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https://www.readbyqxmd.com/read/28426137/hydroxyurea-hydroxycarbamide-for-sickle-cell-disease
#1
REVIEW
Sarah J Nevitt, Ashley P Jones, Jo Howard
BACKGROUND: Sickle cell disease (SCD) is one of the most common inherited diseases worldwide. It is associated with lifelong morbidity and a reduced life expectancy. Hydroxyurea (hydroxycarbamide), an oral chemotherapeutic drug, ameliorates some of the clinical problems of SCD, in particular that of pain, by raising fetal haemoglobin. This is an update of a previously published Cochrane Review. OBJECTIVES: To assess the effects of hydroxyurea therapy in people with SCD (all genotypes), of any age, regardless of setting...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28421813/hemin-causes-lung-microvascular-endothelial-barrier-dysfunction-by-necroptotic-cell-death
#2
Sunit Singla, Justin R Sysol, Benjamin Dille, Nicole Jones, Jiwang Chen, Roberto F Machado
Hemin, the oxidized prosthetic moiety of hemoglobin, has been implicated in the pathogenesis of acute chest syndrome (ACS) in sickle cell patients by virtue of its endothelial-activating properties. In this study, we examined whether hemin can cause lung microvascular endothelial barrier dysfunction. By assessing transendothelial resistance using electrical cell impedance sensing, and by directly measuring trans-monolayer FITC-dextran flux, we found that hemin does cause endothelial barrier dysfunction in a concentration-dependent manner...
April 19, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28418520/rapid-rule-out-of-acute-myocardial-infarction-with-a-single-high-sensitivity-cardiac-troponin-t-measurement-below-the-limit-of-detection-a-collaborative-meta-analysis
#3
John W Pickering, Martin P Than, Louise Cullen, Sally Aldous, Ewoud Ter Avest, Richard Body, Edward W Carlton, Paul Collinson, Anne Marie Dupuy, Ulf Ekelund, Kai M Eggers, Christopher M Florkowski, Yonathan Freund, Peter George, Steve Goodacre, Jaimi H Greenslade, Allan S Jaffe, Sarah J Lord, Arash Mokhtari, Christian Mueller, Andrew Munro, Sebbane Mustapha, William Parsonage, W Frank Peacock, Christopher Pemberton, A Mark Richards, Juan Sanchis, Lukas P Staub, Richard Troughton, Raphael Twerenbold, Karin Wildi, Joanna Young
Background: High-sensitivity assays for cardiac troponin T (hs-cTnT) are sometimes used to rapidly rule out acute myocardial infarction (AMI). Purpose: To estimate the ability of a single hs-cTnT concentration below the limit of detection (<0.005 µg/L) and a nonischemic electrocardiogram (ECG) to rule out AMI in adults presenting to the emergency department (ED) with chest pain. Data Sources: EMBASE and MEDLINE without language restrictions (1 January 2008 to 14 December 2016)...
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28416165/influence-of-cardiovascular-risk-in-the-prediction-and-timing-of-cardiac-events-after-exercise-echocardiogram-testing-without-ischemia
#4
Sonia Velasco Del Castillo, Ane Antón Ladislao, Verónica Gómez Sánchez, José Juan Onaindia Gandarias, Ángela Cacicedo Fernández de Bobadilla, Ibon Rodríguez Sánchez, Eva Laraudogoitia Zaldumbide
INTRODUCTION AND OBJECTIVES: There have been no analyses of the influence of cardiovascular risk as a predictor of events in patients with exercise echocardiography (EE) without ischemia. Our objective was to determine the predictors of cardiac events, paying special attention to cardiovascular risk. METHODS: This study included 1640 patients with EE without ischemia. Of these, there were 1206 with no previously known coronary artery disease (CAD), whose risk of a fatal cardiovascular disease event was estimated according to the European SCORE (Systematic COronary Risk Evaluation) risk assessment system, and 434 with known CAD...
