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Dyspnea approach

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https://www.readbyqxmd.com/read/29454783/comparison-of-the-diastolic-stress-test-with-a-combined-resting-echocardiography-and-biomarker-approach-to-patients-with-exertional-dyspnea-diagnostic-and-prognostic-implications
#1
Wojciech Kosmala, Monika Przewlocka-Kosmala, Aleksandra Rojek, Thomas H Marwick
OBJECTIVES: This study sought to establish the diagnostic and prognostic value of a strategy for prediction of abnormal diastolic response to exercise (AbnDR) using clinical, biochemical, and resting echocardiographic markers in dyspneic patients with mild diastolic dysfunction. BACKGROUND: An AbnDR (increase in left ventricular filling pressure) may indicate heart failure with preserved ejection fraction as the cause of symptoms in dyspneic patients, despite a nonelevated noncardiac at rest...
February 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29438332/diaphragmatic-palsy
#2
REVIEW
Laxmi Kokatnur, Mohan Rudrappa
The diaphragm is the primary muscle of respiration, and its weakness can lead to respiratory failure. Diaphragmatic palsy can be caused by various causes. Injury to the phrenic nerve during thoracic surgeries is the most common cause for diaphragmatic palsy. Depending on the cause, the symptoms of diaphragmatic palsies vary from completely asymptomatic to disabling dyspnea requiring mechanical ventilation. On pulmonary function tests, there will be a decrease in the maximum respiratory muscle power. Spirometry shows reduced lung functions and a significant drop of lung function in supine position is typical of diaphragmatic palsy...
February 13, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29407093/evolution-of-natriuretic-peptide-biomarkers-in-heart-failure-implications-for-clinical-care-and-clinical-trials
#3
Nicolas Vodovar, Alexandre Mebazaa, James L Januzzi, Gillian Murtagh, Wendy Gattis Stough, Kirkwood F Adams, Faiez Zannad
Natriuretic peptides (NPs) are recommended by international guidelines to exclude non-heart failure causes of acute dyspnea and to assess prognosis. NPs are commonly used as an entry criterion for clinical trials, to minimize enrollment of misdiagnosed patients, or to ensure enrollment of a sufficiently at-risk population. NP values used to select trial populations to date have been inconsistent across studies. Future trials should consider using standardized thresholds for NP levels, with protocol-specified adaptations appropriate for the specific study and patient population to account for factors that can influence the NP level...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29391101/comparative-analysis-of-laparoscopic-and-open-approaches-in-emergency-abdominal-surgery
#4
Anaar Siletz, Jonathan Grotts, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
The objective of this study was to evaluate usage and outcomes of emergency laparoscopic versus open surgery at a single tertiary academic center. Over a three-year period 165 patients were identified retrospectively using National Surgical Quality Improvement Program results. Appendectomies and cholecystectomies were excluded. Open and laparoscopic approaches were compared regarding preoperative and operative characteristics, the development of postoperative complications, 30-day mortality, and length of hospital stay...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29390370/coexisting-myasthenia-gravis-myositis-and-polyneuropathy-induced-by-ipilimumab-and-nivolumab-in-a-patient-with-non-small-cell-lung-cancer-a-case-report-and-literature-review
#5
Jia-Hung Chen, Kang-Yun Lee, Chaur-Jong Hu, Chen-Chih Chung
RATIONALE: Immune checkpoint inhibitors have led to the development of new approaches for cancer treatment with positive outcomes. However, checkpoint blockade is associated with a unique spectrum of immune-related adverse events (irAEs), which may cause irreversible neurological deficits and even death. PATIENT CONCERNS: We presented a case of a 57-year-old man with non-small-cell lung cancer.who developed ptosis, dyspnea, and muscle weakness as initial symptoms with progression after the treatment with ipilimumab and nivolumab...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388467/emerging-therapeutics-in-pulmonary-hypertension
#6
Matthew K Hensley, Andrea Levine, Mark T Gladwin, Yen-Chun Lai
Pulmonary hypertension (PH) is a progressive and often fatal illness presenting with nonspecific symptoms of dyspnea, lower extremity edema, and exercise intolerance. Pathologically, endothelial dysfunction leads to abnormal intimal and smooth muscle proliferation along with reduced apoptosis, resulting in increased pulmonary vascular resistance (PVR) and elevated pulmonary pressures. PH is subdivided into five WHO groups based on the disease pathology and specific cause. While there are FDA-approved medications for the treatment of pulmonary arterial hypertension (PAH, Group 1 PH), as well as for chronic thromboembolic pulmonary hypertension (CTEPH, Group 4 PH), the morbidity and mortality remain high...
