Chest Pain: Pressure, burning, or numbness in the chest.Chest Tubes: Plastic tubes used for drainage of air or fluid from the pleural space. Their surgical insertion is called tube thoracostomy.Radiography, Thoracic: X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.Thoracic Wall: The outer margins of the thorax containing SKIN, deep FASCIA; THORACIC VERTEBRAE; RIBS; STERNUM; and MUSCLES.Mass Chest X-Ray: X-ray screening of large groups of persons for diseases of the lung and heart by means of radiography of the chest.Thorax: The upper part of the trunk between the NECK and the ABDOMEN. It contains the chief organs of the circulatory and respiratory systems. (From Stedman, 25th ed)Flail Chest: A complication of multiple rib fractures, rib and sternum fractures, or thoracic surgery. A portion of the chest wall becomes isolated from the thoracic cage and exhibits paradoxical respiration.Thoracic Injuries: General or unspecified injuries to the chest area.Thoracic NeoplasmsTomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Chest Wall Oscillation: A respiratory support system used to remove mucus and clear airway by oscillating pressure on the chest.Funnel Chest: A developmental anomaly in which the lower sternum is posteriorly dislocated and concavely deformed, resulting in a funnel-shaped thorax.Heart Massage: Rhythmic compression of the heart by pressure applied manually over the sternum (closed heart massage) or directly to the heart through an opening in the chest wall (open heart massage). It is done to reinstate and maintain circulation. (Dorland, 28th ed)Thoracic Diseases: Disorders affecting the organs of the thorax.Pneumothorax: An accumulation of air or gas in the PLEURAL CAVITY, which may occur spontaneously or as a result of trauma or a pathological process. The gas may also be introduced deliberately during PNEUMOTHORAX, ARTIFICIAL.Rib FracturesRibs: A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs.Thoracostomy: Surgical procedure involving the creation of an opening (stoma) into the chest cavity for drainage; used in the treatment of PLEURAL EFFUSION; PNEUMOTHORAX; HEMOTHORAX; and EMPYEMA.Wounds, Nonpenetrating: Injuries caused by impact with a blunt object where there is no penetration of the skin.Lung Diseases: Pathological processes involving any part of the LUNG.Thoracic Surgical Procedures: Surgery performed on the thoracic organs, most commonly the lungs and the heart.Hemothorax: Hemorrhage within the pleural cavity.Sternum: A long, narrow, and flat bone commonly known as BREASTBONE occurring in the midsection of the anterior thoracic segment or chest region, which stabilizes the rib cage and serves as the point of origin for several muscles that move the arms, head, and neck.Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.Lung: Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.Pleural DiseasesElectrocardiography: Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself.Thoracotomy: Surgical incision into the chest wall.Drainage: The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Bronchoscopy: Endoscopic examination, therapy or surgery of the bronchi.Solitary Pulmonary Nodule: A single lung lesion that is characterized by a small round mass of tissue, usually less than 1 cm in diameter, and can be detected by chest radiography. A solitary pulmonary nodule can be associated with neoplasm, tuberculosis, cyst, or other anomalies in the lung, the CHEST WALL, or the PLEURA.Percussion: Act of striking a part with short, sharp blows as an aid in diagnosing the condition beneath the sound obtained.Thoracic Surgery, Video-Assisted: Endoscopic surgery of the pleural cavity performed with visualization via video transmission.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Pain Clinics: Facilities providing diagnostic, therapeutic, and palliative services for patients with severe chronic pain. These may be free-standing clinics or hospital-based and serve ambulatory or inpatient populations. The approach is usually multidisciplinary. These clinics are often referred to as "acute pain services". (From Br Med Bull 1991 Jul;47(3):762-85)Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Heart Injuries: General or unspecified injuries to the heart.Radiographic Image Enhancement: Improvement in the quality of an x-ray image by use of an intensifying screen, tube, or filter and by optimum exposure techniques. Digital processing methods are often employed.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Lung Neoplasms: Tumors or cancer of the LUNG.Pleura: The thin serous membrane enveloping the lungs (LUNG) and lining the THORACIC CAVITY. Pleura consist of two layers, the inner visceral pleura lying next to the pulmonary parenchyma and the outer parietal pleura. Between the two layers is the PLEURAL CAVITY which contains a thin film of liquid.Pulmonary Atelectasis: Absence of air in the entire or part of a lung, such as an incompletely inflated neonate lung or a collapsed adult lung. Pulmonary atelectasis can be caused by airway obstruction, lung compression, fibrotic contraction, or other factors.Thoracoplasty: Surgical removal of ribs, allowing the chest wall to move inward and collapse a diseased lung. (Dorland, 28th ed)Dyspnea: Difficult or labored breathing.Hemoptysis: Expectoration or spitting of blood originating from any part of the RESPIRATORY TRACT, usually from hemorrhage in the lung parenchyma (PULMONARY ALVEOLI) and the BRONCHIAL ARTERIES.Respiratory Function Tests: Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc.Empyema, Pleural: Suppurative inflammation of the pleural space.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Mediastinum: A membrane in the midline of the THORAX of mammals. It separates the lungs between the STERNUM in front and the VERTEBRAL COLUMN behind. It also surrounds the HEART, TRACHEA, ESOPHAGUS, THYMUS, and LYMPH NODES.Cough: A sudden, audible expulsion of air from the lungs through a partially closed glottis, preceded by inhalation. It is a protective response that serves to clear the trachea, bronchi, and/or lungs of irritants and secretions, or to prevent aspiration of foreign materials into the lungs.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Pneumoconiosis: A diffuse parenchymal lung disease caused by inhalation of dust and by tissue reaction to their presence. These inorganic, organic, particulate, or vaporized matters usually are inhaled by workers in their occupational environment, leading to the various forms (ASBESTOSIS; BYSSINOSIS; and others). Similar air pollution can also have deleterious effects on the general population.Esophageal Diseases: Pathological processes in the ESOPHAGUS.Tuberculosis, Pulmonary: MYCOBACTERIUM infections of the lung.Thoracoscopy: Endoscopic examination, therapy or surgery of the pleural cavity.Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Microvascular Angina: ANGINA PECTORIS or angina-like chest pain with a normal coronary arteriogram and positive EXERCISE TEST. The cause of the syndrome is unknown. While its recognition is of clinical importance, its prognosis is excellent. (Braunwald, Heart Disease, 4th ed, p1346; Jablonski Dictionary of Syndromes & Eponymic Diseases, 2d ed). It is different from METABOLIC SYNDROME X, a syndrome characterized by INSULIN RESISTANCE and HYPERINSULINEMIA, that has increased risk for cardiovascular disease.Heart Arrest: Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Acute Disease: Disease having a short and relatively severe course.Auscultation: Act of listening for sounds within the body.Hemopneumothorax: Collection of air and blood in the pleural cavity.Radiographic Image Interpretation, Computer-Assisted: Computer systems or networks designed to provide radiographic interpretive information.Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.ManikinsMultiple Trauma: Multiple physical insults or injuries occurring simultaneously.Drainage, Postural: A rehabilitation therapy for removal of copious mucus secretion from the lung of patients with diseases such as CHRONIC BRONCHITIS; BRONCHIECTASIS; PULMONARY ABSCESS; or CYSTIC FIBROSIS. The patient's head is placed in a downward incline (so the TRACHEA is inferior to the affected area) for 15- to 20-minute sessions.Pneumonia: Infection of the lung often accompanied by inflammation.Esophagus: The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.Pericarditis: Inflammation of the PERICARDIUM from various origins, such as infection, neoplasm, autoimmune process, injuries, or drug-induced. Pericarditis usually leads to PERICARDIAL EFFUSION, or CONSTRICTIVE PERICARDITIS.Pleural Cavity: Paired but separate cavity within the THORACIC CAVITY. It consists of the space between the parietal and visceral PLEURA and normally contains a capillary layer of serous fluid that lubricates the pleural surfaces.Wounds, Stab: Penetrating wounds caused by a pointed object.Lung Volume Measurements: Measurement of the amount of air that the lungs may contain at various points in the respiratory cycle.Exercise Test: Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.Mediastinal Diseases: Disorders of the mediastinum, general or unspecified.Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures.Pericardial Effusion: Fluid accumulation within the PERICARDIUM. