Database : MEDLINE
Search on : Pulmonary and Heart and Disease [Words]
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[PMID]: 29523779
[Au] Autor:Greiver M; Sullivan F; Kalia S; Aliarzadeh B; Sharma D; Bernard S; Meaney C; Moineddin R; Eisen D; Rahman N; D'Urzo T
[Ad] Address:Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada. mgreiver@rogers.com.
[Ti] Title:Agreement between hospital and primary care on diagnostic labeling for COPD and heart failure in Toronto, Canada: a cross-sectional observational study.
[So] Source:NPJ Prim Care Respir Med;28(1):9, 2018 Mar 09.
[Is] ISSN:2055-1010
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Patients with chronic obstructive pulmonary disease (COPD) or heart failure (HF) are frequently cared for in hospital and in primary care settings. We studied labeling agreement for COPD and HF for patients seen in both settings in Toronto, Canada. This was a retrospective observational study using linked hospital-primary care electronic data from 70 family physicians. Patients were 20 years of age or more and had at least one visit in both settings between 1 January 2012 and 31 December 2014. We recorded labeling concordance and associations with clinical factors. We used capture-recapture models to estimate the size of the populations. COPD concordance was 34%; the odds ratios (ORs) of concordance increased with aging (OR 1.84 for age 75+ vs. <65, 95% CI 0.92-3.69) and more inpatient admissions (OR 2.89 for 3+ visits vs. 0 visits, 95% CI 1.59-5.26). HF concordance was 33%; the ORs of concordance decreased with aging (OR 0.39 for 75+ vs. <65, 95% CI 0.18-0.86) and increased with more admissions (OR = 2.39; 95% CI 1.33-4.30 for 3+ visits vs. 0 visits). Based on capture-recapture models, 21-24% additional patients with COPD and 18-20% additional patients with HF did not have a label in either setting. The primary care prevalence was estimated as 748 COPD patients and 834 HF patients per 100,000 enrolled adult patients. Agreement levels for COPD and HF were low and labeling was incomplete. Further research is needed to improve labeling for these conditions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1038/s41533-018-0076-8

