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https://www.readbyqxmd.com/read/29329993/pulmonary-arterial-hypertension-in-four-patients-treated-by-leflunomide
#1
Valentin Coirier, Alain Lescoat, Céline Chabanne, Maxime Fournet, Guillaume Coiffier, Stéphane Jouneau, Elisabeth Polard, Patrick Jégo
Pulmonary arterial hypertension (PAH) is a rare disorder that can be drug-induced, mostly following treatment by appetite-suppressant drugs. We report four cases of patients who developed PAH following a treatment by leflunomide for rheumatoid arthritis, psoriatic arthritis or undetermined connective tissue disease. All patients described a progressive dyspnea from grade II to IV of NYHA classification; clinical examination found signs of heart failure. PAH was finally diagnosed and confirmed by right heart catheterisation...
January 9, 2018: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29316368/rash-fever-and-pulmonary-hypertension-in-a-6-year-old-female
#2
David Buchbinder, Gina A Montealegre Sanchez, Raphaela Goldbach-Mansky, Hermine Brunner, Andrew I Shulman
A previously healthy 2-year-old Guatemalan female with an undiagnosed chronic illness characterized by fever and rash had presented with anorexia, weight loss, periorbital edema, abdominal pain and distention. A chest radiograph documented cardiomegaly. An echocardiogram demonstrated a pericardial effusion, dilated right atrium, right ventricle, and main pulmonary artery as well as diminished right ventricular systolic function and pulmonary hypertension. Right ventricular systolic pressure was estimated at 90 mmHg...
January 5, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29315054/ambulatory-management-of-pulmonary-embolism
#3
Houssam Abusibah, Muntasir M Abdelaziz, Peter Standen, Praveen Bhatia, Mahir Ma Hamad
The diagnosis of pulmonary embolism can be very difficult and elusive. It depends greatly on the use of diagnostic tests, which are in turn interpreted according to a pre-test clinical probability. These include non-specific tests such as the chest X-ray and electrocardiograph, which help exclude other conditions such as pneumonia or myocardial infarction. On the other hand, more specific tests such as computed tomography or ventilation/perfusion scanning are used to confirm or exclude the diagnosis of pulmonary embolism...
January 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29301920/risk-factors-for-recurrent-venous-thromboembolism-after-unprovoked-pulmonary-embolism-the-padis-pe-randomised-trial
#4
Cécile Tromeur, Olivier Sanchez, Emilie Presles, Gilles Pernod, Laurent Bertoletti, Patrick Jego, Elisabeth Duhamel, Karine Provost, Florence Parent, Philippe Robin, Lucile Deloire, Florent Leven, Fanny Mingant, Luc Bressollette, Pierre-Yves Le Roux, Pierre-Yves Salaun, Michel Nonent, Brigitte Pan-Petesch, Benjamin Planquette, Philippe Girard, Karine Lacut, Solen Melac, Patrick Mismetti, Silvy Laporte, Guy Meyer, Dominique Mottier, Christophe Leroyer, Francis Couturaud
We aimed to identify risk factors for recurrent venous thromboembolism (VTE) after unprovoked pulmonary embolism.Analyses were based on the double-blind randomised PADIS-PE trial, which included 371 patients with a first unprovoked pulmonary embolism initially treated during 6 months who were randomised to receive an additional 18 months of warfarin or placebo and followed up for 2 years after study treatment discontinuation. All patients had ventilation/perfusion lung scan at inclusion (i.e. at 6 months of anticoagulation)...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29275453/inhaled-treprostinil-in-pulmonary-hypertension-associated-with-lung-disease
#5
Mariana Faria-Urbina, Rudolf K F Oliveira, Manyoo Agarwal, Aaron B Waxman
PURPOSE: Pulmonary hypertension (PH) in the setting of parenchymal lung disease adversely affects quality of life and survival. However, PH-specific drugs may result in ventilation/perfusion imbalance and currently, there are no approved PH treatments for this patient population. In the present retrospective study, data from 22 patients with PH associated with lung disease treated with inhaled treprostinil (iTre) and followed up clinically for at least 3 months are presented. METHODS: PH was defined by resting right heart catheterization as a mean pulmonary artery pressure (mPAP) ≥ 35 mmHg, or mPAP ≥ 25 mmHg associated with pulmonary vascular resistance ≥ 4 Woods Units...
