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https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#1
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29332925/pulmonary-artery-pseudoaneurysm-secondary-to-lung-inf-lammation
#2
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
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
#3
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/29326049/quantitative-ct-assessment-of-gynecomastia-in-the-general-population-and-in-dialysis-cirrhotic-and-obese-patients
#4
Eyal Klang, Nayroz Kanana, Alon Grossman, Steve Raskin, Jana Pikovsky, Miri Sklair, Lior Heller, Shelly Soffer, Edith M Marom, Eli Konen, Marianne Michal Amitai
RATIONALE AND OBJECTIVES: Gynecomastia is the benign enlargement of the male breast because of proliferation of the glandular component. To date, there is no radiological definition of gynecomastia and no quantitative evaluation of breast glandular tissues in the general male population. The aims of this study were to supply radiological-based measurements of breast glandular tissue in the general male population, to quantitatively assess the prevalence of gynecomastia according to age by decades, and to evaluate associations between gynecomastia and obesity, cirrhosis, and dialysis...
January 8, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29322585/scapular-fractures-in-the-pan-scan-era
#5
Cortlyn Brown, Karim Elmobdy, Ali S Raja, Robert M Rodriguez
BACKGROUND: Scapular fractures have been traditionally taught to be associated with significant injuries and major morbidity. As we demonstrated with sternal fracture, pulmonary contusion and rib fracture, increased chest CT utilization and head-to-pelvis CT (pan-scan) protocols in blunt trauma evaluation, however, may diagnose minor, clinically irrelevant scapular fractures, possibly rendering previous teachings obsolete. OBJECTIVES: To determine the 1) percentages of scapular fractures seen on chest CT only (SOCTO) versus seen on both CXR and CT and of isolated scapular fracture (scapular fracture without other thoracic injuries), 2) frequencies of associated thoracic injury with scapular fracture, and 3) proportion of patients admitted, mortality, hospital length of stay, and injury severity scores (ISS), comparing four patient groups: scapular fracture, non-scapular fracture, scapular fracture SOCTO, and isolated scapular fracture...
January 11, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29319833/spontan-pneumomediastinum-ovanlig-orsak-till-akut-br%C3%A3-stsm%C3%A3-rta
#6
Carl Wengse, Gustav Bolinder, Emil Aman
A previously healthy 21-year old man presented to the emergency department with sudden onset central chest pain exacerbated by breathing. A plain chest X-ray showed air within the mediastinum and pericardium confirmed by a CT scan with contrast. The patient history did not raise suspicion of any concomitant disease and the diagnosis of spontaneous pneumomediastinum with pneumopericardium was made. The patient recovered completely over the next few days with bed rest and analgesics. Spontaneous pneumomediastinum is an uncommon disease caused by rupture of perivascular alveoli causing air leakage to the mediastinum...
January 9, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29310701/severe-thoracic-trauma-still-an-independent-predictor-for-death-in-multiple-injured-patients
#7
Michael Grubmüller, Maximilian Kerschbaum, Eva Diepold, Katharina Angerpointner, Michael Nerlich, Antonio Ernstberger
BACKGROUND: Over the past, the severe thoracic trauma has had decisive influence on the outcome of multiple injured patients. Today, new therapies (e.g. extracorporeal membrane oxygenation (ECMO), protective ventilation methods and new forms of patient positioning) are available and applied regularly. What impact on the patient's outcome does the thoracic trauma have today? METHODS: Prospective data collection of multiple injured patients in a level-I trauma center was performed between 2008 and 2014...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency 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/29307927/tomographic-aspects-of-penetrating-thoracic-trauma-injuries-from-firearms-and-other-weapons
#9
Alessandro Severo Alves de Melo, Luiza Beatriz Melo Moreira, Fernanda Miraldi Clemente Pessoa, Nara Saint-Martin, Roger Ancilotti Filho, Arthur Soares Souza, Edson Marchiori
Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2...
