Thoracic Radiation Normal Tissue Injury

Thoracic malignancies are often a difficult group of tumors to treat definitively as the radiation doses needed to achieve a high probability for tumor control are often associated with high rates of radiation-induced toxicities. The lungs are particularly radiosensitive and are susceptible to radiation pneumonitis in the acute and subacute settings and pulmonary fibrosis in the late setting. Acute esophagitis is common and affects patient quality of life. Beyond acute pericarditis, late cardiac toxicities are increasingly being recognized as clinically relevant when delivering thoracic radiotherapy and can affect overall survival.
Source: Seminars in Radiation Oncology - Category: Cancer & Oncology Authors: Source Type: research

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Authors: Mori H, Kato R, Ikeda Y, Tsutsui K, Hasegawa S, Tanaka S, Iwanaga S, Nakano S, Muramatsu T, Sumitomo N, Matsumoto K Abstract Right ventricular (RV) lead perforations are relatively rare but a potentially life-threatening complication of surgical implantations of cardiac implantable electronic devices (CIEDs). The result of percutaneous simple lead traction after lead perforations in the Japanese population has not been well clarified.We retrospectively studied 1359 patients (pacemakers [PMs], 973 patients; implantable cardioverter defibrillators [ICD], 386 patients) from April 2007 to December 2018 who und...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
In this report, we present a 72-year-old man who developed a coronary stent infection complicated by coronary aneurysm and purulent pericarditis. Coronary artery aneurysm resolved over a period of 8 months following the successful management of infection with intensive antibiotic therapy alone. This case suggests that conservative therapy can be one of the therapeutic options in patients with high operative risks.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
This study adds to the body of evidence in describing incidence and type of cardiac events experienced by an allogeneic and autologous HSCT population at one institution from 2012-2017. Sixty-five patients (9.8%) experienced cardiac events, including atrial arrhythmia (N = 39), acute heart failure (N = 9), acute coronary syndrome (N = 7), new onset hypertension (N = 9), with a few instances of bradycardia, ventricular arrhythmia, pericardial effusion, and pericarditis. Our multivariable regression analysis identified age (older), creatinine (higher) and history of coronary artery disease to significantly correlate with ris...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
AbstractPurpose of ReviewThis review provides an update on the immunopathogenesis of tuberculous pericarditis (TBP), investigations to confirm tuberculous etiology, the limitations of anti-tuberculous therapy (ATT), and recent efficacy trials.Recent FindingsA profibrotic immune response characterizes TBP, with low levels of AcSDKP, high levels of γ-interferon and IL-10 in the pericardium, and high levels of TGF-β and IL-10 in the blood. These findings may have implications for future therapeutic targets. Despite advances in nucleic acid amplification approaches, these tests remain disappointing for TBP. Trials o...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Source: eMedicineHealth.com - Category: General Medicine Source Type: news
p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 10.0px Helvetica; background-color: #fefefe}A 40-something y.o. male with only PMH of DM and tobacco use presented with chest pain. Patient complained of 2 days of sharp, constant, sternal chest pain, 10/10, waxing and waning, worse with laying down and improved with leaning forward or walking.  He has not had pain like this before.Here is his ED ECG:Diffuse ST Elevation.The only reciprocal depression is in aVRThere is a lot of PR depression.The inferolateral T/ST ratio is low (i.e., T-waves are not large in spite of STE)What do you think?This ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Discussion The pericardium is a bi-layered membrane that envelops the heart and provides a barrier to prevent disease and also decreases friction as the heart moves. Pericarditis is the inflammation of pericardium. The incidence is underreported as asymptomatic or mild disease may go unrecognized. From hospitalized patient data, 0.2-5% of patients with various cardiac disease had pericarditis. An incidence rate for hospitalizations of 3.32 per 100,000 person years has been cited. Percarditis occurs more often in adolescent males. Treatment of the underlying cause or suspected cause is important, along with close monitorin...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Authors: Fauter M, Gerfaud-Valentin M, Delplanque M, Georgin-Lavialle S, Sève P, Jamilloux Y Abstract Adult-onset Still's disease (AOSD), first described in 1971 by Bywaters, is a rare systemic auto-inflammatory disorder of unknown etiology, characterized by a symptomatic triad associating prolonged fever, polyarthritis and rash. The management of this disease has significantly improved since its first description, and, although the overall prognosis of the AOSD is good, with a low attributable mortality, below 3% (but up to 18% depending on the series), some rare complications are still possible, can be lif...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
CONSTRICTIVE PERICARDITIS is characterized by progressive inflammation and fibrosis of the pericardium. It manifests with symptoms of heart failure. The only effective treatment is surgical pericardiectomy. The assessment and diagnosis of constrictive pericarditis with echocardiography is well described with spontaneous ventilation. However, there are limited data on constrictive pericarditis assessment with transesophageal echocardiography with positive pressure ventilation. Also, intraoperative hepatic venous Doppler flow mostly is used intraoperatively to assess the severity of tricuspid regurgitation by focusing on the...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: E-Challenges & Clinical Decisions Source Type: research
A late 30's male presented with fever, sore throat, headache, vomiting, and body aches ( " bones hurting " ) for 2 days.He presented to the ED because he developed sudden severe, sharp, pleuritic (but not positional), substernal and left mid to lower chest pain.He had this ECG at time 0What do you think?There was an old ECG for comparison:Very normalInterpretation:There is serious widespread ST elevation that could easily by due to a wraparound LAD with anterior and inferior MI.  It could also be due to pericarditis or myocarditis, but I always say that " you diagnose pericarditis at your peril. &q...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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