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of THORACIC DUCT. Severe cases can lead to CARDIAC TAMPONADE.Thoracic Cavity: The region of the thorax that includes the PLEURAL CAVITY and MEDIASTINUM.Pulmonary Embolism: Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Bronchography: Radiography of the bronchial tree after injection of a contrast medium.Sternotomy: Making an incision in the STERNUM.Incidental Findings: Unanticipated information discovered in the course of testing or medical care. Used in discussions of information that may have social or psychological consequences, such as when it is learned that a child's biological father is someone other than the putative father, or that a person tested for one disease or disorder has, or is at risk for, something else.Vital Capacity: The volume of air that is exhaled by a maximal expiration following a maximal inspiration.Bronchiectasis: Persistent abnormal dilatation of the bronchi.Sputum: Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Lung Diseases, Interstitial: A diverse group of lung diseases that affect the lung parenchyma. They are characterized by an initial inflammation of PULMONARY ALVEOLI that extends to the interstitium and beyond leading to diffuse PULMONARY FIBROSIS. Interstitial lung diseases are classified by their etiology (known or unknown causes), and radiological-pathological features.Chylothorax: The presence of chyle in the thoracic cavity. (Dorland, 27th ed)Coronary Vasospasm: Spasm of the large- or medium-sized coronary arteries.Wounds, Penetrating: Wounds caused by objects penetrating the skin.Respiration, Artificial: Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.Thoracic Surgery: A surgical specialty concerned with diagnosis and treatment of disorders of the heart, lungs, and esophagus. Two major types of thoracic surgery are classified as pulmonary and cardiovascular.Respiratory Therapy: Care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It includes the therapeutic use of medical gases and their administrative apparatus, environmental control systems, humidification, aerosols, ventilatory support, bronchopulmonary drainage and exercise, respiratory rehabilitation, assistance with cardiopulmonary resuscitation, and maintenance of natural, artificial, and mechanical airways.Asbestosis: A form of pneumoconiosis caused by inhalation of asbestos fibers which elicit potent inflammatory responses in the parenchyma of the lung. The disease is characterized by interstitial fibrosis of the lung, varying from scattered sites to extensive scarring of the alveolar interstitium.Accidents, Traffic: Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Anemia, Sickle Cell: A disease characterized by chronic hemolytic anemia, episodic painful crises, and pathologic involvement of many organs. It is the clinical expression of homozygosity for hemoglobin S.Acute Coronary Syndrome: An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.Radiation Dosage: The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv).Mediastinal Cyst: Cysts of one of the parts of the mediastinum: the superior part, containing the trachea, esophagus, thoracic duct and thymus organs; the inferior middle part, containing the pericardium; the inferior anterior part containing some lymph nodes; and the inferior posterior part, containing the thoracic duct and esophagus.Pleurodesis: The production of adhesions between the parietal and visceral pleura. The procedure is used in the treatment of bronchopleural fistulas, malignant pleural effusions, and pneumothorax and often involves instillation of chemicals or other agents into the pleural space causing, in effect, a pleuritis that seals the air leak. (From Fishman, Pulmonary Diseases, 2d ed, p2233 & Dorland, 27th ed)Mediastinal Neoplasms: Tumors or cancer of the MEDIASTINUM.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Foreign Bodies: Inanimate objects that become enclosed in the body.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Tietze's Syndrome: Idiopathic painful nonsuppurative swellings of one or more costal cartilages, especially of the second rib. The anterior chest pain may mimic that of coronary artery disease. (Dorland, 27th ed.)Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure.Pneumopericardium: Presence of air or gas in the space between the heart and the PERICARDIUM. The degree of respiratory distress depends on the amount of trapped air and circulation blocked in the systemic and pulmonary veins.Bronchial Neoplasms: Tumors or cancer of the BRONCHI.Spirometry: Measurement of volume of air inhaled or exhaled by the lung.Coronary Disease: An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.Medicine Chests: Boxes in which physicians kept their drugs and other medications, medical instruments and supplies, manuals, etc. As a carrying case or convenient storage receptacle, or a kind of portable pharmacy, the medicine chest was indispensable to the itinerant physician. The chest was usually larger and sturdier than a doctor's kit or bag.Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).Subcutaneous Emphysema: Presence of air or gas in the subcutaneous tissues of the body.Radiography, Abdominal: Radiographic visualization of the body between the thorax and the pelvis, i.e., within the peritoneal cavity.Total Lung Capacity: The volume of air contained in the lungs at the end of a maximal inspiration. It is the equivalent to each of the following sums: VITAL CAPACITY plus RESIDUAL VOLUME; INSPIRATORY CAPACITY plus FUNCTIONAL RESIDUAL CAPACITY; TIDAL VOLUME plus INSPIRATORY RESERVE VOLUME plus functional residual capacity; or tidal volume plus inspiratory reserve volume plus EXPIRATORY RESERVE VOLUME plus residual volume.Empyema: Presence of pus in a hollow organ or body cavity.Multiple Pulmonary Nodules: A number of small lung lesions characterized by small round masses of 2- to 3-mm in diameter. They are usually detected by chest CT scans (COMPUTED TOMOGRAPHY, X-RAY). Such nodules can be associated with metastases of malignancies inside or outside the lung, benign granulomas, or other lesions.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Troponin T: One of the three polypeptide chains that make up the TROPONIN complex. It is a cardiac-specific protein that binds to TROPOMYOSIN. It is released from damaged or injured heart muscle cells (MYOCYTES, CARDIAC). Defects in the gene encoding troponin T result in FAMILIAL HYPERTROPHIC CARDIOMYOPATHY.Forced Expiratory Volume: Measure of the maximum amount of air that can be expelled in a given number of seconds during a FORCED VITAL CAPACITY determination . It is usually given as FEV followed by a subscript indicating the number of seconds over which the measurement is made, although it is sometimes given as a percentage of forced vital capacity.Respiration Disorders: Diseases of the respiratory system in general or unspecified or for a specific respiratory disease not available.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Cardiac Tamponade: Compression of the heart by accumulated fluid (PERICARDIAL EFFUSION) or blood (HEMOPERICARDIUM) in the PERICARDIUM surrounding the heart. The affected cardiac functions and CARDIAC OUTPUT can range from minimal to total hemodynamic collapse.Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality.Respiratory Muscles: These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES.Syndrome: A characteristic symptom complex.Sarcoidosis, Pulmonary: Sarcoidosis affecting predominantly the lungs, the site most frequently involved and most commonly causing morbidity and mortality in sarcoidosis. Pulmonary sarcoidosis is characterized by sharply circumscribed granulomas in the alveolar, bronchial, and vascular walls, composed of tightly packed cells derived from the mononuclear phagocyte system. The clinical symptoms when present are dyspnea upon exertion, nonproductive cough, and wheezing. (Cecil Textbook of Medicine, 19th ed, p431)Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body.Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands.Airway Obstruction: Any hindrance to the passage of air into and out of the lungs.Respiratory Insufficiency: Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)Gastroesophageal Reflux: Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER.Respiratory Tract DiseasesTomography, Spiral Computed: Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.Radiography, Dual-Energy Scanned Projection: A method of producing a high-quality scan by digitizing and subtracting the images produced by high- and low-energy x-rays.Respiratory Sounds: Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT.Diagnostic Tests, Routine: Diagnostic procedures, such as laboratory tests and x-rays, routinely performed on all individuals or specified categories of individuals in a specified situation, e.g., patients being admitted to the hospital. These include routine tests administered to neonates.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Contusions: Injuries resulting in hemorrhage, usually manifested in the skin.Pulmonary Medicine: A subspecialty of internal medicine concerned with the study of the RESPIRATORY SYSTEM. It is especially concerned with diagnosis and treatment of diseases and defects of the lungs and bronchial tree.Pleurisy: INFLAMMATION of PLEURA, the lining of the LUNG. When PARIETAL PLEURA is involved, there is pleuritic CHEST PAIN.Abdomen: That portion of the body that lies between the THORAX and the PELVIS.Angina, Unstable: Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.Lung Abscess: Solitary or multiple collections of PUS within the lung parenchyma as a result of infection by bacteria, protozoa, or other agents.Heart Diseases: Pathological conditions involving the HEART including its structural and functional abnormalities.Observer Variation: The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).Pleural Neoplasms: Neoplasms of the thin serous membrane that envelopes the lungs and lines the thoracic cavity. Pleural neoplasms are exceedingly rare and are usually not diagnosed until they are advanced because in the early stages they produce no symptoms.Manometry: Measurement of the pressure or tension of liquids or gases with a manometer.Diaphragm: The musculofibrous partition that separates the THORACIC CAVITY from the ABDOMINAL CAVITY. Contraction of the diaphragm increases the volume of the thoracic cavity aiding INHALATION.Bronchitis: Inflammation of the large airways in the lung including any part of the BRONCHI, from the PRIMARY BRONCHI to the TERTIARY BRONCHI.Unnecessary Procedures: Diagnostic, therapeutic, and investigative procedures prescribed and performed by health professionals, the results of which do not justify the benefits or hazards and costs to the patient.ROC Curve: A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.Pulmonary Emphysema: Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Diagnostic Techniques, Cardiovascular: Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes.Respiration: The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).Out-of-Hospital Cardiac Arrest: Occurrence of heart arrest in an individual when there is no immediate access to medical personnel or equipment.Abdominal Injuries: General or unspecified injuries involving organs in the abdominal cavity.Diagnosis, Computer-Assisted: Application of computer programs designed to assist the physician in solving a diagnostic problem.Pulmonary Edema: Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening.Asbestos: Asbestos. Fibrous incombustible mineral composed of magnesium and calcium silicates with or without other elements. It is relatively inert chemically and used in thermal insulation and fireproofing. Inhalation of dust causes asbestosis and later lung and gastrointestinal neoplasms.Cryptogenic Organizing Pneumonia: An interstitial lung disease of unknown etiology, occurring between 21-80 years of age. It is characterized by a dramatic onset of a "pneumonia-like" illness with cough, fever, malaise, fatigue, and weight loss. Pathological features include prominent interstitial inflammation without collagen fibrosis, diffuse fibroblastic foci, and no microscopic honeycomb change. There is excessive proliferation of granulation tissue within small airways and alveolar ducts.Intubation, Intratracheal: A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.Troponin I: One of the three polypeptide chains that make up the TROPONIN complex. It inhibits F-actin-myosin interactions.Reconstructive Surgical Procedures: Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures.Ventricular Fibrillation: A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST.Pain, Referred: A type of pain that is perceived in an area away from the site where the pain arises, such as facial pain caused by lesion of the VAGUS NERVE, or throat problem generating referred pain in the ear.Infant, Newborn: An infant during the first month after birth.Inhalation: The act of BREATHING in.Device Removal: Removal of an implanted therapeutic or prosthetic device.