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https://www.readbyqxmd.com/read/29429475/-osteosynthesis-of-rib-fractures-unstable-chest-wall-pseudoarthroses-and-acquired-defects-of-the-chest-wall
#1
Kirsten Neckelmann, Rikke Hagelberg
Several patients suffer from rib fractures after traumas, and in severe cases it can be life-threatening. Until recently, attempts to perform surgical fixation in patients with instability have been unsuccessful. Chronic non-union causes persistent pain, disability and loss of quality of life. Implementation of surgical stabilization of rib fractures with tailored plates seems to improve pain relief, especially in cases of non-union but also in patients with instability of the chest wall after severe traumas, where advanced pain treatment (epidural catheter) is insufficient or weaning off fails...
February 5, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29411245/single-coronary-artery-anomaly-a-case-report-and-review-of-literature
#2
Ayman Elbadawi, Basarat Baig, Islam Y Elgendy, Erfan Alotaki, Ahmed H Mohamed, Kirolos Barssoum, David Fries, Muhammad Khan, Rami N Khouzam
INTRODUCTION: Single coronary artery is a rare anomaly, which is usually associated with other cardiac congenital abnormalities. CASE REPORT: A 56-year-old female presented with unstable angina. The patient reported complaints of typical chest pain on exertion few months prior to presentation, which progressed to become at rest. The pain was associated palpitations and dizziness. Past medical history was significant for hypertension and hyperlipidemia. Vital signs were stable...
February 6, 2018: Cardiology and Therapy
https://www.readbyqxmd.com/read/29390466/iatrogenic-acute-aortic-dissection-induced-by-off-pump-coronary-artery-bypass-grifting-a-case-report-and-review-of-the-literature
#3
Jiachen Li, Xinliang Guan, Ming Gong, Xiaolong Wang, Hongjia Zhang
RATIONALE: Iatrogenic acute aortic dissection (IAAD) induced by cardiac surgery is a fatal complication, with 0.04% of therapeutic procedures and worse outcomes than spontaneous aortic dissection. PATIENTS CONCERNS: A 64-year-old male complaining of intermittent chest tightness for 4 years received an off-pump coronary artery bypass grifting (OPCABG) and IAAD was found during surgery. DIAGNOSIS: Unstable angina, coronary artery triple vessel lesion, IAAD...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29367383/understanding-pulmonary-stress-strain-relationships-in-severe-ards-and-its-implications-for-designing-a-safer-approach-to-setting-the-ventilator
#4
REVIEW
Rolf D Hubmayr, Richard H Kallet
This review describes the current understanding of the lungs' response to deforming stress under conditions of both normal physiology and acute lung injury. Several limiting assumptions are needed to infer lung parenchymal stress and strain from airway pressure, volume, and flow data from mechanically ventilated patients with injured lungs. These assumptions include the effects of the chest wall on lung-surface pressure, its topographical distribution, and the effects of non-uniform tissue properties on local parenchymal stresses...
February 2018: Respiratory Care
https://www.readbyqxmd.com/read/29330983/ultrasound-and-supine-chest-radiograph-in-road-traffic-accident-patients-a-reliable-and-convenient-way-to-diagnose-pleural-effusion
#5
Uzma Mumtaz, Zainab Zahur, Muhammad Ali Raza, Madiha Mumtaz
BACKGROUND: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29322167/use-of-high-risk-coronary-atherosclerotic-plaque-detection-for-risk-stratification-of-patients-with-stable-chest-pain-a-secondary-analysis-of-the-promise-randomized-clinical-trial
#6
Maros Ferencik, Thomas Mayrhofer, Daniel O Bittner, Hamed Emami, Stefan B Puchner, Michael T Lu, Nandini M Meyersohn, Alexander V Ivanov, Elizabeth C Adami, Manesh R Patel, Daniel B Mark, James E Udelson, Kerry L Lee, Pamela S Douglas, Udo Hoffmann
Importance: Coronary computed tomographic angiography (coronary CTA) can characterize coronary artery disease, including high-risk plaque. A noninvasive method of identifying high-risk plaque before major adverse cardiovascular events (MACE) could provide practice-changing optimizations in coronary artery disease care. Objective: To determine whether high-risk plaque detected by coronary CTA was associated with incident MACE independently of significant stenosis (SS) and cardiovascular risk factors...