  2 / 80390 MEDLINE  
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[PMID]: 29523720
[Au] Autor:Charbonneau V; Kwok E; Boyle L; Stiell IG
[Ad] Address:Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
[Ti] Title:Impact of emergency department surge and end of shift on patient workup and treatment prior to referral to internal medicine: a health records review.
[So] Source:Emerg Med J;, 2018 Mar 09.
[Is] ISSN:1472-0213
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The goal of this study was to determine if ED surge and end-of-shift assessment of patients affect the extent of diagnostic tests, therapeutic interventions and accuracy of diagnosis prior to referral to internal medicine. METHODS: This study was a health records review of consecutive patients referred to the internal medicine service with an ED diagnosis of heart failure, chronic obstructive pulmonary disease (COPD) or sepsis starting 1 December 2013 until 100 cases for each condition had been obtained. We developed a scoring system in consultation with emergency and internal medicine physicians to uniformly assess the completeness of treatments and investigations performed. These scores, expressed as percentage of possible points, were compared at high and low surge levels and at middle and end of shift at time of patient referral. End of shift was defined as 7:30-8:30, 15:30-16:30 and 23:30-00:30 as our shift changes occur at 8:00, 16:00 and 24:00. Rate of admission, diversion to other services and diagnosis disagreements were also assessed. RESULTS: We included 308 patients (101 heart failure, 101 COPD, 106 sepsis) with a mean age of 74.7. Comparing middle of shift to end of shift, the mean scores were 91.9% versus 91.8% (difference 0.1% (95% CI -2.4 to 3.0)) for investigations and 73.0% versus 70.4% (difference 2.6% (95% CI -1.8 to 7.4)) for treatments. Comparing low to high surge times, the mean scores were 92.1% versus 91.7% (difference 0.4% (95% CI -1.2 to 2.4)) for investigations and 71.4% versus 73.6% (difference -2.2% (95% CI -5.6 to 1.3)) for treatments. We found low rates of diversion to alternate services (8.9% heart failure, 0% COPD, 6.6% sepsis) and low rates of diagnosis disagreement (4.0% heart failure, 10.9% COPD, 8.5% sepsis). CONCLUSIONS: We found no evidence that surge levels and end of shift impact the extent of investigations and treatments provided to patients diagnosed in the ED with heart failure, COPD or sepsis and referred to internal medicine.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29505531
[Au] Autor:Li Y; Ye T; Gu Q; Dong L; Chen G; Lu S
[Ad] Address:Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University.
[Ti] Title:Primary, cardiac, fibroblastic osteosarcoma: A case report.
[So] Source:Medicine (Baltimore);97(1):e9543, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Primary cardiac osteosarcoma is a rare tumor. To our knowledge, only 15 cases have been reported in the literature in the past 10 years. We describe a case of primary, cardiac, fibroblastic osteosarcoma in a 42-year-old woman. PATIENT CONCERNS: A 42-year-old woman with a 10-day history of chest pain. Intraoperatively, a mass was found originating from the ostium of the left inferior pulmonary vein in the left atrium, extending to the mitral orifice. Histologically, the tumor contained variable amounts of spindle cells and osseous differentiation in different areas. Primary, cardiac fibroblastic osteosarcoma had the typical appearance of interlacing hyperchromatic spindle-shaped stromal cells associated with osseous matrix. DIAGNOSES: According to the clinicopathological features, diagnosis of primary, cardiac fibroblastic osteosarcoma was made. INTERVENTIONS: Wide surgical excision of the mass was performed. OUTCOMES: Three months after the operation, transthoracic echocardiography demonstrated a 3.2 cm × 2 cm recurrent mass in the wall of the left atrium (LA). She died shortly afterwards as a result of the local disease recurrence. LESSONS: In this report, we describe a rare case of primary, cardiac fibroblastic osteosarcoma, and findings are helpful for the pathologists would like to further identify the clinicopathological features of this rare tumor.
[Mh] MeSH terms primary: Heart Neoplasms/diagnostic imaging
Myocardium/pathology
Osteosarcoma/diagnostic imaging
[Mh] MeSH terms secundary: Adult
Fatal Outcome
Female
Heart Neoplasms/pathology
Humans
Osteosarcoma/pathology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009543

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[PMID]: 29263174
[Au] Autor:Chan SY; Rubin LJ
[Ad] Address:Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Dept of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, USA chansy@pitt.edu.
[Ti] Title:Metabolic dysfunction in pulmonary hypertension: from basic science to clinical practice.
[So] Source:Eur Respir Rev;26(146), 2017 Dec 31.
[Is] ISSN:1600-0617
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Pulmonary hypertension (PH) is an often-fatal vascular disease of unclear molecular origins. The pulmonary vascular remodelling which occurs in PH is characterised by elevated vasomotor tone and a pro-proliferative state, ultimately leading to right ventricular dysfunction and heart failure. Guided in many respects by prior evidence from cancer biology, recent investigations have identified metabolic aberrations as crucial components of the disease process in both the pulmonary vessels and the right ventricle. Given the need for improved diagnostic and therapeutic options for PH, the development or repurposing of metabolic tracers and medications could provide an effective avenue for preventing or even reversing disease progression. In this review, we describe the metabolic mechanisms that are known to be dysregulated in PH; we explore the advancing diagnostic testing and imaging modalities that are being developed to improve diagnostic capability for this disease; and we discuss emerging drugs for PH which target these metabolic pathways.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process

