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Chest Guidelines

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https://www.readbyqxmd.com/read/28544041/marked-variability-observed-in-inpatient-management-of-bronchiolitis-in-three-finnish-hospitals
#1
Varpu Elenius, Eija Bergroth, Petri Koponen, Sami Remes, Pedro A Piedra, Janice A Espinola, Matti Korppi, Carlos A Camargo, Tuomas Jartti
AIM: Infants hospitalised for bronchiolitis undergo examinations and treatments not supported by current research evidence and we investigated practice variations with regard to Finnish children under the age of two. METHODS: This prospective, multi-centre cohort study was conducted in paediatric units in three university hospitals in Finland from 2008-2010. Hospital medical records were reviewed to collect data on clinical course, testing and treatment. Data were analysed separately for children meeting our strict definition of bronchiolitis, aged under 12 months without a history of wheezing, and a loose definition, aged 12-23 months or with a history of wheezing...
May 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28539572/malondialdehyde-modified-low-density-lipoprotein-as-oxidative-stress-marker-in-vasospastic-angina-patients
#2
Tetsuo Oumi, Toshihiro Nozato, Atsushi Sakakibara, Hidetsugu Nomoto, Masakazu Ohno, Yoshihide Takahashi, Takashi Ashikaga, Yasuhiro Satoh, Mitsuaki Isobe
Vasospastic angina (VSA) is caused by endothelial dysfunction and hypercontraction of vascular smooth muscle cells. Although oxidative-stress can induce endothelial dysfunction, the relationship of VSA and the oxidative-stress marker malondialdehyde-modified low density lipoprotein (MDA-LDL) remains unclear. PURPOSE: Serum MDA-LDL was evaluated in candidate VSA patients.The subjects were 84 patients admitted to our hospital because of chest pain at rest. We stratified the patients into 3 groups; definite VSA, suspected VSA, and unlikely VSA according to a Japanese Circulation Society (JCS) guideline...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#3
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515745/new-aspects-in-the-diagnosis-and-treatment-of-primary-spontaneous-pneumothorax
#4
Agata Dżeljilji, Wojciech Rokicki, Marek Rokicki, Krzysztof Karuś
This paper provides a recapitulation of the position of the British Thoracic Society and the American College of Chest Physicians based on a review of the literature concerning the current methods of diagnosing and treating primary spontaneous pneumothorax (PSP). The previously developed guidelines were re-evaluated in 2015 by a task force of the European Respiratory Society (ERS). They are intended to be used by surgeons as well as emergency and pulmonary ward physicians, and they apply largely to emergency procedures...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28508877/an-overview-of-female-to-male-gender-confirming-surgery
#5
REVIEW
Shane D Morrison, Mang L Chen, Curtis N Crane
Gender dysphoria is estimated to occur in approximately 25 million people worldwide, and can have severe psychosocial sequelae. Medical and surgical gender transition can substantially improve quality-of-life outcomes for individuals with gender dysphoria. Individuals seeking to undergo female-to-male (FtM) transition have various surgical options available for gender confirmation, including facial and chest masculinization, body contouring, and genital surgery. The World Professional Association for Transgender Health guidelines should be met before the patient undergoes surgery, to ensure that gender-confirming surgery is appropriate and indicated...
May 16, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28505345/cardio-oncology-a-multidisciplinary-approach-for-detection-prevention-and-management-of-cardiac-dysfunction-in-cancer-patients
#6
Kazuko Tajiri, Kazutaka Aonuma, Ikuo Sekine
Cardiac dysfunction that develops during or after completion of cancer therapy is a growing health concern that should be addressed in a multidisciplinary setting. Cardio-oncology is a new discipline that focuses on screening, monitoring and treating cardiovascular disease during and after cancer treatment. A baseline cardiovascular risk assessment is essential. For high-risk patients, a tailored and detailed plan for cardiovascular management throughout treatment and beyond should also be established. Anthracycline and/or trastuzumab-containing chemotherapy and chest-directed radiation therapy are well known cardiotoxic cancer therapies...
May 15, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#7
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28499516/improving-cpr-performance
#8
REVIEW
Boulos S Nassar, Richard Kerber
Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions; avoiding hyperventilation; encouraging intraosseus access, and monitoring capnography...
May 9, 2017: Chest
https://www.readbyqxmd.com/read/28497853/respiratory-morbidity-among-u-s-coal-miners-in-states-outside-of-central-appalachia
#9
Laura E Reynolds, David J Blackley, Anthony S Laney, Cara N Halldin
BACKGROUND: Recent NIOSH publications have focused on the respiratory health of coal miners in central Appalachia, yet 57% of U.S. coal miners work in other regions. We characterized respiratory morbidity in coal miners from these regions. METHODS: Active coal miners working outside of central Appalachia who received chest radiographs and/or spirometry during 2005-2015 were included. Chest radiographs were classified according to International Labour Office standards and spirometry was interpreted using the American Thoracic Society guidelines...