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Deglutition Disorders: Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.Pressure: A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)Equipment Design: Methods of creating machines and devices.Intercostal Nerves: The ventral rami of the thoracic nerves from segments T1 through T11. The intercostal nerves supply motor and sensory innervation to the thorax and abdomen. The skin and muscles supplied by a given pair are called, respectively, a dermatome and a myotome.Silicosis: A form of pneumoconiosis resulting from inhalation of dust containing crystalline form of SILICON DIOXIDE, usually in the form of quartz. Amorphous silica is relatively nontoxic.Breathing Exercises: Therapeutic exercises aimed to deepen inspiration or expiration or even to alter the rate and rhythm of respiration.Esophageal Spasm, Diffuse: A hypermotility disorder of the ESOPHAGUS that is characterized by spastic non-peristaltic responses to SWALLOWING; CHEST PAIN; and DYSPHAGIA.Pectoralis Muscles: The pectoralis major and pectoralis minor muscles that make up the upper and fore part of the chest in front of the AXILLA.Esophageal Motility Disorders: Disorders affecting the motor function of the UPPER ESOPHAGEAL SPHINCTER; LOWER ESOPHAGEAL SPHINCTER; the ESOPHAGUS body, or a combination of these parts. The failure of the sphincters to maintain a tonic pressure may result in gastric reflux of food and acid into the esophagus (GASTROESOPHAGEAL REFLUX). Other disorders include hypermotility (spastic disorders) and markedly increased amplitude in contraction (nutcracker esophagus).Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Multidetector Computed Tomography: Types of spiral computed tomography technology in which multiple slices of data are acquired simultaneously improving the resolution over single slice acquisition technology.Heart Murmurs: Heart sounds caused by vibrations resulting from the flow of blood through the heart. Heart murmurs can be examined by HEART AUSCULTATION, and analyzed by their intensity (6 grades), duration, timing (systolic, diastolic, or continuous), location, transmission, and quality (musical, vibratory, blowing, etc).Occupational Diseases: Diseases caused by factors involved in one's employment.Lung Diseases, Fungal: Pulmonary diseases caused by fungal infections, usually through hematogenous spread.Creatine Kinase: A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.Hernia, Diaphragmatic: Protrusion of abdominal structures into the THORAX as a result of congenital or traumatic defects in the respiratory DIAPHRAGM.Esophageal Perforation: An opening or hole in the ESOPHAGUS that is caused by TRAUMA, injury, or pathological process.Functional Residual Capacity: The volume of air remaining in the LUNGS at the end of a normal, quiet expiration. It is the sum of the RESIDUAL VOLUME and the EXPIRATORY RESERVE VOLUME. Common abbreviation is FRC.Recurrence: The return of a sign, symptom, or disease after a remission.Cardiology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.Cystic Fibrosis: An autosomal recessive genetic disease of the EXOCRINE GLANDS. It is caused by mutations in the gene encoding the CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR expressed in several organs including the LUNG, the PANCREAS, the BILIARY SYSTEM, and the SWEAT GLANDS. Cystic fibrosis is characterized by epithelial secretory dysfunction associated with ductal obstruction resulting in AIRWAY OBSTRUCTION; chronic RESPIRATORY INFECTIONS; PANCREATIC INSUFFICIENCY; maldigestion; salt depletion; and HEAT PROSTRATION.Pleural Effusion, Malignant: Presence of fluid in the PLEURAL CAVITY as a complication of malignant disease. Malignant pleural effusions often contain actual malignant cells.Pulmonary Fibrosis: A process in which normal lung tissues are progressively replaced by FIBROBLASTS and COLLAGEN causing an irreversible loss of the ability to transfer oxygen into the bloodstream via PULMONARY ALVEOLI. Patients show progressive DYSPNEA finally resulting in death.
doi:10.1378/chest.120.6_suppl.400s. PMID 11742961.. *^ McConville JF, Kress JP. Weaning patients from the ventilator. N Engl J ... As an example, a patient who has a respiratory rate of 25 breaths/min and an average tidal volume of 250 mL/breath has an RSBI ... A patient with a rapid shallow breathing index (RSBI) of less than 105 has an approximately 80% chance of being successfully ... Patients should be assessed daily for their readiness to be weaned from mechanical ventilation by withdrawing sedation and ...
Chest (American College of Chest Physicians). June 2008, 133 (6 suppl b-C).. ... Patient UK. 深靜脈血栓. MeSH. D020246. [編輯此條目的維基數據] ... doi:10.1378/chest.115.2.440.. *^ Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW; American College ... doi:10.1378/chest.08-0656.. *^ Meyering C, Howard T. Hypercoagulability in athletes. Curr Sports Med Rep. 2004, 3 (2): 77-83. ...
Often, they consist of a short dialogue of doctor or nurse with a patient:. *An autopsy of a dead patient revealed that cause ... It's trampling on my chest!" ... A dystrophy patient is lying in bed and shouting: "Nurse! Nurse ... Muscular dystrophy patients are playing hide and seek in the hospital: "Vovka, where are you?" / "I'm here, behind this ... The main themes are the extreme weakness, slowness, gauntness, and emaciation of a dystrophic patient. Some of the jibes ...
American College of Chest Physicians; American Thoracic Society (September 2013). "Five Things Physicians and Patients Should ... "Chest. 123 (1 Suppl): 89S-96S. doi:10.1378/chest.123.1_suppl.89S. PMID 12527568. Archived from the original on 2013-01-12.. CS1 ... Conversely, 10 to 20% of patients with lung cancer are diagnosed in this way.[3] If the patient has a history of smoking or the ... Around 95% of patients with a malignant nodule will have an abnormal PET scan, while around 78% of patients with a benign ...
Chest Physiotherapy. Physiotherapy for Torture Victim Patients. Posture of old age group. Importance of Physiotherapy in ... He also attended the Conference for torture victim Patients at Lahore in 1991. Occupational Therapy Doctor of Physical Therapy ...
Finger clubbing is present in one third of patients.[3] Dental decay is common especially in alcoholics and children. On ... Computed tomography (CT) scan of chest showing bilateral pneumonia with abscesses, effusions, and caverns. 37-year-old male. ... Hirshberg B, Sklair-Levi M, Nir-Paz R, Ben-Sira L, Krivoruk V, Kramer MR (1999). "Factors predicting mortality of patients with ... Onset of symptoms is often gradual, but in necrotizing staphylococcal or gram-negative bacillary pneumonias patients can be ...
Chest. 1998;114;208-12S Gerbes. ET1 and 3 plasma conc in patients with cirrhosis: role of splanchnic and renal passage and ... chest pain and syncope. Patients tend to have a poor cardiac status, with 60% having stage III-IV NYHA heart failure. PPH is ... Typically, patients present in their fifth decade, aged 49 +/- 11 years on average. In general, PPH is diagnosed 4-7 years ... Clin Chest Med 1996; 17: 1 Matsubara O, Nakamura T, Uehara T, Kasuga T. Histometrical investigations of the pulmonary artery in ...
The patient's initial comments to a physician, nurse, or other health care professional help form the differential diagnosis. ... "Differentiating Chest Pain". Emergency Medicine. Archived from the original on 2011-07-30. Graff, Louis G.; Robinson, Dave ( ... Identified patient Medical history "VI. Evaluation and Management (E/M) Services". Compliance Training Manual. ... In acute care settings, such as emergency rooms, reports of chest pain are among the most common chief complaints. The most ...
Chest tubes are put in so that excess fluids may be removed. Because the patient is confined to bed, a urinary catheter is used ... These patients must also be prepared to move to their chosen transplant center at a moment's notice. Such patients may be ... Post-transplant patients are held from driving for the first 3 months pending an assessment of the patient's capacity to drive ... Some respiratory patients may also have severe cardiac disease which would necessitate a heart transplant. These patients can ...
Palpitation associated with chest pain suggests coronary artery disease, or if the chest pain is relieved by leaning forward, ... It is both a symptom reported by the patient and a medical diagnosis. Palpitation can be associated with anxiety and does not ... This recorder is implanted under the skin on the front of the chest, like a pacemaker. It can be programmed and the data ... More recent technology such as the Zio Patch allows continuous recording for up to 14 days; the patient indicates when symptoms ...
A long-term follow-up of 12 patients". Chest. 103 (1): 162-5. doi:10.1378/chest.103.1.162. PMID 8031327. Cottin V, Frognier R, ... A chest x-ray can show abnormalities anywhere, but the most specific finding is increased shadow in the periphery of the lung, ... AEP can occur at any age, even in previously healthy children, though most patients are between 20 and 40 years of age. Men are ... changes in multiple areas and fluid in the area surrounding the lungs on a chest x-ray, and greater than 25% eosinophils on a ...
Shin MS, Ho KJ (1993). "Bronchiectasis in patients with alpha 1-antitrypsin deficiency. A rare occurrence?". Chest. 104 (5): ... Sheikh S, Madiraju K, Steiner P, Rao M (1997). "Bronchiectasis in pediatric AIDS". Chest. 112 (5): 1202-7. doi:10.1378/chest. ... While smoking has not been found to be a direct cause of bronchiectasis, it is certainly an irritant that all patients should ... A common cause is cystic fibrosis, which affects chloride ion transport, in which a small number of patients develop severe ...