February 1, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29380022/nasal-alar-schwannoma-an-unusual-case-report
#7
Timothy C Blood, Thomas G Townes, Shaun C Desai
PURPOSE: To present the second known case of nasal alar schwannoma, first since 1973, with important considerations for surgical management. CASE REPORT: We present the case of a 25-year-old male with a 5-year history of progressively enlarging, non-tender, right alar mass with resultant ipsilateral nasal congestion and dyspnea secondary to nasal valve collapse. The mass was located cephalic to the mid-lateral aspect of the lower lateral crural cartilage, which extended to the pyriform aperture...
January 29, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29361923/percutaneous-therapy-of-a-mediastinal-lymphangioma-with-fibrin-glue-case-report-with-clinical-success-after-4%C3%A2-years
#8
Siyu Zhou, Siyuan Dong, Jiang Du
BACKGROUND: Lymphangioma of the mediastinum is a rare benign tumor, and most of the cases are treated by a surgical approach. CASE PRESENTATION: This work reports the case of a 62-year-old female with a large lymphangioma extending from her neck to her abdomen with dysphagia, dyspnea, and cough for 2 months. Because of the location of the mass, only bilateral excision could remove the multiloculated cyst completely. However, the patient's overall physical condition was very poor, and we thought she could not tolerate the bilateral surgery...
January 24, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29351312/prognostic-relevance-of-elevated-pulmonary-arterial-pressure-assessed-non-invasively-analysis-in-a-large-patient-cohort-with-invasive-measurements-in-near-temporal-proximity
#9
Sebastian Greiner, Andreas Jud, Matthias Aurich, Christoph Geisenberger, Lorenz Uhlmann, Thomas Hilbel, Meinhard Kieser, Hugo A Katus, Derliz Mereles
BACKGROUND: The clinical relevance of non-invasively derived pulmonary arterial pressure (PAP) by Doppler echocardiography (DE) has been questioned in the past. However, transthoracic echocardiography is used as a cornerstone examination for patients with dyspnea and suspected pulmonary hypertension (PH). This study aimed to evaluate the prognostic value of non-invasive assessed PAP in a large population of patients with known or suspected cardiopulmonary disease. METHODS: The analyses are based on data of patients of a tertiary cardiology center that received right heart catheterization (RHC) as well as non-invasively assessed PAP by DE within five days, and includes serological and clinical parameters in a retrospective follow-up for up to eight years...
2018: PloS One
https://www.readbyqxmd.com/read/29321022/serum-metabolic-profiling-identified-a-distinct-metabolic-signature-in-patients-with-idiopathic-pulmonary-fibrosis-a-potential-biomarker-role-for-lysopc
#10
Barbara Rindlisbacher, Cornelia Schmid, Thomas Geiser, Cédric Bovet, Manuela Funke-Chambour
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a lethal lung disease of unknown etiology. Patients present loss of lung function, dyspnea and dry cough. Diagnosis requires compatible radiologic imaging and, in undetermined cases, invasive procedures such as bronchoscopy and surgical lung biopsy. The pathophysiological mechanisms of IPF are not completely understood. Lung injury with abnormal alveolar epithelial repair is thought to be a major cause for activation of profibrotic pathways in IPF...