November 2017: Radiologia Brasileira
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
#10
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
#11
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
#12
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/29303440/predictive-value-of-positive-high-sensitivity-troponin-t-in-intubated-traumatic-brain-injury-patients
#13
Ayman El-Menyar, Mohammad Asim, Rifat Latifi, Shrikant I Bangdiwala, Hassan Al-Thani
OBJECTIVE The clinical relevance of high-sensitivity troponin T (HsTnT) in trauma patients is not well explored. In this study, the authors aimed to study the predictive value of serum HsTnT in intubated patients who had sustained traumatic brain injury (TBI). METHODS A retrospective analysis was conducted for all intubated TBI patients between 2010 and 2014 at a national level 1 trauma center. Data were analyzed and compared based on the HsTnT status on admission (group 1, negative results; and group 2, positive results)...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29303132/surgical-decompression-for-traumatic-spinal-cord-injury-in-a-tertiary-center
#14
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/29301811/incidental-discovery-of-a-new-and-clinically-important-anatomic-variant-of-the-internal-thoracic-artery-in-a-young-male-trauma-patient
#15
Kirsteen R Burton, Noah Ditkofsky
The internal thoracic artery (ITA) is the largest thoracic wall artery and is clinically important primarily for use in coronary artery bypass grafting. A number of anatomic variants of the ITA have been reported; however, bilateral, aberrant lateral branches of the ITA never have. The importance of this finding lies in the positioning of the artery at a potential chest tube insertion site. Here, we report the identification, on CT scan, of this rare variation in a young male trauma patient.
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29298241/is-observation-for-traumatic-hemothorax-safe
#16
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/29289269/myocardial-infarction-secondary-to-blunt-chest-trauma
#17
Tariq S Marroush, Amreeta V Sharma, Louis D Saravolatz, Robert Takla, Howard S Rosman
Myocardial infarction (MI) following blunt chest trauma is rare, but potentially fatal. We treated a young patient for acute MI after falling chest-first on ice while playing hockey. Coronary artery bypass grafting (CABG) was performed after percutaneous stenting attempts were unsuccessful. By reviewing the related literature, we found 179 cases, the majority of which affected young males following road accidents. Left anterior descending artery was most frequently affected followed by right coronary artery particularly in their proximal thirds...
January 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29283957/early-tracheostomy-in-patients-with-traumatic-cervical-spinal-cord-injury-appears-safe-and-may-improve-outcomes
#18
Christopher Flanagan, Benjamin R Childs, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective case series OBJECTIVE.: To characterize outcomes associated with tracheostomy timing following traumatic cervical spinal cord injury (CSCI). SUMMARY OF BACKGROUND DATA: The morbidity associated with cervical spine trauma is substantially increased in the setting of concomitant CSCI. Despite recent evidence, it remains uncertain if early tracheostomy following traumatic CSCI can improve outcomes. METHODS: From January 1, 2007, to December 31, 2015, retrospective chart review identified seventy (70) patients who presented to a single Level 1 trauma center with traumatic CSCI and received tracheostomy for management of respiratory compromise...
December 27, 2017: Spine
https://www.readbyqxmd.com/read/29278540/a-case-of-fatal-cerebral-air-embolism-after-blunt-lung-trauma-postmortem-computed-tomography-and-autopsy-findings
#19
Isabella Mercurio, Daniele Capano, Riccardo Torre, Aldo Taddei, Gianmarco Troiano, Michele Scialpi, Mario Gabbrielli
Cerebral air embolism is caused by gas bubbles in the vascular system. These bubbles can cause cerebral ischemia by obstructing encephalic blood vessels. It is frequently associated with blunt and penetrating chest trauma as well as iatrogenic interventions. Lung trauma involving laceration of the respiratory tract, lung parenchyma, and blood vessels may result in direct communication of these structures, driving air or gas into the pulmonary venous system. We report a case of a blunt chest trauma that led to massive arterial air embolism that was possible to recognize with the help of postmortem computed tomographic scan examination...
December 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29261721/the-multistep-road-to-ventilator-associated-lung-abscess-a-retrospective-study-of-s-aureus-ventilator-associated-pneumonia
#20
Roman Mounier, David Lobo, Julia Voulgaropoulos, Mathieu Martin, Bouziane Aït-Mamar, Valérie Bitot, Paul-Henri Jost, Ron Birnbaum, Biba Nebbad, Fabrice Cook, Gilles Dhonneur
OBJECT: We observed some cases of lung abscess (LA) in ICU patients suffering S.aureus ventilator-associated pneumonia (S.aureus-VAP). We aimed to assess which of the host and/or bacteria-related features are associated with LA. METHODS: We conducted a retrospective study from January 2009 to July 2013 in a trauma surgical ICU within a teaching hospital. All adult patients presenting with S.aureus-VAP were included. We compared two groups of patients according to the formation or not of LA concomitantly to S...
2017: PloS One
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