  5 / 80390 MEDLINE  
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[PMID]: 28749044
[Au] Autor:Li X; Fu Y; Miao J; Li H; Hu B
[Ad] Address:Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
[Ti] Title:Video-assisted thoracoscopic lobectomy after percutaneous coronary intervention in lung cancer patients with concomitant coronary heart disease.
[So] Source:Thorac Cancer;8(5):477-481, 2017 Sep.
[Is] ISSN:1759-7714
[Cp] Country of publication:Singapore
[La] Language:eng
[Ab] Abstract:BACKGROUND: In recent years, based on clinical observations, the number of lung cancer patients with concomitant coronary heart disease (CHD) has gradually increased. However, because of the requirement of long-term anticoagulant therapy after percutaneous coronary intervention (PCI), some of these patients lose the opportunity for surgical treatment, resulting in tumor progression. The objective of this study was to determine the appropriate timing of video-assisted thoracic surgery (VATS) lobectomy after PCI without increasing perioperative cardiovascular risk. METHODS: This study retrospectively analyzed clinical data of patients with a combination of NSCLC and CHD who underwent selective pulmonary lobectomy by VATS in the early postoperative PCI period between 2010 and 2015 at Beijing Chaoyang Hospital, China. RESULTS: Fourteen patients received VATS lobectomy after PCI. The disease had progressed to T stage in two patients after PCI. No perioperative death occurred. Two patients suffered postoperative atrial fibrillation: one had a pulmonary infection, and the other had acute coronary syndrome. All patients recovered and were discharged. CONCLUSION: For NSCLC patients with severe CHD, the use of VATS lobectomy in the early postoperative PCI period could not only advance the timing of surgery, but may also control perioperative hemorrhage and CHD event risks within acceptable ranges, which could provide more patients with an opportunity to undergo surgical treatment.
[Mh] MeSH terms primary: Carcinoma, Non-Small-Cell Lung/surgery
Coronary Disease/surgery
Lung Neoplasms/surgery
[Mh] MeSH terms secundary: Aged
Comorbidity
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Pneumonectomy/methods
Retrospective Studies
Thoracic Surgery, Video-Assisted/methods
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170728
[St] Status:MEDLINE
[do] DOI:10.1111/1759-7714.12471

  6 / 80390 MEDLINE  
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[PMID]: 29521655
[Au] Autor:El-Kersh K; Suliman S; Smith JS
[Ad] Address:Department of Medicine, Division of Pulmonary, Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
[Ti] Title:Selexipag in Congenital Heart Disease-Associated Pulmonary Arterial Hypertension and Eisenmenger Syndrome: First Report.
[So] Source:Am J Ther;, 2018 Jan 23.
[Is] ISSN:1536-3686
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/MJT.0000000000000727

  7 / 80390 MEDLINE  
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[PMID]: 29521437
[Au] Autor:Zahn EM; Chang JC; Armer D; Garg R
[Ad] Address:The Heart Institute and the Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California.
[Ti] Title:First human implant of the Alterra Adaptive Prestent : A new self-expanding device designed to remodel the right ventricular outflow tract.
[So] Source:Catheter Cardiovasc Interv;, 2018 Mar 09.
[Is] ISSN:1522-726X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Current balloon expandable transcatheter valves have limited applicability to patients with "native" right ventricular outflow tracts (RVOT), meaning those who have had previous surgery and are left with large, compliant, irregular RVOT. The Alterra Adaptive Prestent is a self-expanding, partially covered stent that was designed to internally reconfigure these types of RVOT, making them suitable for implantation of a commercially available balloon expandable heart valve, the SAPIEN 3. Herein, we describe the first human implant of this device.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/ccd.27581

  8 / 80390 MEDLINE  
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[PMID]: 29520781
[Au] Autor:Qi H; Li B; Wang H; Cai Q; Quan X; Cui Y; Meng W
[Ad] Address:Department of Dental Implantology, School and Hospital of Stomatology, Jinlin University, Changchun, China.
[Ti] Title:Effects of d-Valine on Periodontal or Peri-Implant Pathogens: Porphyromonas gingivalis Biofilm.
[So] Source:J Periodontol;, 2018 Feb 22.
[Is] ISSN:1943-3670
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: When presented with a surface or an interface, bacteria often grow as biofilms in which cells are held together by an extracellular matrix. Biofilm formation on implants is an initiating factor for their failure. Porphyromonas gingivalis is the primary etiologic bacteria of initiation and progression of periodontal disease. This microorganism is also the risk factor of many systemic diseases, such as cardiovascular disease, diabetes, and pulmonary infection. To date, no medication that can remove such biofilm has been accepted for clinical use. D-valine (D-val) can reportedly inhibit the formation of biofilm and/or trigger the scattering of mature biofilm. Accordingly, this study investigated the effects of d-val on single-species P. gingivalis biofilms in vitro. METHODS: P. gingivalis grown in brain heart infusion culture with or without d-val was inoculated in 24- or 96-well plates. After incubation for 72 hours, biomass via crystal violet staining, extracellular polysaccharide production by biofilms, and scanning electron microscopy (SEM) were used to determine the d-val concentration that can effectively prevent P. gingivalis biofilm formation. RESULTS: Experimental results showed that d-val effectively inhibited biofilm formation at concentrations ≥50 mM (mMol/L), and that d-val inhibition increased with increased concentration. Moreover, at high concentrations, the bacterial form changed from the normal baseball form into a rodlike shape. d-val also notably affected extracellular polysaccharide production by P. gingivalis. CONCLUSIONS: d-val can inhibit P. gingivalis biofilm formation, and high concentrations can affect bacterial morphology.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/JPER.17-0405

