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Gokalp Altun, Zerrin Pulathan, Dogus Hemsinli
True extracranial carotid artery aneurysms (ECCAs) are uncommon. Atherosclerosis is the most common etiological factor. Neck pain, a pulsatile mass and murmur at auscultation are the most common symptoms. ECCAs may exhibit severe clinical manifestations due to complications. Cases of rupture can be fatal. There is a risk of distal embolization and stroke in thrombosed cases. We discuss two cases of enlarged ECCA treated surgically in the light of the most recent literature.
March 2018: Journal of Korean Neurosurgical Society
Gerald Paul Fitzgerald, John Joseph Coughlan, Zahir Satti, Samer Arnous
A 23-year-old Asian student presented to our service with a 1-month history of fever, weight loss of 10 kg, night sweats, fatigue and general malaise. He was previously well with no significant medical or family history. He had a low-grade pyrexia and cardiac auscultation revealed a diastolic murmur consistent with 'tumour plop'. He had no sequelae of endocarditis. He had low-grade pyrexia of 37.7°C, and ECG showed sinus tachycardia at 130 bpm. He had raised inflammatory markers and was started on broad spectrum antibiotics...
March 9, 2018: BMJ Case Reports
Guillaume Chaussé, Tina Kader, Gad Abikhzer, Stephan Probst
A 44-year-old woman was found to have new diffuse lung uptake on a follow-up whole-body I scan 1 year after being treated with surgery and radioactive iodine for papillary thyroid cancer. However, subsequent CT thorax and thyroglobulin levels were both unremarkable. Shortly after, she presented with respiratory symptoms, exhibiting end-expiratory wheezing on auscultation. Metacholine challenge test confirmed asthma. Symptoms improved under inhaled corticosteroids and beta-2 agonists. Resolution of lung uptake was confirmed on a second I imaging 6 months later...
April 2018: Clinical Nuclear Medicine
Angela Tedesco, Valentina Lavermicocca, Marilina Notarnicola, Luca De Francesco, Anna Rita Dellomonaco
The process of medical-healthcare technological revolution represents an advantage for the patient and for the care provider, in terms of costs and distances reduction. The telehomecare approach could be useful for monitoring the swallowing disorder in neurodegenerative diseases, preventing complications. In this study the applicability of telemedicine techniques for the monitoring of swallowing function, in patients affected by Huntington's disease (HD), was evaluated through the acquisition and analysis of the sound of swallowing...
February 2018: Recenti Progressi in Medicina
Si-Hyuck Kang, Byunggill Joe, Yeonyee Yoon, Goo-Yeong Cho, Insik Shin, Jung-Won Suh
BACKGROUND: Cardiac auscultation is a cost-effective, noninvasive screening tool that can provide information about cardiovascular hemodynamics and disease. However, with advances in imaging and laboratory tests, the importance of cardiac auscultation is less appreciated in clinical practice. The widespread use of smartphones provides opportunities for nonmedical expert users to perform self-examination before hospital visits. OBJECTIVE: The objective of our study was to assess the feasibility of cardiac auscultation using smartphones with no add-on devices for use at the prehospital stage...
February 28, 2018: JMIR MHealth and UHealth
Jagat Narula, Y Chandrashekhar, Eugene Braunwald
Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number of reasons including diminishing interest and expertise, performs well less than what is required of a modern diagnostic strategy. Improving the performance of physical examination is vital given that it is crucial to guide diagnostic possibilities and further testing. Current efforts at improving physical examination skills during medical training have not been very successful, and incorporating appropriate technology at the bedside might improve its performance...
