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Dyspnea approach

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https://www.readbyqxmd.com/read/28821988/presentation-and-management-of-symptomatic-central-bone-cement-embolization
#1
Ahmed Samir Barakat, Tamer Owais, Mohamed Alhashash, Mootaz Shousha, Hesham El Saghir, Bernward Lauer, Heinrich Boehm
BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...
August 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28819869/new-echocardiographic-parameters-in-the-diagnosis-of-heart-failure-with-preserved-ejection-fraction
#2
Monika Špinarová, Jaroslav Meluzín, Helena Podroužková, Radka Štěpánová, Lenka Špinarová
Heart failure with preserved ejection fraction (HFpEF) is a serious clinical disease. The pathophysiology of HFpEF is complex, and specific diagnostic criteria have evolved over time. Limited data are available on the quantification of diastolic function using two-dimensional real-time echocardiography, and a simple parameter has not yet been established. The aim of this work is to evaluate new echocardiographic parameters-the diastolic wall strain of the posterior wall (DWS PW) and the vortex formation time (VFT)...
August 17, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28819824/-update-pulmonary-arterial-hypertension-definitions-diagnosis-therapy
#3
N Sommer, M J Richter, K Tello, F Grimminger, W Seeger, H A Ghofrani, H Gall
The term pulmonary arterial hypertension comprises a group of pulmonary vascular diseases of different etiologies that are characterized by similar precapillary vascular remodeling processes and result in exertional dyspnea and right heart insufficiency. The specific pharmacological treatment approach considers the risk of mortality and phenotypical properties and includes treatment with phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostanoids, as well as with more novel substances, such as a soluble guanylyl cyclase stimulator and an oral prostacyclin receptor agonist...
August 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28819622/mixed-pyolaryngocele-a-rare-case-of-deep-neck-infection
#4
Rachid Mahdoufi, Ismail Barhmi, Nabil Tazi, Redallah Abada, Mohamed Roubal, Mohamed Mahtar
INTRODUCTION: Pyolaryngocele is a very rare and serious complication of laryngocele. It can present as deep neck space infection and mislead the diagnosis. Our aim is to bring this unusual entity to the attention of surgeons and describe its clinical features. CASE REPORT: We report a case of a 45-year-old male patient with a five-week history of neck swelling, dysphonia, dyspnea and odynophagia. An urgent CT scan showed a mixed pyolaryngocele. The management consisted of a high dose antibiotic and an excision of the residual laryngocele via an external approach...
July 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28817366/trajectory-of-dyspnea-and-respiratory-distress-among-patients-in-the-last-month-of-life
#5
Margaret L Campbell, Jason M Kiernan, John Strandmark, Hossein N Yarandi
BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#6
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28808371/efficacy-of-osteopathic-manipulative-treatment-approach-in-the-patient-with-pulmonary-fibrosis-in-critical-care-outpatient-department
#7
Manu Goyal, Kanu Goyal, Kanimozhi Narkeesh, Asir John Samuel, Narkeesh Arumugam, Subhasish Chatterjee, Sorabh Sharma
The purpose of the present case study was to explore the efficacy of osteopathic manipulative treatment (OMT) in patient with pulmonary fibrosis (PF) in the critical care outpatient department. Here, we present a 48-year-old male case with breathlessness, increased frequency of defecation, and pain in and around the nape of neck with diagnosed pulmonary fibrosis. He scored 3 on a patient-reported modified Medical Research Council (mMRC) dyspnea scale. Osteopathic examination reveals multiple somatic findings across the chest and abdominal region and treated by OMT...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28797429/early-procedural-and-health-status-outcomes-after-chronic-total-occlusion%C3%A2-angioplasty-a-report-from-the-open-cto-registry-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures
#8
James Sapontis, Adam C Salisbury, Robert W Yeh, David J Cohen, Taishi Hirai, William Lombardi, James M McCabe, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Steven P Marso, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
OBJECTIVES: This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. METHODS: Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28789663/inorganic-nitrate-as-a-treatment-for-acute-heart-failure-a-protocol-for-a-single-center-randomized-double-blind-placebo-controlled-pilot-and-feasibility-study
#9
Roman Falls, Michael Seman, Sabine Braat, Joshua Sortino, Jason D Allen, Christopher J Neil
BACKGROUND: Acute heart failure (AHF) is a frequent reason for hospitalization worldwide and effective treatment options are limited. It is known that AHF is a condition characterized by impaired vasorelaxation, together with reduced nitric oxide (NO) bioavailability, an endogenous vasodilatory compound. Supplementation of inorganic sodium nitrate (NaNO3) is an indirect dietary source of NO, through bioconversion. It is proposed that oral sodium nitrate will favorably affect levels of circulating NO precursors (nitrate and nitrite) in AHF patients, resulting in reduced systemic vascular resistance, without significant hypotension...
