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Penetrating cardiac injury

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https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#1
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28502713/an-autopsy-case-of-fatal-acute-peritonitis-complicated-by-illegal-acupuncture-therapy
#2
DongJa Kim, SangHan Lee
Acupuncture is an alternative medical therapy and widely practiced in Northeast Asia. Although it is known as a safe procedure, complications including infection, pneumothorax, hemorrhage, and cardiac tamponade have been reported. The authors present a rare case of fatal acute peritonitis due to penetration of acupuncture needles directly into the abdominal and pelvic cavity. The victim was a 55-year-old woman who had a recent history of chemo-radiotherapy due to breast cancer. She was collapsed three days after receiving acupuncture...
May 1, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28486324/case-report-and-review-of-management-of-penetrating-trauma-and-cardiac-pericarditis
#3
Elizabeth Thomas, Pamela Golden, Vicki Moran
Acute pericarditis is the most common form of pericardial disease worldwide and it has many potential etiologies. This case study examines a patient admitted for multiple gunshot wounds who developed acute pericarditis postpericardial drain removal. The initial penetrating abdominal trauma, along with facial injuries and a suspected myocardial infarction, led to confusion in which the initial etiology of pericarditis was missed, creating a delay in overall patient care and extended length of stay.
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28452883/kaolin-based-hemostatic-dressing-improves-hemorrhage-control-from-a-penetrating-ivc-injury-in-coagulopathic-swine
#4
Kiavash R Koko, Brian M McCauley, John P Gaughan, Ryan S Nolan, Marc W Fromer, Ashleigh L R Hagaman, Rachel L Choron, Spencer A Brown, Joshua P Hazelton
BACKGROUND: Retrohepatic Vena Cava (RIVC) Injuries are often lethal due to challenges in obtaining hemorrhage control. We hypothesized that packing with a new kaolin-based hemostatic dressing (Z-Medica, Control + ®) would improve hemorrhage control from a penetrating RIVC injury compared to packing with standard laparotomy sponges alone. METHODS: Twelve male Yorkshire pigs received a 25% exchange transfusion of blood for refrigerated normal saline to induce a hypothermic coagulopathy...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28445175/traumatic-ventral-septal-defect-after-stab-wound-to-the-chest-missed-by-transthoracic-echocardiogram-a-case-report
#5
Abimbola O Faloye, Raphael Y Gershon
Traumatic ventral septal defect may be sustained after either blunt force or penetrating trauma to the chest. Severity ranges from asymptomatic to acute decompensated heart failure. Our patient suffered a stab wound to the chest and was initially taken to the operating room for repair of a lacerated right ventricle. Subsequent postoperative hemodynamic deterioration prompted a bedside transthoracic echocardiogram, which failed to identify causal factors. A transesophageal echocardiogram performed immediately after ventral septal defect was demonstrated...
April 25, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28442204/out-of-hospital-thoracotomy-for-cardiac-arrest-after-penetrating-thoracic-trauma
#6
Mark G Van Vledder, Oscar J F Van Waes, Fabian O Kooij, Joost H Peters, Esther M M Van Lieshout, Michael H J Verhofstad
INTRODUCTION: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated thoracotomy on the accident scene. The aim of this study was to determine the proportion of patients with return of spontaneous circulation and subsequent survival after out of hospital thoracotomy in the Netherlands...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28422918/reassessing-the-cardiac-box-a-comprehensive-evaluation-of-the-relationship-between-thoracic-gunshot-wounds-and-cardiac-injury
#7
Rashi Jhunjhunwala, Michael J Mina, Elizabeth I Roger, Christopher J Dente, Michael Heninger, Jacquelyn S Carr, Stacy D Dougherty, Rondi B Gelbard, Jeffrey M Nicholas, Amy D Wyrzykowski, David V Feliciano, Bryan C Morse
BACKGROUND: High energy missiles can cause cardiac injury regardless of entrance site. This study assesses the adequacy of the anatomic borders of the current "cardiac box" to predict cardiac injury. METHODS: Retrospective autopsy review was performed to identify patients with penetrating torso gunshot wounds 2011-2013. Using a circumferential grid system around the thorax, logistic regression analysis was performed to detect differences in rates of cardiac injury from entrance/exit wounds in the "cardiac box" vs...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28400940/early-diagnosis-of-penetrating-cardiac-and-pleural-injury-by-extended-focused-assessment-with-sonography-for-trauma
#8
K P Singaravelu, Rama Prakasha Saya, Vinay R Pandit
In India, stab injury is not uncommon, but identifying potential life threatening conditions in the emergency room (ER) and initiating prompt treatment are challenging. This is a case report of a young patient who presented to the ER with assault injury to the chest and shock; timely extended focused assessment with sonography for trauma helped to fast-track the patient to the operating room. A brief review of diagnosis and management of penetrating cardiac injury is presented herewith.
