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Lung Failure

Radmila Choate, David M Mannino, Kristen E Holm, Robert A Sandhaus
Background : The aim of this study was to examine differences in demographic, health, and behavioral characteristics in individuals with ZZ and SZ genotypes of alpha-1 antitrypsin deficiency (AATD) within AlphaNet's Disease Management and Prevention Program (ADMAPP). Methods : Self-reported data from 3535 patients with AATD, including 3031 (85.7%) patients with ZZ, ZNull, and NullNull genotypes (referred to here as ZZ), and 504 (14.3%) with the SZ genotype were analyzed using t-tests, ANOVAs, and Chi-squared tests...
November 30, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Diogo Cordeiro, Zhiyuan Xu, Matthew Shepard, Darrah Sheehan, Chelsea Li, Jason Sheehan
Introduction: In the present study, we reviewed the efficacy of stereotactic radiosurgery (SRS) alone or in combination with WBRT, for the treatment of patients with BM secondary to SCLC. We further identified patient and treatment specific factors that correlated with improved survival. Methods: Forty-one patients treated with GKRS for BM secondary to SCLC from 2004 to 2017 at the University of Virginia were identified with histopathologically proven SCLC and included in the study...
2019: Journal of Radiosurgery and SBRT
Francis T Delaney, Emma L Gray, Joseph C Lee
We present a case of lung cancer incidentally detected as a pulmonary nodule on computed tomography attenuation correction (CTAC) images during myocardial perfusion scintigraphy (MPS). Unfortunately, the incidental lesion was not fully investigated following MPS report and had developed into metastatic lung carcinoma when diagnosed over 1 year later, with failure of subsequent emergent chemotherapy. The disease appeared to be localized when initially detected during MPS. This case highlights the importance and potential clinical value of routine review of CTAC images in MPS with appropriate reporting and further investigation of suspicious incidental findings...
January 2019: World Journal of Nuclear Medicine
Taiki Hakozaki, Makiko Yomota
Background: Osimertinib is the standard of care for patients with non-small-cell lung cancer (NSCLC) patients harboring acquired EGFR T790M resistance mutation. However, the frequency of T790M resistance mutation acquisition and the efficacy of osimertinib in patients harboring uncommon EGFR mutations, which accounts for approximately 10% of EGFR mutations, remain unclear. Case presentation: We present the case of a 72-year-old Japanese woman with recurrent NSCLC harboring uncommon EGFR mutations, who was subsequently found to have acquired the T790M resistance mutation and was treated with osimertinib...
2019: OncoTargets and Therapy
Kieran M Halloran, Michael D Parkes, Jessica Chang, Irina L Timofte, Gregory I Snell, Glen P Westall, Ramsey Hachem, Daniel Kreisel, Elbert Trulock, Antoine Roux, Stephen Juvet, Shaf Keshavjee, Peter Jaksch, Walter Klepetko, Philip F Halloran
BACKGROUND: Improved understanding of lung transplant disease states is essential because failure rates are high, often due to chronic lung allograft dysfunction. However, histologic assessment of lung transplant transbronchial biopsies (TBBs) is difficult and often uninterpretable even with 10 pieces. METHODS: We prospectively studied whether microarray assessment of single TBB pieces could identify disease states and reduce the amount of tissue required for diagnosis...
February 6, 2019: Journal of Heart and Lung Transplantation
Krista C J Wink, Steffen Löck, Maddalena Rossi, Angela van Baardwijk, José Belderbos, Dirk de Ruysscher, Esther G C Troost
BACKGROUND AND PURPOSE: The aim was to investigate the incidence of isolated regional failure following stereotactic ablative radiotherapy (SABR) and risk factors for recurrence. MATERIALS AND METHODS: Early stage non-small cell lung cancer (NSCLC) patients treated with SABR were included in this retrospective cohort study, with isolated regional recurrence (IRR) as primary endpoint, distant recurrence (DR) and overall survival (OS) as secondary endpoints. Survival analyses were performed using the cumulative incidence function (IRR and DR) or the Kaplan-Meier method (OS) and Cox proportional hazards modelling for univariate and multivariate analyses...
February 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Y Ma, N-Y Che, Y-H Liu, W Shu, J Du, S-H Xie, Liang Li
Tuberculosis, smoking, and alcohol drinking are major public health and social issues worldwide. We investigated the joint effect of smoking plus alcohol drinking on TB treatment. Retrospective study was conducted among TB patients in 49 units from eight provinces in China. All patients enrolled were classified into four groups according to their smoking and/or alcohol status. Current smokers plus drinkers belonged to group 1; ex-smokers plus ex-drinkers were in group 2; current smokers and ex-drinkers, current smokers and never drinkers, ex-smokers and current drinkers, ex-smokers and never drinkers, never smokers and current drinkers, and never smokers and ex-drinkers belonged to group 3; while the never smokers plus never drinkers were in group 4...
