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https://www.readbyqxmd.com/read/28728716/thoracic-trauma-injuries-evaluation-and-treatment
#1
REVIEW
Joseph J Platz, Loic Fabricant, Mitch Norotsky
Thoracic injury is common in high-energy and low-energy trauma, and is associated with significant morbidity and mortality. Evaluation requires a systematic approach prioritizing airway, respiration, and circulation. Chest injuries have the potential to progress rapidly and require prompt procedural intervention. For the diagnosis of nonemergent injuries, a careful secondary survey is essential. Although medicine and trauma management have evolved throughout the decades, the basics of thoracic trauma care have remained the same...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28726014/a-study-of-the-therapeutic-effects-of-resveratrol-on-blunt-chest-trauma-induced-acute-lung-injury-in-rats-and-the-potential-role-of-endocan-as-a-biomarker-of-inflammation
#2
Aysun Caglar Torun, Serife Tutuncu, Burcu Ustun, Hızır Ufuk Akdemir
The present study focused on the therapeutic effects of resveratrol in a rat model of blunt chest trauma-induced acute lung injury and the potential role of endocan as a biomarker of inflammation. They were randomly divided into the following four groups (n = 7 in each group): control group (no treatment or trauma); trauma group (trauma-induced group); resveratrol group (resveratrol [0.3 mg/kg] administered via the i.p. route group); and resveratrol + trauma group (resveratrol [0.3 mg/kg] administered via the i...
July 19, 2017: Inflammation
https://www.readbyqxmd.com/read/28719089/development-and-implementation-of-an-emergency-department-telephone-follow-up-system
#3
O John Ma, Mary Tanski, Beech Burns, Elizabeth F Spizman, James A Heilman
Implementing a telephone follow-up system after a patient's emergency department (ED) visit is challenging, but it may improve patient safety and care. This study's objective was to describe the development and implementation of a comprehensive ED telephone follow-up system over a 9-year period. Discharged patients who received a follow-up telephone call within 48 hours of their ED visit included all pediatric patients, those who left without being seen by a provider, and any adult patient with a "high-risk chief complaint," which was defined as a headache, visual problem, chest pain, dyspnea, abdominal pain, syncope, trauma, and neurological-related problems...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28718249/frequency-of-undiagnosed-chronic-obstructive-pulmonary-disease-in-patients-with-coronary-artery-disease
#4
Raza Ullah, Shahid Salam, Tahir Ghaffar, Rahim Muhammad, Imran Khan
BACKGROUND: Chronic obstructive airway disease (COPD) is considered as risk factor for coronary artery disease (CAD) along with other risk factors. This study was conducted to determine the frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease. METHODS: This cross-sectional study was conducted in the Pulmonology and Cardiology wards/OPD's of Khyber Teaching Hospital Peshawar. Patients more than 35 years of age, diagnosed with CAD of either gender were included...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717905/analysis-of-injury-and-mortality-patterns-in-deceased-patients-with-road-traffic-injuries-an-autopsy-study
#5
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#6
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716296/clinical-and-radiologic-predictive-factors-of-rib-fractures-in-outpatients-with-chest-pain
#7
REVIEW
Liang Zhang, Colm J McMahon, Samir Shah, Jim S Wu, Ronald L Eisenberg, Justin W Kung
PURPOSE: To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. METHOD AND MATERIALS: Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting...
May 30, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28715125/acute-alcohol-binge-deteriorates-metabolic-and-respiratory-compensation-capability-after-blunt-chest-trauma-followed-by-hemorrhagic-shock-a-new-research-model
#8
Nils Wagner, Niklas Franz, Scott Dieteren, Mario Perl, Katharina Mörs, Ingo Marzi, Borna Relja
BACKGROUND AND PURPOSE: The clinical relevance of blunt (thoracic) chest trauma (TxT) and hemorrhagic shock is indisputable due to the high prevalence of this injury type, as well as its close association with mortality and/or preventable deaths. Furthermore, there is an ongoing discussion about the influence of alcohol in trauma patients. Thus, we established a model of TxT followed by hemorrhagic shock and resuscitation (H/R) in alcohol-intoxicated rats. EXPERIMENTAL APPROACH: Depending on group allocation, twelve (sub-acute) or two (acute) hours before experimentation, the animals received a single oral dose of alcohol (ethanol, EtOH) or saline (NaCl) followed by TxT, hemorrhagic shock (35 ± 3 mm Hg) and resuscitation (TxT+H/R)...