May 12, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28493596/overcoming-the-tower-of-babel-in-medical-science-by-finding-the-equator-research-reporting-guidelines
#10
Christopher R Carpenter, Zachary F Meisel
You are hosting a journal club on chest pain management in the emergency department (ED) for colleagues and trainees in your department. Interested in understanding the history of cardiac biomarkers to evaluate ED patients with chest pain, you search PubMed using the combination of terms "cardiac biomarker", "chest pain", and "emergency department". Your search nets no studies prior to 2002 which you doubt is accurate, so you take the old-fashioned approach and start flipping through the oldest issues of emergency medicine journals at your local medical school library...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28490939/measuring-quality-care-in-localized-renal-cell-cancer-use-of-appropriate-preoperative-investigations-in-a-population-based-cohort
#11
N Moideen, K H Marzouk, K J Matheson, L A Wood
INTRODUCTION: Obtaining appropriate preoperative risk-specific staging investigations for localized renal cell carcinoma (rcc) is a recognized quality indicator. The goal of the present work was to determine the use and appropriateness of preoperative investigations in patients undergoing curative surgery for rcc. METHODS: This population-based retrospective study of patients having surgery for localized rcc recorded the use of preoperative imaging and laboratory investigations within 6 months of surgery...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28484658/thermal-esophageal-injury-following-ingestion-of-boiling-mushroom-water
#12
Allison Prevost, Adam Talley, Emily Klepper, Elizabeth McDonough
Thermal esophageal and gastric damage from ingestion of hot liquids is poorly studied in pediatrics. Limited case reports exist in the literature. Many cases presented with chest pain, dysphagia, and odynophagia. Variable histologic findings were reported. No definitive management guidelines exist for such injuries. We provide a report of the acute assessment and management of an obvious thermal esophageal injury and contribute to what is known about this presentation. A 16-year-old male presented with odynophagia, dysphagia, and hematemesis following ingestion of "nearly boiling" mushroom water...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28479767/reimbursements-and-frequency-of-tests-in-privately-insured-testicular-cancer-patients-in-the-united-states-implications-to-national-guidelines
#13
Mohamed H Kamel, Austin Barber, Rodney Davis, Omer A Raheem, Nabil Bissada, Alaa Eldin A Abdelmaksoud, Ehab Eltahawy
OBJECTIVES: The objective of this study was to assess the frequency of utilization and reimbursement of the common diagnostic tests and treatment modalities used in testicular cancer care. METHODS: LifeLink™ (IMS Health, Danbury, CT, USA) Claims Database was used. We identified 877 subjects with a primary diagnosis of testicular cancer (ICD 186.9) between 2007 and 2012. Median reimbursement and frequency of the diagnostic/treatment modalities used were recorded...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28476474/the-association-between-aha-cpr-quality-guideline-compliance-and-clinical-outcomes-from-out-of-hospital-cardiac-arrest
#14
Sheldon Cheskes, Robert H Schmicker, Tom Rea, Laurie J Morrison, Brian Grunau, Ian R Drennan, Brian Leroux, Christian Vaillancourt, Terri A Schmidt, Allison C Koller, Peter Kudenchuk, Tom P Aufderheide, Heather Herren, Katharyn H Flickinger, Mark Charleston, Ron Straight, Jim Christenson
BACKGROUND: Measures of chest compression fraction (CCF), compression rate, compression depth and pre-shock pause have all been independently associated with improved outcomes from out-of-hospital (OHCA) cardiac arrest. However, it is unknown whether compliance with American Heart Association (AHA) guidelines incorporating all the aforementioned metrics, is associated with improved survival from OHCA. METHODS: We performed a secondary analysis of prospectively collected data from the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest database...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28473096/acr-appropriateness-criteria-%C3%A2-chronic-chest-pain-high-probability-of-coronary-artery-disease
#15
Scott R Akers, Vandan Panchal, Vincent B Ho, Garth M Beache, Richard K J Brown, Brian B Ghoshhajra, S Bruce Greenberg, Joe Y Hsu, Gregory A Kicska, James K Min, Arthur E Stillman, Jadranka Stojanovska, Suhny Abbara, Jill E Jacobs
In patients with chronic chest pain in the setting of high probability of coronary artery disease (CAD), imaging has major and diverse roles. First, imaging is valuable in determining and documenting the presence, extent, and severity of myocardial ischemia, hibernation, scarring, and/or the presence, site, and severity of obstructive coronary lesions. Second, imaging findings are important in determining the course of management of patients with suspected chronic myocardial ischemia and better defining those patients best suited for medical therapy, angioplasty/stenting, or surgery...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473092/acr-appropriateness-criteria-%C3%A2-suspected-pulmonary-hypertension
