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https://www.readbyqxmd.com/read/29775966/an-enigmatic-case-presentation-of-budd-chiari-syndrome-with-pulmonary-embolism-an-unusual-syndrome-with-an-uncommon-complication
#1
A M Al-Sharydah, A H Al-Abdulwahhab, H A Abu AlOla
INTRODUCTION: In patients with a hypercoagulable state, such as patients with pulmonary embolism and/or Budd-Chiari syndrome, the complications from multiple gene mutations are more numerous than those from a single mutation. The authors present a woman with no major prior medical history who presented with pulmonary embolism and Budd-Chiari syndrome; this enigmatic co-occurrence has never been solely reported without underlying aetiology in a patient without prior medical conditions...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29773665/hypersensitivity-pneumonitis-and-acute-respiratory-distress-syndrome-from-e-cigarette-use
#2
Casey G Sommerfeld, Daniel J Weiner, Andrew Nowalk, Allyson Larkin
Electronic cigarette (e-cigarette) use, or "vaping," is gaining widespread popularity as an alternative to conventional cigarettes among adolescents. Little is known of the health risks of e-cigarette use, especially in children and adolescents. We present a Case Report of a previously healthy 18-year-old woman who presented with dyspnea, cough, and pleuritic chest pain after e-cigarette use. She developed respiratory failure with hypoxia and was intubated, and ultimately met diagnostic criteria for acute respiratory distress syndrome...
May 17, 2018: Pediatrics
https://www.readbyqxmd.com/read/29771705/the-causality-nexus-between-the-tako-tsubo-syndrome-and-an-assault-a-forensic-case-report
#3
Malek Zribi, Syrine Azza Manoubi, Narjes Karray, Salma Charfeddine, Wiem Benamar, Zouhir Hammami, Samir Kammoun, Samir Maatoug
"Tako-tsubo" cardiomyopathy, also known as "broken heart syndrome," is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor...
May 4, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29769510/surgical-management-of-a-critical-ischemic-mitral-regurgitation-patient
#4
S A Sunny, S Moinuddin, A B Adhikary, M A Hossain
Functional ischemic mitral regurgitation is strongly associated with poor outcomes in patient with coronary artery disease. The best management for mitral regurgitation at the time of coronary revascularization remains controversial. We report, a case of 58 years-old men admitted to GKNM hospital, Coimbatore, Tamil Nadu, India with chest pain and respiratory distress for last 6 hours during my fellowship training in that hospital. ECG showed acute antero-septal MI. The transthoracic echocardiogram revealed severe left ventricular dysfunction with moderate mitral regurgitation...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768320/monocyte-chemoattractant-protein-1-as-a-predictor-of-coronary-atherosclerosis-in-patients-receiving-coronary-angiography
#5
Simon A Mahler, Thomas C Register, Robert F Riley, Ralph B D'Agostino, Jason P Stopyra, Chadwick D Miller
BACKGROUND: Animal studies suggest that monocyte chemoattractant protein-1 (MCP-1) is a promising biomarker for coronary artery atherosclerosis (CAA), but human studies have been inconclusive. OBJECTIVE: To determine potential relationships between plasma MCP-1 and CAA in patients with acute chest pain. METHODS: A secondary analysis of 150 patients enrolled in emergency department chest pain risk stratification clinical investigations was conducted...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768317/heart-failure-episodes-of-missed-major-cardiac-events-when-applying-the-heart-pathway-to-an-observation-unit-population
#6
Alan Tesson, Rami Abdo, Aparna Kamath, Joanne Sutter, Rachel Cline, Sarah L Hale, Jonathan Bae, Lalit Verma
OBJECTIVE: The HEART Pathway risk prediction tool (HEART score plus serial troponin measures at 0 and 3 hours post-presentation) is used to identify low-risk patients with chest pain who may qualify for safe, early discharge. We calculated the percentage of patients in our observation unit that qualified as low risk using HEART Pathway, as well as their associated outcomes. METHODS: We retrospectively reviewed charts on 966 consecutive patients admitted to our observation unit for chest pain (January 2015 to February 2016); HEART Pathway scores were retrospectively calculated and serial cardiac troponin values logged...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29760864/3-for-the-price-of-1-teaching-chest-pain-risk-stratification-in-a-multidisciplinary-problem-based-learning-workshop
#7
William D Alley, Cynthia Burns, Nicholas D Hartman, Kim Askew, Simon A Mahler
Introduction: Chest pain is a common chief complaint among patients presenting to health systems and often leads to complex and intensive evaluations. While these patients are often cared for by a multidisciplinary team (primary care, emergency medicine, and cardiology), medical students usually learn about the care of these patients in a fragmented, single-specialty paradigm. The present and future care of patients with chest pain is multidisciplinary, and the education of medical students on the subject should be as well...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29755709/perioperative-management-of-sickle-cell-disease
#8
REVIEW
Kwame Ofori Adjepong, Folashade Otegbeye, Yaw Amoateng Adjepong
Over 30 million people worldwide have sickle cell disease (SCD). Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlusive (painful) crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include a careful review of the patient's known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and opioid use...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29754134/surprising-pathological-and-clinical-manifestations-of-miliary-tuberculosis
#9
Kamonkiat Wirunsawanya, Dennis Thomas Bolger
We report a surprising pathological finding of miliary tuberculosis (TB) in a 49-year-old Chuukese, immunocompetent woman who was initially admitted to the hospital for a 1-month duration of chronic abdominal pain and intermittent fevers. Her clinical symptoms did not improve despite treatment with vancomycin and piperacillin-tazobactam. Based on the primary abdominal CT findings suggesting advanced ovarian cancer with omental metastatic disease, further workup with omental core biopsy was performed and demonstrated acute neutrophilic necrosis without malignant cells or granulomata...
