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Generalized Edema Above the Diaphragm

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1. Generalized Edema Above the Diaphragm

Generalized Edema Above the Diaphragm Generalized Edema Above the Diaphragm Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Generalized Edema Above the Diaphragm Generalized Edema Above the Diaphragm Aka: Generalized Edema Above the Diaphragm From Related Chapters II. Causes: Infectious causes Trichinosis III. Causes: Superior Vena Cava Obstruction Thoracic aneurysm Mediastinal cancer Thrombosis secondary to upper extremity infection Intraluminal metastasis secondary to hypernephroma IV. Causes: Increased Capillary Permeability Acute nephritis (Angioneurotic edema) V. Causes: Miscellaneous Images: Related links to external

2018 FP Notebook

2. Generalized Edema Above the Diaphragm

Generalized Edema Above the Diaphragm Generalized Edema Above the Diaphragm Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Generalized Edema Above the Diaphragm Generalized Edema Above the Diaphragm Aka: Generalized Edema Above the Diaphragm From Related Chapters II. Causes: Infectious causes Trichinosis III. Causes: Superior Vena Cava Obstruction Thoracic aneurysm Mediastinal cancer Thrombosis secondary to upper extremity infection Intraluminal metastasis secondary to hypernephroma IV. Causes: Increased Capillary Permeability Acute nephritis (Angioneurotic edema) V. Causes: Miscellaneous Images: Related links to external

2015 FP Notebook

3. Study of Oral Minocycline in Treating Bilateral Cystoid Macular Edema Associated With Retinitis Pigmentosa

Study of Oral Minocycline in Treating Bilateral Cystoid Macular Edema Associated With Retinitis Pigmentosa Study of Oral Minocycline in Treating Bilateral Cystoid Macular Edema Associated With Retinitis Pigmentosa - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Study of Oral Minocycline in Treating Bilateral Cystoid Macular Edema Associated With Retinitis Pigmentosa The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02140164 Recruitment Status : Completed First Posted : May 16, 2014 Results First Posted

2014 Clinical Trials

4. NEWTON: Aflibercept Injection for Previously Treated Macular Edema Associated With Central Retinal Vein Occlusions

Volunteers: No Criteria Inclusion Criteria: Patients aged 18 and above with documented history of center-involved macular edema secondary to CRVO. Patients must have received treatment for at least 6 months before baseline, with 3 initial loading doses, and evidence of recurrence of edema when extended beyond 4 weeks. Protocol refracted ETDRS BCVA of 20/25 to 20/320 (73-24 letters). Willing and able to comply with clinic visits and study-related procedures. Provide signed informed consent. Exclusion (...) NEWTON: Aflibercept Injection for Previously Treated Macular Edema Associated With Central Retinal Vein Occlusions NEWTON: Aflibercept Injection for Previously Treated Macular Edema Associated With Central Retinal Vein Occlusions - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2013 Clinical Trials

5. Study of Intravitreal Aflibercept Injection for Persistent CRVO-associated Macular Edema Despite Prior Anti-VEGF Therapy

Study of Intravitreal Aflibercept Injection for Persistent CRVO-associated Macular Edema Despite Prior Anti-VEGF Therapy Study of Intravitreal Aflibercept Injection for Persistent CRVO-associated Macular Edema Despite Prior Anti-VEGF Therapy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Study of Intravitreal Aflibercept Injection for Persistent CRVO-associated Macular Edema Despite Prior Anti-VEGF Therapy The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01857544 Recruitment Status : Unknown Verified

2013 Clinical Trials

6. A Safety and Efficacy Trial of a Treat and Extend Protocol Using Ranibizumab With and Without Laser Photocoagulation for Diabetic Macular Edema

for all scheduled visits and assessments Disease related considerations The presence of center-involving diabetic macular edema on clinical exam and SDOCT Best corrected visual acuity in the study eye, using ETDRS testing, between 20/25 and 20/320 (Snellen equivalent), inclusive. Clear ocular media and adequate pupillary dilation to permit good quality fundus imaging. Exclusion Criteria: General Exclusion Criteria Pregnancy (positive urine pregnancy test) or lactation. Premenopausal women not using (...) A Safety and Efficacy Trial of a Treat and Extend Protocol Using Ranibizumab With and Without Laser Photocoagulation for Diabetic Macular Edema A Safety and Efficacy Trial of a Treat and Extend Protocol Using Ranibizumab With and Without Laser Photocoagulation for Diabetic Macular Edema - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save

