Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Trastuzumab induced diastolic heart failure

Abstract: Background: Trastuzumab-induced cardiotoxicity has been well accepted. Cardiotoxicity especially with concomitant or sequential use of anthracycline has been clinically identified as decreased left ventricular ejection fraction with or without symptoms of heart failure. Acute diastolic heart failure has not been reported. Case report : A 62-year-old female patient with HER2 + positive breast cancer presented to the emergency room with acute heart failure symptoms after trastuzumab use. Chest X-ray and CT demonstrated acute pulmonary edema. Echocardiography showed normal left ventricular ejection fraction, elevated left ventricular filling pressure, and moderate pulmonary hypertension, which are consistent with acute diastolic heart failure. The patient symptoms resolved quickly with diuretic therapy and Trastuzumab was discontinued. A follow-up echocardiography showed normal left and right ventricular function and a follow-up right heart catheterization demonstrated normal cardiac filling pressure and normal cardiac index. Conclusions: Trastuzumab induced cardiac toxicity could occur in a spectrum - from transient diastolic heart failure to systolic heart failure. The monitoring of both diastolic and systolic function during the course of trastuzumab treatment with or without other chemotherapy agents should be considered. Normal 0 false false false EN-US ZH-CN X-NONE

Recurrent syncope from parapharyngeal cancer.

Abstract: The glossopharyngeal nerve is a cause of reflex bradycardia and syncope in patients with head and neck cancer. These clinical syndromes are rare but can be debilitating with variation in clinical presentation. The underlying mechanism is often incorrectly assumed to be carotid sinus hypersensitivity due to the cancerous lesion; however, examples in the literature also report the effect on the glossopharyngeal nerve or its branches by parapharyngeal lesions. We report two such cases known to a palliative care service. The symptomatic treatment options were limited due to patients’ frailty. Both patients experienced some reduction in their syncopal symptoms with anticholinergic agents.

Follow-Up of Abnormal Pelvic Ultrasound

Abstract: Pelvic ultrasounds (US) are commonly ordered in the outpatient setting. In premenopausal women, pelvic scans are often performed for a variety of conditions. Uterine fibroids is a common diagnosis that is followed to assess for stability and /or growth. During these exams, incidental findings are frequently identified in the adnexa. What kind of follow-up, if any, should these incidentally discovered lesions have? This chapter details the recommended follow-up of asymptomatic ovarian and other adnexal cysts as outlined by the SRU (Society of Radiologists in Ultrasound) consensus guidelines in 2010. The recommendations so drafted are based on current literature and common practice strategies.

Racial Disparities in Outcomes of Adults Hospitalized for Viral Pneumonia.

Abstract: Background Viral pneumonia is an important cause of respiratory morbidity and mortality. Cases of viral pneumonia are becoming increasingly more common as at-risk populations increase globally. We sought to highlight the racial distribution of hospitalized patients with viral pneumonia and compare their outcomes. Materials and methods Data were obtained from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. The study involved adults who had a principal discharge diagnosis of viral pneumonia. The primary outcome analyzed was inpatient mortality. Secondary outcomes included the development of sepsis, septic shock, acute respiratory failure, acute respiratory distress syndrome, non-ST segment elevation myocardial infarction (NSTEMI), acute kidney failure, deep vein thrombosis, pulmonary embolism, cerebrovascular accident, need for mechanical ventilation, and use of vasopressors as well as mean length of hospitalization and mean total hospital charges. Results Blacks and Hispanics had lower inpatient mortality adjusted odds (aOR: 0.39, 95% CI = 0.229 - 0.662, p<0.001 and aOR: 0.55, 95% CI = 0.347 - 0.858, p=0.009, respectively) compared to Whites. Black and Hispanic patients were also found to have lower adjusted odds ratio of having acute respiratory failure (aOR: 0.54, 95% CI = 0.471 - 0.614, p<0.001, and 0.66, 95% CI = 0.576 - 0.753, p<0.001, respectively). Conclusion Black and Hispanic patients are at lower risk of adverse outcomes when compared to White patients with viral pneumonia.