April 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28410822/diagnostic-validity-of-hand-gestures-in-chest-pain-of-coronary-origin
#5
F J Montero-Pérez, F de Borja Quero-Espinosa, M J Clemente-Millán, J A Castro-Giménez, J de Burgos-Marín, M Á Romero-Moreno
OBJECTIVES: To determine the frequency of 3 hand gestures by patients with chest pain and determine the diagnostic validity of the gestures in acute coronary syndrome. PATIENTS AND METHODS: A prospective study was conducted on 383 adult patients treated for chest pain in an emergency department. We observed certain hand gestures, previously referred to in the medical literature as characteristic of coronary pain (gesture 1: a clenched fist held over the sternal area or Levine's sign; gesture 2: open hand located over the same area; gesture 3: both hands placed in the centre of the chest), as well as other gestures...
April 11, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28400292/is-takotsubo-syndrome-a-benign-condition
#6
EDITORIAL
Maria I Drakopoulou, Michael A Gatzoulis
Takotsubo syndrome has emerged as a unique form of acute myocardial injury associated with chest pain or dyspnea, new ST-T segment abnormalities, serum cardiac enzyme release, distinctive transient regional myocardial dysfunction and absence of significant coronary disease at coronary angiography. The initial diagnosis of Takotsubo syndrome at the emergency room is challenging and although its clinical manifestations usually spontaneously resolve over time, it is not always a disease with benign course. Future prospective studies may be helpful to explore the clinical features and prognostic markers for the outcome of patients diagnosed with Takotsubo syndrome...
April 8, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28399929/xanthogranulomatous-pyelonephritis-presenting-as-acute-pleuritic-chest-pain-a-case-report
#7
Justin Chow, Rameez Kabani, Kirstie Lithgow, Magdalena A Sarna
BACKGROUND: Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present with vague nonspecific symptoms. CASE PRESENTATION: A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuritic chest pain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss...
April 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28396659/disease-phenotype-and-outcome-depending-on-the-age-at-disease-onset-in-patients-carrying-the-r92q-low-penetrance-variant-in-tnfrsf1a-gene
#8
Estíbaliz Ruiz-Ortiz, Estíbaliz Iglesias, Alessandra Soriano, Segundo Buján-Rivas, Marta Español-Rego, Raul Castellanos-Moreira, Adrià Tomé, Jordi Yagüe, Jordi Antón, José Hernández-Rodríguez
BACKGROUND: Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal-dominant autoinflammatory disease caused by mutations in the TNFRSF1A gene. R92Q, a low-penetrance variant, is usually associated with a milder TRAPS phenotype than structural or pathogenic mutations. No studies differentiating R92Q-related disease in patients with pediatric and adult onset have been performed to date. OBJECTIVE: To analyze clinical features and disease outcomes in patients diagnosed with TRAPS associated with R92Q variant and to investigate differences between patients with pediatric and adult disease onset...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28393005/a-case-of-chronic-cough-in-a-winemaker
#9
Ernesto Viteri, Nathalie Foray, Mingchen Song, Danxuan Long
BACKGROUND: Fungi have been known to cause a variety of respiratory conditions, ranging from mold- associated asthma to allergic bronchopulmonary mycosis and invasive disease. More recently some fungal species have been implicated in a non-asthmatic chronic cough syndrome. CASE PRESENTATION: A 59-year-old male presented to the pulmonary clinic with chronic nonproductive cough. Workup included pulmonary function tests with methacholine challenge, sputum cultures, CT scans of the chest and therapeutic trial with proton pump inhibitors...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28390915/predictors-of-stable-aortic-dimensions-in-medically-managed-acute-aortic-syndromes
#10
Arnoud V Kamman, Frederik Hw Jonker, Udo Sechtem, Kevin M Harris, Arturo Evangelista, Daniel G Montgomery, Himanshu J Patel, Kim A Eagle, Santi Trimarchi
PURPOSE: We aimed to identify predictors of stable aortic dimensions in medically managed type B aortic dissections (TBAD). METHODS: Medically managed TBAD patients from the International Registry of Acute Aortic Dissection (IRAD) with available aortic measurements at up to 24 months were included. Growth rate was calculated by dividing the largest descending diameter at the latest endpoint not influenced by intervention minus initial descending diameter, by the recorded time interval...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390834/coronary-artery-calcium-scoring-for-ruling-out-acute-coronary-syndrome-in-chest-pain-ct
#11
Ricarda Hinzpeter, Kai Higashigaito, Fabian Morsbach, David Benz, Robert Manka, Burkhardt Seifert, Dagmar I Keller, Hatem Alkadhi
No abstract text is available yet for this article.