2013 Clinical Trials

7. Studying Skeletal Muscle, Heart, and Diaphragm Imaging in Boys With Duchenne Muscular Dystrophy

. Eligibility: Boys who have DMD and are in the GSK2402968 drug test study. Healthy boys of the same age as the above study participants. Design: Participants will be screened with a medical history and physical exam. Healthy volunteers will have one 2-hour visit with three tests. Magnetic resonance imaging (MRI) scans of the skeletal muscles and heart and diaphragm muscles will be carried out. Muscle ultrasound imaging of leg and arm muscles will also be done. Participants should not perform heavy physical (...) Studying Skeletal Muscle, Heart, and Diaphragm Imaging in Boys With Duchenne Muscular Dystrophy Studying Skeletal Muscle, Heart, and Diaphragm Imaging in Boys With Duchenne Muscular Dystrophy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one

2011 Clinical Trials

8. Ranibizumab and Bevacizumab for Diabetic Macular Edema

Ranibizumab and Bevacizumab for Diabetic Macular Edema Ranibizumab and Bevacizumab for Diabetic Macular Edema - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Ranibizumab and Bevacizumab for Diabetic Macular (...) Edema The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01610557 Recruitment Status : Completed First Posted : June 4, 2012 Results First Posted : April 27, 2016 Last Update Posted : August 19, 2016 Sponsor: National Eye Institute (NEI) Collaborator: The EMMES Corporation Information provided

2012 Clinical Trials

9. Ranibizumab in Residual Diabetic Macular Edema Following Previous Anti-VEGF Therapy

> 180/110 (systolic above 180 OR diastolic above 110) Any condition that, in the opinion of the investigator, would preclude participation in the study (e.g. chronic alcoholism, drug abuse). Evidence of vitreoretinal interface abnormality after ocular exam or OCT that may be contributing to the macular edema. An eye that, in the investigator's opinion, has no chance of improving in visual acuity following resolution of macular edema (e.g. presence of subretinal fibrosis, ischemic maculopathy (...) Ranibizumab in Residual Diabetic Macular Edema Following Previous Anti-VEGF Therapy Ranibizumab in Residual Diabetic Macular Edema Following Previous Anti-VEGF Therapy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2011 Clinical Trials

10. Dextromethorphan for Diabetic Macular Edema

Dextromethorphan for Diabetic Macular Edema Dextromethorphan for Diabetic Macular Edema - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Dextromethorphan for Diabetic Macular Edema (MiDME2) The safety (...) Institutes of Health Clinical Center (CC) ( National Eye Institute (NEI) ) Study Details Study Description Go to Brief Summary: Background: Many people with diabetes have macular edema (swelling) at the back of the eye. Macular edema can cause loss of vision. Studies suggest that inflammation may be involved in the swelling. A drug called dextromethorphan may help prevent the inflammation and the swelling. Dextromethorphan is approved for use as a cough medicine, but it has not been studied to see

2011 Clinical Trials

11. A Pilot Study for the Evaluation of Minocycline as a Microglia Inhibitor in the Treatment of Diabetic Macular Edema

A Pilot Study for the Evaluation of Minocycline as a Microglia Inhibitor in the Treatment of Diabetic Macular Edema A Pilot Study for the Evaluation of Minocycline as a Microglia Inhibitor in the Treatment of Diabetic Macular Edema - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. A Pilot Study for the Evaluation of Minocycline as a Microglia Inhibitor in the Treatment of Diabetic Macular Edema The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01120899 Recruitment Status : Completed First Posted : May 11