Some patients may present with normal or near-normal pulmonary pressures at rest despite symptomatic disease. These patients ... Late prognosis and evolution of hemodynamic and respiratory data". Chest. 81 (2): 151-158. ISSN 0012-3692. PMID 7056079. Pengo ... is the gold standard treatment for suitable CTEPH patients. Operability of patients with CTEPH is determined by multiple ... Decision making for patients with CTEPH can be complex and needs to be managed by CTEPH teams in expert centres. CTEPH teams ...
doi:10.1378/chest.132.4_meetingabstracts.710. Grossman, C. E; A. Fowler (2005). "Paecilomyces: emerging fungal pathogen". Chest ... Byrd Jr, R. P.; T. M. Roy; C. L. Fields; J. A. Lynch (1992). "Paecilomyces variotii pneumonia in a patient with diabetes ... Cohen-Abbo, A; K. M. Edwards (1995). ". Multifocal osteomyelitis caused by Paecilomyces variotii in a patient with chronic ... Saddad, N.; H. Shigemitsu; A. Christianson (2007). "Pneumonia from Paecilomyces in a 67-year-old immunocompetent man". Chest. ...
American College of Chest Physicians; American Thoracic Society. Five Things Physicians and Patients Should Question. Choosing ... Chest (American College of Chest Physicians). September 2007, 132 (3 Suppl): 29S-55S. PMID 17873159. doi:10.1378/chest.07-1347. ... 大多数(85%)肺癌患者患病的原因为长期吸菸[4],然而亦有大约10-15%的患者从不吸菸[13]。这部分人患上肺癌常是由于遗传因素和吸入氡氣、石棉、二手煙,或其他空气污染物共
American College of Chest Physicians; American Thoracic Society (September 2013), "Five Things Physicians and Patients Should ... doi:10.1378/chest.12-1095. PMC 3590883. PMID 22814873.. *^ a b c ... Chest, abdomen and pelvis CT 9.9[66] 12[66] Cardiac CT ... A qualitative analysis of patients' reactions to discussions with their doctors about pulmonary nodules". Chest. 143 (3): 672- ... the left side of the image is to the patient's right and vice versa, while anterior in the image also is the patient's anterior ...
Kaski JC (February 2004). "Pathophysiology and management of patients with chest pain and normal coronary arteriograms (cardiac ... Cardiac syndrome X is chest pain (angina pectoris) and chest discomfort in people who do not show signs of blockages in the ... "Emergency department and office-based evaluation of patients with chest pain". Mayo Clinic Proceedings. 85 (3): 284-99. doi: ... "Five Things Physicians and Patients Should Question". Choosing Wisely: An Initiative of the ABIM Foundation. Archived from the ...
"The golden factor in adherence to inhaled corticosteroid in asthma patients". Egyptian Journal of Chest Diseases and ... Patients can be routinely defined as being 'Adherent Patients' if the amount of medication furnished is at least 80% based on ... Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important ... Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important ...
Stravitz, RT (2008). "Critical management decisions in patients with acute liver failure". Chest. 134 (5): 1092-1102. doi: ... In many cases it will not be needed, unless the patient presents a PTT inferior to 160 seconds. In patients with normal values ... for all observed in all patients. In the last 22 patients, cerebral perfusion pressure was monitored by Doppler (mean flow ... By stabilizing the patient's clinical state, or by creating the right conditions that could allow the recovery of native liver ...
A prospective study of 67 patients with anatomic validation". Chest. 83 (2): 228-232. doi:10.1378/chest.83.2.228. Reeder G. S ... AMI patients most at risk display the 3 characteristics of Virchow's triad: The risk of LVT formation increases as infarction ... Van de Werf F., Staff E. S. C. (2008). "ESC Guidelines on the Management of Acute Myocardial Infarction in Patients Presenting ... Solheim S.; Seljeflot I.; Lunde K.; Bratseth V.; Aakhus S.; Forfang K.; Arnesen H. (2013). "Prothrombotic markers in patients ...
Merrill RM, Henson DE, Barnes M (September 1999). "Conditional survival among patients with carcinoma of the lung". Chest. 116 ... doi:10.1378/chest.116.3.697. PMID 10492274. Kim DJ, Kim KD, Shin DH, Ro JY, Chung KY (December 2003). "Basaloid carcinoma of ... As patients with uncommon lung tumor variants, including tumors composed of mixtures of histological subtypes, tend to be ... prevalence of Bas-SqCC among 1,418 consecutive NSCLC patients at their institution. Basaloid carcinomas of the lung - like ...
Caring well for the families of our patients. Chest 2007 November 132(5): 1420-22. Norris K, Merriman MP, Curtis JR, Asp C, ... Patient refusal of nutrition and hydration: Walking the ever-finer line. Am J Hosp Pall Care 1995 March-April;12(21):8-13. When ... Byock I, Davies C: Spiritual care of the renal patient. In: Chambers EJ, Germain M, Brown E (eds): Supportive care of the renal ... Bakitas M, Lyons KD, Hegel MT, Byock IR, et al: Effects of a palliative care intervention on clinical outcomes in patients with ...
Marantz P, Kaplan M, Alderman M (1990). "Clinical diagnosis of congestive heart failure in patients with acute dyspnea". Chest ... In patients with severe right heart congestion, observation of the inner jugular might not be feasible due to its distention ... Reflux in this context means backflow of the circulatory system and is not to be confused with reflex The patient is asked to ... Does this patient have abnormal central venous pressure?". JAMA. 275 (8): 630-4. doi:10.1001/jama.1996.03530320054034. PMID ...
Persons with recent contacts with a TB patient. *Persons with nodular or fibrotic changes on chest X-ray consistent with old ... For example, a low-risk patient must have a larger induration for a positive result than a high-risk patient. High-risk groups ... The QuantiFERON-TB Gold blood test measures the patient's immune reactivity to the TB bacterium, and is useful for initial and ... Chaturvedi N, Cockcroft A (1992). "Tuberculosis screening among health service employees: who needs chest X-rays?". J Soc Occup ...
"SAfety of ultrasound-guided thoracentesis in patients with abnormal preprocedural coagulation parameters". Chest. 144 (2): 456 ... Thoracentesis /ˌθɔːrəsɪnˈtiːsɪs/, also known as thoracocentesis (from the Greek θώραξ thōrax "chest, thorax"-GEN thōrakos-and ... "Limited utility of chest radiograph after thoracentesis". Chest. 117 (4): 1038-1042. doi:10.1378/chest.117.4.1038. ISSN 0012- ... Chest wall, pleura,. mediastinum,. and diaphragm. pleura/pleural cavity. Thoracentesis. Pleurodesis. Thoracoscopy. Thoracotomy ...
... and chest pain. For the elderly, they may include confusion, low alertness, and the former listed symptoms to a lesser degree. ... "The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study". BMC Infectious ...
Got a chest cold? When you should see a doctor and what treatments will help you feel better. ... For Patientsplus icon * Common Illnessesplus icon *Chest Cold (Acute Bronchitis) ... What is a chest cold (acute bronchitis)?. A chest cold occurs when the airways of the lungs swell and produce mucus in the ... Cough keeping you up at night? Soreness in your chest and feeling tired? You could have a chest cold. ...
These improved her wheezing, but she still complained of a severe central chest pain. In light of the unresolved chest pain and ... Severe chest pain in an asthmatic patient. BMJ 2017; 358 doi: (Published 13 July 2017) Cite ... The patient had had several previous exacerbations of asthma, and recently had not been using her inhalers regularly. On ... 3. What are the next steps in management of patients with this diagnosis? ...
C. Shekhar and P. J. Whorwell, "Evaluation and Management of Patients with Noncardiac Chest Pain," Gastroenterology Research ... Evaluation and Management of Patients with Noncardiac Chest Pain. C. Shekhar and P. J. Whorwell ...
Chest pain assessment units allow safe early discharge of patients BMJ 2001; 323 :d ... Chest pain assessment units allow safe early discharge of patients. BMJ 2001; 323 doi: ...
Patient with chest pain, Family history, Introduction, Chief complaint, History of present complaint, Past medical history & ... Patient with chest pain. by Mohammed Haneef 1. Family history. 1.1. No diseases run in the family. 1.2. His dad had a heart ... Greeted the patient. 2.2. Introduced myself and the team. 2.3. Took the patients date of birth. 2.3.1. Abdulkareem Sami ... Chest pain, and hes worried its from his heart. 4. History of present complaint. 4.1. Pain assessment (SOCRATES). 4.1.1. Site ...
Certified mastectomy fitter Elisa Lawson uses her tablet to record a precise image of Helens chest. Until recently, patients ... "The beauty of the custom breast form is that were recreating on the back of the form the image of the chest wall, so it fits ... Soft stickers on Helens chest and torso are the first step in a three-dimensional scanning process. ... But now, a high-tech process provides some breast cancer patients with additional options. ...
A) Admission chest radiograph. (B) Repeat chest radiograph following episode of pleuritic chest pain and haemoptysis. ... a repeat chest radiograph was ordered to ensure the correct patient had been imaged. The findings were confirmed. CT of the ... A repeat chest radiograph appeared to demonstrate complete resolution of the right upper zone consolidation and new right lower ... We are grateful to the patient in question for his kind permission to use his case as a teaching point, to the excellent ...