August 8, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28774381/first-in-human-closed-chest-transcatheter-superior-cavopulmonary-anastomosis
#10
Kanishka Ratnayaka, John W Moore, Rodrigo Rios, Robert J Lederman, Sanjeet R Hegde, Howaida G El-Said
BACKGROUND: In the care of patients with congenital heart disease, percutaneous interventional treatments have supplanted many surgical approaches for simple lesions, such as atrial septal defect. By contrast, complex congenital heart defects continue to require open-heart surgery. In single-ventricle patients, a staged approach is employed, which requires multiple open-heart surgeries and significant attendant morbidity and mortality. A nonsurgical transcatheter alternative would be attractive...
August 8, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28762298/cardiac-myxoma-clinical-characteristics-surgical-intervention-intra-operative-challenges-and-outcome
#11
Mahmoud Abu Abeeleh, Suhayl Saleh, Emad Alhaddad, Moaath Alsmady, Musa Alshehabat, Zuhair Bani Ismail, Islam Massad, Amjad Bani Hani, Sami Abu Halaweh
OBJECTIVE: The objectives of this retrospective study were to characterize the clinical presentation, diagnostic findings, surgical approaches, intra-operative challenges and complications following the surgical treatment of cardiac myxoma in two of the largest referral hospitals in Jordan. METHODS: Medical records of all patients presented to the cardiology department during the period between 1984 and 2016 were reviewed. Criteria for inclusion in the study were: (1) patients who were presented for cardiac evaluation due to symptoms suggestive of a primary cardiac problem, (2) completed medical records, including results of echocardiography suggestive of intra-cardiac occupying mass, (3) the surgical operation was undertaken and intra-operative data was available, (4) a histological diagnosis of myxoma was available and (5) the discharge status and follow-up data were available for at least 2 years after initial surgery...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28726799/the-insular-cortex-dynamically-maps-changes-in-cardiorespiratory-interoception
#12
Mahlega S Hassanpour, W Kyle Simmons, Justin S Feinstein, Qingfei Luo, Rachel Lapidus, Jerzy Bodurka, Martin P Paulus, Sahib S Khalsa
Palpitations and dyspnea are fundamental to the human experience of panic anxiety, but it remains unclear how the brain dynamically represents changes in these interoceptive sensations. We used isoproterenol, a rapidly acting peripheral beta-adrenergic agonist similar to adrenaline, to induce sensations of palpitation and dyspnea in healthy individuals (n=23) during arterial spin labeling (ASL) functional Magnetic Resonance Imaging (fMRI). We hypothesized that the right mid-insular cortex, a central recipient of viscerosensory input, would preferentially respond during the peak period of cardiorespiratory stimulation...
