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https://www.readbyqxmd.com/read/29350325/evaluation-and-management-of-rotator-cuff-tears-a-primary-care-perspective
#1
REVIEW
Ross Mathiasen, Christopher Hogrefe
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement...
January 19, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29347961/relevant-pericardial-effusion-caused-by-cytomegalovirus-infection-in-an-immunocompetent-patient-a-case-report
#2
Tabea Hutter, Dirk Springe, Lukas Ebnöther, Marcos Delgado
BACKGROUND: Cytomegalovirus infection is known to cause symptomatic disease in immunocompromised patients, while an infection in immunocompetent individuals normally causes few or no symptoms. We present the case of an immunocompetent adult patient with unexpected severe evolution. CASE PRESENTATION: An otherwise healthy, 72-year-old Caucasian woman presented with complaints of progressive shoulder pain and dyspnoea on exertion. The blood test results showed elevated inflammation parameters and elevated hepatic transaminase levels...
January 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29346252/sarcoidosis-with-pleural-effusion-as-the-presenting-symptom
#3
Estefania Rivera, Yaron Gesthalter, Paul Vardelaan, Alex Chee, Adnan Majid
A 65-year-old woman, never smoker, with medical history of hypertension, nonischemic cardiomyopathy, and moderate pulmonary hypertension presented with symptomatic bilateral pleural effusions. Thoracentesis revealed a lymphocyte predominant transudate and was negative for malignancy, microbiologic cultures were negative for an infectious cause. Chest tomography showed mediastinal and bilateral hilar lymphadenopathy, lymph node biopsy with endobronchial ultrasound-guided transbronchial needle aspiration showed non-necrotizing granulomas compatible with sarcoidosis...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29333006/rational-use-of-imaging-to-stage-breast-cancer-evidences-for-a-selective-approach
#4
S G D Gangadaran
Introduction: Staging investigations at diagnosis are customary to accurately assign a clinical stage before therapy. The practice of routine imaging in patients asymptomatic for metastasis is not recommended but widely adopted. This study was done to reexamine the basis behind guideline recommendations and to identify the factors predictive of asymptomatic metastasis. Methods: Oncology records of 200 breast cancer patients in clinical Stages I-III at diagnosis were prospectively reviewed...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29332607/the-role-of-t2-weighted-gradient-echo-in-the-diagnosis-of-tumefactive-intrahepatic-extramedullary-hematopoiesis-in-myelodysplastic-syndrome-and-diffuse-hepatic-iron-overload-a-case-report-and-review-of-the-literature
#5
Abel A Belay, Andrew M Bellizzi, Alan H Stolpen
BACKGROUND: Extramedullary hematopoiesis is the proliferation of hematopoietic cells outside bone marrow secondary to marrow hematopoiesis failure. Extramedullary hematopoiesis rarely presents as a mass-forming hepatic lesion; in this case, imaging-based differentiation from primary and metastatic hepatic neoplasms is difficult, often leading to biopsy for definitive diagnosis. We report a case of tumefactive hepatic extramedullary hematopoiesis in the setting of myelodysplastic syndrome with concurrent hepatic iron overload, and the role of T2*-weighted gradient-echo magnetic resonance imaging in differentiating extramedullary hematopoiesis from primary and metastatic hepatic lesions...
January 15, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29331648/lung-ultrasound-to-detect-residual-pneumothorax-after-chest-drain-removal-in-lung-resections
#6
Miriam Patella, Andrea Saporito, Carla Puligheddu, Francesco Mongelli, Davide La Regina, Ramon Pini, Rolf Inderbitzi, Stefano Cafarotti
BACKGROUND: Indication for post-drain removal imaging after lung resection is debated. Chest x-ray (CXR) is widely used to confirm lung expansion but not evidence-based. We propose to introduce lung ultrasound (LUS) as alternative to exclude significant pneumothorax (PTx) in this setting. METHODS: Fifty patients undergoing lung resections were enrolled. Inclusion criteria were: complete expansion of the lung at post-operative CXR, pleural effusion <300ml/24h, air leak 10-20ml/min for 6 hours...