February 15, 2019: European Journal of Clinical Microbiology & Infectious Diseases
Yuli Y Kim, Katherine Awh, Michael Acker, Pavan Atluri, Christian Bermudez, Maria Crespo, Joshua M Diamond, David Drajpuch, Rhondalyn Forde-Mclean, Stephanie Fuller, Lee Goldberg, Jeremy Mazurek, Christopher Mascio, Jonathan N Menachem, Eduardo Rame, Emily Ruckdeschel, Lynda Tobin, Joyce Wald
BACKGROUND: Systemic right ventricular [RV] failure may progress necessitating referral for orthotropic heart transplantation [OHT]. Pulmonary hypertension [PH] frequently coexists in adult congenital heart disease and can complicate the assessment for OHT. METHODS: Single-center case series of six patients [median age 34.9 years (IQR, 31.9-42.4)] with systemic RV physiology with PH referred for OHT evaluation from 2008-2017. RESULTS: One-third (n=6) of 18 patients with systemic RV physiology referred for OHT evaluation had pulmonary arterial hypertension [PAH] defined as mean pulmonary artery pressure [mPAP] > 25 mmHg and pulmonary vascular resistance [PVR] > 3 Wood Units...
February 15, 2019: Clinical Transplantation
David Ball, G Tao Mai, Shalini Vinod, Scott Babington, Jeremy Ruben, Tomas Kron, Brent Chesson, Alan Herschtal, Marijana Vanevski, Angela Rezo, Christine Elder, Marketa Skala, Andrew Wirth, Greg Wheeler, Adeline Lim, Mark Shaw, Penelope Schofield, Louis Irving, Benjamin Solomon
BACKGROUND: Stereotactic ablative body radiotherapy (SABR) is widely used to treat inoperable stage 1 non-small-cell lung cancer (NSCLC), despite the absence of prospective evidence that this type of treatment improves local control or prolongs overall survival compared with standard radiotherapy. We aimed to compare the two treatment techniques. METHODS: We did this multicentre, phase 3, randomised, controlled trial in 11 hospitals in Australia and three hospitals in New Zealand...
February 12, 2019: Lancet Oncology
Sophie Masmejan, David Baud, Greg Ryan, Tim Van Mieghem
In this review article, we discuss the most common fetal tumors, their prenatal management, and outcomes. Overall, the most important outcome predictors are tumor histology, size, vascularity, and location. Very large lesions, lesions causing cardiac failure, and hydrops and lesions obstructing the fetal airway have the poorest outcome, as they may cause fetal death or complications at the time of delivery. Fetal therapy has been developed to improve outcomes for the most severe cases and can consist of transplacental therapy (sirolimus for rhabdomyomas or steroids for hemangiomas and microcystic lung lesions) or surgical intervention (shunting of cystic masses, tumor ablation, occlusion of blood flow or airway exploration, and protection)...
January 14, 2019: Best Practice & Research. Clinical Obstetrics & Gynaecology
Masatake Kobayashi, Masataka Watanabe, Stefano Coiro, Matthieu Bercker, Yuki Paku, Yoichi Iwasaki, Taishiro Chikamori, Akira Yamashina, Kevin Duarte, João Pedro Ferreira, Patrick Rossignol, Faiez Zannad, Nicolas Girerd
AIMS: Pulmonary congestion is associated with poor prognosis following hospitalization for worsening heart failure (HF), although its quantification and optimal timing during HF hospitalization remains challenging. The aim of this study was to assess the prognostic value of radiographic pulmonary congestion at admission and discharge in patients with worsening HF. METHODS AND RESULTS: Clinical, echocardiographic, laboratory and chest X-ray data of 292 acute decompensated HF patients were retrospectively studied (follow-up 1 year)...
February 8, 2019: International Journal of Cardiology
Kei Ouchi, Naomi George, Jeremiah D Schuur, Emily L Aaronson, Charlotta Lindvall, Edward Bernstein, Rebecca L Sudore, Mara A Schonberg, Susan D Block, James A Tulsky
During the last 6 months of life, 75% of older adults with preexisting serious illness, such as advanced heart failure, lung disease, and cancer, visit the emergency department (ED). ED visits often mark an inflection point in these patients' illness trajectories, signaling a more rapid rate of decline. Although most patients are there seeking care for acute issues, many of them have priorities other than to simply live as long as possible; yet without discussion of preferences for treatment, they are at risk of receiving care not aligned with their goals...
February 12, 2019: Annals of Emergency Medicine
Susan K Mathai, David A Schwartz
Pulmonary fibrosis refers to the development of diffuse parenchymal abnormalities in the lung that cause dyspnea, cough, hypoxemia, and impair gas exchange, ultimately leading to respiratory failure. Though pulmonary fibrosis can be caused by a variety of underlying etiologies, ranging from genetic defects to autoimmune diseases to environmental exposures, once fibrosis develops it is irreversible and most often progressive, such that fibrosis of the lung is one of the leading indications for lung transplantation...
