Lymphangioleiomyomatosis is a rare multisystem disease associated with genetic mutations. The disease usually occurs in women of reproductive age and is characterized by infiltration of immature smooth muscle cells into the lungs, airways, and axial lymphatic systems of the thorax and abdomen. The disease often destroys the lung parenchyma and produces air cysts. Cellular infiltration of lymphangioleiomyomatosis into the lymphatic axis can affect hilar lymph nodes, mediastinal nodes, and extrathoracic lymph nodes. The disease can cause lymphatic dilation in the lungs and thoracic ducts, causing chylous effusion in the pleural or abdominal cavities. Invasion of cells in the walls of pulmonary veins can lead to venous obstruction and pulmonary venous hypertension with hemoptysis. Most patients have cough, dyspnea, pneumothorax, hemoptysis, and abnormal lung function. Definitive diagnosis is usually based on histopathology and immunohistochemistry. We expect that, in the near future, quantitative blood tests for the growth factors VEGF-C and VEGF-D will become commonplace. Then the disease can be diagnosed more easily and in greater numbers.
To evaluate the prevalence of smoking in patients who have suffered acute myocardial infarction with ST-segment elevation. Results: The findings of this study suggested that predictors of plaque erosion varied with different smoking status in patients with STEMI and broaden clinicians' understanding of clinical and lesion predictors of plaque erosion, especially in relation to smoking. Conclusion: In current smokers, diabetes mellitus was negatively associated with plaque erosion compared with plaque rupture. In nonsmokers, higher MLA and close bifurcation were positively related to plaque erosion, but not to plaque rupture. Compared to plaque rupture, the correlation between plaque erosion and current smoking complements clinicians' understanding of plaque erosion. There was a strong indication of the relationship between smoking and the development of STEMI.
Point of care ultrasound (POCUS) is a versatile, non-invasive bedside diagnostic tool that increases the sensitivity of conventional physical examination to assess congestion in these patients. It also helps to monitor the effectiveness of decongestive therapy and has prognostic significance. POCUS ultrasound for the management of critically ill patients is increasingly performed by intensivists or emergency Doctors. Results from needs surveys among intensivists reveal an emphasis on basic cardiac, pulmonary, and abdominal ultrasound, which are the most common POCUS modalities in the intensive care unit. Therefore, our aim is to describe the main diagnostic features of basic cardiac, pulmonary and abdominal ultrasound as practiced by intensivists or emergency Doctors in terms of accuracy (sensitivity, specificity), clinical utility and limitations. We also intend to explore POCUS protocols that integrate basic cardiac, pulmonary and abdominal ultrasound and highlight areas for future research.
At the end of 2019, cases of a new acute viral respiratory disease, later recognized as COVID-19, were described. The pandemic has greatly affected healthcare services around the world and is in addition to existing challenges for emergency services such as ST-elevation myocardial infarction. Both conditions can coexist, initial presentations can overlap, and there is no such thing as a true and reliable point-of-care test. Pre-hospital diagnosis and timely treatment of acute coronary syndrome are necessary to achieve optimal outcomes. The use of risk stratification tools (such as GRACE scores) can assist in prioritizing cases to minimize their hospital stay. Critically ill patients with STelevation myocardial infarction, no catheter lab facilities in place or too unstable for transfer must be considered for thrombolysis and activation of services for facilitated PCI, if needed. Patients with cardiovascular disease are particularly vulnerable during this period, regardless of their infectious status. Adapting cardiac services to ensure continuity of care for these patients, even in the context of a new wave of COVID-19, is essential to minimize preventable cardiovascular death.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.