December 23, 2017: Lung
https://www.readbyqxmd.com/read/29236220/automatic-lung-segmentation-in-functional-spect-images-using-active-shape-models-trained-on-reference-lung-shapes-from-ct
#6
Grigorios-Aris Cheimariotis, Mariam Al-Mashat, Kostas Haris, Anthony H Aletras, Jonas Jögi, Marika Bajc, Nicolaos Maglaveras, Einar Heiberg
OBJECTIVE: Image segmentation is an essential step in quantifying the extent of reduced or absent lung function. The aim of this study is to develop and validate a new tool for automatic segmentation of lungs in ventilation and perfusion SPECT images and compare automatic and manual SPECT lung segmentations with reference computed tomography (CT) volumes. METHODS: A total of 77 subjects (69 patients with obstructive lung disease, and 8 subjects without apparent perfusion of ventilation loss) performed low-dose CT followed by ventilation/perfusion (V/P) SPECT examination in a hybrid gamma camera system...
December 13, 2017: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/29226891/the-relationship-between-right-ventricular-outflow-tract-fractional-shortening-and-pulmonary-embolism-severity-index-in-acute-pulmonary-embolism
#7
Ekrem Şahan, Murat Karamanlıoğlu, Suzan Şahan, Murat Gül, Ahmet Korkmaz, Omaç Tüfekçioğlu
OBJECTIVE: Right ventricular (RV) functions are clinically important in acute pulmonary embolism (APE). Measurement of systolic function of the right ventricular outflow tract (RVOT) with echocardiography is a simple method to evaluate RV function. The aim of this study was to determine the relationship between RVOT systolic function and the Pulmonary Embolism Severity Index (PESI). METHODS: A total of 151 patients diagnosed with APE by pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were included...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29224973/residual-pulmonary-embolism-as-a-predictor-for-recurrence-after-a-first-unprovoked-episode-results-from-the-reverse-cohort-study
#8
Tony Wan, Marc Rodger, Wanzhen Zeng, Philippe Robin, Marc Righini, Michael J Kovacs, Melanie Tan, Marc Carrier, Susan R Kahn, Philip S Wells, David R Anderson, Isabelle Chagnon, Susan Solymoss, Mark Crowther, Richard H White, Linda Vickars, Sadri Bazarjani, Grégoire Le Gal
BACKGROUND: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. OBJECTIVES: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5-7months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism...
December 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29222030/regional-ventilation-distribution-and-dead-space-in-anaesthetised-horses-treated-with-and-without-continuous-positive-airway-pressure-novel-insights-by-electrical-impedance-tomography-and-volumetric-capnography
#9
Martina Mosing, Ulrike Auer, Paul MacFarlane, David Bardell, Johannes P Schramel, Stephan H Böhm, Regula Bettschart-Wolfensberger, Andreas D Waldmann
OBJECTIVE: The aim of this study was to evaluate the effect of continuous positive airway pressure (CPAP) on regional distribution of ventilation and dead space in anaesthetized horses. STUDY DESIGN: Randomized, experimental, crossover study. ANIMALS: A total of eight healthy adult horses. METHODS: Horses were anaesthetized twice with isoflurane in 50% oxygen and medetomidine as continuous infusion in dorsal recumbency, and administered in random order either CPAP (8 cmH2O) or NO CPAP for 3 hours...
July 3, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29217649/an-unusual-cause-of-hypoxia-getting-to-the-heart-of-the-matter
#10
Daniel Hammersley, Aamire Shamsi, Mohammad Murtaza Zaman, Phillip Berry, Lydia Sturridge
A 63 year old female presented to hospital with progressive exertional dyspnoea over a 6 month period. In the year preceding her admission, she reported an intercurrent history of abdominal pain, diarrhoea and weight loss. She was found to be hypoxic, the cause for which was initially unclear. A ventilation-perfusion scan identified a right-to-left shunt. Transoesophageal echocardiography (TOE) demonstrated a significant right-to-left intracardiac shunt through a patent foramen ovale (PFO); additionally severe tricuspid regurgitation was noted through a highly abnormal tricuspid valve...
