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https://www.readbyqxmd.com/read/27910800/routine-x-ray-of-the-chest-is-not-justified-in-staging-of-cutaneous-melanoma-patients
#1
Caroline Asirvatham Gjørup, Helle Westergren Hendel, Rita Kaae Pilegaard, Cecilie Balslev Willert, Lisbet Rosenkrantz Hölmich
INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27910139/characterization-of-patients-with-chronic-pulmonary-aspergillosis-according-to-the-new-escmid-ers-ecmm-and-idsa-guidelines
#2
Helmut J F Salzer, Jan Heyckendorf, Barbara Kalsdorf, Thierry Rolling, Christoph Lange
Recently, the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) in cooperation with the European Respiratory Society (ERS) and the European Confederation of Medical Mycology (ECMM) published guidelines for the diagnosis of chronic pulmonary aspergillosis (CPA). Both guidelines, however, carry significant differences. We retrospectively applied the diagnostic recommendations on a patient cohort of 71 previously diagnosed CPA patients in order to compare both guidelines...
December 1, 2016: Mycoses
https://www.readbyqxmd.com/read/27904816/an-unusual-presentation-of-nocardiosis-in-an-allogeneic-transplant-recipient
#3
Uroosa Ibrahim, Amina Saqib, Farhan Mohammad, Terenig Terjanian
Nocardiosis is a rare cause of opportunistic infection post hematopoietic stem cell transplant (HSCT) occurring in about 0.3% of patients. The risk factors include delayed immune reconstitution, prolonged neutropenia, and graft-versus-host disease. The most common site of infection is the lung, followed by the brain and the skin. Concomitant pulmonary and central nervous system (CNS) nocardiosis is an extremely rare entity as presented in our case. We present the case of a 72-year-old male at 137 days post transplant presenting with complaints of headache and slurred speech...
October 17, 2016: Curēus
https://www.readbyqxmd.com/read/27900539/seom-clinical-guideline-for-treatment-of-muscle-invasive-and-metastatic-urothelial-bladder-cancer-2016
#4
M Lázaro, E Gallardo, M Doménech, Á Pinto, A González Del Alba, J Puente, O Fernández, A Font, N Lainez, S Vázquez
The goal of this article is to provide recommendations for the diagnosis and treatment of muscle-invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by pathologic evaluation after transurethral resection. Recently, a molecular classification has been proposed. Staging of muscle-invasive bladder cancer must be done by computed tomography scans of the chest, abdomen and pelvis and classified on the basis of UICC system. Radical cystectomy and lymph node dissection are the treatment of choice...
November 29, 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27899520/is-adherence-to-the-american-college-of-chest-physicians-recommended-anticoagulation-treatment-duration-associated-with-different-outcomes-among-patients-with-venous-thromboembolism
#5
Alex C Spyropoulos, Ron Preblick, Winghan J Kwong, Melissa Lingohr-Smith, Jay Lin
Clinical and economic outcomes associated with venous thromboembolism (VTE) patient adherence to the American College of Chest Physicians (ACCP) anticoagulant (AC) treatment guidelines are incompletely understood. Patients with ≥1 inpatient or ≥2 separate outpatient claims for deep vein thrombosis and/or pulmonary embolism, based on International Classification of Diseases, Ninth Revision, Clinical Modification codes, were identified from the IMS PharMetrics Plus database. Patients had continuous insurance coverage for 12 months before (baseline) and after (follow-up) the index event (first VTE claim) but no baseline VTE claims...
