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Chest Pain
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1. Delivery of local anaesthetic via a sternal catheter to reduce the pain caused by sternal fractures: first case series using the new technique.
Match Strength: 6.923

Sternal fractures cause considerable pain, and a proportion of patients require admission for analgesia. Local anaesthetic techniques have been used to reduce the pain from chest wall injuries and may reduce complications from these injuries. The use of a local anaesthetic delivered via a sternal catheter over a fractured sternum has been described in a patient whose pain was inadequately controlled with opiates. This technique was recently offered to patients in the emergency department at the Royal Devon and Exeter Hospital, Exeter, UK, and the experiences of patients and doctors are ... Read More »
» Published in Emerg Med J. 2006 Oct;23(10):791-3.

2. Takotsubo cardiomyopathy--transient left ventricular apical ballooning mimicking acute myocardial infarction.
Match Strength: 6.737

Takotsubo cardiomyopathy is characterized by transient left ventricular dysfunction with clinical symptoms of chest pain, electrocardiographic changes of ST-segment elevation or T wave inversion, which mimics acute myocardial infarction in patients without angiographically significant coronary artery stenosis. We report a 75-year-old woman with a history of chest tightness who presented with typical pictures of takotsubo cardiomyopathy. Acute myocardial infarction was initially diagnosed based on the electrocardiographic changes and elevated troponin. Apical akinesis and ballooning with basal ... Read More »
» Published in J Formos Med Assoc. 2006 Oct;105(10):839-43.

3. The PRIMA study: presentation ischaemia-modified albumin in the emergency department.
Match Strength: 6.682

OBJECTIVES: To investigate the diagnostic accuracy of presentation ischaemia-modified albumin (IMA), in addition to cardiac troponin I (TnI), as a strategy to rapidly ascribe low risk to patients with chest pain attending an emergency department, and to determine whether IMA has the potential to reduce transit time in emergency departments. METHODS: A prospective observational study was carried out in two emergency departments (belonging to the John Radcliffe Hospital, Oxford, UK; and the Frenchay Hospital, Bristol, UK) of similar size. Consecutive adult patients presenting with features of ... Read More »
» Published in Emerg Med J. 2006 Oct;23(10):764-8.

4. The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients.
Match Strength: 6.623

STUDY OBJECTIVE: We compared the accuracy of multidetector computed tomography (CT) coronary angiography with stress nuclear imaging for the detection of an acute coronary syndrome or 30-day major adverse cardiac events in low-risk chest pain patients. METHODS: This was a prospective study of the diagnostic accuracy of myocardial perfusion imaging and multidetector CT in low-risk chest pain patients. The target condition was an acute coronary syndrome (confirmed >70% coronary stenosis on coronary artery catheterization) or major adverse cardiac events within 30 days. Patients were low risk ... Read More »
» Published in Ann Emerg Med. 2007 Feb;49(2):125-36. Epub 2006 Sep 15.

5. Effects of Erigeron injection on vascular endothelium in patients after intracoronary stenting.
Match Strength: 6.424

OBJECTIVE: To observe the levels of serum C-reactive protein (CRP), endothelin-1 (ET-1), nitric oxide (NO), and superoxide dismutase (SOD) in patients after intracoronary stenting (ICS), and the effects of Erigeron Injection (EI) on them. METHODS: Seventy-two patients, who received ICS and had symptoms of chest stuffiness, palpitation and chest pain, were randomly divided into two groups, with 36 patients in the control group treated with Plavix alone for anti-platelet aggregation, and the other 36 patients in the treated group treated with Plavix and EI in combination. CRP, ET-1, NO and SOD ... Read More »
» Published in Chin J Integr Med. 2006 Sep;12(3):185-8.

6. Spontaneous hemopneumothorax in children: case report and review of literature.
Match Strength: 6.269

Spontaneous hemopneumothorax is rare, occurs in young adolescents, and can be life threatening secondary to massive bleeding. An adolescent with spontaneous hemopneumothorax and shock managed by tube thorascostomy is described here. We compared our case with published data of spontaneous hemopneumothorax in the pediatric age group. Spontaneous hemopneumothorax involves the accumulation of air and blood in the pleural space in the absence of trauma or other obvious causes. Spontaneous hemopneumothorax is usually seen in adolescents, more common in males than females. The common clinical ... Read More »
» Published in Pediatrics. 2006 Oct;118(4):e1268-70. Epub 2006 Sep 18.