January 10, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29313744/dyspnea-in-children-with-life-threatening-and-life-limiting-complex-chronic-conditions
#11
Lucas Pieper, Boris Zernikow, Ross Drake, Michael Frosch, Michael Printz, Julia Wager
BACKGROUND: Dyspnea is one of the most frequent symptoms in children with complex chronic conditions (CCC) requiring palliative care. Although it is a subject of high importance, there has been little research on dyspnea in critically ill children. OBJECTIVE: The purpose of this systematic review was to investigate the prevalence and causes of dyspnea in children with CCC and to identify the current state of research on the measurements, treatments, and the evaluation of therapeutic interventions...
January 9, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29312703/isolated-unilateral-absence-of-pulmonary-artery-in-adulthood-a-clinical-analysis-of-65-cases-from-a-case-series-and-systematic-review
#12
Ping Wang, Ling Yuan, Juhong Shi, Zuojun Xu
Background: Isolated unilateral absence of pulmonary artery (UAPA) in adulthood is a rare congenital anomaly. Although some case reports exist, the clinical symptomatology, lung parenchymal features, collateral circulation and therapeutic approaches in adult patients with isolated UAPA remain unknown. The objectives of this study are to investigate the clinical characteristics, elucidate the correlation between clinical symptomatology and radiology, and summarize treatment of adult patients with isolated UAPA...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29289262/clinical-heterogeneity-of-interstitial-lung-disease-in-polymyositis-and-dermatomyositis-patients-with-or-without-specific-autoantibodies
#13
Fang Chen, Shanshan Li, Tao Wang, Jingli Shi, Guochun Wang
BACKGROUND: The aim of this study was to compare the heterogeneity of interstitial lung disease (ILD) in patients with polymyositis and dermatomyositis (PM/DM) according to serological type. METHODS: A total of 182 patients with PM/DM-ILD were observed retrospectively. Antiaminoacyl-tRNA synthetase (ARS) and antimelanoma differentiation-associated gene5 (MDA5) antibodies were screened using immunoblotting approach. The patients with ILD were divided into 3 groups: MDA5 (with anti-MDA5 antibody), ARS (with anti-ARS antibody) and MSN (without anti-MDA5 or anti-ARS antibody) group...
January 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29288156/left-ventricular-torsion-shear-angle-volume-approach-for-noninvasive-evaluation-of-diastolic-dysfunction-in-preserved-ejection-fraction
#14
Oleg F Sharifov, Chun G Schiros, Inmaculada Aban, Gilbert J Perry, Louis J Dell'italia, Steven G Lloyd, Thomas S Denney, Himanshu Gupta
BACKGROUND: Accurate noninvasive diagnostic tools for evaluating left ventricular (LV) diastolic dysfunction (LVDD) are limited in preserved LV ejection fraction. We previously proposed the relationship of normalized rate of change in LV torsion shear angle (φ') to corresponding rate of change in LV volume (V') during early diastole (represented as -dφ'/dV') as a measure of LV diastolic function. We prospectively evaluated diagnostic accuracy of -dφ'/dV' in respect to invasive LV parameters...
December 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29242142/use-of-a-penicillin-allergy-screening-algorithm-and-penicillin-skin-testing-for-transitioning-hospitalized-patients-to-first-line-antibiotic-therapy
#15
Allison Ramsey, Mary L Staicu
BACKGROUND: Penicillin allergy is the most commonly reported antibiotic allergy. Avoidance of β-lactam antibiotics in hospitalized patients leads to the use of second-line therapies. OBJECTIVE: The utility of a penicillin allergy history algorithm (PAHA) and subsequent penicillin skin testing (PST) in transitioning hospitalized patients from second- to first-line antibiotic therapy is described. METHODS: Through an electronic medical record report, pharmacists identified adult inpatients with penicillin allergy receiving moxifloxacin, intravenous vancomycin, aztreonam, daptomycin, or linezolid, in which a β-lactam antibiotic was preferred...