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28341580/efficacy-and-safety-of-sildenafil-in-men-with-sexual-dysfunction-and-spinal-cord-injury
#9
REVIEW
Dana A Ohl, Martin Carlsson, Vera J Stecher, Gregory A Rippon
INTRODUCTION: Spinal cord injury (SCI) is estimated to affect approximately 276,000 individuals in the United States. Since 2010, the mean age of individuals at the time of the SCI has been 42 years, with nearly 80% of cases involving men. This means that individuals with SCI generally are young men who typically place a great deal of importance on normal sexual and reproductive function. AIM: To assess the effect of sildenafil treatment on erectile function and the frequency of ejaculation in men with SCI...
March 21, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28261766/an-evaluation-of-factors-affecting-clinical-outcomes-in-penetrating-cardiac-injuries-a-single-center-experience
#10
Orhan Tezcan, Oğuz Karahan, Celal Yavuz, Sinan Demirtaş, Ahmet Çalışkan, Binali Mavitaş
BACKGROUND: Penetrating cardiac injury (PCI) has highly mortal outcome. Therefore, management of this emergency situation is extremely important. The present study is an investigation of main factors that can affect mortality and morbidity in PCI. METHODS: Records of 112 patients who were admitted to emergency department with PCI in the last decade were evaluated retrospectively. Demographic data, initial approach, transfer duration and conditions, vital status and findings, type of injury, localization, characteristics, and type of surgical application were recorded...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28255632/population-based-autopsy-study-of-traumatic-fatalities
#11
S Saar, A Lomp, J Laos, V Mihnovitš, R Šalkauskas, T Lustenberger, M Väli, U Lepner, P Talving
BACKGROUND: Injuries result in 5.8 million global fatalities annually and are the leading cause of death in younger individuals. Nevertheless, population-based autopsy investigations on traumatic deaths are scarce. We set out to study all consecutive autopsies on traumatic fatalities performed in a 5-year time segment in Estonia. METHODS: After the ethics review board approval, all consecutive autopsies after blunt or penetrating deaths occurring in prehospital or in-hospital settings between January 1, 2009, and December 31, 2013, were retrospectively reviewed using the National Forensic Medicine Database...
March 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28247763/n-n-dimethyl-tertiary-amino-group-mediated-dual-pancreas-and-lung-targeting-therapy-against-acute-pancreatitis
#12
Shi Luo, Peiwen Li, Sha Li, Zhengwu Du, Xun Hu, Yao Fu, Zhirong Zhang
Acute pancreatitis (AP) is a sudden inflammation of the pancreas with high mortality rate worldwide. As a severe complication to AP, acute lung injury has been the major cause of death among patients with AP. Poor penetration across the blood pancreas barrier (BPB) and insufficient drug accumulation at the target site often result in poor therapeutic outcome. Our previous work successfully demonstrated a dual-specific targeting strategy to pancreas and lung using a phenolic propanediamine moiety. Inspired by this, a simplified ligand structure, N,N-dimethyl tertiary amino group, was covalently conjugated to celastrol (CLT) to afford tertiary amino conjugates via either an ester (CP) or an amide linkage (CTA)...
May 1, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28191375/self-inflicted-cardiac-injury-with-nail-gun-without-hemodynamic-compromise-a-case-report
#13
Simon Ho, Bo Liu, Nicholas Feranec
Pneumatically powered nail guns have been used in construction since 1959. Penetrating injuries to the heart with nail guns have a wide range of presentations from asymptomatic to cardiac tamponade and exsanguination. Mortality related to cardiac nail gun injuries is similar to knife injuries, estimated at 25%. Surgical exploration is the treatment of choice. We describe a case of self-inflicted nail gun injury to the chest without hemodynamic compromise in a 51-year-old man. Computed tomography (CT) imaging confirmed nail penetrating the right ventricle, with the tip adjacent to but not violating the abdominal aorta...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28164016/isolated-rupture-of-bicuspid-aortic-valve-following-blunt-chest-trauma-a-case-report-and-systematic-review-of-literature
#14
Hemindermeet Singh, Sajid Ali, Faraz Khan Luni, Fayyaz Hashmi, Mohammed Taleb
Blunt trauma to chest cause injury to various cardiac structures. Isolated rupture of aortic valve without aortic dissection is rare complication of blunt chest trauma and can be caused by a tear or avulsion of the valve. We report a case of a 35-year-old male who presented with severe aortic insufficiency due to rupture of a non-infected congenital bicuspid aortic valve following non-penetrating chest trauma. The diagnosis was suggested by echocardiography and was confirmed by intra-operative and histological findings...
