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https://www.readbyqxmd.com/read/28087547/risk-of-pneumonia-in-patients-with-isolated-minor-rib-fractures-a-nationwide-cohort-study
#1
Sai-Wai Ho, Ying-Hock Teng, Shun-Fa Yang, Han-Wei Yeh, Yu-Hsun Wang, Ming-Chih Chou, Chao-Bin Yeh
OBJECTIVES: Isolated minor rib fractures (IMRFs) after blunt chest traumas are commonly observed in emergency departments. However, the relationship between IMRFs and subsequent pneumonia remains controversial. This nationwide cohort study investigated the association between IMRFs and the risk of pneumonia in patients with blunt chest traumas. DESIGN: Nationwide population-based cohort study. SETTING: Patients with IMRFs were identified between 2010 and 2011 from the Taiwan National Health Insurance Research Database...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28079832/usefulness-of-low-dose-chest-ct-for-initial-evaluation-of-blunt-chest-trauma
#2
Sung Jung Kim, Anjali Basnyat Bista, Young Gi Min, Eun Young Kim, Kyung Joo Park, Doo Kyoung Kang, Joo Sung Sun
We aimed to compare the diagnostic performance and inter-observer consistency between low dose chest CT (LDCT) and standard dose chest CT (SDCT) in the patients with blunt chest trauma.A total of 69 patients who met criteria indicative of blunt chest trauma (77% of male; age range, 16-85) were enrolled. All patients underwent LDCT without intravenous (IV) contrast and SDCT with IV contrast using parameters as following: LDCT, 40 mAs with automatic tube current modulation (ATCM) and 100 kVp (BMI <25, n = 51) or 120 kVp (BMI>25, n = 18); SDCT, 180 mAs with ATCM and 120 kVp...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#3
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28062098/midshaft-clavicle-fractures-with-associated-ipsilateral-acromioclavicular-joint-dislocations-incidence-and-risk-factors
#4
Christina Ottomeyer, Benjamin C Taylor, Mark Isaacson, Lara Martinez, Pierce Ebaugh, Bruce G French
INTRODUCTION: Simultaneous ipsilateral clavicle and acromioclavicular (AC) joint injury have been infrequently reported in the literature at this time. The purpose of this study was to assess incidence as well as assess risk factors for this dual injury pattern. METHODS: We performed a retrospective review of a prospectively collected database (Level III evidence), evaluating 383 adult patients without previous shoulder girdle injury or trauma with a minimum 1-year follow-up who sustained a displaced diaphyseal clavicle fracture...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28061502/brain-abscesses-associated-with-asymptomatic-pulmonary-arteriovenous-fistulas
#5
Taek-Kyun Nam, Yong-Sook Park, Jeong-Taik Kwon
Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28052158/factors-associated-with-nontransfer-in-trauma-patients-meeting-american-college-of-surgeons-criteria-for-transfer-at-nontertiary-centers
#6
Quanhong Zhou, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
Importance: Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. Objective: To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. Design, Setting, and Participants: A retrospective cohort study was performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28041756/trauma-induced-acute-myocardial-infarction-due-to-delayed-dissection-of-the-left-anterior-descending-coronary-artery
#7
Magdalena Wilczynska-Golonka, Pawel Rostoff, Aleksander Siniarski, Agnieszka Skrzypek, Andrzej Gackowski, Ewa Konduracka, Jadwiga Nessler
Acute myocardial infarction is a very rare, life-threatening complication of blunt chest trauma. A 27-year-old man with no previous medical history was admitted to the emergency department due to multiple trauma following a car accident. After 48h following the accident, the patient's condition rapidly deteriorated, with severe dyspnea at rest, tachycardia, and increasing chest pain. A 12-lead ECG showed a sinus tachycardia at 120bpm with significant ST-segment elevation in leads V1 to V5, pathologic Q wave in I, aVL, and QS complex in leads V1 to V4...