... and hypercapnic stimulation in patients with hemiparesis. We studied eight patients with hemiparesis and nine normal sex- and ... 23891767 - Informing patients about the impact of provocation methods increases the rate of psycho.... 20052487 - Presence of ... Next Document: Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with chronic ob.... ... 17711917 - Mechanical ventilation in duchenne patients with chronic respiratory insufficiency: cli.... 15080207 - A case of ...
The presenting complaint is often with retrosternal chest pain and most patients are initially investigated to exclude more ... Spontaneous Intramural Oesophageal Haematoma in a Patient with Uncontrolled Hypertension: An Unusual Chest Pain Aetiology. ... presenting with chest pain, haematemesis, and dysphagia. Usually the diagnosis is one of exclusion, based on computed ...
Certain asthma medications may provide marginal improvements in chronic obstructive pulmonary disease patients, according to a ... in patients with confirmed COPD and no history of asthma. Overall, there were 126 patients on active treatment and 127 controls ... CHEST 2008. Source Reference: Nguyen M, Woo D "Beyond asthma: a meta-analysis of leukotriene antagonists in the treatment of ... When the data from the four studies were pooled, patients on active treatment had a mean increase in FEV1 of 0.0987 L (95% CI ...
... at Duke University Medical Center have said that emergency physicians should trust their judgment when evaluating patients ... Emergency Physicians Must Trust Their Judgment on Chest Pain Patients. by Rajashri on August 7, 2009 at 10:15 PM Heart Disease ... Chest Pain. Ask any one who has experienced intense chest pain and they will vouch for the fact that it was the most ... One way to formalize the value of the gut instinct about chest pain patients would be to introduce objective tools, like those ...
Explain to interested patients that symptoms such as tightness in the chest or clamminess can be caused by anxiety, but CAD ... TCT: Primary Care Physicians Think Zebras When Chest Pain Patient Is an Anxious Woman MedpageToday ... "primary care physicians interpret chest pain or other coronary artery disease symptoms as psychogenic when the patient is an ... The variables were the addition of life stressors such as divorce or job loss and the gender of the patients. Dr. Lansky and ...
Patients presenting to the emergency department with an undetectable level of the blood biomarker high-sensitivity cardiac ... In a study of all patients (14,636 in total) reporting to a Swedish emergency department with chest pain over a two-year period ... Blood test helps predict heart attack risk for patients with chest pain Negative test of sensitive marker may help guide ... What this means, according to researchers, is that only one in 594 patients who seek medical attention for chest pain - but ...
Retrospective studies of patients with cocaine-associated chest pain suggest that a strategy of discharging patients from the ... Three hundred forty-four patients with cocaine-associated chest pain were evaluated. Forty-two of these patients (12 percent) ... Consecutive patients who reported or tested positive for cocaine use and who received protocol-driven care in a chest-pain ... Validation of a brief observation period for patients with cocaine-associated chest pain.. Weber JE1, Shofer FS, Larkin GL, ...
... suggesting that routine inpatient admission may not be a beneficial strategy for this group of patients, according to an ... Patients with chest pain who are admitted to the hospital after an emergency department evaluation with negative findings and ... chest tightness, chest burning or chest pressure and with negative findings for serial biomarkers. Data were collected from ... But a primary outcome event occurred in only four patients after excluding from the 20 patients those patients who were not ...
Fifty-one participants were randomly assigned to receive manual or mechanical chest percussion three times a day. Twenty-tw … ... We compared the efficacy of manual and mechanical chest percussion during hospitalization for acute exacerbations of cystic ... Comparison of manual and mechanical chest percussion in hospitalized patients with cystic fibrosis J Pediatr. 1994 Feb;124(2): ... this study suggests that patients can be encouraged to use the form of chest percussion that they prefer. ...
... and number of concurrent transports of other patients with chest pain (the total number of patients with chest pain transported ... Each year in Toronto, about 5000 patients with chest pain are transported by ambulance. Up to 20% of these patients have acute ... We sought to determine the resulting prehospital delays for cardiac patients.. Methods: Data on consecutive patients with chest ... the patient was over 18 years of age, the patients chief complaint was chest pain and the call originated in the city of ...
Physicians experiencing burnout are twice as likely to be associated with patient safety issues and deliver a lower quality of ... reduced patient satisfaction, and an increased risk of patient safety issues.. Major finding: Physicians with burnout were ... Because of a lack of funding for research into burnout and the immediate need for change based on the effect it has on patient ... "The primary conclusion of this review is that physician burnout might jeopardize patient care," Maria Panagioti, PhD, from the ...
Differentiating ST-elevation myocardial infarction from nonischemic ST-elevation in patients with chest pain.. Tran V1, Huang ... Seven readers studied electrocardiograms of consecutive patients showing STE. Patients with left bundle branch block or ... Of 84 patients, 40 (48%) had adjudicated STEMI. The percentage for which readers recommended pPCI varied (33% to 75%). Readers ... Current guidelines state that patients with compatible symptoms and ST-segment elevation (STE) in ≥2 contiguous ...
... have fitted a patient with a device that might eliminate the need for surgery in some ... It must be fitted to each patient and fit snugly on the chest. The bulb is used to create a vacuum inside the device. ... Home Brain & Behavior First patients in US receive non-surgical device of sunken chest syndrome ... First patients in US receive non-surgical device of sunken chest syndrome. November 22, 2012. ...
Evaluation of Patients in Chest Pain in the Emergency Room. Official Title Evaluation of Patients in Chest Pain in the ... Emergency Department Patients Patients presenting to the Emergency Department complaining of chest pain. ... Evaluation of Patients in Chest Pain in the Emergency Room (EPIC-ER). The safety and scientific validity of this study is the ... Chief complaint upon admission to the ED: chest pain. *The patient or legal representative is able to understand and provide ...
Stress CT Perfusion in Patients With Chest Pain. The safety and scientific validity of this study is the responsibility of the ...
Endothelial dysfunction in patients with chest pain and normal coronary arteries.. A A Quyyumi, R O Cannon, J A Panza, J G ... Endothelial dysfunction in patients with chest pain and normal coronary arteries.. A A Quyyumi, R O Cannon, J A Panza, J G ... Endothelial dysfunction in patients with chest pain and normal coronary arteries.. A A Quyyumi, R O Cannon, J A Panza, J G ... CONCLUSIONS Patients with chest pain, normal epicardial coronary arteries, and reduced vasodilation in response to atrial ...
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Conclusions: Patients with acute ischaemic chest pain who call their general practice instead of the ambulance service are ... Patients who decided to call the ambulance service were compared with patients who contacted any other service. Most patients ... The most beneficial current approach is for general practices to divert all patients with possible ischaemic chest pain onset ... Objective: To define and measure patient reported prehospital delay in presentation to the emergency department with chest pain ...
  • On examination, her airway was patent and she had a generalised moderate wheeze in her chest, but no other obvious clinical signs. (
  • There is evidence for emergency room physicians to trust their gut instinct when they have to make a quick decision about a potential heart patient, before lab results are even returned," said Chandra, director of acute care research and of the clinical evaluation unit in the Duke Division of Emergency Medicine. (
  • The combination of the pre-hospital ECG and our EMS system design helps get patients to the cath lab more quickly to open up the blocked artery," explained co-author and City Medical Director, James Dunford, MD, professor emeritus of clinical medicine, Department of Emergency Medicine, UCSD School of Medicine. (
  • The study, which was published in JAMA Cardiology and was partly funded by NHLBI, suggests that the noninvasive detection of high-risk plaques can help clinicians identify and appropriately care for patients who will be more likely to experience poor clinical outcomes related to coronary artery disease. (
  • After adjustment for clinical factors, the patients triaged by the risk-seeking physicians had half the odds of admission [odds ratio (OR) 0.51, 95% confidence interval (95% CI) 0.27 to 0. and the patients triaged by the risk-avoiding physicians had nearly twice the odds of admission (OR 1.83, 95% CI 1.10 to 3.03) of the patients triaged by the medium-risk scoring physicians. (
  • Patients who go to the emergency room (ER) with chest pain often receive unnecessary tests to evaluate whether they are having a heart attack, a practice that provides no clinical benefit and adds hundreds of dollars in health-care costs, according to a new study from researchers at Washington University School of Medicine in St. Louis. (
  • Our study is not a definitive randomized clinical trial, but it does suggest that we are over-testing and over-treating these patients. (
  • The current study revisited data from that trial, looking for any differences in outcomes for patients who received a clinical evaluation alone (118 patients) compared with those who received a clinical evaluation plus either a CT scan or a stress test (882 patients). (
  • It's common practice, if you have a very abnormal stress test, to go to the cardiac catheterization lab pretty promptly, because [doctors] are afraid that the patient is going to have a heart attack or die," said study leader Dr. Judith Hochman, the senior associate dean for clinical sciences at New York University School of Medicine. (
  • They caution that the available studies are small and these studies look at chest drains inserted under differing clinical situations and by differing grades of clinicians. (
  • Academy of Women's Health is an interdisciplinary, international association of physicians, nurses, and other health professionals who work across the broad field of women's health, providing its members with up-to-date advances and options in clinical care that will enable the best outcomes for their women patients. (
  • Prevalence and clinical significance of collateral findings detected by chest computed tomography in patients undergoing atrial fibrillation ablation. (