November 28, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#6
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27889066/does-thoracoscopy-have-advantages-over-open-surgery-for-asymptomatic-congenital-lung-malformations-an-analysis-of-1626-resections
#7
Stephen Adams, Matthew Jobson, Patarawan Sangnawakij, Adam Heetun, Anthony Thaventhiran, Navroop Johal, Dankmar Böhning, Michael P Stanton
AIM: The apparent incidence of antenatally diagnosed congenital lung malformations (CLM) is rising (1 in 3000), and the majority undergo elective resection even if asymptomatic. Thoracoscopy has been popularized, but early series report high conversion rates and significant complications. We aimed to perform systematic review/meta-analysis of outcomes of thoracoscopic vs open excision of asymptomatic CLMs. METHODS: A systematic review according to PRISMA guidelines was performed...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27888429/inappropriateness-of-diagnostic-imaging-examinations-in-the-inpatient-setting-a-case-study-research
#8
Ettore Squillaci, Francesca Bolacchi, Jacopo Scaggiante, Francesca Ricci, Luca Pugliese, Alberto Bergamini, Francesco Garaci, Roberto Floris
OBJECTIVE: The purpose of our study was to audit the clinical appropriateness of the prescriptions of whole body CT (WB-CT), PET-CT and chest X-rays (CXRs) performed at Tor Vergata University Hospital in the inpatient setting. MATERIALS AND METHODS: WB-CT, PET-CT and CXRs examinations were retrospectively analysed in the period between January and December 2014. CXR examinations were divided into bedside CXRs and traditional CXRs. The appropriateness of the examinations was defined according the American College of Radiology Appropriateness Criteria...
November 25, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27887644/copenhagen-comorbidity-in-hiv-infection-cocomo-study-a-study-protocol-for-a-longitudinal-non-interventional-assessment-of-non-aids-comorbidity-in-hiv-infection-in-denmark
#9
Andreas Ronit, Judith Haissman, Ditte Marie Kirkegaard-Klitbo, Thomas Skårup Kristensen, Anne-Mette Lebech, Thomas Benfield, Jan Gerstoft, Henrik Ullum, Lars Køber, Andreas Kjær, Klaus Kofoed, Jørgen Vestbo, Børge Nordestgaard, Jens Lundgren, Susanne Dam Nielsen
BACKGROUND: Modern combination antiretroviral therapy (cART) has improved survival for people living with HIV (PLWHIV). Non-AIDS comorbidities have replaced opportunistic infections as leading causes of mortality and morbidity, and are becoming a key health concern as this population continues to age. The aim of this study is to estimate the prevalence and incidence of non-AIDS comorbidity among PLWHIV in Denmark in the cART era and to determine risk factors contributing to the pathogenesis...
November 26, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27878801/strength-training-effects-on-quality-of-prolonged-basic-cardiopulmonary-resuscitation
#10
Cristian Abelairas-Gómez, Roberto Barcala-Furelos, Łukasz Szarpak, Óscar García-García, Álvaro Paz-Domínguez, Sergio López-García, Antonio Rodríguez-Núñez
BACKGROUND: Providing high-quality chest compressions and rescue breaths are a key elements affecting the effectiveness of cardiopulmonary resuscitation (CPR). AIM: To investigate the effects of a strength training program on the quality of prolonged in time basic cardiopulmonary resuscitation on a manikin. METHODS: This was a quasi-experimental.trial. Thirty-nine participants with prior basic life support knowledge were randomized to an experimental or control group...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27873512/antimicrobial-resistance-and-clinical-outcomes-in-nursing-home-acquired-pneumonia-compared-to-community-acquired-pneumonia
#11
Yun Seong Kang, Soo Ryeong Ryoo, Seung Joo Byun, Yun Jeong Jeong, Jin Young Oh, Young Soon Yoon
PURPOSE: Patients with nursing home-acquired pneumonia (NHAP) should be treated as hospital-acquired pneumonia (HAP) according to guidelines published in 2005. However, controversy still exists on whether the high mortality of NHAP results from multidrug resistant pathogens or underlying disease. We aimed to outline differences and factors contributing to mortality between NHAP and community-acquired pneumonia (CAP) patients. MATERIALS AND METHODS: We retrospectively evaluated patients aged 65 years or older with either CAP or NHAP from 2008 to 2014...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27873006/feasibility-of-omitting-provocation-test-with-50%C3%A2-%C3%AE-g-of-acetylcholine-in-left-coronary-artery
#12
Yuichi Saito, Hideki Kitahara, Toshihiro Shoji, Satoshi Tokimasa, Takashi Nakayama, Kazumasa Sugimoto, Yoshihide Fujimoto, Yoshio Kobayashi
According to the Japanese Circulation Society guideline of vasospastic angina, incremental doses of acetylcholine (ACh) are prescribed for coronary spasm provocation: 20 and 50 μg for the right coronary artery (RCA), and 20, 50 and 100 μg for the left coronary artery (LCA). However, provocation by low doses of ACh in patients with low vasoreactivity may be less needed, and the requirement of 50 μg of ACh for the LCA in these patients has not been evaluated. In the present study, patients who underwent ACh provocation test for both the RCA and LCA were included...