December 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#8
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28030506/rib-fracture-fixation-in-the-65-year-and-older-population-a-paradigm-shift-in-management-strategy-at-a-level-i-trauma-center
#9
Michael T Fitzgerald, DennisW Ashley, Hesham Abukhdeir, D Benjamin Christie
BACKGROUND: Rib fractures after chest wall trauma are a common injury, however carry a significant morbidity and mortality risk. The impact of rib fractures in the ≥ 65yo patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients ≥ 65yo receiving rib plating have decreased mortality, complication rates, and an accelerated return to normal functional states when compared to controls. METHODS: With IRB approval, a retrospective review analyzed patients ≥ 65yo with rib fractures admitted from 2009-2015 receiving rib plating(RP group)(n=23) compared to non-operative, injury-matched controls admitted from 2003-2008(NO group)(n=50)...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#10
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030491/severe-injuries-associated-with-skiing-and-snowboarding-a-national-trauma-data-bank-study
#11
Amory de Roulet, Kenji Inaba, Aaron Strumwasser, Konstantinos Chouliaras, Demetrios Demetriades
BACKGROUND: Injuries following skiing and snowboarding accidents lead to an estimated 7,000 hospital admissions annually and present a significant burden to the health care system. The epidemiology, injury patterns, hospital resource utilization, and outcomes associated with these severe injuries need further characterization. METHODS: The National Trauma Data Bank was queried for the period 2007-2014 for admissions with injury severity score (ISS) >15 and ICD-9 codes 885...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28028415/scapular-fractures-in-blunt-chest-trauma-self-experience-study
#12
Tabet A Al-Sadek, Desislav Niklev, Ahmed Al-Sadek, Lina Al-Sadek
AIM: The aim of this retrospective study was to report the scapular fractures in patients with blunt chest trauma and to present the type and the frequency of associated thoracic injuries. MATERIAL AND METHODS: Nine patients with fractures of the scapula were included in the study. The mechanisms of the injury, the type of scapular fractures and associated thoracic injuries were analysed. RESULTS: Scapular fractures were caused by high-energy blunt chest trauma...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28027723/selective-packing-for-uncontrollable-traumatic-thoracic-wall-bleeding-preserving-cardiopulmonary-function
#13
David Pérez-Alonso, Norberto Santana-Rodríguez, José Ramón Cano, Adil Ayub, Wissam Raad, Khalid Alshehri, César Calderón-Murgas, Francisco Hernández, Gara Torrent, Faiz Y Bhora
BACKGROUND: Uncontrollable chest wall bleeding secondary to thoracic trauma has been a challenging problem faced by surgeons. Thoracic packing has been described as a good alternative although most thoracic surgeons avoid it because of the potential deleterious effects on cardiopulmonary function. METHODS: We describe a selective gauze packing technique of the thoracic wall preserving cardiopulmonary function in 3 patients with uncontrollable bleeding, where gauze packs were placed on bleeding areas holding them in a "sandwich-like" arrangement between the skin and the pleura and tightly fixed with coated wire stitches using internal and external-thoracic Ventrofil® devices...
