesis of bronchial asthma presented himself with exertional dyspnea. High titer antibodies of cytoplasmic pattern in the indirect immunofluorescence test (IIFT) on HEp-2cells, not attributable to common specificities like anti-tRNA-synthetases, anti-signal recognition particle (SRP) or anti-ribosomal proteins (RPs) prompted the molecular biological approach for determination of antigen specificity. In-depth investigation of the patient's clinical settings revealed a lymphocyte predominant Hodgkin's lymphoma, which could be brought to complete remission by chemotherapy...
August 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28151877/impact-of-standardized-patients-on-the-training-of-medical-students-to-manage-emergencies
#10
Frank Herbstreit, Stefanie Merse, Rainer Schnell, Marcel Noack, Daniel Dirkmann, Anna Besuch, Jürgen Peters
BACKGROUND: Teaching emergency management should educate medical students not only for facts and treatment algorithms but also for time effective physical examination, technical skills, and team interaction. We tested the hypothesis, that using standardized emergency patients would be more effective in transmitting knowledge and skills compared with a more traditional teaching approach. METHODS: Medical students (n = 242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings ("acute chest pain," "stroke," and "acute dyspnea/asthma") or traditional small group seminars...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149069/impact-of-yoga-in-a-case-of-vocal-cord-dysfunction-with-dysautonomia
#11
Rozina Wadhwania
A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion characteristic of vocal cord dysfunction...
January 2017: International Journal of Yoga
https://www.readbyqxmd.com/read/28107437/hyperventilation-with-maintenance-of-isocapnia-an-old-new-method-in-carbon-monoxide-intoxication
#12
Jacek Sein Anand, Daria Schetz, Wojciech Waldman, Marek Wiśniewski
INTRODUCTION: Exposure to carbon monoxide (CO) is among the most common causes of acute and chronic poisonings worldwide. The crucial point of treatment of such acute poisonings is to eliminate CO from the body as fast as possible. There are currently two approaches to the management of the CO intoxication: hyperbaric oxygen therapy (HOT) and normobaric oxygen therapy (NOT). HOT is highly effective and capable of achieving the CO elimination half-time (T½) as low as 15 minutes. Unfortunately this method is expensive and not always readily available...
2017: PloS One
https://www.readbyqxmd.com/read/28100958/routine-dyspnea-assessment-and-documentation-nurses-experience-yields-wide-acceptance
#13
Kathy M Baker, Susan DeSanto-Madeya, Robert B Banzett
BACKGROUND: Dyspnea (breathing discomfort) is a common and distressing symptom. Routine assessment and documentation can improve management and relieve suffering. A major barrier to routine dyspnea documentation is the concern that it will have a deleterious effect on nursing workflow and that it will not be readily accepted by nurses. Nurses at our institution recently began to assess and document dyspnea on all medical-surgical patients upon admission and once per shift throughout their hospitalization...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28072848/physiologic-determinants-of-exercise-capacity-in-pulmonary-langerhans-cell-histiocytosis-a-multidimensional-analysis
#14
Camille Rolland-Debord, Stephanie Fry, Jonathan Giovannelli, Carole Langlois, Nicolas Bricout, Bernard Aguilaniu, Agnes Bellocq, Olivier Le Rouzic, Stephane Dominique, Alain Delobbe, Geraldine François, Abdellatif Tazi, Benoit Wallaert, Cecile Chenivesse
BACKGROUND: Reduced exercise capacity severely impacts quality of life in pulmonary Langerhans cell histiocytosis. Ascertaining mechanisms that impair exercise capacity is necessary to identify targets for symptomatic treatments. METHODS: Dyspnea, pulmonary function tests and cardiopulmonary exercise test were analysed in 62 study participants. Data were compared between subjects with impaired and normal aerobic capacity (V'O2 peak less than 84% versus 84% predicted or more)...
2017: PloS One
https://www.readbyqxmd.com/read/28060255/a-model-of-cardiac-remodeling-through-constriction-of-the-abdominal-aorta-in-rats
#15
Hui-Chun Ku, Shih-Yi Lee, Yuan-Kun Aden Wu, Kai-Chien Yang, Ming-Jai Su
Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and fluid retention. Changes in myocardial structure, electrical conduction, and energy metabolism develop with heart failure, leading to contractile dysfunction, increased risk of arrhythmias, and sudden death. Hypertensive heart disease is one of the key contributing factors of cardiac remodeling associated with heart failure. The most commonly-used animal model mimicking hypertensive heart disease is created via surgical interventions, such as by narrowing the aorta...