January 10, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29321430/new-onset-takayasu-s-arteritis-as-acute-myocardial-infarction
#7
Yusuke Ishiyama, Kazuo Eguchi, Katsuaki Yokota, Tomokazu Ikemoto, Kazuomi Kario
We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and adventitia was not clearly visible, and the vessel was concentrically thickened; unstable plaque and calcification were not seen. AMI is rarely seen in young women, but Takayasu's arteritis is one major cause...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29310353/complex-pelvic-ring-injuries-associated-with-floating-knee-in-a-poly-trauma-patient-a-case-report
#8
Yuebin Zhou, Honggang Guo, Zhiwei Cai, Yuan Zhang
RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO)...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29303132/surgical-decompression-for-traumatic-spinal-cord-injury-in-a-tertiary-center
#9
O A Ojo, E O Poluyi, B S Owolabi, O O Kanu, M O Popoola
BACKGROUND: There are controversies regarding the importance and timing of spinal cord decompression following trauma. Documented evidence shows that early decompression in the setting of acute spinal cord injury (SCI) improves neurologic outcomes. Our objective was to evaluate the outcome of posttraumatic spinal cord decompression with or without spinal stabilization in our region. METHODOLOGY: We performed a cross-sectional study on adult patients who presented with acute spinal cord compression of traumatic etiology within a 2-year period...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29275346/clinical-features-and-prognosis-of-patients-with-acute-non-specific-chest-pain-in-emergency-and-cardiology-departments-after-the-introduction-of-high-sensitivity-troponins-a-prospective-cohort-study
#10
Nivethitha Ilangkovan, Hans Mickley, Axel Diederichsen, Annmarie Lassen, Thomas L Sørensen, Hussam Mahmoud Sheta, Peter B Stæhr, Christian Backer Mogensen
OBJECTIVES: To determine the incidence of clinical, cardiac-related endpoints and mortality among patients presenting to an emergency or cardiology department with non-specific chest pain (NSCP), and who receive testing with a high-sensitivity troponin. A second objective was to identify risk factors for the above-noted endpoints during 12 months of follow-up. DESIGN: A prospective multicentre study. SETTING: Emergency and cardiology departments in Southern Denmark...
December 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29248654/value-of-myocardial-perfusion-assessment-with-coronary-computed-tomography-angiography-in-patients-with-recent-acute-onset-chest-pain
#11
Mathias H Sørgaard, Jesper J Linde, J Tobias Kühl, Henning Kelbæk, Jens D Hove, Gitte G Fornitz, Tem B S Jørgensen, Merete Heitmann, Charlotte Kragelund, Thomas F Hansen, Jawdat Abdulla, Thomas Engstrøm, Jan S Jensen, Yaffah T Wiegandt, Dan E Høfsten, Lars V Køber, Klaus F Kofoed
OBJECTIVES: The authors sought to perform a randomized controlled trial to evaluate the clinical efficacy of combined examination with coronary computed tomography angiography (CTA) and computed tomography perfusion imaging (CTP) compared to coronary CTA alone. BACKGROUND: Stress myocardial CTP may increase diagnostic specificity when added to coronary CTA in patients suspected of having ischemic heart disease. METHODS: Patients recently hospitalized for acute-onset chest pain, in whom acute coronary syndrome had been ruled out by normal electrocardiograms, normal troponin levels, and relief of symptoms, and who had a clinical indication for outpatient noninvasive testing, were screened for inclusion in the CATCH-2 (CArdiac cT in the treatment of acute CHest pain 2) trial (NCT02014311)...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29239759/alternative-treatment-options-for-atrioventricular-nodal-reentry-tachycardia-an-emergency-medicine-review
#12
Sarah Brubaker, Brit Long, Alex Koyfman
BACKGROUND: Atrioventricular-nodal-reentry tachycardia (AVNRT) is a form of supraventricular tachycardia (SVT) that is relatively common in the emergency department (ED). It is rarely indicative of underlying electrical or structural pathology. OBJECTIVE: This review evaluates the literature and controversies concerning treatment of AVNRT in the ED. DISCUSSION: For treatment of narrow-complex tachycardia, Advanced Cardiovascular Life Support guidelines recommend the use of vagal maneuvers, followed by adenosine...
November 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29184613/gender-differences-among-patients-with-acute-coronary-syndrome-in-the-middle-east
#13
Aliah Ali Khesroh, Faisal Al-Roumi, Ibrahim Al-Zakwani, Sreeja Attur, Wafa Rashed, Mohammad Zubaid
Background: There is controversy regarding the relationship between gender and acute coronary syndrome (ACS). Objective: To study the impact of gender on presentation, management, and mortality among patients with ACS in the Middle East. Methodology: From January 2012 to January 2013, 4057 patients with ACS were enrolled from four Arabian Gulf countries (Kuwait, Oman, United Arab Emirates, and Qatar), representing more than 85% of the general hospitals in each of the participating countries...
July 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29179592/elevated-plasma-procalcitonin-level-predicts-poor-prognosis-of-st-elevation-myocardial-infarction-in-asian-elderly
#14
Junru Dai, Bangbo Xia, Xiaomiao Wu
Previous studies have focused on relationship between plasma procalcitonin level and myocardial infarction risk, but this relationship in Asian elderly has not been investigated. The aim of this study was to reveal the association of peripheral procalcitonin concentration (both immediate and average levels) with myocardial infarction prognosis in Asian elderly. A total of 400 ST-elevation myocardial infarction patients, 400 unstable angina patients and 400 controls were included. Plasma levels of high-sensitivity C-reactive protein and procalcitonin were measured using commercially available kits...