March 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28380043/club-cell-protein-16-and-cytokeratin-fragment-21-1-as-early-predictors-of-pulmonary-complications-in-polytraumatized-patients-with-severe-chest-trauma
#12
Lukas L Negrin, Gabriel Halat, Stephan Kettner, Markus Gregori, Robin Ristl, Stefan Hajdu, Thomas Heinz
BACKGROUND: Acute respiratory distress syndrome (ARDS) and pneumonia have a great impact on the treatment regimen of polytraumatized patients with severe chest trauma. The objective of our study was to determine whether biomarker levels assessed shortly after multiple trauma may predict the occurrence of these conditions. METHODS AND FINDINGS: Our patient population included 71 men and 30 women (mean age, 40.3 ± 15.8 years) with an Injury Severity Score that ranged from 17 to 59 and an Abbreviated Injury Scale Thorax of at least 3...
2017: PloS One
https://www.readbyqxmd.com/read/28378340/long-term-prognostic-value-of-peak-exercise-echocardiogram-in-patients-hospitalized-with-acute-chest-pain
#13
German Merchan Ortega, Juan Carlos Bonaque Gonzalez, Alejandro Dionisio Sanchez Espino, Maria Jose Aguado Martin, Francisco Navarro Garcia, Fuensanta Ruiz Lopez, Francisco Ramos Perales, Jose Luis Zamorano Gomez
INTRODUCTION: Peak exercise echocardiogram (EEcho) has shown reasonable sensitivity and specificity in detecting significant coronary artery disease (CAD). The objective was to evaluate the prognostic value of EEcho in patients hospitalized for acute chest pain (CP) and its additional prognostic information regarding exercise electrocardiogram test (EECG). METHODS: Prospective observational study performed between May 2011 and September 2013, including 250 patients consecutively admitted for acute CP with normal cardiac biomarkers and nondiagnostic electrocardiogram...
April 5, 2017: Echocardiography
https://www.readbyqxmd.com/read/28377021/triggers-and-timing-of-acute-coronary-syndromes
#14
Geoffrey H Tofler, Eran Kopel, Robert Klempfner, Michael Eldar, Thomas Buckley, Ilan Goldenberg
Previous studies have shown that an acute coronary syndrome (ACS) may be triggered by external activities; however, their frequency, predictors, and significance are uncertain. We evaluated data from the National Israel Survey of Acute Coronary Syndromes, which was conducted in 2004 (February to March) in all 25 coronary care units and cardiac wards in Israel. Demographic and clinical data were recorded for consecutive participants, including potential triggers and time of symptom onset of ACS. Among the 1,849 patients who completed the trigger question, 1/4 (25...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28373264/association-of-circulating-transcriptomic-profiles-with-mortality-in-sickle-cell-disease
#15
Ankit A Desai, Zhengdeng Lei, Neil Bahroos, Mark Maienschein-Cline, Santosh L Saraf, Xu Zhang, Binal N Shah, Seyed M Nouraie, Taimur Abbasi, Amit R Patel, Roberto M Lang, Yves Lussier, Joe G N Garcia, Victor R Gordeuk, Roberto F Machado
Sickle cell disease (SCD) complications are associated with increased morbidity and risk of mortality. We sought to identify a circulating transcriptomic profile predictive of these poor outcomes in SCD. Training and Testing cohorts consisting of adult patients with SCD were recruited and prospectively followed. A pathway-based signature derived from grouping peripheral blood mononuclear cell transcriptomes distinguished two patient clusters with differences in survival in the Training cohort. These findings were validated in a Testing cohort where the association between Cluster 1 molecular profiling and mortality remained significant in a fully adjusted model...