#16
Arlene Sirajuddin, Edwin F Donnelly, Traves P Crabtree, Travis S Henry, Mark D Iannettoni, Geoffrey B Johnson, Ella A Kazerooni, Fabien Maldonado, Kathryn M Olsen, Carol C Wu, Tan-Lucien Mohammed, Jeffrey P Kanne
Pulmonary hypertension may be idiopathic or related to a large variety of diseases. Various imaging examinations that may be helpful in diagnosing and determining the etiology of pulmonary hypertension are discussed. Imaging examinations that may aid in the diagnosis of pulmonary hypertension include chest radiography, ultrasound echocardiography, ventilation/perfusion scans, CT, MRI, right heart catheterization, pulmonary angiography, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473078/acr-appropriateness-criteria-%C3%A2-plexopathy
#17
Julie Bykowski, Joseph M Aulino, Kevin L Berger, R Carter Cassidy, Asim F Choudhri, A Tuba Kendi, Claudia F E Kirsch, Michael D Luttrull, Aseem Sharma, Vilaas S Shetty, Khoi Than, Christopher J Winfree, Rebecca S Cornelius
MRI without and with contrast is the most accurate imaging method to determine whether a process is intrinsic or extrinsic to a nerve of the brachial or lumbosacral plexus. However, there are no Current Procedural Terminology codes to correspond to imaging studies of the brachial or lumbar plexus discretely. This assessment uses "MRI of the brachial plexus" or "MRI of the lumbosacral plexus" as independent entities given that imaging acquisition for the respective plexus differs in sequences and planes compared with those of a routine neck, chest, spine, or pelvic MRI, yet acknowledges the potential variability of ordering practices across institutions...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473076/acr-appropriateness-criteria-%C3%A2-acute-chest-pain-suspected-pulmonary-embolism
#18
Jacobo Kirsch, Richard K J Brown, Travis S Henry, Cylen Javidan-Nejad, Clinton Jokerst, Paul R Julsrud, Jeffrey P Kanne, Christopher M Kramer, Jonathon A Leipsic, Kalpesh K Panchal, James G Ravenel, Amar B Shah, Tan-Lucien Mohammed, Pamela K Woodard, Suhny Abbara
Pulmonary embolism (PE) remains a common and important clinical condition that cannot be accurately diagnosed on the basis of signs, symptoms, and history alone. The diagnosis of PE has been facilitated by technical advancements and multidetector CT pulmonary angiography, which is the major diagnostic modality currently used. Ventilation and perfusion scans remain largely accurate and useful in certain settings. Lower-extremity ultrasound can substitute by demonstrating deep vein thrombosis; however, if negative, further studies to exclude PE are indicated...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473073/acr-appropriateness-criteria-%C3%A2-known-or-suspected-congenital-heart-disease-in-the-adult
#19
Pamela K Woodard, Vincent B Ho, Scott R Akers, Garth Beache, Richard K J Brown, Kristopher W Cummings, S Bruce Greenberg, James K Min, Arthur E Stillman, Jadranka Stojanovska, Jill E Jacobs
The incidence of congenital heart disease (CHD) has been increasing in the adult patient population in part as a result of better patient survival. Patients with more severe CHD are living longer. Nearly all adults with known CHD require periodic imaging as a means of monitoring their disease process. Furthermore, adult patients with suspected CHD require imaging as a means of definitive diagnosis. As a result, it is important for both the referring clinician and the imager to be aware of the most appropriate imaging modality needed to obtain the data most needed to direct the next steps in patient care...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473067/acr-appropriateness-criteria-%C3%A2-chylothorax-treatment-planning
#20
Bill S Majdalany, Douglas A Murrey, Baljendra S Kapoor, Thomas R Cain, Suvranu Ganguli, Michael S Kent, Fabien Maldonado, Joseph J McBride, Jeet Minocha, Stephen P Reis, Jonathan M Lorenz, Sanjeeva P Kalva
Chylothorax is an uncommon but serious medical condition, which arises when intestinal lymphatic fluid leaks into the pleural space. Treatment strategies depend on the daily output and underlying etiology, which may be due to direct injury to lymphatic vessels or a nontraumatic disorder. Chest radiographs confirm the presence of pleural fluid and lateralize the process. In the setting of direct injury, lymphangiography can often be both diagnostic and facilitate a minimally invasive attempt at therapy. CT and MRI in this setting may be appropriate for cases when lymphangiography is not diagnostic...
May 2017: Journal of the American College of Radiology: JACR
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