July 17, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28712882/perfusion-of-muscle-flaps-independent-of-the-anatomical-vascular-pedicle-pedicle-autonomy
#9
K Bradshaw, M Wagels
INTRODUCTION: Free muscle flaps are being used more commonly for complex lower limb reconstruction. Up to 33% of flaps used to reconstruct lower limb trauma will require an orthopaedic procedure after reconstruction. To date there have been only case reports detailing the variable survival of muscle flaps after actual or simulated pedicle injury and the process and timeframe of neovascularisation remains undefined. We aim to show that perfusion of a muscle flap is possible after injury to its anatomical vascular pedicle...
June 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28700410/quantifying-and-exploring-the-recent-national-increase-in-surgical-stabilization-of-rib-fractures
#10
Erica Kane, Elan Jeremitsky, Fredric M Pieracci, Sarah Majercik, Andrew R Doben
INTRODUCTION: Surgical Stabilization of Rib Fractures (SSRF) has become pivotal in the management of severe chest injuries. Recent literature supports improved outcomes and mortality in severe fracture and flail chest patients who undergo SSRF compared to non-operative management (NOM). A 2014 National Trauma Data Bank (NTDB) review provided a point prevalence of 0.7% SSRF in flail patients. We hypothesize that this prevalence is increasing and that temporal, regional, and American College of Surgeons (ACS) trauma designation vary in SSRF utilization...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28699390/randomized-controlled-trial-of-chest-tube-removal-aided-by-a-party-balloon
#11
Puwadon Thitivaraporn, Natawat Narueponjirakul, Pasurachate Samorn, Supparerk Prichayudh, Sukanya Sriussadaporn, Rattaplee Pak-Art, Suvit Sriussadaporn, Kritaya Kritayakirana
Background Recurrent pneumothorax is one of the most common complications after thoracostomy tube removal. The purpose of this study was to assess the optimal method of thoracostomy tube removal by comparing party balloon-assisted Valsalva and classic Valsalva techniques. Methods Trauma patients with indications for tube thoracostomy from 2014 to 2015 were recruited. Exclusion criteria were age < 15- or > 64-years-old, history of chronic lung disease, Glasgow Coma Scale < 13, latex allergy, or tracheostomy...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#12
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire Oâ Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28687342/comparison-of-ultrasonography-and-radiography-in-diagnosis-of-rib-fractures
#13
Elham Pishbin, Koorosh Ahmadi, Molood Foogardi, Maryam Salehi, Farrokh Seilanian Toosi, Vafa Rahimi-Movaghar
PURPOSE: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. METHODS: In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography...
