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Journal of Cardiothoracic Surgery Jun 2024Symptom assessment based on patient-reported outcome (PRO) can correlate with disease severity, making it a potential tool for threshold alerts of postoperative...
PURPOSE
Symptom assessment based on patient-reported outcome (PRO) can correlate with disease severity, making it a potential tool for threshold alerts of postoperative complications. This study aimed to determine whether shortness of breath (SOB) scores on the day of discharge could predict the development of post-discharge complications in patients who underwent lung cancer surgery.
METHODS
Patients were from a study of a dynamic perioperative rehabilitation cohort of lung cancer patients focusing on patient-reported outcomes. Patients were assessed using the Perioperative Symptom Assessment Scale for Lung surgery (PSA-Lung). Logistic regression model was used to examine the potential association between SOB on the day of discharge and complications within 3 months after discharge. The post-discharge complications were taken as the anchor variable to determine the optimal cutpoint for SOB on the day of discharge.
RESULTS
Complications within 3 months post-discharge occurred in 71 (10.84%) of 655 patients. Logistic regression analysis revealed that being female (OR 1.764, 95% CI 1.006-3.092, P < 0.05) and having two chest tubes (OR 2.026, 95% CI 1.107-3.710, P < 0.05) were significantly associated with post-discharge complications. Additionally, the SOB score on the day of discharge (OR 1.125, 95% CI 1.012-1.250, P < 0.05) was a significant predictor. The optimal SOB cutpoint was 5 (on a scale of 0-10). Patients with an SOB score ≥ 5 at discharge experienced a lower quality of life 1 month later compared to those with SOB score<5 at discharge (73 [50-86] vs. 81 [65-91], P < 0.05).
CONCLUSION
SOB on the day of discharge may serve as an early warning sign for the timely detection of 3 month post-discharge complications.
Topics: Humans; Female; Male; Patient Discharge; Lung Neoplasms; Dyspnea; Postoperative Complications; Aged; Middle Aged; Pneumonectomy
PubMed: 38937786
DOI: 10.1186/s13019-024-02845-1 -
BMJ Case Reports Jun 2024We describe an unusual case of bilateral pulmonary venous thrombosis in a pregnant woman in her mid 30s, who presented at 34 weeks of gestation with symptoms of sudden...
We describe an unusual case of bilateral pulmonary venous thrombosis in a pregnant woman in her mid 30s, who presented at 34 weeks of gestation with symptoms of sudden onset chest pain, shortness of breath and near syncope attacks. The patient was treated with enoxaparin and made an excellent clinical and hemodynamic recovery.
Topics: Humans; Female; Pregnancy; Adult; Venous Thrombosis; Pregnancy Complications, Cardiovascular; Enoxaparin; Pulmonary Veins; Anticoagulants; Chest Pain; Dyspnea
PubMed: 38937266
DOI: 10.1136/bcr-2024-259773 -
Brazilian Journal of Physical Therapy Jun 2024The relationship between cardiorespiratory fitness and its possible determinants in post-COVID-19 survivors has not been systematically assessed. (Review)
Review
Determinants of cardiorespiratory fitness measured by cardiopulmonary exercise testing in COVID-19 survivors: a systematic review with meta-analysis and meta‑regression.
BACKGROUND
The relationship between cardiorespiratory fitness and its possible determinants in post-COVID-19 survivors has not been systematically assessed.
OBJECTIVES
To identify and summarize studies comparing cardiorespiratory fitness measured by cardiopulmonary exercise testing in COVID-19 survivors versus non-COVID-19 controls, as well as to determine the influence of potential moderating factors.
METHODS
We conducted a systematic search of MEDLINE/PubMed, Cochrane Library, EMBASE, Google Scholar, and SciELO since their inceptions until June 2022. Mean differences (MD), standard mean differences (SMD), and 95% confidence intervals (CI) were calculated. Subgroup and meta-regression analyses were used to evaluate potential moderating factors.
RESULTS
48 studies (3372 participants, mean age 42 years, and with a mean testing time of 4 months post-COVID-19) were included, comprising a total of 1823 COVID-19 survivors and 1549 non-COVID-19 controls. After data pooling, VO peak (SMD=1.0 95% CI: 0.5, 1.5; 17 studies; N = 1273) was impaired in COVID-19 survivors. In 15 studies that reported VO peak values in ml/min/kg, non-COVID-19 controls had higher peak VO values than COVID-19 survivors (MD=6.2, 95% CI: 3.5, 8.8; N = 905; I=84%). In addition, VO peak was associated with age, time post-COVID-19, disease severity, presence of dyspnea, and reduced exercise capacity.
CONCLUSION
This systematic review provides evidence that cardiorespiratory fitness may be impaired in COVID-19 survivors, especially for those with severe disease, presence of dyspnea, and reduced exercise capacity. Furthermore, the degree of reduction of VO peak is inversely associated with age and time post-COVID.
PubMed: 38936313
DOI: 10.1016/j.bjpt.2024.101089 -
Semergen Jun 2024Contributing to elucidate the pathophysiology of dyspnoea and exertion intolerance in post-COVID syndrome patients with normal cardiopulmonary imaging and functional...
OBJECTIVE
Contributing to elucidate the pathophysiology of dyspnoea and exertion intolerance in post-COVID syndrome patients with normal cardiopulmonary imaging and functional tests at rest, while determining their fitness and level of endurance in order to individualize working parameters for physical rehabilitation.