January 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29330983/ultrasound-and-supine-chest-radiograph-in-road-traffic-accident-patients-a-reliable-and-convenient-way-to-diagnose-pleural-effusion
#7
Uzma Mumtaz, Zainab Zahur, Muhammad Ali Raza, Madiha Mumtaz
BACKGROUND: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29329599/gallbladder-ascariasis-in-kosovo-focus-on-ultrasound-and-conservative-therapy-a-case-series
#8
Vlora Ismaili-Jaha, Halim Toro, Lidvana Spahiu, Mehmedali Azemi, Teuta Hoxha-Kamberi, Muharrem Avdiu, Shqipe Spahiu-Konjusha, Luan Jaha
BACKGROUND: Ascaris lumbricoides is one of the most common intestinal infections in developing countries, including Kosovo. In contrast to migration to the bile duct, migration of the worm to the gallbladder, due to the narrow and tortuous nature of the cystic duct, is rare. When it does occur, it incites acalculous cholecystitis. CASE PRESENTATIONS: This case series describes a 16-month-old Albanian girl, a 22-month-old Albanian girl, a 4-year-old Albanian girl, and a 10-year-old Albanian boy...
January 13, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29322942/purulent-pericarditis-an-unusual-complication-of-pneumococcal-pneumonia-a-case-report
#9
Ghizlane Zoulati, Ramatou Yèya Maïga, Rachid Kerzaz, Ghita Yahyaoui, Mustapha Harandou, Mustapha Mahmoud
Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid...
January 11, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29322296/catheter-directed-ultrasound-facilitated-fibrinolysis-in-obese-patients-with-massive-and-submassive-pulmonary-embolism
#10
Brett J Carroll, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Obesity is a well-established risk factor for pulmonary embolism (PE). However, treatment of PE in obese patients is challenging because of limited outcomes data, especially with advanced therapies such as catheter-based fibrinolysis. We assessed the efficacy and safety of ultrasound-facilitated, catheter-directed fibrinolysis in obese patients with submassive and massive PE enrolled in the SEATTLE II Trial. Eligible patients had a right ventricular-to-left ventricular (RV/LV) diameter ratio ≥ 0.9 on chest computed tomography (CT)...
January 10, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29321931/novel-hybrid-cryo-radial-method-an-emerging-alternative-to-ct-guided-biopsy-in-suspected-lung-cancer-a-prospective-case-series-and-description-of-technique
#11
Samantha Herath, Elaine Yap
In diagnosing peripheral pulmonary lesions (PPL), radial endobronchial ultrasound (R-EBUS) is emerging as a safer method in comparison to CT-guided biopsy. Despite the better safety profile, the yield of R-EBUS remains lower (73%) than CT-guided biopsy (90%) due to the smaller size of samples. We adopted a hybrid method by adding cryobiopsy via the R-EBUS Guide Sheath (GS) to produce larger, non-crushed samples to improve diagnostic capability and enhance molecular testing. We report six prospective patients who underwent this procedure in our institution...
February 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29321430/new-onset-takayasu-s-arteritis-as-acute-myocardial-infarction
#12
Yusuke Ishiyama, Kazuo Eguchi, Katsuaki Yokota, Tomokazu Ikemoto, Kazuomi Kario
We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and adventitia was not clearly visible, and the vessel was concentrically thickened; unstable plaque and calcification were not seen. AMI is rarely seen in young women, but Takayasu's arteritis is one major cause...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29320805/success-rate-of-medical-thoracoscopy-and-talc-pleurodesis-in-malignant-pleurisy-a-single-centre-experience
#13
Joke Leemans, Christophe Dooms, Vincent Ninane, Jonas Yserbyt
BACKGROUND AND OBJECTIVE: Malignant pleurisy is associated with advanced oncological disease and dyspnoea is the most common presenting symptom. Pleurodesis is the preferred palliative and supportive treatment option, targeting symptom relief. The identification of clinical and endoscopic features that determine the success of talc pleurodesis in malignant pleurisy could guide clinical decision-making. METHODS: All symptomatic patients with malignant pleurisy subjected to talc pleurodesis through medical thoracoscopy between January 2012 and December 2015 were included...