7. Prevalence of life-threatening arrhythmias in ED patients transported to the radiology suite while monitored by telemetry.
Match Strength: 5.798

OBJECTIVE: The aim of this study was to determine the prevalence of life-threatening arrhythmias in monitored ED patients while in the radiology suite. METHODS: This is a retrospective analysis at a tertiary care hospital with an ED census of 52,000 visits. The patient population consisted of 3,051 adult ED patients with a chief complaint of chest pain, who were monitored with telemetry while they were sent to the radiology suite, and who were ultimately admitted to the hospital. RESULTS: Of a total of 3,051 consecutive patients with a cardiac presentation who received a nonportable chest x ... Read More »
» Published in Am J Emerg Med. 2006 Oct;24(6):655-7.

8. Correlation of gastroesophageal reflux disease symptoms characteristics with long-segment Barrett's esophagus.
Match Strength: 5.723

Thus far, there has been a paucity of studies that have assessed the value of the different gastroesophageal reflux disease (GERD) symptom characteristics in identifying patients with long-segment Barrett's esophagus versus those with short-segment Barrett's esophagus. To determine if any of the symptom characteristics of GERD correlates with long-segment Barrett's esophagus versus short-segment Barrett's esophagus. Patients seen in our Barrett's clinic were prospectively approached and recruited into the study. All patients underwent an endoscopy, validated GERD symptoms questionnaire and a ... Read More »
» Published in Dis Esophagus. 2006;19(5):360-5.

9. Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair: a multicenter, prospective, randomized trial.
Match Strength: 5.532

OBJECTIVE: Laparoscopic paraesophageal hernia repair (LPEHR) is associated with a high recurrence rate. Repair with synthetic mesh lowers recurrence but can cause dysphagia and visceral erosions. This trial was designed to study the value of a biologic prosthesis, small intestinal submucosa (SIS), in LPEHR. METHODS: Patients undergoing LPEHR (n = 108) at 4 institutions were randomized to primary repair -1 degrees (n = 57) or primary repair buttressed with SIS (n = 51) using a standardized technique. The primary outcome measure was evidence of recurrent hernia (> or =2 cm) on UGI, read by a ... Read More »
» Published in Ann Surg. 2006 Oct;244(4):481-90.

10. Modified central line for pneumothorax.
Match Strength: 5.120

Pneumothoraxes, whether spontaneous or iatrogenic, frequently require drainage. Although the recent trend has been toward a catheter-based approach, many thoracic surgeons continue to use chest tubes. Tube thoracostomy is associated with significant pain at the time of insertion and during continued drainage. Pneumothorax catheters are less painful but more expensive, and some have been associated with significant failure. After disappointing experience with pneumothorax catheters, we have modified a central line to use in lieu of a pneumothorax kit. We have found this technique to be ... Read More »
» Published in Ann Thorac Surg. 2006 Oct;82(4):1543-4.

11. Minimally invasive repair of pectus excavatum in adult patients.
Match Strength: 4.650

Since 1996, the technique for minimally invasive repair of pectus excavatum (MIRPE) has gained increasing acceptance among pediatric patients. However, the feasibility of the operation and outcomes have not yet been evaluated in adult patients. This study was a retrospective analysis of the author's experience combined with a survey of members of the American Pediatric Surgical Association in treating adult patients with MIRPE. Thirty adults (age range, 18-32 years; mean, 23 years; 75% men) with severe pectus excavatum (chest index > 3.2) were treated with MIRPE. The main indication for ... Read More »
» Published in Am Surg. 2006 Sep;72(9):837-42.