May 26, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28685017/traumatic-diaphragmatic-rupture-with-underlying-lung-laceration-and-tension-pneumoperitoneum
#14
Zexi Allan, Calvin Peng, Raaj Chandra
Tension pneumoperitoneum is commonly caused by gastrointestinal perforation and pulmonary causes are extremely rare. We present a case of a 47-year-old male post motor vehicle accident with a suspected left-sided haemopneumothorax on initial chest x-ray. CT of the chest post chest tube insertion showed a left-sided diaphragmatic rupture and an extensive diaphragmatic hernia. While en-route to the operating theatre, the intubated patient developed tension pneumoperitoneum with positive pressure ventilation and required immediate surgical intervention and repair...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28681368/a-case-of-incarcerated-and-perforated-stomach-in-delayed-traumatic-diaphragmatic-hernia
#15
Shinjiro Wakai, Hiroyuki Otsuka, Hiromichi Aoki, Takeshi Yamagiwa, Yoshihide Nakagawa, Sadaki Inokuchi
The patient was an emergency transported, 57-year-old man complaining of left thoraco-lateroabdominal pain, with a history of blunt chest trauma 3 months prior. Thoracoabdominal computed tomography (CT) resulted in a diagnosis of diaphragmatic hernia with incarceration and perforation of the stomach, and same-day emergency surgery was performed. The surgery was performed via an abdominal approach, and after manually repositioning the stomach incarceration, the perforated region was resected and the diaphragm sutured closed...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#16
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28673640/small-tube-thoracostomy-20-22-fr-in-emergent-management-of-chest-trauma
#17
Shinsuke Tanizaki, Shigenobu Maeda, Makoto Sera, Hideya Nagai, Minoru Hayashi, Hiroyuki Azuma, Ken-Ichi Kano, Hiroki Watanabe, Hiroshi Ishida
BACKGROUND: The optimal tube size for an emergent thoracostomy for traumatic pneumothorax or hemothorax is unknown. Both small catheter tube thoracostomy and large-bore chest tube thoracostomy have been shown to work for the nonemergent management of patients with traumatic pneumothorax or hemothorax. This study was conducted to compare the efficacy of a small chest tube with that of a large tube in emergent thoracostomy due to chest trauma. Our hypothesis was that there would be no difference in clinical outcomes including tube-related complications, the need for additional tube placement, and thoracotomy, with the replacement of large tubes with small tubes...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28673353/anatomical-landmarks-for-safely-implementing-resuscitative-balloon-occlusion-of-the-aorta-reboa-in-zone-1-without-fluoroscopy
#18
Yohei Okada, Hiromichi Narumiya, Wataru Ishi, Ryoji Iiduka
BACKGROUND: Resuscitative balloon occlusion of the aorta (REBOA) can maintain hemodynamic stability during hemorrhagic shock after a following torso injury, although inappropriate balloon placement may induce brain or visceral organ ischemia. External anatomical landmarks [the suprasternal notch (SSN) and xiphoid process (Xi)] are empirically used to implement REBOA in zone 1. We aimed to confirm if these landmarks were useful for determining a balloon catheter length for safe implementation of REBOA in zone 1 without using fluoroscopy...
July 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28673321/open-chest-versus-closed-chest-cardiopulmonary-resuscitation-in-blunt-trauma-analysis-of-a-nationwide-trauma-registry
#19
Akira Endo, Atsushi Shiraishi, Yasuhiro Otomo, Makoto Tomita, Hiroki Matsui, Kiyoshi Murata
BACKGROUND: Although open-chest cardiopulmonary resuscitation (OCCPR) is often considered as the last salvage maneuver in critically injured patients, evidence on the effectiveness of OCCPR has been based only on the descriptive studies of limited numbers of cases or expert opinions. This study aimed to compare the effectiveness of OCCPR with that of closed-chest cardiopulmonary resuscitation (CCCPR) in an emergency department (ED). METHODS: A nationwide registry-based, retrospective cohort study was conducted...
July 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28671152/effect-of-analgesia-on-the-changes-in-respiratory-parameters-in-blunt-chest-injury-with-multiple-rib-fractures
#20
Eyo Effiong Ekpe, Catherine Eyo
BACKGROUND: Blunt chest injury with multiple rib fractures can result in such complications as pneumonia, atelectasis, bronchiectasis, empyema thoracis, acute respiratory distress syndrome, and prolonged Intensive Care Unit and hospital stay, with its concomitant mortality. These may be prevented or reduced by good analgesic therapy which is the subject of this study. METHODS: This was a prospective study of effects of analgesia on changes in pulmonary functions of patients with traumatic multiple rib fractures resulting from blunt chest injury...
July 2017: Annals of African Medicine
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