July 20, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28720670/symptom-clusters-and-quality-of-life-in-subjects-with-copd
#13
Kyeung Eun Lim, Sung Reul Kim, Hyun Kyung Kim, So Ri Kim
BACKGROUND: COPD is one of the most common respiratory diseases. Patients with COPD experience and suffer from various physical and psychological symptoms. We performed this study to identify symptom clusters and the effects on quality of life (QOL) in patients with COPD. METHODS: A total of 130 COPD subjects were recruited from a university hospital in South Korea. Dyspnea, fatigue, depression, anxiety, sleep disturbance, dry mouth, and physical functional status were assessed with structured questionnaires...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#14
REVIEW
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28712898/iatrogenic-vertebral-artery-injury-during-anterior-cervical-spine-surgery-a-systematic-review
#15
REVIEW
Qing Guan, Long Chen, Ye Long, Zhou Xiang
BACKGROUND: Iatrogenic vertebral artery injury (VAI) during anterior cervical surgery is rare but potentially catastrophic. METHOD: The causes, presentation, diagnosis, management, prognosis, and prevention of VAI were reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies and case reports published from 1980 to 2017 were retrieved. Data on diagnosis, surgical procedures and approach, site and cause of VAI, management, outcomes, and VA status were extracted...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28696624/-it-all-started-with-a-simple-symptom-and-then%C3%A2-basic-palliative-medical-tools-for-primary-care-physicians
#16
Christophe Dulong De Rosnay, Tony Tai, Olivier Pasche
The treatment of symptoms in palliative care is of primary importance, though this in itself is not sufficient for the relief of all aspects of a patient's suffering. Pain, dyspnea, or anxiety cannot be reduced to a single somatic characteristic, the psychological implications and the consequences on the patient's daily life being of paramount importance. A respect with regard to certain basic principles, and a full knowledge of the main therapeutic approaches available, allow for a better initial management of the symptoms...
November 2, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28695764/laryngeal-cysts-in-adults-simplifying-classification-and-management
#17
Richard Heyes, David G Lott
Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Data Sources PubMed/Medline. Review Methods A primary literature search of the entire Medline database was performed for all titles of publications pertaining to laryngeal cysts and reviewed for relevance...
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28694693/prevalence-and-characteristics-of-asthma-copd-overlap-syndrome-identified-by-a-stepwise-approach
#18
Hiromasa Inoue, Takahide Nagase, Satoshi Morita, Atsushi Yoshida, Tatsunori Jinnai, Masakazu Ichinose
BACKGROUND AND OBJECTIVE: There is increasing recognition of asthma-COPD overlap syndrome (ACOS), which shares some features of both asthma and COPD; however, the prevalence and characteristics of ACOS are not well understood. The aim of this study was to investigate the prevalence of ACOS among patients with COPD and its characteristics using a stepwise approach as stated in the recent report of the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28683951/diagnosis-and-exclusion-of-pulmonary-embolism
#19
Jeffrey A Kline
BACKGROUND: Failure to test for pulmonary embolism (PE) can be a lethal mistake, but PE and produces symptoms similar to many other diseases. Overtesting for PE has negative consequences. OBJECTIVES: Use published evidence to create a rationale and safe diagnostic approach for ambulatory and emergency patients with suspected PE in 2017. FINDINGS: Pulmonary embolism need not be pursued in patients with no symptoms of PE in the present or recent history (dyspnea, chest pain, cough or syncope), and always normal vital signs...
June 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28680634/thyrotoxicosis-presenting-as-exertional-dyspnea-and-pulmonary-hypertension-case-report-and-review-of-literature
#20
Farid Rashidi, Hossein Sate, Esmaeil Faraji, Sepideh Tahsini Tekantapeh
OBJECTIVES: In this case study, we describe a 35-year-old woman with pulmonary hypertension that was secondary to thyrotoxicosis who presented with exertional dyspnea. In the approach to exertional dyspnea, detailed physical examination and laboratory findings helped to get the diagnosis. METHODS: Echocardiography showed right ventricular systolic pressure = 60 mmHg. A suppressed thyroid-stimulating hormone was seen in lab tests. The patient was treated with radioactive iodine...
2017: SAGE open medical case reports
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