April 3, 2017: Blood
https://www.readbyqxmd.com/read/28372575/implementing-a-bedside-assessment-of-respiratory-mechanics-in-patients-with-acute-respiratory-distress-syndrome
#16
Lu Chen, Guang-Qiang Chen, Kevin Shore, Orest Shklar, Concetta Martins, Brian Devenyi, Paul Lindsay, Heather McPhail, Ashley Lanys, Ibrahim Soliman, Mazin Tuma, Michael Kim, Kerri Porretta, Pamela Greco, Hilary Every, Chris Hayes, Andrew Baker, Jan O Friedrich, Laurent Brochard
BACKGROUND: Despite their potential interest for clinical management, measurements of respiratory mechanics in patients with acute respiratory distress syndrome (ARDS) are seldom performed in routine practice. We introduced a systematic assessment of respiratory mechanics in our clinical practice. After the first year of clinical use, we retrospectively assessed whether these measurements had any influence on clinical management and physiological parameters associated with clinical outcomes by comparing their value before and after performing the test...
April 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28365634/lesson-of-the-month-1-beware-the-atypical-presentation-eosinophilic-granulomatosis-with-polyangiitis-presenting-as-acute-coronary-syndrome
#17
Juergen Schiefermueller, Bashir Alaour, Alison Calver, Nick Curzen
We describe the case of a 45-year-old woman presenting with troponin positive cardiac-sounding chest pain. An initial emergency angiogram demonstrated two vessel coronary disease, including a distal right coronary artery occlusion. No percutaneous coronary intervention was performed and the patient was treated medically. At re-presentation with further pain a few days later, coronary angiography demonstrated no significant coronary lesions. After consideration of other multisystem symptoms and raised eosinophil count, the patient was diagnosed with eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome) presenting with coronary arteritis...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28363994/validating-the-manchester-acute-coronary-syndromes-macs-and-troponin-only-manchester-acute-coronary-syndromes-t-macs-rules-for-the-prediction-of-acute-myocardial-infarction-in-patients-presenting-to-the-emergency-department-with-chest-pain
#18
Jaimi H Greenslade, Robert Nayer, William Parsonage, Shaela Doig, Joanna Young, John W Pickering, Martin Than, Christopher Hammett, Louise Cullen
BACKGROUND: The Manchester Acute Coronary Syndromes (MACS) rule and the Troponin-only MACS (T-MACS) rule risk stratify patients with suspected acute coronary syndrome (ACS). This observational study sought to validate and compare the MACS and T-MACS rules for assessment of acute myocardial infarction (AMI). METHODS: Prospectively collected data from twoEDs in Australia and New Zealand were analysed. Patients were assigned a probability of ACS based on the MACS and T-MACS rules, incorporating high-sensitivity troponin T, heart-type fatty acid-binding protein, ECG results and clinical symptoms...
March 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28363616/an-end-user-s-guide-to-the-heart-score-and-pathway
#19
Brit Long, Joshua Oliver, Matthew Streitz, Alex Koyfman
BACKGROUND: Chest pain accounts for a significant percentage of emergency department (ED) presentations. The HEART score and pathway have demonstrated an ability to appropriately risk stratify and discharge from the ED a significant proportion of patients. OBJECTIVE: This review evaluates vital components of the HEART score and pathway, while discussing important considerations for current and future use. DISCUSSION: Chest pain is a common ED presentation, and several conditions associated with chest pain result in patient morbidity and mortality...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28357836/safety-of-hyperbaric-oxygen-therapy-in-mechanically-ventilated-patients
#20
Jacques Bessereau, Jérôme Aboab, Thomas Hullin, Anne Huon-Bessereau, Jean-Luc Bourgeois, Pierre-Marie Brun, Sylvie Chevret, Djillali Annane
BACKGROUND: To evaluate the epidemiology of patients who require mechanical ventilation during hyperbaric oxygen therapy. MATERIALS AND METHODS: One-hundred-fifty patients who required mechanical ventilation during hyperbaric oxygen therapy were prospectively studied during a 6-year period in a French university hyperbaric centre. We analysed the indication of hyperbaric oxygen therapy, agent used for sedation, presence of a chest tube, need for vasopressor agents and tolerance and appearance of side effects...
2017: International Maritime Health
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