November 21, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27872397/pulmonary-mycobacterium-marinum-infection-fish-tank-granuloma-of-the-lung
#13
Prasad Palani Velu, Susan E Fernandes, Ian F Laurenson, Donald D Noble
A 65-year-old man presented with a six-month history of lethargy, weight loss and dry cough. He had a background of mild chronic obstructive pulmonary disease. Chest radiograph showed new right upper lobe cavitary opacification. Sputum cultures were acid-fast bacilli smear positive and yielded Mycobacterium marinum - a non-tuberculous mycobacterium (NTM) often found in aquatic environments and rarely associated with respiratory disease. The suspected source was silent aspiration of contaminated water, likely due to his initiating the siphon of his fish-tank by mouth...
November 2016: Scottish Medical Journal
https://www.readbyqxmd.com/read/27871517/guidelines-for-preoperative-investigations-for-elective-surgery-at-queen-elizabeth-hospital-effects-on-practices-outcomes-and-costs
#14
Judith Nicholls, Pamela S Gaskin, Justin Ward, Yasodananda K Areti
STUDY OBJECTIVE: We endeavor to assess the impact of introduction of guidelines for preoperative investigations (PIs) on anesthetic practices and costs and compare their efficacy to current practices. DESIGN: A prospective study. SETTING: Queen Elizabeth Hospital, Barbados. PATIENTS: Participants comprised all patients undergoing general, epidural, spinal, and regional anesthesia, with the exception of emergency cases or instances where an anesthesiologist was not required...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27866549/-characteristics-of-lung-function-in-patients-with-asbestosis-of-different-stages
#15
X L Yang, X L Zhu, A Li, X Q Du, Y G Song, Q Ye
Objective: To investigate the characteristics of lung function in the patients with asbestosis of different stages, and analyze the correlations between the pulmonary function values and imaging score of chest X-ray. Methods: A cohort of newly diagnosed 249 asbestosis patients over a period of eight years in a single center were evaluated. Clinical data were collected from clinical charts. Radiographs were reviewed by the experts blinded to clinical data. The asbestosis patients were classified into I to III stages by chest X-ray according to the guideline...
September 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27865877/cough-in-the-athlete-chest-guideline-and-expert-panel-report
#16
Louis-Philippe Boulet, Julie Turmel, Richard S Irwin
BACKGROUND: Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess in this population: 1) the main etiologies of acute and recurrent cough, either exercise-induced or not; 2) how it is assessed; and 3) how cough is treated in this population. From the systematic review, suggestions for management were developed. METHOD: ology: This review was done according to the CHEST methodological guidelines and GRADE framework up to April 2015...