2010 Clinical Trials

12. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

of Surgery, Brigham and Women's Hospital, Boston, Mass , MD, MBA, MPH i , x Gustavo S. Oderich Affiliations Department of Surgery, Mayo Clinic, Rochester, Minn , MD j , x Madhukar S. Patel Affiliations Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass Department of Surgery, Massachusetts General Hospital, Boston, Mass , MD, MBA, ScM a , k , x Marc L. Schermerhorn Affiliations Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass , MD, MPH a , x Benjamin W (...) death or morbidity. Methods The committee made specific practice recommendations using the Grading of Recommendations Assessment, Development, and Evaluation system. Three systematic reviews were conducted to support this guideline. Two focused on evaluating the best modalities and optimal frequency for surveillance after endovascular aneurysm repair (EVAR). A third focused on identifying the best available evidence on the diagnosis and management of AAA. Specific areas of focus included (1) general

2018 Society for Vascular Surgery

13. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease

and therefore a higher risk of anaerobic metabolism. 18 The risk of inadequate cardiac output is increased in the early postoperative period and during periods of increased oxygen demand, such as from agitation, fever, inflammation, and pain. Post- operative ischemia-reperfusion injury and mural edema can reduce diastolic and systolic function and stroke volume, resulting in heart rate and preload dependence and risk of rapid deterioration. Inadequate cardiac output can be detected by close observation (...) The effects of manipulation of PVR are less important when an appropriately restrictive shunt is in place. In patients with a restrictive shunt, supplementary oxygen administration generally increases Do 2 and maintains AVo 2 D, and the absence of supplementary oxygen may be associated with pulmonary venous desaturation. 45 Manipulation of SVR. Reducing SVR can favorably modify a high Qp:Qs state, improving cardiac out- put and Do 2 . 61 A reduction in SVR will also have the benefit of reducing myocardial

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2018 American Heart Association

14. CRACKCast E193 – Mechanical Ventilation and Noninvasive Ventilatory Support

reference). Core Questions: [1] What are the physiologic changes that occur with a transition from negative to positive pressure ventilation? Normal Breathing = Negative Intrathoracic Pressure Generation Accomplished by the diaphragm and intercostal mm. Contraction increases intrathoracic volume which in turn decreases intrathoracic pressure . Chest Recoil and diaphragm relaxation reverses those changes. Normally, Cardiac output is transiently increased by negative intrathoracic pressure, due (...) , but poor. Delivers both mandatory and spontaneous breaths. Mandatory breath given at preset rate. But the vent synchronizes with spontaneous patient breaths as much as possible. If patient breathing below set rate – essentially similar to A/C. If patient breathing above rate, patient-generated breaths will be at a volume determined by their resp effort. Clinical application : patients who are sedated but have weak resp effort. – attenuates air trapping and promotes synchrony. Continuous Spontaneous

2018 CandiEM

15. Imaging Guidelines

Imaging Guidelines ACS TQIP BEST PRACTICES GUIDELINES IN IMAGING ER AS 1988 THE AMERICAN SOCIETY OFTable of Contents Introduction 3 1. Overview 4 Part 1: General Issues 4 Part 2: Contrast Considerations 8 Part 3: Sedation 10 2. Brain Imaging 15 3. Cervical Spine Imaging 21 4. Imaging for Blunt Cerebrovascular Injury 32 5. Chest Imaging 36 6. Abdominal Imaging 40 7 . Genitourinary Imaging 45 8. Thoracic and Lumbar Spine Imaging 48 9. Whole-Body CT Imaging 51 10. Imaging in Orthopaedic Trauma 56 (...) notice. 31. OVERVIEW Part 1: General Issues Key Points z Chest and pelvic radiographs continue to be a primary adjunct to diagnose immediate threats to life related to breathing and hemorrhage in the chest and/ or extraperitoneal pelvis. z A best practice is concurrent trauma evaluation and radiograph interpretation to facilitate timely treatment interventions for patients with severe injuries. z Definitive imaging of complex vascular injuries ideally requires at least a 64-channel scanner to perform

