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https://www.readbyqxmd.com/read/28635208/association-of-clinical-characteristics-of-patients-presenting-with-influenza-like-illness-or-severe-acute-respiratory-illness-with-development-of-acute-respiratory-distress-syndrome
#1
Muhammad Ijaz, Muhammad Jaffar Khan, Jawad Khan, Usama Usama
Clinical judgement and suspicion of influenza based on signs and symptoms of influenza-like illness and severe acute respiratory illness are critical for better patient outcome. Whether clinical characteristics of patients are associated with the development of acute respiratory distress syndrome and PCR positivity of samples was the aim of this study. We included all patients (n=37) presenting with influenza like illness (ILI) or severe acute respiratory illness (SARI) to a tertiary care hospital in northwest Pakistan during December 2015 until the end of January 2016...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634285/frequency-of-chest-pain-in-primary-care-diagnostic-tests-performed-and-final-diagnoses
#2
Beatrijs Bn Hoorweg, Robert Ta Willemsen, Lotte E Cleef, Tom Boogaerts, Frank Buntinx, Jan Fc Glatz, Geert Jan Dinant
OBJECTIVE: Observational study of patients with chest pain in primary care: determination of incidence, referral rate, diagnostic tests and (agreement between) working and final diagnoses. METHODS: 118 general practitioners (GPs) in the Netherlands and Belgium recorded all patient contacts during  2weeks. Furthermore, patients presenting with chest pain were registered extensively. A follow-up form was filled in after 30 days. RESULTS: 22 294 patient contacts were registered...
June 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28630238/impact-of-sex-on-cardiac-troponin-concentrations-a-critical-appraisal
#3
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: The use of sex-specific cutoffs for cardiac troponin (cTn) is currently debated. Although endorsed by scientific working groups, concerns have been raised that sex-specific cutoffs may have only a small clinical effect at the cost of increased complexity in decision-making. METHODS: We reviewed studies investigating the interrelations between high-sensitivity (hs) cTn results and sex, diagnoses, and outcome. Investigated populations included community-dwelling subjects and patients with stable angina, congestive heart failure, or acute chest pain including those with acute coronary syndromes...
June 19, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28628525/assessing-sensitivity-and-specificity-of-the-manchester-triage-system-in-the-evaluation-of-acute-coronary-syndrome-in-adult-patients-in-emergency-care-a-systematic-review
#4
Fernanda Ayache Nishi, Flávia de Oliveira Motta Maia, Itamar de Souza Santos, Dina de Almeida Lopes Monteiro da Cruz
BACKGROUND: Triage is the first assessment and sorting process used to prioritize patients arriving in the emergency department (ED). As a triage tool, the Manchester Triage System (MTS) must have a high sensitivity to minimize the occurrence of under-triage, but must not compromise specificity to avoid the occurrence of overtriage. Sensitivity and specificity of the MTS can be calculated using the frequency of appropriately assigned clinical priority levels for patients presenting to the ED...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28626545/case-of-acute-st-segment-elevation-myocardial-infarction-in-infective-endocarditis-management-with-intra-coronary-stenting
#5
Ghulam Murtaza, Zia Ur Rahman, Puja Sitwala, Vatsal Ladia, Bhavesh Barad, Kais Albalbissi, Timir K Paul, Vijay Ramu
Embolic events from infective endocarditis can cause acute coronary syndrome. Mortality rate is high and optimal management might be different from those chosen in setting of classic atherosclerotic coronary artery disease. We present a case of 56-year-old male who had received 5 weeks of antibiotics for aortic valve endocarditis and developed acute ST segment elevation myocardial infarction in hospital settings. Interestingly, patient had recent left heart catheterization that was normal. This was recognized as embolic event from sterile vegetation...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28626030/gender-race-and-the-presentation-of-acute-coronary-syndrome-and-serious-cardiopulmonary-diagnoses-in-ed-patients-with-chest-pain
#6
Ahmed Allabban, Judd E Hollander, Jesse M Pines
OBJECTIVE: To assess the relationship between reported chest pain symptoms and a diagnosis of acute coronary syndrome (ACS) and serious cardiopulmonary diagnoses (SCPD) in black males, white males, black females and white females. METHODS: This was a secondary analysis of a prospective cohort study of 4162 ED patients with chest pain enrolled between 1999 and 2008. We used logistic regression, adjusting for age and cardiovascular comorbidities to test the association between 24 chest pain symptoms and 30-day ACS for the primary outcome and SCPD as the secondary outcome...