November 16, 2016: Chest
https://www.readbyqxmd.com/read/27864607/computed-tomography-versus-invasive-coronary-angiography-design-and-methods-of-the-pragmatic-randomised-multicentre-discharge-trial
#17
Adriane E Napp, Robert Haase, Michael Laule, Georg M Schuetz, Matthias Rief, Henryk Dreger, Gudrun Feuchtner, Guy Friedrich, Miloslav Špaček, Vojtěch Suchánek, Klaus Fuglsang Kofoed, Thomas Engstroem, Stephen Schroeder, Tanja Drosch, Matthias Gutberlet, Michael Woinke, Pál Maurovich-Horvat, Béla Merkely, Patrick Donnelly, Peter Ball, Jonathan D Dodd, Martin Quinn, Luca Saba, Maurizio Porcu, Marco Francone, Massimo Mancone, Andrejs Erglis, Ligita Zvaigzne, Antanas Jankauskas, Gintare Sakalyte, Tomasz Harań, Malgorzata Ilnicka-Suckiel, Nuno Bettencourt, Vasco Gama-Ribeiro, Sebastian Condrea, Imre Benedek, Nada Čemerlić Adjić, Oto Adjić, José Rodriguez-Palomares, Bruno Garcia Del Blanco, Giles Roditi, Colin Berry, Gershan Davis, Erica Thwaite, Juhani Knuuti, Mikko Pietilä, Cezary Kępka, Mariusz Kruk, Radosav Vidakovic, Aleksandar N Neskovic, Ignacio Díez, Iñigo Lecumberri, Jacob Geleijns, Christine Kubiak, Anke Strenge-Hesse, The-Hoang Do, Felix Frömel, Iñaki Gutiérrez-Ibarluzea, Gaizka Benguria-Arrate, Hans Keiding, Christoph Katzer, Jacqueline Müller-Nordhorn, Nina Rieckmann, Mario Walther, Peter Schlattmann, Marc Dewey
OBJECTIVES: More than 3.5 million invasive coronary angiographies (ICA) are performed in Europe annually. Approximately 2 million of these invasive procedures might be reduced by noninvasive tests because no coronary intervention is performed. Computed tomography (CT) is the most accurate noninvasive test for detection and exclusion of coronary artery disease (CAD). To investigate the comparative effectiveness of CT and ICA, we designed the European pragmatic multicentre DISCHARGE trial funded by the 7th Framework Programme of the European Union (EC-GA 603266)...
November 18, 2016: European Radiology
https://www.readbyqxmd.com/read/27861214/body-mass-hides-the-curve-thoracic-scoliometer-readings-vary-by-body-mass-index-value
#18
Adam Margalit, Greg McKean, Adam Constantine, Carol B Thompson, Rushyuan Jay Lee, Paul D Sponseller
BACKGROUND: Guidelines suggest referral for scoliosis when rib slope (scoliometer measurement, angle of trunk rotation) is ≥7 degrees. We hypothesized that overweight and obese patients would have lower scoliometer measurements compared with normal-weight and underweight patients for a given spinal curvature, causing overweight and obese patients with adolescent idiopathic scoliosis to present for treatment later and with larger curves. Our goal was to determine the association between scoliometer readings and major curve magnitudes in relation to body mass index (BMI)...
November 17, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27854541/what-exactly-is-a-centrally-located-lung-tumor-results-of-an-on-line-survey
#19
Roberto F Casal, Macarena R Vial, Russell Miller, Lakshmi Mudambi, Horiana B Grosu, George A Eapen, Carlos A Jimenez, Rodolfo C Morice, Lorraine Cornwell, David Ost
RATIONALE: Accurate mediastinal staging is cornerstone in the management of patients with lung cancer. For patients with radiographically normal mediastinum, current lung cancer guidelines recommend invasive mediastinal staging when tumors are centrally located. However, definitions of central tumors are non-specific and there are discrepancies among guidelines (e.g. some use the inner one third of the hemithorax while others use the inner two thirds). OBJECTIVES: To describe the definitions of central tumors used by pulmonologists and thoracic surgeons in their practice...
November 17, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27852427/monitoring-the-hospital-management-of-acute-asthma-the-italian-pediatric-network-experience
#20
A G Martelli, R Bianchi, B Boldrighini, M Bosoni, A De Vuono, A Flores D'Arcais, G Gargantini, R Longhi, M T Ortisi, E Racchi, L Parola
BACKGROUND: The Study Group on Accreditation and Quality Improvement of the Italian Society of Pediatrics has developed an observational study about the hospital management of pediatric patients affected by severe asthma, in order to evaluate how the Guidelines for severe asthma in childhood are applied in the daily practice. METHODS: This study included patients between 2 and 17 years, hospitalized or under short intensive observation for acute asthma. The data collection was carried out through the compilation of on-line forms...
November 2016: European Annals of Allergy and Clinical Immunology
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