December 21, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28018814/spontaneous-rupture-of-a-mediastinal-bronchial-artery-aneurysm-induced-by-anticoagulant-agent
#14
Zhimin Wang, Chenghua Xu, Xiaoxiao Ding, Jinying Chen, Huaping Xin
Nontraumatic spontaneous rupture of a bronchial artery aneurysm is rarely seen. In this report, we described such a phenomenon in a patient induced by usage of anticoagulant agent. The patient had no antecedent history of trauma, hypertension, or apparent aortic pathology. The patient who had been taking low-molecular-weight heparin and warfarin to treat deep vein thrombosis complained of a sudden upper abdomen pain with shortness of breath and hypoxemia. The patient was diagnosed and treated for an acute hemomediastinum caused by a ruptured bronchial artery aneurysm...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28003829/cardiac-arrest-as-a-consequence-of-air-embolism-a-case-report-and-literature-review
#15
Zia Ur Rahman, Ghulam Murtaza, Mohsin Pourmorteza, Wael K El Minaoui, Pooja Sethi, Peyman Mamdouhi, Timir Paul
Air embolism is an infrequent but potentially catastrophic complication. It could be a complication of invasive procedures including surgery, central line placement, positive pressure ventilation, trauma, hemodialysis, pacemaker placement, cardiac ablation, and decompression sickness. Usually, it does not cause any hemodynamic complication. In rare cases, it could lodge in the heart and cause cardiac arrest. We present a case of an 82-year-old white female who underwent computed tomography (CT) guided biopsy of right lung pulmonary nodule...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/28000769/characterization-of-blunt-chest-trauma-in-a-long-term-porcine-model-of-severe-multiple-trauma
#16
K Horst, T P Simon, R Pfeifer, M Teuben, K Almahmoud, Q Zhi, S Aguiar Santos, C Castelar Wembers, S Leonhardt, N Heussen, P Störmann, B Auner, B Relja, I Marzi, A T Haug, M van Griensven, M Kalbitz, M Huber-Lang, R Tolba, L K Reiss, S Uhlig, G Marx, H C Pape, F Hildebrand
Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock)...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27998635/predictors-of-intrathoracic-injury-after-blunt-torso-trauma-in-children-presenting-to-an-emergency-department-as-trauma-activations
#17
Caitlin McNamara, Irina Mironova, Erik Lehman, Robert P Olympia
BACKGROUND: Thoracic injuries are a major cause of death associated with blunt trauma in children. Screening for injury with chest x-ray study, compared with chest computed tomography (CT) scan, has been controversial, weighing the benefits of specificity with the detriment of radiation exposure. OBJECTIVE: To identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27998316/decompressive-craniectomy-for-malignant-middle-cerebral-artery-infarction-in-a-16-year-old-boy-a-case-report
#18
Simon Lammy, Paul Fivey, Meharpal Sangra
BACKGROUND: Cryptogenic stroke frequently occurs in younger patients and has a high risk of recurrence. Consequently, secondary prevention is often suboptimal as there is no known risk factor to target. This case demonstrates an unexpected finding of middle cerebral artery infarction and extensive malignant transformation in a 16-year-old boy more than a day post-admission. The lack of a proven culprit lesion makes this case even more intriguing and subsequently raises questions of cryptogenic mechanisms in the context of unrelated trauma...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27994332/thoracotomy-for-traumatic-diaphragmatic-hernia
#19
Zhang Fangbiao, Zheng Chunhui, Zhao Chun, Shi Hongcan, Zhang Xiangyan, Tu Shaosong
The aim of this retrospective study is to review our experience in the diagnosis and role of thoracotomy for traumatic diaphragmatic hernia (TDH). Between January 2008 and June 2014, 23 patients from Yangzhou Medical College (Yangzhou China) and Lishui Center Hospital (Lishui China), who underwent thoracotomy for TDH, were analyzed. The clinical features, imaging findings, operative findings, and outcome of treatment in these patients are presented. There were 23 patients (18 males and 5 females) who underwent surgical procedures due to TDH...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27994306/a-rare-case-of-hamartoma-chest-wall-following-trauma-in-a-42-year-old-man
#20
Mojtaba Ahmadinejad, Asghar Alie Pour, Peyman Khadem Hosseini, Amir Masoud Hashemian, Koorosh Ahmadi
BACKGROUND: Chest wall mesenchymal hamartoma (CWH) is a distinct and extremely rare tumor-like lesion of the thorax. It usually presents in the neonatal period or in infancy. The common presentation is in the form of a visible chest wall mass with or without respiratory distress. CASE PRESENTATION: A 42-year-old man with a history of chest wall trauma since 5 years ago was admitted with a swelling of the anterior of the chest wall and during this period has grown slowly...
October 2016: Medical Archives
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