June 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#7
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623174/sex-differences-in-the-management-and-5-year-outcome-of-young-patients-55y-with-acute-coronary-syndromes
#8
Avi Sabbag, Shlomi Matetzky, Avital Porter, Zaza Iakobishvili, Mady Moriel, Donna Zwas, Paul Fefer, Elad Asher, Roy Beigel, Shmuel Gottlieb, Ilan Goldenberg, Amit Segev
BACKGROUND: Young women are usually protected against coronary artery disease due to hormonal and risk-factor profile. Previous studies have suggested poorer outcome in women hospitalized with acute coronary syndrome as compared to men. However, when adjusted to age and other risk factors, this difference does not remain significant. We compared the risk-profile and outcome between young (≤55) women and men admitted with acute coronary syndrome. METHODS: We analyzed clinical characteristics, management strategies, and outcomes of men and women ≤55y enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) between 2000 and 2013...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28619423/acute-respiratory-distress-syndrome-following-alemtuzumab-therapy-for-relapsing-multiple-sclerosis
#9
Keh Yann, Fran Jackson, Nazar Sharaf, Tatiana Mihalova, Paul Talbot, David Rog, Adrian Pace
We present the case of a 54 year old woman with known relapsing-remitting multiple sclerosis who presented with acute respiratory deterioration five weeks after a first course of alemtuzumab. Imaging showed bilateral ground glass changes and extensive investigations confirmed chest infection with dual pathogens - Pneumocystis jirovecii and Cytomegalovirus. She responded to standard anti-PJP and CMV therapy and was discharged on oral prophylaxis. Opportunistic infections in the weeks immediately following alemtuzumab therapy remain an uncommon complication but one that requires clinical vigilance, careful monitoring and appropriate prophylactic therapy...
May 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28614245/wellens-syndrome-in-hiv-infected-patients-two-case-reports
#10
Bowei Tan, Carlos Morales-Mangual, Dan Zhao, Abdullah Khan, Hal Chadow
BACKGROUND: Wellens syndrome is a pattern of electrocardiographic (ECG) changes in the context of unstable angina characterized with deep inverted T-waves or biphasic T-waves in the precordial leads. These specific ECG changes are highly suggestive of stenosis in the left anterior descending artery (LAD), which can result in acute myocardial infarction, left ventricular dysfunction, or death. Human immunodeficiency virus (HIV) infection is known as an independent risk factor for the cardiovascular disease...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28613283/risk-factors-for-no-reflow-phenomenon-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndrome
#11
Tian Liang, Min Liu, Chengyu Wu, Qing Zhang, Lei Lu, Zhongliang Wang
BACKGROUND: To explore risk factors for no-reflow phenomenon after percutaneous coronary intervention in patients with acute coronary syndrome. METHODS: A total of 733 acute myocardial infarction patients with persistent ischemic chest pain within 12 or 12-24 hours after onset received emergency percutaneous coronary intervention. Patients were divided into a normal reflow group and a no-reflow group, according to TIMI grading and myocardial blush grading after percutaneous coronary intervention...
May 2017: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/28611898/utility-of-the-history-and-physical-examination-in-the-detection-of-acute-coronary-syndromes-in-emergency-department-patients
#12
REVIEW
Zachary Dw Dezman, Amal Mattu, Richard Body
Chest pain accounts for approximately 6% of all emergency department (ED) visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS). This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611879/pitfalls-in-electrocardiographic-diagnosis-of-acute-coronary-syndrome-in-low-risk-chest-pain
#13
REVIEW
Semhar Z Tewelde, Amal Mattu, William J Brady
Less than half of patients with a chest pain history indicative of acute coronary syndrome have a diagnostic electrocardiogram (ECG) on initial presentation to the emergency department. The physician must dissect the ECG for elusive, but perilous, characteristics that are often missed by machine analysis. ST depression is interpreted and often suggestive of ischemia; however, when exclusive to leads V1-V3 with concomitant tall R waves and upright T waves, a posterior infarction should first and foremost be suspected...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28609750/association-of-plasma-cd40l-with-acute-chest-syndrome-in-sickle-cell-anemia
#14
Vanessa Tonin Garrido, Laura Sonzogni, Siana Nkya Mtatiro, Fernando F Costa, Nicola Conran, Swee Lay Thein
Platelet activation and platelet-derived cytokines contribute to the vascular inflammation and increased thrombotic activity known to occur in patients with sickle cell anemia (SCA). CD40 ligand (CD40L), a platelet-associated pro-inflammatory molecule that promotes endothelial cell activation, is elevated in the circulation of SCA patients. We sought to evaluate the association of CD40L and inflammation with sickle-related clinical complications and laboratory variables in SCA patients. Soluble CD40L, thrombospondin (TSP)-1 and tumor necrosis factor (TNF)-α were determined in the platelet-poor plasma of healthy individuals and steady-state SCA patients by ELISA...
June 10, 2017: Cytokine
https://www.readbyqxmd.com/read/28604999/percutaneous-cardiac-support-during-myocardial-infarction-drastically-reduces-mortality-perspectives-from-a-swine-model
#15
Maria Giovanna Trivella, Alessandra Piersigilli, Fabio Bernini, Gualtiero Pelosi, Silvia Burchielli, Stefano Puzzuoli, Claudia Kusmic, Antonio L'Abbate
BACKGROUND/AIMS: Acute myocardial infarction (AMI) with cardiogenic shock (CS) remains the leading cause of in-hospital death in acute coronary syndromes. In the AMI-CS pig model we tested the efficacy of temporary percutaneous cardiorespiratory assist device (PCRA) in rescuing the failing heart and reducing early mortality. METHODS: In open-chest pigs we induced AMI by proximal left anterior descending coronary artery (LAD) ligation. Eight animals without PCRA (C group) were compared with 12 animals otherwise treated with PCRA (T group), starting approximately at 60 minutes post-occlusion and lasting 120-180 minutes...