January 10, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29319767/variables-associated-with-lung-congestion-as-assessed-by-chest-ultrasound-in-diabetics-undergoing-hemodialysis
#14
Paulo Roberto Santos, José Antonio de Lima Neto, Raimundo Aragão Aires Carneiro, Antônio Igor Taumaturgo Dias Soares, Wanessa Ribeiro de Oliveira, Juliana Oliveira Figueiredo, Narcélio Menezes Silva Filho, Thais Oliveira Silva
INTRODUCTION: Ultrasound is an emerging method for assessing lung congestion but is still seldom used. Lung congestion is an important risk of cardiac events and death in end-stage renal disease (ESRD) patients on hemodialysis (HD). OBJECTIVE: We investigated possible variables associated with lung congestion among diabetics with ESRD on HD, using chest ultrasound to detect extracellular lung water. METHODS: We studied 73 patients with diabetes as the primary cause of ESRD, undergoing regular HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319027/comparison-of-diagnostic-yield-and-safety-profile-of-radial-endobronchial-ultrasound-guided-bronchoscopic-lung-biopsy-with-computed-tomography-guided-percutaneous-needle-biopsy-in-evaluation-of-peripheral-pulmonary-lesions-a-randomized-controlled-trial
#15
Ayush Gupta, Jagdish Chander Suri, Dipak Bhattacharya, Manas Kamal Sen, Shibdas Chakrabarti, Abhijeet Singh, Tulsi Adhikari
BACKGROUND: Peripheral pulmonary lesions (PPLs) pose a diagnostic challenge, and the optimal investigation in many such cases remains unclear. Computed tomography (CT)-guided percutaneous needle biopsy (CT-PNB) has been the modality of choice for such lesions with a high diagnostic accuracy but with high rates of pneumothorax. Endobronchial ultrasound (EBUS) with a radial probe is an alternate diagnostic modality with increased diagnostic yield of bronchoscopy in the evaluation of PPL...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29317990/artefactual-angulated-lesion-on-angiography-a-case-report-and-review-of-literature
#16
Sadat Ali Edroos, Jeremy William Sayer
We present a case of a patient who presented with chest pain, and on diagnostic coronary angiography appeared to have a grossly angulated yet significant coronary stenosis. This was proven to be an artefactual appearance on further assessment with intravascular ultrasound imaging. We describe the causes and associations of coronary tortuosity with other arteriopathy, and highlight challenges in the interpretation of tortuous vessels to accurately assess luminal narrowing and suitability for coronary intervention...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29312744/pathway-and-application-value-of-exploration-of-the-pulmonary-artery-by-endobronchial-ultrasound
#17
Peng Li, Cen Wu, Wei Zheng, Li Zhao
Background: The current standard methods for detecting pulmonary artery diseases are pulmonary artery enhanced computed tomography (CT) scan and pulmonary arteriography. However, some patients cannot tolerate these procedures for various reasons. The present study aimed to investigate the feasibility and operation process of endobronchial ultrasound (EBUS) in exploring the pulmonary artery. Methods: Based on normal contrast-enhanced chest CT images, the sites and process for exploring the pulmonary arteries were established...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310702/mondor-s-disease-a-rare-cause-of-chest-pain-a-case-report
#18
Navaneethakrishnan Suganthan, Vithiya Ratnasamy
BACKGROUND: Chest pain is one of the common presenting symptoms encountered in an emergency department. Prompt history taking and careful clinical examination do help to differentiate cardiac chest pain from other causes. Mondor's disease is a rare cause of chest pain which is often underdiagnosed due to lack of awareness. Mondor's disease is a condition characterized by thrombophlebitis of the superficial veins of breast and anterior chest wall. The diagnosis is often made clinically...
January 9, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29309906/extrapulmonary-small-cell-carcinoma-an-unfortunate-case-of-metastatic-disease
#19
Amie L Harvey, Tommy Yen, Anand Kunda
A 48- year-old man presented with weight loss and 3 weeks of right sided lower abdominal pain. Liver ultrasound and contrast-enhanced computed tomographic scan of the chest, abdomen, and pelvis revealed a 6.8 x 4.3 cm mass like thickening of ascending colon, with numerous hepatic lesions, enlarged mesenteric lymph nodes, peritoneal nodularity and multiple small (2-4 mm) pulmonary nodules concerning for widely metastatic disease (Figure A). A colonoscopy revealed an ulcerated right colon mass obliterating the lumen (Figure B)...
January 5, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29307163/isolated-right-atrial-mass-in-a-candidate-of-coronary-bypass-grafting
#20
Feridoun Sabzi, Aghigh Heidari, Reza Faraji
Hepatocellular carcinoma (HCC) is not uncommon neoplasm, and its occurrences with coronary artery disease (CAD) is more confronted by cardiac surgeon today. In most cases, when the HCC is detected, it has invaded to regional or distant sites. The most frequent location of HCC metastasis includes pulmonary system, musculoskeletal, lymphatic system, and central nervous system. Indeed, intra-atrial metastasis is a rare phenomenon and associated with poor outcome. We report a case of CAD with known HCC that referred for CABG before scheduling for hepatic tumor management...
November 2017: Acta Medica Iranica
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