May 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29749756/sensitivity-and-specificity-of-the-manchester-triage-system-in-risk-prioritization-of-patients-with-acute-myocardial-infarction-who-present-with-chest-pain
#10
Fernanda A Nishi, Catarina Polak, Diná de Almeida Lopes Monteiro da Cruz
BACKGROUND: The purpose of the Manchester Triage System is to clinically prioritize each patient seeking care in an emergency department. Patients with suspected acute myocardial infarction who have typical symptoms including chest pain should be classified in the highest priority groups, requiring immediate medical assistance or care within 10 min. As such, the Manchester Triage System should present adequate sensitivity and specificity. AIMS: This study estimated the sensitivity and specificity of the Manchester Triage System in the triage of patients with chest pain related to the diagnosis of acute myocardial infarction, and the associations between the performance of the Manchester Triage System and selected variables...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29748527/extreme-right-axis-deviation-in-acute-myocardial-infarction-a-hazardous-signal-of-poor-prognosis
#11
Qingyu Wang, Shuo Pan, Fuqiang Liu, Dan Yang, Jun-Kui Wang
BACKGROUND New-onset extreme right axis deviation and right bundle branch block (RBBB) are rare during acute myocardial infarction (AMI), and has only been reported in several cases reflecting the severity of AMI. It could predict severe clinical complications and higher risks in coronary artery disease. Although there is little electrophysiological explanation, the complications are severe. They should be emphasized in newly diagnosed extreme right axis deviation and RBBB in AMI. CASE REPORT A 72-year-old male was admitted to our department with a chief complaint of intermittent retrosternal chest pain and was diagnosed with extensive anterior myocardial infarction with RBBB, by elevated myocardial enzymes and ECG...
May 11, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29743472/a-case-of-perforated-jejunal-diverticulum-an-unexpected-cause-of-pneumoperitoneum-in-a-patient-presenting-with-an-acute-abdomen
#12
Bruno Augusto Alves Martins, Rosana Rodrigues Galletti, Júlio Marinho Dos Santos Neto, Caroline Neiva Mendes
BACKGROUND Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an 'acute abdomen' and with pneumoperitoneum on X-ray radiography. CASE REPORT A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting...
May 10, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29742716/symptom-clusters-and-treatment-time-delay-in-korean-patients-with-st-elevation-myocardial-infarction-on-admission
#13
Hee-Sook Kim, Sang Jun Eun, Jin Yong Hwang, Kun-Sei Lee, Sung-Il Cho
Most patients with acute myocardial infarction (AMI) experience more than one symptom at onset. Although symptoms are an important early indicator, patients and physicians may have difficulty interpreting symptoms and detecting AMI at an early stage. This study aimed to identify symptom clusters among Korean patients with ST-elevation myocardial infarction (STEMI), to examine the relationship between symptom clusters and patient-related variables, and to investigate the influence of symptom clusters on treatment time delay (decision time [DT], onset-to-balloon time [OTB])...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29741642/a-cross-sectional-surveillance-study-of-the-frequency-and-etiology-of-acute-respiratory-illness-among-pregnant-women
#14
Anne M Hause, Vasanthi Avadhanula, Maurizio L Maccato, Phillip M Pinell, Nanette Bond, Patricia Santarcangelo, Laura Ferlic-Stark, Flor M Munoz, Pedro A Piedra
Background: Other than influenza, little is known about the consequences of viral acute respiratory illness (ARI) on pregnant women and fetuses. Our objectives were to determine the frequency of ARI due to respiratory viruses and the associated clinical outcomes during pregnancy. Methods: Pregnant women in their second or third trimester were enrolled if they reported having symptoms of ARI or were healthy within the preceding 2 weeks. Nasopharyngeal secretions were evaluated for respiratory viruses by molecular diagnostic assays...