June 6, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28601817/the-organisational-value-of-diagnostic-strategies-using-high-sensitivity-troponin-for-patients-with-possible-acute-coronary-syndromes-a-trial-based-cost-effectiveness-analysis
#16
Paul Jülicher, Jaimi H Greenslade, William A Parsonage, Louise Cullen
OBJECTIVES: To evaluate hospital-specific health economic implications of different protocols using high-sensitivity troponin I for the assessment of patients with chest pain. DESIGN: A cost prediction model and an economic microsimulation were developed using a cohort from a single centre recruited as part of the (ADAPT) trial, a prospective observational trial conducted from 2008 to 2011. The model was populated with 40 000 bootstrapped samples in five high-sensitivity troponin I-enabled algorithms versus standard care...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28599856/-bilateral-pulmonary-embolism-mimicking-acute-chest-syndrome-in-an-adolescent-with-sickle-cell-disease
#17
P Mornand, F Chalard, A-S Romain, M Rohr, C Paluel-Marmont, A Niakaté, B Quinet, E Grimprel, M-H Odièvre-Montanié
Pulmonary embolism is a life-threatening and potentially lethal disease. Its incidence in children with sickle cell disease is probably underestimated and pediatric case reports in the literature are rare. Moreover, symptoms can mimic an acute chest syndrome. We report on the case of a 17-year-old boy with SS sickle cell disease, admitted for chest pain with dyspnea and tachycardia. Pulmonary angiography revealed a partial bilateral obstructive pulmonary embolism. We did not find any deep venous thrombosis or thrombophilia...
June 6, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28599831/alterations-in-cardiac-deformation-timing-of%C3%A2-contraction-and-relaxation-and-early-myocardial-fibrosis-accompany-the-apparent-recovery-of-acute-stress-induced-takotsubo-cardiomyopathy-an-end-to-the-concept-of%C3%A2-transience
#18
Konstantin Schwarz, Trevor Ahearn, Janaki Srinivasan, Christopher J Neil, Caroline Scally, Amelia Rudd, Baljit Jagpal, Michael P Frenneaux, Cristina Pislaru, John D Horowitz, Dana K Dawson
BACKGROUND: Takotsubo syndrome is an increasingly recognized cause of chest pain and occasionally of cardiogenic shock. Despite rapid improvement of the left ventricular (LV) ejection fraction, recent registry data raise concerns about long-term prognosis. The aim of this study was to test the hypothesis that restoration of normal ejection fraction after acute takotsubo syndrome is not equivalent to full functional recovery. METHODS: Fifty-two patients with takotsubo syndrome (according to the Mayo Clinic criteria plus cardiac magnetic resonance imaging to exclude myocardial infarction) and 44 healthy control subjects of the same age, gender, and cardiovascular comorbidity distribution were prospectively recruited...
June 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28596831/ofatumumab-associated-acute-pneumonitis-not-new-but-still-the-first-case
#19
Alice Bonanni, Enrica Bertelli, Chiara Panicucci, Matteo D'Alessandro, Andrea Moscatelli, Elisabetta Lampugnani, Oliviero Sacco, Gian Michele Magnano, Pietro Ravani, Gian Marco Ghiggeri
Ofatumumab is an anti-CD20 humanized monoclonal antibody utilized in the treatment of several clinical conditions resistant to other treatments. In spite there was a general expectation that ofatumumab was less toxic compared to rituximab, side effects have been reported that resemble those of its anti-CD20 chimeric precursor. Here, we describe the first case of Ofatumumab associate lung injury occurring in a 14-year-old boy affected by nephrotic syndrome dependent to prednisone plus cyclosporine A who had been treated with the dose of drug utilized in nephrotic syndrome (1500 mg/173 m(2))...
February 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28584527/efficacy-and-safety-of-manual-partial-red-cell-exchange-in-the-management-of-severe-complications-of-sickle-cell-disease-in-a-developing-country
#20
B F Faye, D Sow, M Seck, N Dieng, S A Toure, M Gadji, A B Senghor, Y B Gueye, D Sy, A Sall, T N Dieye, A O Toure, S Diop
INTRODUCTION: The realization of red cell exchange (RCE) in Africa faces the lack of blood, transfusion safety, and equipment. We evaluated its efficacy and safety in severe complications of sickle cell disease. PATIENTS AND METHOD: Manual partial RCE was performed among sickle cell patients who had severe complications. Efficacy was evaluated by clinical evolution, blood count, and electrophoresis of hemoglobin. Safety was evaluated on adverse effects, infections, and alloimmunization...
2017: Advances in Hematology
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