February 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28137632/generation-6-hydroxyl-pamam-dendrimers-improve-cns-penetration-from-intravenous-administration-in-a-large-animal-brain-injury-model
#15
Fan Zhang, J Trent Magruder, Yi-An Lin, Todd C Crawford, Joshua C Grimm, Christopher M Sciortino, Mary Ann Wilson, Mary E Blue, Sujatha Kannan, Michael V Johnston, William A Baumgartner, Rangaramanujam M Kannan
Hypothermic circulatory arrest (HCA) provides neuroprotection during cardiac surgery but entails an ischemic period that can lead to excitotoxicity, neuroinflammation, and subsequent neurologic injury. Hydroxyl polyamidoamine (PAMAM) dendrimers target activated microglia and damaged neurons in the injured brain, and deliver therapeutics in small and large animal models. We investigated the effect of dendrimer size on brain uptake and explored the pharmacokinetics in a clinically-relevant canine model of HCA-induced brain injury...
March 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28088937/traumatic-cardiac-injury-experience-from-a-level-1-trauma-centre
#16
Biplab Mishra, Amit Gupta, Sushma Sagar, Maneesh Singhal, Subodh Kumar
PURPOSE: Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI. METHODS: Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27899393/penetrating-injury-to-the-cardiac-box-and-the-deadly-dozen
#17
Michael Nicoara, David Parizh, Vadim Meytes, Anthony Kopatsis
No abstract text is available yet for this article.
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27879614/getting-a-better-look-outcomes-of-laparoscopic-versus-transdiaphragmatic-pericardial-window-for-penetrating-thoracoabdominal-trauma-at-a-level-i-trauma-center
#18
Jamie E Anderson, Edgardo S Salcedo, Kacie M Rounds, Joseph M Galante
BACKGROUND: In penetrating thoracoabdominal trauma, it is necessary to evaluate both the pericardial fluid and the diaphragm directly. Transdiaphragmatic pericardial windows (TDWs) provide direct access to the pericardium and diaphragm but expose the patient to the risks of laparotomy. We hypothesize that transabdominal laparoscopic pericardial windows (LPWs) are a safe and effective alternative to TDWs in stable patients. METHODS: This is a retrospective observational study of stable patients with thoracoabdominal penetrating trauma at a level I trauma center between January 2007 and June 2015, comparing outcomes after TDW versus LPW...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27871682/factors-affecting-mortality-after-penetrating-cardiac-injuries-10-year-experience-at-urban-level-i-trauma-center
#19
Michael J Mina, Rashi Jhunjhunwala, Rondi B Gelbard, Stacy D Dougherty, Jacquelyn S Carr, Christopher J Dente, Jeffrey M Nicholas, Amy D Wyrzykowski, Jeffrey P Salomone, Gary A Vercruysse, David V Feliciano, Bryan C Morse
BACKGROUND: Despite the lethality of injuries to the heart, optimizing factors that impact mortality for victims that do survive to reach the hospital is critical. METHODS: From 2003 to 2012, prehospital data, injury characteristics, and clinical patient factors were analyzed for victims with penetrating cardiac injuries (PCIs) at an urban, level I trauma center. RESULTS: Over the 10-year study, 80 PCI patients survived to reach the hospital...
October 15, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27789730/a-severe-penetrating-cardiac-injury-in-the-absence-of-cardiac-tamponade
#20
Tara M Connelly, Walenty Kolcow, Dave Veerasingam, Mark DaCosta
Penetrating cardiac injury is rare and frequently not survivable. Significant haemorrhage resulting in cardiac tamponade commonly ensues. Such cardiac tamponade is a clear clinical, radiological and sonographic indicator of significant underlying injury. In the absence of cardiac tamponade, diagnosis can be more challenging. In this case of a 26-year old sailor stabbed at sea, a significant pericardial effusion and cardiac tamponade did not occur despite an injury transversing the pericardium. Instead, the pericardial haemorrhage drained into the left pleural cavity resulting in a haemothorax...
October 26, 2016: Interactive Cardiovascular and Thoracic Surgery
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