May 5, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29739762/delayed-recurrent-pleuropericardial-effusions-following-atrial-septal-defect-closure-with-amplatzer-septal-occluder-device-a-case-of-postpericardiotomy-syndrome
#15
Grace Ghtk Kwok, Rachel Witts, Alessandra Frigiola
The authors present the case of a 41-year-old woman, who presented with moderate pericardial effusion and bilateral pleural effusion 11 months following a secundum atrial septal defect closure with an Amplatzer septal occluder (ASO) device. The acute presentation responded well to diuretics and a short course of corticosteroid therapy. The patient, however, continued to experience pleuritic chest pain and a recurrence of pericardial effusion a month later. The patient showed significant symptomatic improvement with a 2-month course of down-titrating prednisolone...
May 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29738753/acute-management-of-infected-chronic-thromboembolic-disease
#16
Donna May Kimmaliardjuk, Carole Dennie, Sean Dickie, Eric C Belanger, Fraser Rubens
A 29-year-old male with chronic pulmonary emboli presented to hospital with progressive pleuritic chest pain. He was in acute right ventricular failure, and thus underwent intra-pulmonary arterial tissue plasminogen (tPA). He developed massive hemoptysis requiring emergent thromboendarterectomy. A clot was visualized in the main left pulmonary artery which had formed a bronchovascular fistula into the left upper lobe bronchus. Pathology of the clot revealed fibrinopurulent exudate and Gram-positive cocci. The left pulmonary artery was repaired with a pericardial patch, and the left upper lobe was oversewn with subsequent left upper lobectomy...
May 5, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29736108/acute-coronary-syndrome-with-normal-coronary-arteries-a-case-of-spontaneous-spasm-lysis
#17
Vogiatzis Ioannis, Koutsambasopoulos Konstantinos, Samaras Antonios, Bostanitis Ioannis
Introduction: Patients suffering from Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) are found with no obstructive coronary artery disease on coronary arteriography. The Aim of this interesting case report is to present a patient with acute chest pain, temporal ST-segment elevation and MINOCA. Case report: A case of a young woman who presented with acute chest pain suggestive of angina, with temporal ST-segment elevation, accidentally recorded and not rising of myocardial necrosis biomarkers in blood tests is described...
April 2018: Medical Archives
https://www.readbyqxmd.com/read/29733991/varicella-zoster-virus-infection-and-osteomyelitis-of-the-skull-a-case-report
#18
Taylor Sommer, Michael Karsy, Meghan J Driscoll, Randy L Jensen
BACKGROUND: Varicella zoster virus (VZV) is a common herpesvirus infection that can result in acute varicella/chickenpox as well as delayed activation in herpes zoster/shingles. Ramsay-Hunt syndrome is a rare presentation of VZV reactivation, involving 1% of cases and resulting in lesion formation along the 7th cranial nerve distribution. We report the first case of a patient who presented with acute calvarial osteomyelitis after VZV reactivation and Propionibacterium acnes suprainfection...
May 4, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29728118/recurrence-of-pericarditis-after-influenza-vaccination-a-case-report-and-review-of-the-literature
#19
Riccardo Mei, Emanuel Raschi, Elisabetta Poluzzi, Igor Diemberger, Fabrizio De Ponti
BACKGROUND: This case report describes a patient with pericarditis likely attributed to influenza vaccination (positive rechallenge), with a literature review. CASE PRESENTATION: A 87-year old patient developed pericarditis after influenza vaccination, with acute chest pain, without ECG abnormalities or increased cardiac enzyme levels. Echocardiogram showed moderate pericardial effusion. Recovery was obtained through steroids One year later, few days after re-immunization, the patient experienced the same symptoms and was admitted to hospital with diagnosis of recurrence of pericarditis with severe pericardial effusion, again treated with steroids...
May 5, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29721336/impact-of-admission-blood-glucose-on-coronary-collateral-flow-in-patients-with-st-elevation-myocardial-infarction
#20
Ozge Kurmus, Turgay Aslan, Berkay Ekici, Sezen Baglan Uzunget, Sukru Karaarslan, Asli Tanindi, Aycan Fahri Erkan, Ebru Akgul Ercan, Celal Kervancıoglu
In patients with acute myocardial infarction, glucose metabolism is altered and acute hyperglycemia on admission is common regardless of diabetes status. The development of coronary collateral is heterogeneous among individuals with coronary artery disease. In this study, we aimed to investigate whether glucose value on admission is associated with collateral flow in ST-elevation myocardial infarction (STEMI) patients. We retrospectively evaluated 190 consecutive patients with a diagnosis of first STEMI within 12 hours of onset of chest pain...
2018: Cardiology Research and Practice
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