MATERIAL AND METHODS
After an anamnesis and clinical examination at rest, 27 subjects (50±11.9 years) (14 women) with post-COVID syndrome of more than 6 months of evolution performed a continuous maximal-incremental graded cardiopulmonary exercise test (CPET) with breath-by-breath gas-exchange monitoring and continuous ECG registration, on an electromagnetically braked cycle ergometer. The values obtained were compared with those of reference, gender or controls, using the Chi-square, t-Student or ANOVA test.
RESULTS
The clinical examination at rest and the CPET were clinically normal and without adverse events. Reasons for stopping exercise were leg discomfort. It is only worth noting a BMI=29.9±5.8kg/m and a basal lactate concentration of 2.1±0.7mmol/L. The physiological assessment of endurance showed the following results relative to predicted VO: 1)peakVO=80.5±18.6%; 2)VO at ventilatory threshold1 (VOVT1): 46.0±12.9%; 3)VOVT2: 57.2±16.4%; 4)working time in acidosis: 5.6±3,0minutes; and 5)maximum lactate concentration: 5.1±2.2mmol/L.
CONCLUSIONS
The CPET identified limited aerobic metabolism and early increase in glycolytic metabolism as causes of dyspnoea and exercise intolerance, determined fitness for physical rehabilitation, and individualized it based on the level of endurance.
PubMed: 38936100
DOI: 10.1016/j.semerg.2024.102282 -
PloS One 2024Although breast cancer has a markedly higher incidence in developed countries, seven out of ten deaths occur in developing countries, including Ethiopia. However, there...
BACKGROUND
Although breast cancer has a markedly higher incidence in developed countries, seven out of ten deaths occur in developing countries, including Ethiopia. However, there is a limited information on the quality of life (QoL) among breast cancer patients in Ethiopia, notably in the Amhara region. Therefore, this study aimed to assess the QoL and its associated factors among patients with breast cancer in the Amhara Region, Ethiopia.
METHODS
An institutional based cross-sectional study was conducted from 25th March 2019 to 7th July 2019. A systematically selected sample of 256 breast cancer patients were participated in the study. A standardized interviewer-administered Amharic version questionnaire was used to collect the data. We used the European Organization for Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ C30) and breast cancer supplementary measure (QLQ-BR23) to measure QoL. The data were analyzed by SPSS version 23. A binary logistic regression model was fitted to identify the predictors of QoL. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported to show the strength of the association.
RESULTS
Sixty-eight percent of breast cancer patients had poor QoL (68.4%; 95% CI: 62.5-73.8). The mean score of QoL was 70.6 (standard deviation (SD) ±13.9; 95% CI: 69.0-72.4). All functional component scores were less than 75 on the symptom scale. Diarrhea (11.6), constipation (17.5), and dyspnea (24.7) were less noticeable symptoms. Being out of marriage (AOR = 2.59, 95% CI: 1.32-5.07), being poor (AOR = 2.39, 95%CI: 1.32-5.03), being non-housewife (AOR = 3.25, 95% CI: 1.16-7.22), and being complaints of dyspnea (AOR = 3.48, 95% CI: 1.79-6.79), and insomnia (AOR = 2.03, 95% CI: 1.05-3.91) were significantly associated with QoL.
CONCLUSIONS
The proportion of poor QoL among breast cancer patients was high. Health care professionals should give attention to breast cancer patients who are out of marriage, poor and non-housewife while offering the recommended treatment courses.
Topics: Humans; Quality of Life; Ethiopia; Female; Breast Neoplasms; Cross-Sectional Studies; Middle Aged; Adult; Surveys and Questionnaires; Aged
PubMed: 38935776
DOI: 10.1371/journal.pone.0305263 -
Kidney360 Jun 2024
Topics: Humans; Dyspnea; Peritoneal Dialysis; Kidney Failure, Chronic; Female; Male; Middle Aged
PubMed: 38935494
DOI: 10.34067/KID.0000000000000467 -
JAMA Oncology Jun 2024
PubMed: 38935383
DOI: 10.1001/jamaoncol.2024.1816 -
European Journal of Emergency Medicine... Aug 2024
Authors' response to comment on 'Acute heart failure in elderly patients admitted to the emergency department with acute dyspnea: a multimarker approach diagnostic study'.
Topics: Humans; Heart Failure; Dyspnea; Emergency Service, Hospital; Aged; Acute Disease; Biomarkers; Aged, 80 and over; Male; Female; Natriuretic Peptide, Brain
PubMed: 38934077
DOI: 10.1097/MEJ.0000000000001125 -
European Journal of Emergency Medicine... Aug 2024
Topics: Humans; Heart Failure; Dyspnea; Emergency Service, Hospital; Aged; Biomarkers; Acute Disease; Aged, 80 and over; Male; Female; Natriuretic Peptide, Brain
PubMed: 38934076
DOI: 10.1097/MEJ.0000000000001112 -
Clinical Case Reports Jul 2024Insertion of a nasogastric tube is one of the most common methods of administering nutrition, but can cause vocal cord paralysis.
Insertion of a nasogastric tube is one of the most common methods of administering nutrition, but can cause vocal cord paralysis.
PubMed: 38933707
DOI: 10.1002/ccr3.8960