2018 American College of Surgeons

16. CRACKCast E077 – Pleural Disease

leave. Once intrapleural pressure reaches above 15 – 20mmHg (remember always the answer for elevated compartment pressures), venous blood flow through the SVC and IVC is impaired. Let it keep going = complete cardiovascular collapse Before we dive in, let’s define some things: Pneumothorax : free air in the intrapleural space Spontaneous PTx : no obvious precipitating factor (ie no trauma and we didn’t do it / iatrogenic) Primary Spont Ptx : no obvious underlying lung disease Secondary Spont Ptx (...) Severe COPD is at highest risk (FEV1 <1L). Rupture of atypical blebs is typical cause 3) List 8 causes of 2° spontaneous pneumothorax 4) List 5 clinical findings suggestive of tension pneumothorax General signs of pneumothorax : absent breath sounds, inflated ipsilateral chest, hyper-resonance etc. Tension: Tachycardia (typically >120) Hypoxia w/ profound dyspnea Hypotension JVD Displacement of trachea to CONTRALATERAL side (away from PTX) 5) Describe how to estimate the size of a pneumothorax

2017 CandiEM

17. CRACKCast E082 – Pericardial & Myocardial Disease

to exercise Young age of diagnosis Stimulant abuse Ischemic heart disease 14) A patient with known hypertrophic cardiomyopathy presents to the ED with acute cardiogenic pulmonary edema causing mild hypoxia. What is the general approach to management in the ED? Explain your choices. Most people with HCM are on long-term betablocker therapy. Some may be on CCB’s. While we would typically think about using nitro in CHF….this is the WRONG answer… Nitro decreases ventricular volume – a bad thing in HCM. So our (...) and diagnosing! They can present with a multitude of symptoms…. Anything that causes pericarditis can lead to → pericardial effusion → tamponade / constrictive pericarditis It’s scary that the incidence of this disease in the ER is UNKNOWN… Remember our anatomy for the pericardium: There are parietal and visceral layers – that potential space The parietal layer is attached to the diaphragm, sternum and the vertebral column. Blood supply from internal mammary artery and innervation from the phrenic nerve

2017 CandiEM

18. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

be hemodynamically significant, particularly when combined with generous intravenous infusion of crystalloid, and thus the gravida is more susceptible to pulmonary edema under these conditions. Cardiac Output Maternal cardiac output begins to rise after conception and plateaus at ≈24 weeks of gestation, as shown in . Maternal cardiac output increases 30% to 50% in a singleton pregnancy, with an additional 10% to 20% increment in a twin pregnancy. Maternal posture can significantly affect cardiac output (...) predictive indicator appears to be of most value. In 1 series, the negative predictive value of NT-pro-BNP <128 pg/mL at 20 weeks’ gestation exceeded 95%. Colloid Oncotic Pressure Circulating albumin concentrations fall 12% to 18% in pregnancy, with the lowest levels at ≈24 weeks’ gestation. The decline in colloid oncotic pressure, along with increased femoral venous pressure caused by uterine compression of the inferior vena cava, elicits the edema of pregnancy. , The fall in oncotic pressure can

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2017 American Heart Association

19. Imaging Program Guidelines: Pediatric Imaging

and/or standards of medical practice. These include: ¾ Oncologic imaging – Considerations include the type of malignancy and the point along the care continuum at which imaging is requested ¾ Conditions which span multiple anatomic regions – Examples include certain gastrointestinal indications or congenital spinal anomalies Repeated Imaging In general, repeated imaging of the same anatomic area should be limited to evaluation following an intervention, or when there is a change in clinical status (...) on the clinical evaluation, there is a reasonable likelihood of disease prior to imaging; and ? Current literature and standards of medical practice support that the requested imaging study is the most appropriate method of narrowing the differential diagnosis generated through the clinical evaluation and can be reasonably expected to lead to a change in management of the patient; and ? The imaging requested is reasonably expected to improve patient outcomes based on current literature and standards

2017 AIM Specialty Health

20. Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease (...) complications are increasingly prevalent in adults with CHD. The prev- alence of noncardiac comorbidities such as DM and renal disease is significantly higher in a primary care population of adults with CHD compared with the general population. 8 Even adult patients with simple CHD may have a significant number George K. Lui, MD, Chair Arwa Saidi, MB BCh, Vice Chair Ami B. Bhatt, MD Luke J. Burchill, MD Jason F. Deen, MD Michael G. Earing, MD Michael Gewitz, MD, FAHA Jonathan Ginns, MD Joseph D. Kay, MD

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2017 American Heart Association

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