February 28, 2018: JAMA Cardiology
Muhammad Mateen Amir, Naveen Abubakar Bugvi
A 22-year male presented in outpatient department with right sided proptosis and chemosis, after a roadside accident two months back. He was on treatment for orbital cellulitis and taking steroids with antibiotics, both orally and topically. He was also on topical antiglaucoma agents. Detailed examination revealed bruit on auscultation. On magnetic resonance imaging (MRI), dilated superior ophthalmic vein led to diagnosis of caroticocavernous fistula (CCF) and the patient was referred to Neurosurgery Department of Lahore General Hospital (LGH), Lahore, where digital subtraction angiography (DSA) and balloon catheterization by a radiologist in the same sitting, resulted in successful closure of fistula and amelioration of all the signs and symptoms within six weeks...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Phillip Schulten Sebastian, Jan Philip Suppelna, Timoleon Dagres, Günter Noè, Michael Anapolski, Joscha Reinhard, Harald Krentel, Clemens Tempfer, Sven Schiermeier
OBJECTIVE: This study examines the recommendations of international guidelines on the use of antepartum and intrapartum cardiotocography. MATERIAL AND METHODS: The guidelines of Germany, Canada, UK, USA, Sri Lanka, Australia as well as FIGO have been compared. The recommendations on the use of cardiotocography were separately evaluated for antepartum and intrapartum use. RESULTS: Antepartum: In risk-free pregnancies the use of cardiotocography is not recommended in all countries...
February 23, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
Ryohei Suzuki, Yohei Mochizuki, Hiroki Yoshimatsu, Ayaka Niina, Takahiro Teshima, Hirotaka Matsumoto, Hidekazu Koyama
Case summary: A 5-month-old intact female Scottish Fold cat was presented for cardiac evaluation. Careful auscultation detected a slight systolic murmur (Levine I/VI). The findings of electrocardiography, thoracic radiography, non-invasive blood pressure measurements and conventional echocardiographic studies were unremarkable. However, two-dimensional speckle tracking echocardiography revealed abnormalities in myocardial deformations, including decreased early-to-late diastolic strain rate ratios in longitudinal, radial and circumferential directions, and deteriorated segmental systolic longitudinal strain...
January 2018: JFMS Open Reports
Yasmin Jahan, Sm Atiqur Rahman, Abu Sayeed Chowdhury, Md Moshiur Rahman
Background: Pneumonia is a major cause of child mortality among children under 5 years, worldwide. Pneumonia infection may be caused by bacteria, viruses, or fungi in single or in both lungs. According to recent criteria developed by the World Health Organization(WHO) in September (2013), pneumonia can be classified into severe pneumonia, pneumonia and no pneumonia. Most of the deaths occur from severe pneumonia. Methods: Disease management of severe childhood pneumonia requires early identification,prompt referral and the availability of intensive quality care...
2018: Health Promotion Perspectives
Sophie Turnbull, Patricia J Lucas, Niamh M Redmond, Hannah Christensen, Hannah Thornton, Christie Cabral, Peter S Blair, Brendan C Delaney, Matthew Thompson, Paul Little, Tim J Peters, Alastair D Hay
BACKGROUND: The objectives were to identify 1) the clinician and child characteristics associated with; 2) clinical management decisions following from, and; 3) the prognostic value of; a clinician's 'gut feeling something is wrong' for children presenting to primary care with acute cough and respiratory tract infection (RTI). METHODS: Multicentre prospective cohort study where 518 primary care clinicians across 244 general practices in England assessed 8394 children aged ≥3 months and < 16 years for acute cough and RTI...
February 5, 2018: BMC Family Practice
Arneh Babakhani, Robert N Clapp, William B Warner
A 25-year-old man, who was an active duty US Navy sailor, went to his ship's medical department complaining of a mild cough that he'd had for 2 days. He denied having any fevers, chills, night sweats, angina, or dyspnea. He said he hadn't experienced any exertional fatigue or difficulty completing the rigorous physical tasks of his occupation as an engineman on the ship. The patient had no medical or surgical history of significance, and he wasn't taking any medications or supplements. On exam, he was not in acute distress and his vital signs were within normal limits...
February 2018: Journal of Family Practice
Daniel M Shindler
The Valsalva maneuver should be incorporated into the routine of auscultation even when a murmur is absent. Valsalva release affects the second heart sound. It is particularly helpful during detailed, non-perfunctory auscultation in patients with bundle branch block.