  • In a new report from the TRILOGY ACS trial from Brigham and Women's Hospital (BWH) and Duke Clinical Research Institute (DCRI), in patients without artery-clearing procedures, those who had an angiography (a type of x-ray to view the inside of blood vessels) followed by prasugrel (Effient) had fewer heart attacks and strokes compared to those who had an angiography followed by clopidogrel (Plavix). (
  • The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. (
  • Clinical, Immunological and molecular analysis in a large cohort of patients with X-linked agammaglobulinaemia: an Italian multicenter study. (
  • In this clinical phase IIb cohort, patients are randomized to receive either the new Edwards Sapien XT valve using the NovaFlex delivery system or the Edwards SAPIEN Transcatheter Heart Valve. (
  • GPs diagnosed pneumonia in 31 (1%) patients on clinical grounds who turned out not to have radiographic pneumonia (n=2670). (
  • In patients diagnosed with pneumonia by GPs on clinical grounds alone, 57% were subsequently diagnosed with radiographic pneumonia (positive predictive value, PPV). (
  • Driven by the need for rapid assessment, treatment and appropriate disposition of patients in the emergency department (ED), blood tests are often performed in a protocolised fashion before full clinical assessment. (
  • The American College of Chest Physicians, publisher of the journal CHEST ®, is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research and team-based care. (
  • The first medical association with a clinical simulation program accredited by the Society for Simulation in Healthcare, the American College of Chest Physicians also provides hands-on training through innovative simulation education. (
  • Thus, ease of use is key, and this study importantly shows the clinical acceptability of Chest Pain Choice, Masoudi stressed. (
  • Clinical Profile of patients undergoing fibreoptic broncoscopy in a tertiary care setting. (
  • After an introductory discussion of normal cardiac anatomy and imaging, the authors provide readers with a systematic approach to understanding chest images in children with congenital or acquired heart disease, followed by bulleted synopses of basic pathologic features, clinical manifestations, and radiographic fi ndings. (
  • Further, they have determined that the drug azithromycin may help patients with short telomeres, an indicator of more rapid biological aging, stave off negative clinical outcomes. (
  • Objectives This study assessed clinical events and patient-reported chest pain 2 years after treatment of all-comers with Resolute Integrity zotarolimus-eluting stents (Medtronic Vascular, Santa Rosa, California) and Promus Element everolimus-eluting stents (Boston Scientific, Natick, Massachusetts). (
  • The MR-INFORM study investigated the clinical effectiveness of non-invasive magnetic resonance perfusion measurements in comparison to invasive coronary angiography supported by pressure measurements in the coronary arteries (fractional flow reserve, FFR), in patients with stable angina. (
  • Non-invasive imaging modalities integrate the clinical and laboratory diagnostic work-up of patients admitted in emergency department for chest pain. (
  • Silverio A, Citro R, Nardi F. Clinical imaging in patients experiencing chest pain. (
  • The present study investigated the clinical application of a contemporary sensitive troponin I assay in patients presenting with concomitant AF and suspected ACS. (
  • The study cohort comprised the remaining 302 patients. (
  • Dr. Panagioti and her colleagues performed a search of the MEDLINE, EMBASE, CINAHL, and PsycInfo databases and found 47 eligible studies on the topics of physician burnout and patient care, which altogether included data from a pooled cohort of 42,473 physicians. (
  • The mean age of the study cohort was 64.2 years and 42% of the patients were male. (
  • Conclusion - In this cohort of low risk patients who presented to an ED with chest pain, follow up with a PCP and cardiologist was associated with significantly reduced risk of death or MI at one-year. (
  • A retrospective cohort of 1000 consecutive patients presenting to the ED with chest pain was identified. (
  • Chart review was performed on a prospectively defined cohort of 142 patients with known CAD presenting to the ED with chest pain thought to be of ischemic origin, all of whom were admitted to the hospital from December 2012 to April 2013. (
  • Contemporary sensitive troponin I was assayed in a derivation cohort of 90 patients with suspected acute coronary syndrome and chronic AF to establish diagnostic cut-offs. (
  • Contrast‐enhanced chest CT has become the imaging modality of choice to detect pleural effusions and assist the differentiation between benign andmalignant effusions detected bystandard radiographs. (
  • From congenital or acquired problems in newborns to cardiovascular abnormalities in older children, this comprehensive text explains how to interpret chest radiographs and how to report that information in day-to-day practice. (
  • That translates into chest pain or tightness - called angina - when those patients exercise or experience emotional stress, because their body is trying to pump more blood, but can't do so effectively through such a restricted space. (
  • People who are having an anxiety attack often if not always manifest some chest pain (pressure, tightness, whatever) as a prominent symptom of their anxiety. (
  • Although our retrospective midterm-analysis after endovascular stent-graft placement suggests a beneficial outcome and confirms procedural safety, the concept of non-surgical aortic reconstruction should be subjected to randomized trials in order to demonstrate improvement of long-term prognosis for patients with dissecting aneurysms of the chest aorta. (
  • Digital tomosynthesis for aortic arch calcification evaluation: performance comparison with chest radiography with CT as the reference standard. (
  • The long-term management of the patient with an aortic coarctation repair. (
  • Results from the first phase of the PARTNER trial showed that the rate of death from any cause at one year was 50.7 percent in the patients who received standard therapy, as compared to 30.7 percent of patients treated with transcatheter aortic valve replacement (TAVR). (
  • Haemopericardium is a well-known complication in the early postoperative phase after heart surgery, but in our patient it presented 35 years after aortic valve replacement. (
  • In this case report, we describe the perioperative use of external chest wall stimulation for temporary inhibition of a pacemaker during endovascular repair of an abdominal aortic aneurysm in a patient with an older generator with limited programmability. (
  • Further results from these two studies will be shared at CHEST Annual Meeting 2018 in San Antonio on Monday, Oct. 8, 7:45 a.m. to 8:00 a.m., at the Henry B. Gonzalez Convention Centre, Room 206A. (
  • CHEST 2018 is the 84th annual meeting for the American College of Chest Physicians held Oct. 6 to Oct. 10, 2018, in San Antonio, Texas. (
  • For more information about CHEST 2018, visit , or follow CHEST meeting hashtag, #CHEST2018, on social media. (
  • among the 66 patients released by the risk-avoiding physicians, 64 (97%) were known to be alive at four to six weeks, one was lost to follow-up, and one died of ischemic heart disease during a subsequent hospitalization (p = NS). (
  • The study focused on patients with what's called ischemic heart disease . (
  • Take, for example, an active 60-year-old woman with ischemic heart disease, whose exercise-induced chest pain has forced her to cut back on the tennis she loves. (
  • This finding also applies to those patients who are diagnosed with ischemic heart disease and those who eventually develop [heart attack]. (
  • Their research suggests that emergency physicians should counsel with other physicians against discharge when they feel strongly about a patient for whom there is no compelling data, other than our evaluation and judgment, Chandra said. (
  • Its hospitals' heart care teams have defined what excellent patient care looks like from the broadest possible point of view, taking in everything from community education through to patient discharge. (
  • Physicians identified 39.7 percent of HEART Pathway patients for early discharge. (
  • Even in Canada, where physicians are far less likely to request objective testing before ED [emergency department] discharge, we suspect that removing the safeguard of subsequent outpatient objective cardiac testing on patients with a reasonable presentation for acute coronary syndrome is not likely to gain widespread traction," wrote Clare L Atzema, MD, MSc, of the Sunnybrook Health Sciences Centre in Toronto, and colleagues. (
  • Results - Among 216,527 patients, 29% had no-physician, 60% had PCP alone, 8% had PCP with cardiologist, and 4% had cardiologist alone follow-up after ED discharge. (
  • Data were collected in Sweden in 670 patients (mean age 65±16 years, 51% women) within one month from discharge using the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, and Patient Health Questionnaire-9. (
  • Moreover, they should balance identification of critical patients with the safe and early discharge, directly from the emergency room, of low-risk subjects with no evidence of disease. (
  • In univariate analysis, the chance of postdischarge adverse cardiac events was higher in patients with hypertension (OR=9.36, CI=3.24-27.03), previous coronary artery disease (OR= 3.8, CI=1.78-8.0), dyslipidemia (OR=3.5, CI=1.7-7.38) and discharge against medical advice (OR=2.85, CI= 1.37-5.91). (
  • Three of these 12 patients and two additional patients had exercise-induced 201 TI perfusion defects. (
  • The MR-INFORM investigators randomized 918 patients with effort induced chest pain into either invasive testing with angiography and FFR measurements or into magnetic resonance perfusion imaging. (
  • In both groups patients did well with a very low event rate (3.9% in the angiography guided group and 3.33% in the MR perfusion guided group). (
  • Both tests performed identically, demonstrating that patients can be safely guided by magnetic resonance perfusion imaging as the first line technique. (
  • Current guidelines recommend that high-sensitivity cardiac troponin T be analyzed at least three hours after the onset of chest pain, which commonly means that patients need to be admitted to the hospital for a second blood test and further evaluation. (
  • The most beneficial current approach is for general practices to divert all patients with possible ischaemic chest pain onset within 12 hours direct to the ambulance service. (
  • The sensitivity of the assay at presentation was 100% among patients who presented four to six hours after symptom onset. (
  • A 58-year-old male with a past medical history significant for hypertension and hypercholesterolemia presents four hours after acute onset of substernal chest pain that rates eight on a scale of 10. (
  • Explain to interested patients that this study found that use of two leukotriene antagonists -- approved for asthma -- appears to be associated with small but significant improvements in the lung function of COPD patients. (
  • There was an opacity with regular contours at right lung middle lobe on her chest X-ray (Fig. 1). (