12. Diagnostic accuracy of serum B-type natriuretic peptide for myocardial ischemia detection during exercise testing with Spect perfusion imaging.
Match Strength: 4.612

OBJECTIVE: To determine whether serum B-type natriuretic peptide measured at rest and peak exercise and DeltaBNP contribute to the predictive value and diagnostic accuracy of exercise test in the diagnosis of myocardial ischemia. BACKGROUND: Ventricular myocytes release BNP in response to increased wall stress that occurs in acute ischemia. During exercise testing, transient myocardial ischemia could also cause acute myocardial stress and changes in circulating BNP. METHODS: BNP was measured before and immediately after exercise testing with radionuclide imaging in 203 consecutive subjects ... Read More »
» Published in Int J Cardiol. 2006 Sep 22;

13. Acute concomitant pulmonary artery and aortic dissection with rupture.
Match Strength: 4.488

Pulmonary artery (PA) dissection is uncommon and may lead to rupture and sudden death if encountered. A 63-year-old man presented to our emergency room with episodic left chest pain radiating to the back followed by shortness of breath. A 64-row multidetector computed tomography (MDCT) revealed ruptured dissection of the PA and the aorta with hemopericardium, hemomediastinum, and prominent extravasated blood along the central bronchovascular bundles of both lungs. The patient experienced cardiogenic shock immediately following CT study and died after resuscitation. Concomitant PA and aortic ... Read More »
» Published in Int J Cardiovasc Imaging. 2006 Sep 27;

14. Sumatriptan alleviates pain in patients with trigeminal neuralgia.
Match Strength: 4.293

OBJECTIVES: Arterial compression of the trigeminal root may lead to trigeminal neuralgia. 5-HT1B/1D receptor agonists may inhibit vasodilation and inflammation near the irritated trigeminal root. A recent study showed attenuation of mechanical allodynia by a 5-HT1A receptor agonist in a rat model of trigeminal neuralgia. The present study examined the effectiveness of a 5-HT1A/1B/1D receptor agonist, sumatriptan, on pain relief in patients with trigeminal neuralgia. METHODS: The study was conducted in 15 patients with idiopathic trigeminal neuralgia. The patients had been suffering from ... Read More »
» Published in Clin J Pain. 2006 Oct;22(8):677-80.

15. Obesity distribution and reproductive hormone levels in women: a report from the NHLBI-sponsored WISE Study.
Match Strength: 3.411

PURPOSE: Relationships between body weight and disease are not straightforward. Central obesity appears to be a relatively greater cardiovascular risk factor than generalized obesity. The purpose of this study was to evaluate body mass index (BMI) and waist circumference and the association of obesity distribution with blood estrogen levels (estradiol, bioavailable estradiol, and estrone). METHODS: The study cohort consisted of 207 postmenopausal women enrolled in the Women's Ischemia Syndrome Evaluation (WISE) undergoing angiography for evaluation of suspected ischemia. RESULTS: Both BMI and ... Read More »
» Published in J Womens Health (Larchmt). 2006 Sep;15(7):836-42.

16. Diagnostic values of sonography for assessment of sternal fractures compared with conventional radiography and bone scans.
Match Strength: 3.251

OBJECTIVE: This study was prospectively undertaken to evaluate the diagnostic value of sonography for detection of sternal fractures. We compared sonographic, conventional radiographic, and bone scan examinations of sternal fractures. METHODS: Fifty consecutive patients (26 male and 24 female; mean age, 45.2 years) were evaluated. Conventional radiography and sonography were performed in all patients, and bone scans were performed in 39 patients. All patients had acute pain and tenderness in anterior midline chest areas. Sonography was performed by 2 musculoskeletal radiologists within 1 to 2 ... Read More »
» Published in J Ultrasound Med. 2006 Oct;25(10):1263-8; quiz 1269-70.

17. The differential effects of age on the association of KLOTHO gene polymorphisms with coronary artery disease.
Match Strength: 2.658

The Klotho knockout mouse is thought to be a good animal model for human aging. Recent studies have reported on the association of KLOTHO gene mutation with cardiovascular disease in humans. We observed the frequencies of single nucleotide polymorphisms, that is, G-395A in the promoter region, C1818T in exon 4, and a functional variant, KL-VS, of KLOTHO gene in Koreans, and we investigated their relationships with the presence of coronary artery disease (CAD) in patients who had undergone coronary angiograms. A total of 274 subjects who underwent coronary angiograms because of chest pain were ... Read More »
» Published in Metabolism. 2006 Oct;55(10):1344-51.

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