November 27, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29135620/safety-of-a-1-hour-rule-out-high-sensitive-troponin-t-protocol-in-patients-with-chest-pain-at-the-emergency-department
#15
E Röttger, S de Vries-Spithoven, J B Reitsma, A Limburg, C E E van Ofwegen-Hanekamp, A W Hoes, J M Poldervaart
BACKGROUND: The 1-hour rule-out high-sensitive cardiac troponin T protocol (hs-cTnT), in which a serial troponin measurement is performed 1 hour after the first to assess the possibility of acute coronary syndrome (ACS), has been implemented in the European guidelines in 2015. Our aim was to assess the safety of this protocol in low-risk patients in the Emergency Department (ED) when implemented in daily practice. METHODS: Patients with acute chest pain presenting to the ED of our hospital and younger than 75 years were included (May 2013 to October 2014, The Netherlands)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29123840/a-system-of-delivering-medical-staff-members-by-helicopter-to-manage-severely-wounded-patients-in-an-area-where-medical-resources-are-limited
#16
Kohei Ishikawa, Kazuhiko Omori, Hiromichi Ohsaka, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Mutsumi Sakurada, Atsuhiko Mogami, Youichi Yanagawa
Aim: We review the case of a severely injured patient to evaluate the system of delivering medical staff by helicopter in areas with limited medical resources. Methods: The patient's chart was reviewed, summarized, and presented. Results: A 22-year-old woman attempted a suicidal fall after using a knife to stab herself. She was transported to a local hospital. A radiological study revealed fractures to the patient's face and the base of her skull, pneumocephalus, traumatic subarachnoid hemorrhage, stab wounds to the neck and chest, pneumothorax, unstable pelvic fracture, and right femoral shaft fracture...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29058975/true-congenital-atresia-of-the-left-main-coronary-ostium-delayed-presentation
#17
Varadaraju Raju, Ramesh Chandrashekar Hebbale, Chandra Sena Muniswamy, Umesh Sivanna, Sunil Kumar Kondethimmanahally Rangaiah
Congenital atresia of the left main coronary ostium is a rare coronary anomaly presenting in adulthood. A 48-year-old man presented with unstable angina. Coronary angiography showed an absent left coronary ostium with a super-dominant right coronary artery retrogradely filling the left system. Computed tomography-angiography with 3-dimensional reconstruction confirmed the absence of the left main coronary artery. In view of ongoing chest pain, the patient was offered coronary artery bypass surgery. Total arterial revascularization was performed with a left internal mammary artery-left radial artery Y-graft...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29054186/isolated-coronary-artery-ectasia-clinical-angiographic-and-follow-up-characteristics
#18
Amit Malviya, Pravin K Jha, Animesh Mishra
BACKGROUND: Isolated Coronary artery ectasia (CAE) is considered an uncommon angiographic finding with varying patterns of presentation and carries significant morbidity burden to the patient. Our objective was to evaluate the prevalence of this condition, to analyse its clinical, angiographic, and follow up characteristics. PATIENTS AND METHODS: Coronary angiography was performed in 4950 patients from January 2009 to August 2014. The epidemiological, clinical, angiographic, and follow up characteristics of 52 patients with isolated CAE were examined...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29046004/-coronary-computed-tomography-angiography-in-patients-with-stable-coronary-artery-disease
#19
Helen Ullrich, Tommaso Gori
The guidelines on the management of stable coronary artery disease (SCAD) recommend the use of coronary computed tomography angiography (CTA) in the process of diagnosing coronary artery disease in patients with low intermediate pre-test probability for SCAD. Particularly in cases where stress electrocardiogram or stress imaging provides unclear results, a computed tomographic examination can be considered as a reliable alternative to invasive coronary angiography. Due to its high negative predictive value, coronary CTA can provide accurate information on the presence of coronary artery stenosis and thus coronary artery disease can be reliably excluded without the risks associated with invasive procedures...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29037517/comparative-studies-of-different-types-of-osteosynthesis-on-the-human-corpse-preparation-in-bilateral-antero-lateral-flail-chest
#20
Sina Grupp, Veronika Fürst, Thomas Buder, Alexander Fichte, Sebastian Krinner, Roman T Carbon, Friedrich F Hennig, Andreas Langenbach, Stefan Schulz-Drost
INTRODUCTION: Bilateral flail chest injuries are challenging in treatment and comparatively often require an operative stabilization of the anterior chest wall to re-establish normal physiological conditions of the chest wall in shape and statics. Various procedures have been described which are technically sophisticated for the surgeon. Consequently there is an increasing interest in potentials of operative care and their effectiveness on the anterolateral chest wall. MATERIALS AND METHODS: 12 Human cadavers were prepared and the natural Sternum Position (NP) was marked...
October 9, 2017: Injury
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