  • The present authors have previously reported the usefulness of a serodiagnostic test to detect serum glycopeptidolipid (GPL) core antibody in diagnosing Mycobacterium avium complex (MAC) lung disease in immunocompetent patients. (
  • The present authors examined the usefulness of the GPL serodiagnostic test in immunocompetent patients with lung disease and found that MAC lung disease could be clearly differentiated from colonisation with MAC and from lung diseases caused by either M. tuberculosis or M. kansasii . (
  • V. Determine the efficacy of spiral CT scanning of the chest in detecting early lung cancers not visible on chest x-rays in patients at high risk for lung cancer. (
  • Compare annual spiral CT scanning versus annual chest x-rays in detecting lung cancer in these patients. (
  • Chest infections are treated with appropriate antibiotics early and for longer in antibody failure than in immunocompetent individuals to prevent structural lung damage, since bronchiectasis is a common feature in patients with severe PADS. (
  • Interstitial lung disease is a particular feature in about 15% or so of sporadic CVID patients, though this may represent several different conditions depending on aetiology, and prognosis is uncertain. (
  • Patients who develop respiratory deterioration and instability can benefit from lung ultrasonogra-phy that is more sensitive than chest X-ray for evaluation of pneumonia and ARDS . (
  • Of the 10,713 patients who met the criteria for our study, 604 were diagnosed with unstable angina. (
  • We don't know what influenced the ultimate decision by the admitting or ER doctor to send the patients home, and that would be an important variable to study further. (
  • In a study of all patients (14,636 in total) reporting to a Swedish emergency department with chest pain over a two-year period from 2010 to 2012, researchers examined patients' blood levels of high-sensitivity cardiac troponin T, a marker that indicates damage to the heart. (
  • Nearly 9,000 patients with an undetectable level of the biomarker, or less than 5ng/L, on initial testing, and whose ECGs showed no heart damage from decreased blood flow, were included in the study to examine the primary endpoint of heart attack within 30 days. (
  • Chest pain is a potentially life-threatening symptom, as well as being a very common one," said Nadia Bandstein, M.D., Department of Medicine, Karolinska Institute, Solna, Sweden, and the lead investigator of the study. (
  • Authors believe this study also has tremendous implications for the 10 million to 15 million patients in the U.S. and Europe who seek emergency treatment for chest pain each year. (
  • The average age of patients in the study was 47, and 53 percent were women. (
  • Of the 45,416 encounters the authors examined, 11,230 patients met the criteria to be included in the study. (
  • Although equal efficacy of outpatient therapy remains to be proved, this study suggests that patients can be encouraged to use the form of chest percussion that they prefer. (
  • Predictor variables were study period (1997 or 1999), day of the week, time of day, geographic location of the patient, dispatch priority, case severity, return priority and number of other patients with chest pain transported within 2 hours of the index transport. (
  • A total of 3609 patients (mean age 66.3 years, 50.3% female) who met the study criteria were transported by ambulance during the 2 study periods. (
  • We chose to study patients with chest pain since this condition is common, serious and urgent. (
  • The study was funded by the United Kingdom National Institute of Health Research (NIHR) School for Primary Care Research and the NIHR Greater Manchester Patient Safety Translational Research Centre. (
  • The primary conclusion of this review is that physician burnout might jeopardize patient care," Maria Panagioti, PhD , from the National Institute for Health Research (NIHR) School for Primary Care Research and the NIHR Greater Manchester Patient Safety Translational Research Centre at the University of Manchester (United Kingdom) and her colleagues wrote in their study. (
  • A study conducted by researchers from the University of California, San Diego School of Medicine along with colleagues from Rural/Metro Ambulance San Diego and the San Diego Fire-Rescue Department, shows that emergency medical personnel can obtain an electrocardiogram (ECG) in the field for chest pain patients without an increase in scene time or transport time to the hospital. (
  • Prior to this study, questions remained as to whether the time required in the field to perform an ECG would lead to a delay in transporting patients to the hospital. (
  • This study analyzed the data on nearly 22,000 patients complaining of chest pain of suspected cardiac origin encountered over a five-year period by San Diego City paramedics. (
  • This study clearly goes against what has been the common wisdom for the last 30, 40 years" and may lead to less testing and invasive treatment for such patients in the future, said Dr. Glenn Levine, a Baylor College of Medicine cardiologist with no role in the research. (
  • The aim of this study was to describe information needs among patients with unexplained chest pain and how those needs were met by health professionals during medical consultations. (
  • Do you really want to put all of the patients with a negative treadmill test at risk by doing cardiac catheterization or exposing them to the radiation of a nuclear study? (
  • In this study, 31 percent of admitted patients did not have a confirmatory study. (
  • Our study suggests that in the emergency room, stress testing and CT scans are unnecessary for evaluating chest pain in possible heart attack patients," said cardiologist and senior author David L. Brown, MD, a professor of medicine. (
  • In the study, 88 percent of patients received the extra testing. (
  • For a study, patients with stable COPD were taught yoga exercises by an instructor for 4 weeks and then continued exercising at home for 8 weeks. (
  • 11 In our study, we evaluated the performance of early measurement with a high-sensitivity troponin T assay in all patients recruited irrespective of their pretest risk. (
  • A new study has found that patients who received chest radiation for Wilms tumor, a rare childhood cancer, face an increased risk of developing breast cancer later in life due to their radiation exposure. (
  • In high-risk patients, especially those with known CAD or the presence of coronary stents, traditional invasive coronary angiography remains the study of choice to rule out coronary stenosis. (
  • Forty-three percent of the patients enrolled in the study were given the drug after angiography, while fifty-seven percent were given the drug without having undergone angiography. (
  • Determine the number of patients necessary to screen in order to identify the high-risk population eligible for this study. (
  • PROJECTED ACCRUAL: A minimum of 1,000 patients (500 per screening arm) will be accrued for this study. (
  • The study included analysis of data from 119,151 patients in a registry that includes all Swedish hospitals. (
  • TORONTO - It's hard to believe that a single small study could cause such a hullabaloo, but that's been the case with a research paper that looked at the effectiveness of using stents to open up clogged coronary arteries in patients with chest pain known as angina. (
  • The U.K.-led study published last week in The Lancet has sparked a heated international debate among doctors about how best to treat such patients - by inserting a mesh tube into their blocked artery to improve blood flow or by prescribing anti-angina pills? (
  • I think there was a lot of hysteria here," said study co-author Dr. Justin Davies, a professor of cardiology at Imperial College London, pointing to the headline on a New York Times story about the study: "'Unbelievable': Heart stents fail to ease chest pain. (
  • The 2014-17 ORBITA study enrolled 230 patients with one blocked coronary artery - there are three such major vessels - who were experiencing chest pain and reduced exercise capacity on speed-modified treadmill stress tests. (
  • Given that the patients were relatively healthy, with only a single blocked artery, and had been on weeks of intensive drug therapy, "it's not really a surprise that the main finding of the study was that their exercise tolerance didn't change," said Overgaard, who was not involved in the study. (
  • Past study results show conclusively that transcatheter valve replacement is a safe and effective alternative to open surgery, which remains the 'gold standard' for most patients," says Hijazi. (
  • The study included 2,116 obstetric patients, with the median age of 26, who were admitted to the ICU and who required mechanical ventilation for more than 24 hours between. (
  • Of the 2,116 patients, 299 (14 percent) pregnant women within the study had acute respiratory failure and required mechanical ventilation. (
  • The study abstracts can be viewed on the journal CHEST® website . (
  • The study results are built around a tool of the same name, Chest Pain Choice , developed by investigators as a single-page guide for the care of low-risk chest pain patients. (
  • Chest Pain Choice had previously been evaluated in a Mayo Clinic pilot study. (
  • For their study, Hess and colleagues randomized 899 adults who presented to six EDS in five states to receive standard care or use of the Chest Pain Choice tool. (
  • In a new study published in the journal CHEST ® researchers report that measuring blood telomeres, a marker of aging of cells, can be used to predict future risk of the disease worsening or death. (
  • This study included 576 patients with moderate-to-severe COPD who had provided a blood sample for DNA analysis. (
  • The study was carried out using 13,141 patients from three multinational registries, of which 32% had kidney disease. (
  • Therefore, this study was planned to estimate IMA levels in patients of acute chest pain with or without cardiac cause. (
  • One hundred patients of acute chest pain (50 patients with cardiac cause and 50 patients with non-cardiac cause) were selected for the study and compared with 50 age and sex matched healthy controls. (
  • This study aimed at investigating 30 days' adverse outcomes of patients discharged from ED of a major heart center in Iran. (
  • Using a random sample of the original medical records, that translated to a primary outcome event occurring in 0.06 percent of patients, according to the results. (
  • The result is that ambulances do not take patients to the closest hospital but travel instead to an alternate one further away, which inevitably results in some prehospital delay. (
  • RESULTS: All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rimenhancement. (
  • Still, Atzema et al found the other results by Mahler et al promising, although "[i]t is clear that researchers are getting closer to a clinically acceptable tool for the safe early disposition of patients with chest pain from ED, but no instrument seems ready for prime-time yet. (
  • Further, for every eight patients with true-positive results who are treated, one to two patients with false-positive results may also be treated if decisions are based on the interpretation of a single electrocardiogram. (