December 7, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29215365/physiologic-evaluation-of-ventilation-perfusion-mismatch-and-respiratory-mechanics-at-different-positive-end-expiratory-pressure-in-patients-undergoing-protective-one-lung-ventilation
#11
Savino Spadaro, Salvatore Grasso, Dan Stieper Karbing, Alberto Fogagnolo, Marco Contoli, Giacomo Bollini, Riccardo Ragazzi, Gilda Cinnella, Marco Verri, Narciso Giorgio Cavallesco, Stephen Edward Rees, Carlo Alberto Volta
BACKGROUND: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. METHODS: Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed...
December 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29182940/clinical-study-of-optical-coherence-tomography-in-the-diagnosis-of-peripheral-pulmonary-artery-thrombus
#12
Cheng Hong, Fu-Quan Luo, Chun-Li Liu, Nan-Shan Zhong, Jie-Ying Li, Wei Wang
BACKGROUND: Peripheral pulmonary artery thrombus (PPT) is common in the clinic. However, due to the lack of an ideal diagnostic tool, PPT cannot be quickly diagnosed and effectively treated at present. Optical coherence tomography (OCT) is a new intravascular imaging technique that is characterized by high image resolution. This technique is suitable for small vessel imaging and has the ability to distinguish red and white thrombi. OBJECTIVE: This study aimed to evaluate the value of OCT in the diagnosis of PPT and in identifying the nature of thrombi by comparing the difference in sensitivity between OCT and selective pulmonary angiography (SPA)...
October 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29175355/an-assessment-of-ventilation-and-perfusion-markers-in-out-of-hospital-cardiac-arrest-patients-receiving-mechanical-cpr-with-endotracheal-or-supraglottic-airways
#13
Torben K Becker, Aric W Berning, Arjun Prabhu, Clifton W Callaway, Francis X Guyette, Christian Martin-Gill
AIM OF THE STUDY: Mechanical chest compression (MCPR) devices are considered equivalent to manual compressions in patient outcomes in out-of-hospital cardiac arrest (OHCA). However, recent data suggest possible harm in patients with a supraglottic airway device (SGA) during MCPR. The aim of this study was to evaluate differences in direct and indirect markers of ventilation and perfusion in patients with cardiac arrest receiving MCPR and who had their airway managed with an endotracheal tube (ETT) or SGA...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29167118/exercise-facilitates-early-recognition-of-cardiac-and-vascular-remodeling-in-chronic-thrombo-embolic-pulmonary-hypertension-in-a-novel-cteph-swine-model
#14
Kelly Stam, Richard W B van Duin, Andre Uitterdijk, Zongye Cai, Dirk J Duncker, Daphne Merkus
Chronic thrombo-embolic pulmonary hypertension (CTEPH) develops in 4% of patients after pulmonary embolism and is accompanied by an impaired exercise tolerance, which is ascribed to the increased right ventricular (RV) afterload and a ventilation/perfusion (V/Q) mismatch in the lungs. This study investigated changes in arterial PO2 and hemodynamics in response to graded treadmill exercise during development and progression of CTEPH in a swine model. Swine were chronically instrumented and received multiple pulmonary embolisms by (i) microsphere infusion (Spheres) over five weeks, (ii) endothelial dysfunction by administration of eNOS inhibitor L-Nω-Nitroarginine methyl ester (LNAME) during seven weeks, (iii) combined pulmonary embolisms and endothelial dysfunction (LNAME+Spheres), or (iv) served as sham-operated controls (Sham)...