December 2, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28055270/takotsubo-cardiomyopathy-a-known-unknown-foe-of-asthma
#16
Ourania S Kotsiou, Alexandros Douras, Demosthenes Makris, Nikoleta Mpaka, Konstantinos I Gourgoulianis
INTRODUCTION: Patients with uncontrolled asthma are at a greater risk of asthma attacks requiring emergency room visits or hospital admissions. Takotsubo cardiomyopathy is potentially a significant complication in a course of status asthmaticus. CASE STUDY: We present a 43-year-old female patient who presented with status asthmaticus further complicated with takotsubo cardiomyopathy. RESULTS: Recognizing apical ballooning syndrome is challenging in patients with a history of respiratory disease because the symptoms of the last entity may complicate the diagnostic approach...
January 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28051194/respiratory-symptoms-and-lung-function-among-greek-cotton-industry-workers-a-cross-sectional-study
#17
Ioannis D Anyfantis, Georgios Rachiotis, Cristos Hadjichristodoulou, Konstantinos I Gourgoulianis
BACKGROUND: Workers in cotton industry are occupationally exposed to various dust-related hazards. The nature of these agents and the respective exposure levels depend on the cotton industry specific sector. These exposures could be associated with respiratory symptoms and changes in lung function parameters. OBJECTIVE: To evaluate associations between occupational exposure and respiratory function as well as reported symptoms in several groups of workers at different stages of the cotton industry in a vertical approach that covers all the major sectors-from cotton ginning to weaving and fabric production...
January 2017: International Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28039229/the-role-of-diastolic-stress-testing-in-the-evaluation-for-hfpef-a-simultaneous-invasive-echocardiographic-study
#18
Masaru Obokata, Garvan C Kane, Yogesh N V Reddy, Thomas P Olson, Vojtech Melenovsky, Barry A Borlaug
BACKGROUND: -Diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) is challenging and relies largely on demonstration of elevated cardiac filling pressures (pulmonary capillary wedge pressure, PCWP). Current guidelines recommend use of natriuretic peptides (NT-proBNP) and rest/exercise echocardiography (E/e' ratio) to make this determination. Data to support this practice is conflicting. METHODS: -Simultaneous echocardiographic-catheterization studies were prospectively conducted at rest and during exercise in subjects with invasively-proven HFpEF (n=50) and participants with dyspnea but no identifiable cardiac pathology (n=24)...
December 30, 2016: Circulation
https://www.readbyqxmd.com/read/28032218/symptom-clusters-during-palliative-chemotherapy-and-their-influence-on-functioning-and-quality-of-life
#19
Sun Young Rha, Jiyeon Lee
INTRODUCTION: Symptom management in patients undergoing palliative chemotherapy is challenging, as patients may suffer from cancer symptoms as well as symptoms related to chemotherapy. Symptom clusters are interrelated symptoms occurring simultaneously that exert a negative impact on survival. Identification of symptom clusters and effective symptom management for patients receiving palliative chemotherapy is crucial. OBJECTIVES: The purpose of this study was to identify symptom clusters among cancer patients undergoing palliative chemotherapy and examine the relationship between symptom clusters and functioning and quality of life (QOL) in these patients...
December 28, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28030345/dictyocaulosis-in-dairy-cows-in-brazil-an-epidemiological-clinical-pathological-and-therapeutic-approach
#20
Luan C Henker, Claiton I Schwertz, Neuber J Lucca, Manoela M Piva, Patricia Giacomin, Anderson Gris, Leandro A Rhoden, Luke J Norbury, Aleksandro S da Silva, Rafael A da Rosa, Ricardo E Mendes
An outbreak of severe parasitic pneumonia caused by Dictyocaulus viviparus was diagnosed in adult dairy cows in the municipality of Arabutã, Southern Brazil. The total morbidity in the herd was 71.9%, and the morbidity amongst adult lactating cattle was 100%. The main clinical signs observed were dyspnea, tachypnea, nasal discharge, decreased milk production, and cough. A necropsy was conducted on one animal in order to establish the diagnosis. The herd had been treated previously with levamisole; however, clinical signs persisted and became worse...
March 1, 2017: Acta Parasitologica
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