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pneumothorax management

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https://www.readbyqxmd.com/read/29325984/minimally-invasive-repair-of-pectus-carinatum
#1
Mustafa Yuksel, Tunc Lacin, Nezih Onur Ermerak, Esra Yamansavci Sirzai, Bihter Sayan
BACKGROUND: The second most common deformity of the anterior chest wall, pectus carinatum, is a diverse deformity that has been largely managed using open techniques. This study reviews clinical experience with a newly designed bar for minimally invasive repair of pectus carinatum. METHODS: We reviewed the records of all patients recorded in our Chest Wall Deformities Clinical Database. Between January 2006 and November 2016, minimally invasive repair of pectus carinatum was performed in 172 patients...
January 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#2
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29306264/management-of-right-main-bronchial-rupture-with-a-double-lumen-endotracheal-tube-in-a-patient-with-blunt-chest-trauma
#3
Seung Hwan Seol, Woon Jeong Lee, Seon Hee Woo, Dae Hui Kim, Jong Hui Suh
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29305713/the-benefit-of-ultrasound-in-deciding-between-tube-thoracostomy-and-observative-management-in-hemothorax-resulting-from-blunt-chest-trauma
#4
Meng-Hsuan Chung, Chen-Yuan Hsiao, Nai-Shin Nian, Yen-Chia Chen, Chien-Ying Wang, Yi-Szu Wen, Hsin-Chin Shih, David Hung-Tsang Yen
BACKGROUND: Hemothorax is most commonly resulted from a closed chest trauma, while a tube thoracostomy (TT) is usually the first procedure attempted to treat it. However, TT may lead to unexpected results and complications in some cases. The advantage of thoracic ultrasound (TUS) over a physical examination combined with chest radiograph (CXR) for diagnosing hemothorax1 has been proposed previously. However, its benefits in terms of avoiding non-therapeutic TT have not yet been confirmed...
January 5, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29305711/early-management-of-retained-hemothorax-in-blunt-head-and-chest-trauma
#5
Fong-Dee Huang, Wen-Bin Yeh, Sheng-Shih Chen, Yuan-Yuarn Liu, I-Yin Lu, Yi-Pin Chou, Tzu-Chin Wu
BACKGROUND: Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. MATERIALS AND METHODS: From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled...
January 5, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29298241/is-observation-for-traumatic-hemothorax-safe
#6
Leah Demetri, Myriam M Martinez Aguilar, Jordan D Bohnen, Ryan Whitesell, D Dante Yeh, David King, Marc de Moya
BACKGROUND: EAST guidelines suggest tube thoracostomy (TT) be considered for all traumatic hemothoraces. However, previous research has suggested that some traumatic hemothoraces may be observed safely. We sought to 1) determine the safety of selective observation for traumatic hemothorax, and 2) identify predictors of failed observation. METHODS: All patients with traumatic hemothorax from 2000-2014 at a Level I Trauma Center were identified and categorized by size as small (<300cc) or large (≥300cc) based on chest CT-scan measurements...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29279641/cerebral-air-embolism-secondary-to-lung-laceration
#7
Ashok Kumar Singh, Jayant Verma, Surendra Kumar
Cerebral air embolism is a rare clinical entity in day-to-day practice. The introduction of air into the venous or the arterial system can cause cerebral air embolism leading to severe neurological deficits. The common causes reported in the literature are iatrogenic; it can be caused by positive pressure maneuvers performed during cardiac resuscitation, lung biopsy, and the placement of venous catheters in the presence of a patent foramen ovale. We report a case of cerebral air embolism which has occurred secondary to lung laceration...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29277465/optimal-timing-of-video-assisted-thoracoscopic-surgery-for-primary-spontaneous-pneumothorax-in-children
#8
Kibileri Williams, Timothy B Lautz, Astrid H Leon, Tolulope A Oyetunji
PURPOSE: There is no consensus in the pediatric surgical community about when to recommend video-assisted thoracoscopic surgery (VATS) for patients with primary spontaneous pneumothorax (PSP). We aimed to identify factors that predict the likelihood of requiring VATS, and to compare recurrence rates and healthcare utilization among different management approaches to PSP. METHODS: A retrospective chart review and a telephone survey were conducted on all patients 12-21years who were diagnosed with PSP from 2007 to 2015...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29273075/management-of-pneumothorax-in-hemodynamically-stable-preterm-infants-using-high-frequency-oscillatory-ventilation-report-of-five-cases
#9
Claudia Aurilia, Cinzia Ricci, Milena Tana, Chiara Tirone, Alessandra Lio, Alessandro Gambacorta, Angela Paladini, Giovanni Vento
BACKGROUND: Despite an increased use of non-invasive ventilatory strategies and gentle ventilation, pneumothorax remains a common complication in preterm infants. The ventilator management of infants with air leaks remains challenging in terms of both prevention and treatment. Recently the safety and efficacy of expectant management avoiding chest tube drainage to treat large air leak in preterm infants hemodynamically stable has been reported. CASE PRESENTATION: In the present study, we report five cases of preterm infants with birth weight ≤ 1250 g affected by respiratory distress syndrome and treated with nasal continuous positive airway pressure as first intention...