November 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29143501/-the-place-of-balloon-pulmonary-angioplasty-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#15
Aileen Kharat, Béatrice Duxbury, Anne-Lise Hachull, Stéphane Noble, Hélène Bouvaist, Paola M Soccal, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) is uncommon. Its diagnosis should not be delayed as its prognosis is poor if not treated. In most cases, an acute pulmonary embolism is found in the medical history of the patient. Once suspected, a specific work-up should be performed in a pulmonary hypertension (PH) center. The ventilation/perfusion scan has a central role in this workup but the emergence of non invasive imaging technologies provides morphological and functional information which take part in the therapeutic decision making, such as operability...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29092970/extracorporeal-membrane-oxygenation-for-post-transplant-hypoxaemia-following-very-severe-hepatopulmonary-syndrome
#16
Lakshmi Kumar, Dinesh Balakrishnan, Rekha Varghese, Sudhindran Surendran
Hepatopulmonary syndrome (HPS) associated with end-stage liver disease has a high morbidity when room air PaO2 is less than 50 mm Hg. Safe levels of oxygenation to facilitate transplantation have not been defined despite advancement in care. Postoperatively, hypoxaemia worsens due to ventilation perfusion mismatch contributed by postoperative pulmonary vasoconstriction and due to decrease in endogenous nitric oxide. A 16-year-old boy with cirrhosis presented with HPS and a PaO2 of 37 mm Hg on room air and underwent living donor liver transplant...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29055626/pulmonary-arterial-hypertension-with-abnormal-v-q-single-photon-emission-computed-tomography
#17
Kenneth Chan, Stefanos Ioannidis, John G Coghlan, Margaret Hall, Benjamin E Schreiber
OBJECTIVES: This study aimed to evaluate the incidence and clinical outcomes of abnormal ventilation/perfusion (V/Q) single-photon emission computed tomography (SPECT) without thromboembolism, especially in patients with group I pulmonary arterial hypertension (PAH). BACKGROUND: American Heart Association/American College of Cardiology and European Society of Cardiology guidelines recommend V/Q scan for screening for chronic thromboembolic pulmonary hypertension...
October 16, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29051337/gravity-outweighs-the-contribution-of-structure-to-passive-ventilation-perfusion-matching-in-the-supine-adult-human-lung
#18
Wendy Kang, Alys R Clark, Merryn H Tawhai
Gravity and matched airway/vascular tree geometries are both hypothesized to be key contributors to ventilation-perfusion (V/Q) matching in the lung, but their relative contributions are challenging to quantify experimentally. We used a structure-based model to conduct an analysis of the relative contributions of tissue deformation (the 'Slinky' effect), other gravitational mechanisms (weight of blood and gravitational gradient in tissue elastic recoil), and matched airway and arterial tree geometry to V/Q matching and therefore to total lung oxygen exchange...
October 19, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29047091/hydrogen-sulfide-as-an-o2-sensor-a-critical-analysis
#19
Jesus Prieto-Lloret, Philip I Aaronson
There is increasing interest in the physiological actions and therapeutic potential of the gasotransmitter hydrogen sulfide (H2S). In addition to exerting antihypertensive, anti-inflammatory, antioxidant, and pro-angiogenic effects, H2S has been suggested to play a central and ubiquitous role in O2 sensing. According to this concept, because H2S is metabolized by oxidation, its cellular concentration varies inversely with the ambient pO2 such that hypoxia causes a rise in intracellular [H2S]; this then acts to induce appropriate cellular responses...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29019812/venous-thromboembolism-after-adult-lung-transplantation-a-frequent-event-associated-with-lower-survival
#20
Manuel L Ribeiro Neto, Marie Budev, Daniel A Culver, C Randall Lane, Marcelo Gomes, Xiao-Feng Wang, Paulo Novis Rocha, Mitchell A Olman
BACKGROUND: The incidence of venous thromboembolism (VTE) after lung transplantation (LTX) varies significantly across studies. Two studies have suggested that these thrombotic events are associated with a lower posttransplant survival. Herein, we sought to determine the incidence, predictors and impact of VTE on survival after LTX at a quaternary referral center. METHODS: This was a large cohort study of LTX recipients. Key outcome parameters were time to VTE after transplant and survival...
October 10, 2017: Transplantation
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