  9 / 80390 MEDLINE  
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[PMID]: 29520672
[Au] Autor:Xu SZ; Yan Liang; Li XP; Li XM; Shuai ZW; Leng RX; Pan HF; Ye DQ
[Ad] Address:Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
[Ti] Title:Features associated with pulmonary arterial hypertension in Chinese hospitalized systemic lupus erythematosus patients.
[So] Source:Clin Rheumatol;, 2018 Mar 08.
[Is] ISSN:1434-9949
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Pulmonary arterial hypertension (PAH) is an increasingly recognized complication of systemic lupus erythematosus (SLE). This study aims to estimate the point prevalence of PAH and identify risk factors for PAH in a large cohort of hospitalized SLE patients. We have collected the medical records of patients hospitalized with SLE at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital. Resting transthoracic echocardiography (TTE) was used to estimate pulmonary artery pressure (PAP) and PAH was defined as systolic PAP (PASP) > 30 mmHg. Patients with other connective tissue diseases, aPL syndrome, left heart disease, valvular heart disease, congenital heart disease, HIV, and portal hypertension were excluded because of diseases affecting the PAP. We assessed potential risk factors for PAH such as thrombogenic factors, SLE clinical manifestations, laboratory abnormalities and disease activity. Ninety-five were diagnosed with PAH of 1639 patients with SLE. The presence of high fibrinogen, serositis, and thrombocytopenia were significantly higher in patients with PAH than in those without PAH (all P < 0.05). Multivariate logistic regression found the associations between high fibrinogen (OR = 1.629), serositis (OR = 2.866), and thrombocytopenia (OR = 1.825) with PAH. The point prevalence of PAH was 5.8% in our cohort of patients with SLE. The significant association of high fibrinogen, serositis, and thrombocytopenia with PAH suggested that hypercoagulable state, organ damage, and hematological abnormality may all contribute to the development of PAH in SLE. This is important, as it is treatable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1007/s10067-018-4056-8

  10 / 80390 MEDLINE  
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[PMID]: 29519873
[Au] Autor:Hutchings DC; Anderson SG; Caldwell JL; Trafford AW
[Ad] Address:Unit of Cardiac Physiology, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
[Ti] Title:Phosphodiesterase-5 inhibitors and the heart: compound cardioprotection?
[So] Source:Heart;, 2018 Mar 08.
[Is] ISSN:1468-201X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Novel cardioprotective agents are needed in both heart failure (HF) and myocardial infarction. Increasing evidence from cellular studies and animal models indicate protective effects of phosphodiesterase-5 (PDE5) inhibitors, drugs usually reserved as treatments of erectile dysfunction and pulmonary arterial hypertension. PDE5 inhibitors have been shown to improve contractile function in systolic HF, regress left ventricular hypertrophy, reduce myocardial infarct size and suppress ischaemia-induced ventricular arrhythmias. Underpinning these actions are complex but increasingly understood cellular mechanisms involving the cyclic GMP activation of protein kinase-G in both cardiac myocytes and the vasculature. In clinical trials, PDE5 inhibitors improve symptoms and ventricular function in systolic HF, and accumulating epidemiological data indicate a reduction in cardiovascular events and mortality in PDE5 inhibitor users at high cardiovascular risk. Here, we focus on the translation of underpinning basic science to clinical studies and report that PDE5 inhibitors act through a number of cardioprotective mechanisms, including a direct myocardial action independent of the vasculature. We conclude that future clinical trials should be designed with these mechanisms in mind to identify patient subsets that derive greatest treatment benefit from these novel cardioprotective agents.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher


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