December 22, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29251708/speed-isn-t-everything-identifying-patients-who-may-benefit-from-helicopter-transport-despite-faster-ground-transport
#10
Xilin Chen, Mark L Gestring, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
BACKGROUND: Helicopter emergency medical services (HEMS) have demonstrated survival benefits over ground emergency medical services (GEMS) for trauma patient transport. While HEMS speed is often-cited, factors such as provider experience and level of care may also play a role. Our objective was to identify patient groups that may benefit from HEMS even when prehospital time for helicopter utilization is longer than GEMS transport. METHODS: Adult patients transported by HEMS or GEMS from the scene of injury in the Pennsylvania State Trauma Registry were included...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29248330/sect-clinical-practice-guideline-on-the-management-of-patients-with-spontaneous-pneumothorax
#11
Borja Aguinagalde, José Luis Aranda, Pablo Busca, Ivan Martínez, Iñigo Royo, Jon Zabaleta
This clinical practice guideline (CPG) emerges as an initiative of the scientific committee of the Spanish Society of Thoracic Surgery. We formulated PICO (patient, intervention, comparison, and outcome) questions on various aspects of spontaneous pneumothorax. For the evaluation of the quality of evidence and preparation of recommendations we followed the guidelines of the Grading of recommendations, Assessment, Development and Evaluation (GRADE) working group.
December 13, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29237135/spontaneous-pneumothorax-in-children-national-management-strategies-and-outcomes
#12
Kibileri Williams, Tolulope A Oyetunji, Grace Hsuing, Richard J Hendrickson, Timothy B Lautz
INTRODUCTION: The timing of surgical intervention in the management of spontaneous pneumothorax remains controversial. The aim of this multicenter review was to compare management strategies and outcomes in children with spontaneous pneumothorax. METHODS: We retrospectively reviewed patients 10-19 years old in the Pediatric Health Information System admitted for spontaneous pneumothorax from 2010 to 2014. Three treatment groups were identified based on initial hospital management-no intervention, initial chest tube placement, and operation; and outcomes were compared...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29223882/recurrent-renal-cancer-in-birt-hogg-dub%C3%A3-syndrome-a-case-report
#13
Hammad Ather, Nida Zahid
INTRODUCTION: Birt-Hogg-Dubé syndrome (BHDS) is a rare autosomal dominant disease. It is caused by constitutional mutations in the FLCN gene. Since BHDS is a rare syndrome therefore it is unknown to many physicians. However, it is important to identify this rare syndrome at early stages because incidence of renal cancer in BHD patients is very high and its detection at early stages can prevent its metastasis. Hence, we want to present a case of BHDS and draw the attention of the treating physician to this rare inherited disorder and discuss its appropriate diagnosis and management...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29223011/veno-venous-ecmo-during-surgical-repair-of-tracheal-perforation-a-case-report
#14
Filippo Antonacci, Chiara De Tisi, Ilaria Donadoni, Marco Maurelli, Giorgio Iotti, Fabio Silvio Taccone, Giulio Orlandoni, Carlo Pellegrini, Mirko Belliato
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is used extensively in cardiothoracic surgery both for hemodynamic and respiratory support. It has proven to be a valuable tool to maintain adequate oxygenation during tracheal surgery. Airway lesion may be an indication for veno-venous ECMO both in case of conservative management and in case of surgical repair. Here we report the case of a patient with a iatrogenic tracheal injury, successfully operated with the support of veno-venous extracorporeal oxygenation...