February 5, 2019: Translational Research: the Journal of Laboratory and Clinical Medicine
Chanu Rhee, Travis M Jones, Yasir Hamad, Anupam Pande, Jack Varon, Cara O'Brien, Deverick J Anderson, David K Warren, Raymund B Dantes, Lauren Epstein, Michael Klompas
Importance: Sepsis is present in many hospitalizations that culminate in death. The contribution of sepsis to these deaths, and the extent to which they are preventable, is unknown. Objective: To estimate the prevalence, underlying causes, and preventability of sepsis-associated mortality in acute care hospitals. Design, Setting, and Participants: Cohort study in which a retrospective medical record review was conducted of 568 randomly selected adults admitted to 6 US academic and community hospitals from January 1, 2014, to December 31, 2015, who died in the hospital or were discharged to hospice and not readmitted...
February 1, 2019: JAMA network open
Vineet Govinda Gupta, Ranga Rao Rangaraju, Waseem Abbas, Peush Bajpai, Ruchika Khetrapal
Context: The immune checkpoint inhibitors (ICIs) nivolumab and pembrolizumab have shown dramatic efficacy with low toxicity in international studies of advanced solid cancers. No published Indian experience with ICIs exist other than isolated case reports. Aims: The aim of this study is to evaluate real-world data about the efficacy and toxicity of ICIs in advanced solid cancers among Indian patients who have progressed on one or more prior lines of chemotherapy...
January 2019: South Asian Journal of Cancer
Alcides Rocha, Flavio F Arbex, Priscila A Sperandio, Frederico Mancuso, Mathieu Marillier, Anne-Catherine Bernard, Maria Clara N Alencar, Denis E O Donnell, J Alberto Neder
Impaired aerobic function is a potential mechanism of exercise intolerance in patients with combined cardiorespiratory disease. We investigated the pathophysiological and sensory consequences of a low Δ O2 uptake (V̇O2 )/Δ work rate (WR) relationship during incremental exercise in patients with coexisting chronic obstructive pulmonary disease (COPD) and systolic heart failure (HF).After clinical stabilisation, 51 COPD-HF patients performed an incremental cardiopulmonary exercise test to symptom limitation...
February 14, 2019: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Matthew Jankowich, Gaurav Choudhary
Circulating plasma levels of endothelin-1 and related peptides generated during the synthesis of endothelin-1 from its precursor molecule pre-proendothelin-1 have been widely studied as potential risk markers for cardiovascular events. The associations of endothelin-1 with aging, blood pressure, lung function, and chronic kidney disease have been described, as have relations between endothelin-1 levels and evidence of cardiac remodeling, including increased left atrial diameter and increased left ventricular mass...
February 1, 2019: Trends in Cardiovascular Medicine
Ahmed AlBadri, C Noel Bairey Merz, B Delia Johnson, Janet Wei, Puja K Mehta, Galen Cook-Wiens, Steven E Reis, Sheryl F Kelsey, Vera Bittner, George Sopko, Leslee J Shaw, Carl J Pepine, Bina Ahmed
BACKGROUND: Currently as many as one-half of women with suspected myocardial ischemia have no obstructive coronary artery disease (CAD), and abnormal coronary reactivity (CR) is commonly found. OBJECTIVES: The authors prospectively investigated CR and longer-term adverse cardiovascular outcomes in women with and with no obstructive CAD in the National Heart, Lung, and Blood Institute-sponsored WISE (Women's Ischemia Syndrome Evaluation) study. METHODS: Women (n = 224) with signs and symptoms of ischemia underwent CR testing...
February 19, 2019: Journal of the American College of Cardiology
Pengcheng Zhou, Wei Yu, Kelin Chen, Xuelian Li, Qianming Xia
RATIONALE: Dieulafoy's lesions are characterized by the presence of a dysplastic artery in the submucosa, most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive or fatal hemoptysis PATIENT CONCERNS:: The patient was a 62-year-old male farmer with intermittent hemoptysis of approximately 2 years duration and a definite diagnosis could not be established. DIAGNOSIS: A thorax-computed tomography at our hospital revealed that the bronchus of left lower lobe was narrowed with associated local atelectasis, and lung cancer was suspected...
February 2019: Medicine (Baltimore)
Angelo Silverio, Maria Vincenza Polito, Leonardo Pace, Federica D'Auria, Gennaro Vitulano, Massimo Scarano, Rodolfo Citro, Gennaro Galasso, Federico Piscione
BACKGROUND: The predictors of outcome in patients with de novo diagnosis of heart failure (HF) with reduced ejection fraction (HFrEF) are poorly known. METHODS AND RESULTS: All consecutive HFrEF patients admitted between October 2012 and November 2017 with their first episode of HF were scheduled for an outpatient follow-up. After 3 months, patients with confirmed HFrEF underwent Iodine-123 Meta-Iodobenzylguanidine imaging. We defined three study endpoints: HF rehospitalization, cardiac death and all-cause death...
February 13, 2019: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
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