January 26, 2018: Cardiology
Supreeya Swarup, Amgad N Makaryus
Cardiovascular disease (CVD) is recognized as the leading cause of mortality throughout the world. About one-third of global mortality is attributable to CVD. In addition to clinical presentation, specific clinical exam findings can assist in treating and preventing CVD. CVD may initially manifest as pulmonary pathology, and thus, accurate cardiopulmonary auscultation is paramount to establishing accurate diagnosis. One of the most powerful tools available to physicians is the stethoscope. The stethoscope first emerged in the year 1818, invented by a French physician, René Laennec...
2018: Medical Devices: Evidence and Research
H M Fahad, M Usman Ghani Khan, Tanzila Saba, Amjad Rehman, Sajid Iqbal
Auscultation of heart dispenses identification of the cardiac valves. An electronic stethoscope is used for the acquisition of heart murmurs that is further classified into normal or abnormal murmurs. The process of heart sound segmentation involves discrete wavelet transform to obtain individual components of the heart signal and its separation into systole and diastole intervals. This research presents a novel scheme to develop a semi-automatic cardiac valve disorder diagnosis system. Accordingly, features are extracted using wavelet transform and spectral analysis of input signals...
January 23, 2018: Microscopy Research and Technique
Emine Atag, Nilay Bas Ikizoglu, Yasemin Gokdemir, Ela Erdem Eralp, Gursu Kiyan, Dilek Yilmazbayhan, Bulent Karadag
Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a rare disorder recently included in rare idiopathic interstitial pneumonias according to the updated American Thoracic Society/European Respiratory Society classification. IPPFE is characterized by pleural and subpleural parenchymal fibrosis causing volume loss predominantly in the upper lung lobes. Age of onset is variable, IPPFE mainly occurs in third and fourth decades. We present a 16 year old patient with a 2-year history of exertional dyspnea, nonproductive cough and weight loss...
February 1, 2018: Archivos Argentinos de Pediatría
Yi-Chen Wang, Chen-Wei Huang, Ting-Wei Lin
No abstract text is available yet for this article.
April 2018: Heart: Official Journal of the British Cardiac Society
Gelila K Goba, Hailesilassie Tsegay, Gebremedhin Berhe, Mengistu Mitiku, Kimberly A Kim, Mussie Alemayehu
OBJECTIVE: To identify perinatal mortality risk factors in the Southern Zone of Tigray, northern Ethiopia. METHODS: The present unmatched case-control study included data from 20 health facilities; stillbirths and neonatal deaths were included as a case group and patients with neonates who survived until discharge or day 7 postpartum were included as a control group. Perinatal mortality risk factors were investigated using bivariate and multivariate logistic regression analyses...
January 9, 2018: International Journal of Gynaecology and Obstetrics
Davor Stamenovic, Korkut Bostanci, Antje Messerschmidt
Background: The acceptance of uniportal video-assisted thoracoscopic surgery (uVATS) for anatomical lung resections has been growing in recent years. This study presents the first case-series in the literature with posterior uVATS (puVATS) technique for specific anatomical lung resections. Methods: The first 20 consecutive patients who underwent an anatomical lung resection by a single surgeon, by means of puVATS technique were evaluated in terms of pre-, peri- and post-operative results...
December 2017: Journal of Thoracic Disease
Bernard Iung, Victoria Delgado, Patrice Lazure, Suzanne Murray, Per Anton Sirnes, Raphael Rosenhek, Susanna Price, Marco Metra, Céline Carrera, Michele De Bonis, Michael Haude, Gerhard Hindricks, Jeroen Bax, Alec Vahanian
Aims: To assess the knowledge and application of European Society of Cardiology (ESC) Guidelines in the management of mitral regurgitation (MR). Methods and results: A mixed-methods educational needs assessment was performed. Following a qualitative phase (interviews), an online survey was undertaken using three case scenarios (asymptomatic severe primary MR, symptomatic severe primary MR in the elderly, and severe secondary MR) in 115 primary care physicians (PCPs), and 439 cardiologists or cardiac surgeons from seven European countries...
January 2, 2018: European Heart Journal
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