November 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29204875/focused-assessment-with-sonography-in-trauma-a-review-of-concepts-and-considerations-for-anesthesiology
#15
Jacob Pace, Robert Arntfield
The use of point-of-care ultrasound in trauma provides diagnostic clarity and routinely influences management. A scanning protocol known as the Focused Assessment with Sonography in Trauma (FAST) has been widely adopted by trauma providers of all specialties. The FAST exam addresses a broad array of pathologic conditions capable of causing instability, including hemoperitoneum, hemopericardium, hemothorax, and pneumothorax. The exam is an integral component to the primary assessment of injured patients and an iconic application of point-of-care ultrasound...
December 4, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29188917/-implementation-of-the-hartford-consensus-and-tactical-combat-casualty-care-recommendations-in-emergency-services-a-review-of-the-literature
#16
REVIEW
Carmen Usero-Pérez, Valentín González Alonso, Luis Orbañanos Peiro, José Manuel Gómez Crespo, Sheima Hossain López
Recent terrorist attacks involving active shooters or improvised explosive devices have shown that traditionally sequenced emergency management leads to delays in attending victims and suboptimal outcomes. Tactical medicine, a new concept in prehospital care, emerged from experience attending the wounded in combat zones, where the Tactical Combat Casualty Care (TCCC) recommendations are applied. TCCC targets 3 main causes of preventable death in combat: bleeding from extremities, tension pneumothorax, and airway obstruction...
2017: Emergencias: revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29181345/intrapleural-penetration-of-a-clavicle-fracture-an-indication-for-operative-fixation
#17
Ryan D DeAngelis, Kenneth W Graf, Rakesh P Mashru
Introduction: Clavicle fractures are common injuries treated by orthopedic surgeons, with most injuries managed nonoperatively. Operative fixation of clavicle fractures is indicated in specific clinical scenarios such as open injuries, ipsilateral shoulder trauma, or fractures with associated neurovasculature compromise. Operative fixation is not widely accepted for closed injuries and is typically reserved for instances of failed closed treatment with resultant nonunion or delayed union...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29169151/cystic-lung-disease-in-genetic-syndromes-with-deficient-tumor-suppressor-gene-function
#18
Cécile Daccord, Laurent P Nicod, Romain Lazor
Cystic lung diseases constitute a distinct group of rare lung disorders, among which two result from monogenic defects affecting tumor suppressor genes: lymphangioleiomyomatosis, either sporadic or associated with tuberous sclerosis complex, and Birt-Hogg-Dubé syndrome. These disorders have similarities in their clinical expression, including occurrence in young adults, multiple pulmonary cysts, recurrent pneumothorax, skin hamartomas, and renal tumors. However, they markedly differ in their gender distribution, pathogenesis, disease course, and prognosis...
November 23, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29167928/pulmonary-contusions-after-blunt-chest-trauma-clinical-significance-and-evaluation-of-patient-management
#19
Z Požgain, D Kristek, I Lovrić, G Kondža, M Jelavić, J Kocur, M Danilović
INTRODUCTION: A pulmonary contusion is an entity defined as alveolar haemorrhage and pulmonary parenchymal destruction after blunt chest trauma. According to the literature, most pulmonary contusions can only be seen on a chest CT. The aim of this study was to evaluate the patients with pulmonary contusions, as well as their management, considering diagnostic and therapeutic options related to their outcomes, since we assumed, based on everyday clinical practice, that an 'overdiagnosing' and 'overtreatment' attitude towards this injury could be present...
November 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29167216/a-rare-case-of-dual-diagnosis-in-a-16-year-old-girl-with-shortness-of-breath
#20
Felicity de Vere, Robyn House, Yunus Gokdogan
Pneumothorax and pulmonary embolism (PE) are two life-threatening causes of shortness of breath in patients presenting to the emergency department. A rare but more serious presentation is that of simultaneous PE and pneumothorax. We present the case of a young patient, with no known comorbidities, who presented with simultaneous submassive PE and pneumothorax. We will review how these two diagnoses may be related, consider the implications of having this dual diagnosis on the patient's management and review the current evidence surrounding thrombolysis in submassive PE...
November 21, 2017: BMJ Case Reports
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