  • These results are one of the more important observations from the TRILOGY ACS trial, which was set up to address the long-term use of dual anti-platelet therapy for patients managed medically after acute coronary syndrome," said E. Magnus Ohman, MD, senior investigator at the DCRI and chairman of the TRILOGY ACS trial. (
  • In what's called blinding to prevent biased results, patients were not told which procedure they received. (
  • Invasive catheter angiography remains the reference standard, although it is usually reserved for high-risk patients or for confirmation of positive noninvasive test results. (
  • That shared decision-making can also improve patients' level of knowledge about their health status and options, according to results from the Chest Pain Choice trial. (
  • This scenario results in [many] low-risk patients undergoing advanced cardiac testing resulting in false positive test results, unnecessary procedures, [and] increased costs. (
  • They provide the test results and a recommended course of action, he said, then ask whether the patient is okay with it. (
  • Results The 2-year follow-up of 1,810 patients (99.9%) was available. (
  • These important results will change how we approach patients with stable angina. (
  • Researchers recently evaluated these so-called high-risk plaques in 4,415 U.S. outpatients with stable chest pain using a noninvasive technique called coronary computed tomographic angiography. (
  • BJR, the BIR's flagship journal, published a special feature in the September issue on Imaging patients with stable chest pain, guest edited by Professor Matthijs Oudkerk, Senior Editor of BJR, and Professor Edwin van Beek. (
  • This special feature is essential reading for any medical professionals interested in stable chest pain, and is one not to be missed! (
  • In summary, MR-INFORM is the first comparative effectiveness trial comparing patient management based on a non-invasive strategy with invasive testing in patients with stable chest pain. (
  • In the remaining 46 patients, coronary blood flow increased with acetylcholine (mean, 78 +/- 43%) and atrial pacing (mean, 51 +/- 37%), and coronary vascular resistance decreased by 35 +/- 16% and 29 +/- 14%, respectively, but the responses were heterogeneous. (
  • Thus, patients with depressed dilation with atrial pacing had reduced endothelium-dependent dilation with acetylcholine, and vice versa. (
  • However, the microvascular dilation caused by sodium nitroprusside was not significantly different between patients with and those without reduced dilation with atrial pacing, indicating that the vasodilator defect was not caused by smooth muscle dysfunction. (
  • There were no differences in the vasodilator responses with atrial pacing, acetylcholine, or nitroprusside between normotensive and hypertensive patients. (
  • CONCLUSIONS Patients with chest pain, normal epicardial coronary arteries, and reduced vasodilation in response to atrial pacing appear to have associated endothelial dysfunction of the coronary microvasculature. (
  • Thus, microvascular endothelial dysfunction may contribute to the reduced vasodilator reserve with atrial pacing and anginal chest pain in these patients. (
  • AimsChest computed tomography (CT) scanning is increasingly used as an imaging technique in patients undergoing atrial fibrillation (AF) catheter ablation. (
  • Atrial fibrillation (AF) is the most common arrhythmia in the general population, and due to changing demographics, the number of patients with AF is continuously increasing [ 9 , 10 ]. (
  • For example, the emergency physician could use an objective tool to categorize a patient with potential acute coronary syndrome and then add his/her judgment and determine the final probability of ACS, the authors noted. (
  • Physician wellness and quality of patient care are critical [as are] complementary dimensions of health care organization efficiency. (
  • A 65-year-old woman presented to her family physician with chest pain that had been present for months. (
  • Background - Chest pain is one of the most common reasons for presentation to the emergency department (ED), however there is a paucity of data evaluating the impact of physician follow-up and subsequent management. (
  • After adjusting for important differences in baseline characteristics between physician follow-up groups, the adjusted hazard ratios for death or MI were 1.07 (95% CI, 1.00 to 1.14) for the PCP group, 0.81 (95% CI, 0.72 to 0.91) for the PCP with cardiologist group, and 0.87 (95% CI, 0.74 to 1.02) for the cardiologist alone group, as compared to patients who had no follow-up. (
  • Videotaped physician-physician interactions also showed greater patient engagement in decision making. (
  • Whether you believe that a provider shortage is in the offing or that the ratio of physicians-to-patients is too high, physician jobs and nursing jobs abound. (
  • Non-ACS patients had a 2.8 day average length of stay and $9,908 average inpatient (post-ED) hospital charges (not including physician fees), which is $980,926 for the 99 (70%) non-ACS patients. (
  • The researchers also found an intermediate risk (4%) of breast cancer among female Wilms tumor patients who had received abdominal but no chest radiation as part of their treatment for Wilms tumor. (
  • As a result of this finding, researchers recommend routinely requesting the glomerular filtrate in the analytical tests carried out on NSTE-ACS patients, because creatinine determination on its own may not be enough to detect some of these high risk patients. (
  • ACS was ultimately diagnosed in 67 patients based on a positive stress test, a positive troponin test, or coronary artery stenosis of greater than 70 percent. (
  • A novel risk score including elevated troponin I in the ED, dynamic ECG changes in the ED, body mass index, home aspirin use, age older than 65, history of chronic kidney disease, and associated illness at presentation to the ED, is a valuable tool for discriminating between ACS and non-ACS among patients with known CAD presenting to the ED with chest pain. (
  • IMA, creatine kinase- MB (CK-MB), Troponin I, routine biochemical investigations, hemoglobin and total leucocyte count were estimated in these patients. (
  • Nothing about me without me," said lead author Erik Hess, MD (Mayo Clinic, Rochester, MN), quoting Valerie Billingham's advice for "patient dignity in the context of medical care" to start his presentation yesterday in a late-breaking trial session at the American College of Cardiology 2016 Scientific Sessions. (
  • One way to formalize the value of the gut instinct about chest pain patients would be to introduce objective tools, like those that already exist for risk stratification of patients with pneumonia and for venous thrombus embolism. (
  • Burnout among physicians was associated with lower quality of care because of unprofessionalism, reduced patient satisfaction, and an increased risk of patient safety issues. (
  • Ninety-two (28.0%) of the 329 high-risk patients had an ACS event. (
  • Although numerous chest pain characteristics (believed to be both associated and not associated with coronary artery disease) have been reportedly linked to panic disorder, only nonanginal chest pain is consistently associated with panic disorder (relative risk = 2.03, 95% CI = 1.41 to 2.92). (
  • To see if such exposure to radiation affects patients' risk of developing breast cancer , Norman Breslow, PhD, of the University of Washington and the Fred Hutchinson Cancer Research Center in Seattle, led a team that studied nearly 2500 young women who had been treated for Wilms tumor during childhood and who had survived until at least 15 years of age. (
  • However CT angiography should not replace cardiac catheterization in high-risk patients, particularly those with prior coronary stenting. (
  • Immediate coronary artery computed tomographic angiography rapidly and definitively excludes coronary artery disease in low-risk acute chest pain. (
  • Because 64-slice CT scanners allow for visualization of the cardiac anatomy and coronary vasculature without catheters, there has been increasing interest in this modality to evaluate for coronary artery stenosis in low- to intermediate-risk patients presenting with chest pain. (
  • Corresponding adjusted absolute risks were a 21.7 percent lower absolute risk for death within one year for patients in Q4 compared with Q2," the authors wrote. (
  • Patients who progress to ARDS and multi-organ failure could benefit from methylprednisolone to decrease the risk of death . (
  • Controversy exists regarding which is the best first-line test among low- or intermediate-risk patients. (
  • Conclusion Several investigative options exist for the evaluation of stable, low-risk chest pain. (
  • Lack of clear guidelines on the best first-line test for coronary artery disease (CAD) leads to overinvestigation, particularly in patients at low or intermediate risk. (
  • However, many patients who are at very high risk for surgery, such as elderly, frail individuals with multiple health concerns, are considered inoperable. (
  • Patient knowledge, the primary outcome, was assessed via a questionnaire that asked patients about their risk and options. (
  • thus, they may represent a clinically translatable biomarker for patient risk-stratification and identifying individuals at increased risk of poor patient-centered outcomes in COPD. (
  • Patients with chest pain after 12 months at no more than moderate physical effort had a higher risk of target vessel revascularization during the following year (hazard ratio: 1.89 [95% confidence interval: 1.05 to 3. p = 0.03). (
  • We assessed whether the use of a novel risk score in the ED could discriminate which of these high-risk patients actually do or do not have ACS. (
  • It shows in 918 patients followed over one year, that non-invasive testing is as reliable as invasive testing in this high-risk population. (
  • Precise identification is of utmost importance in these individuals, as patients at risk with type 1 MI benefit from an early and aggressive MI-specific treatment [ 18 ] compared with individuals suffering a type 2 MI due to AF in whom a treatment targeting coronary alterations does not seem constructive. (
  • Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients. (
  • The patients were from nine hospitals, including two non-teaching hospitals and a hospital in Singapore. (
  • Approximately 120 000 patients are transported annually to Toronto hospitals (Brian Schwartz, Medical Director, Toronto EMS, personal communication, August 2001). (
  • You'll be in good hands at Mercy Health's five area hospitals, currently the only hospitals in Cincinnati to have earned chest pain accreditation for delivering excellent care," said Mercy Health - Cincinnati President David Fikse. (
  • All five of Mercy Health's Cincinnati-area hospitals now hold Chest Pain Center Accreditation. (
  • Background: The sail sign is a well-known radiographic feature of the pediatric chest. (
  • This book will improve the accuracy and confidence of any radiologist, cardiologist, cardiac surgeon, or intensivist involved in the interpretation of pediatric chest images and is ideal for residents and fellows in radiology, pediatric cardiology, cardiac surgery, and intensive care medicine. (