December 11, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29238185/occupational-exposure-to-vapor-gas-dust-or-fumes-and-chronic-airflow-limitation-copd-and-emphysema-the-swedish-cardiopulmonary-bioimage-study-scapis-pilot
#16
Kjell Torén, Jenny Vikgren, Anna-Carin Olin, Annika Rosengren, Göran Bergström, John Brandberg
Background: The aim of this study was to estimate the occupational burden of airflow limitation, chronic airflow limitation, COPD, and emphysema. Materials and methods: Subjects aged 50-64 years (n=1,050) were investigated with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Airflow limitation was defined as FEV1/FVC <0.7 before bronchodilation. Chronic airflow limitation was defined after bronchodilation either according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as FEV1/FVC <0...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29229098/pulmonary-veno-occlusive-disease-an-important-consideration-in-patients-with-pulmonary-hypertension
#17
REVIEW
Ryan Balko, Hawa Edriss, Kenneth Nugent, Victor Test
Pulmonary veno-occlusive disease is a rare subcategory of pulmonary arterial hypertension (WHO Group 1). The disease is poorly understood and difficult to diagnose; it has no definitive cure to date. These patients present with nonspecific symptoms, including dyspnea, exercise intolerance, and weakness. Chest x-rays sometimes differ from idiopathic pulmonary arterial hypertension and may demonstrate alveolar infiltrates and pleural effusions. High resolution computed tomography scans reveal ground glass opacities, interlobular septal thickening, and lymphadenopathy...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29227712/a-comparison-of-pain-fatigue-dyspnea-and-their-impact-on-quality-of-life-in-pulmonary-rehabilitation-participants-with-chronic-obstructive-pulmonary-disease
#18
Yi-Wen Chen, Pat G Camp, Harvey O Coxson, Jeremy D Road, Jordan A Guenette, Michael A Hunt, W Darlene Reid
In addition to dyspnea and fatigue, pain is a prevalent symptom in chronic obstructive pulmonary disease (COPD). Understanding the relative prevalence, magnitude, and interference with aspects of daily living of these symptoms can improve COPD management. Therefore, the purposes of this study were to: (1) compare the prevalence and magnitude of dyspnea, fatigue, and pain and how each limits aspects of daily living; (2) determine the association between pain and the other two symptoms; and (3) assess the impact of these symptoms on quality of life in COPD...
December 11, 2017: COPD
https://www.readbyqxmd.com/read/29225831/delayed-right-ventricular-lead-perforation-complicated-by-tamponade-in-biventricular-hypertrophic-cardiomyopathy
#19
Najla Kourireche, Amal Boutakhrit, Fatima Chikhi, Ibtissam Fellat, Mohammed Cherti
This report highlights the importance of a more cautious approach in a patient with a history of implanted cardiac leads presenting with chest pain or dyspnea, to prevent overlooking cardiac lead perforations especially in hypertrophic cardiomyopathy which seems to be not absolutely protective.
December 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29221325/foreign-body-aspiration-in-adult-airways-therapeutic-approach
#20
REVIEW
Justin C Hewlett, Otis B Rickman, Robert J Lentz, Udaya B Prakash, Fabien Maldonado
Tracheobronchial foreign body (FB) aspiration is an uncommon but potentially life-threatening event in adults. Symptoms typically consist of a choking event followed by cough and dyspnea, however, these findings are inconsistent and symptoms may mimic more chronic lung diseases such as asthma or chronic obstructive pulmonary disease. Chest radiography and computed tomography can provide information regarding the location and characteristics of foreign bodies and aid in diagnosis. Bronchoscopy remains the gold standard for diagnosis and management of FB aspiration...
September 2017: Journal of Thoracic Disease
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