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https://www.readbyqxmd.com/read/28929041/severe-late-toxicity-after-adjuvant-breast-radiotherapy-in-a-patient-with-a-germline-ataxia-telangiectasia-mutated-gene-future-treatment-decisions
#1
Maryam Dosani, Kasmintan A Schrader, Alan Nichol, Sophie Sun, Tamara Shenkier, Zoe Lohn, Gudrun Aubertin, Scott Tyldesley
Ataxia telangiectasia mutated (ATM) gene mutations may confer increased sensitivity to ionizing radiation and increased risk of late toxicity for cancer patients. We present the case of a 55-year-old female treated with adjuvant breast and regional nodal radiation following lumpectomy and axillary lymph node dissection for stage II invasive ductal carcinoma of the breast. She developed severe telangiectasia, fibrosis, induration, chest wall pain (with evidence of rib fractures on imaging), and painful limitation in her range of motion at the shoulder...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#2
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28912975/an-incidentally-detected-right-ventricular-pseudoaneurysm
#3
Vamsi C Gaddipati, Angel I Martin, Mauricio O Valenzuela, Asef Mahmud, Aarti A Patel
Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28906368/traumatic-fractures-as-a-result-of-falls-in-children-and-adolescents-a-retrospective-observational-study
#4
Hongwei Wang, Hailong Yu, Yue Zhou, Changqing Li, Jun Liu, Lan Ou, Yiwen Zhao, Guoli Song, Jianda Han, Yu Chen, Liangbi Xiang
The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height <2 m). The incidence and pattern were summarized with respect to different age groups, year of admission, etiologies, genders, and the neurological function...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905100/frequency-and-influencing-factors-of-cardiopulmonary-resuscitation-related-injuries-during-implementation-of-the-american-heart-association-2010-guidelines-a-retrospective-study-based-on-autopsy-and-postmortem-computed-tomography
#5
Rutsuko Yamaguchi, Yohsuke Makino, Fumiko Chiba, Suguru Torimitsu, Daisuke Yajima, Go Inokuchi, Ayumi Motomura, Mari Hashimoto, Yumi Hoshioka, Tomohiro Shinozaki, Hirotaro Iwase
AIM: To determine the frequency of cardiopulmonary resuscitation (CPR)-related injuries and factors involved in their occurrence, data based on forensic autopsy and postmortem computed tomography (PMCT) during implementation of the 2010 American Heart Association Guidelines for CPR were studied. METHODS: We retrospectively evaluated data on adult patients with non-traumatic deaths who had undergone manual CPR and autopsy from January 2012 to December 2014. CPR-related injuries were analyzed on autopsy records and PMCT images and compared with results of previous studies...
September 13, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#6
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28894371/radiologic-findings-of-thoracic-trauma
#7
Cihan Akgul Ozmen, Serdar Onat, Delal Aycicek
INTRODUCTION: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. METHODS: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28882147/unexpected-collateral-impact-after-out-of-hospital-resuscitation-using-lucas-system
#8
Jasmin Hasmik Shahinian, Jonas Quitt, Mark Wiese, Friedrich Eckstein, Oliver Reuthebuch
BACKGROUND: Mechanical chest compression using a piston device during reanimation is often the only way to ensure stable chest compression at a constant rate and force. However, its use can be associated with severe fractures of the thoracic rib cage and endanger the clinical course of the patient. Thus, the usage of such a piston device during the reanimation has currently been classified as a mere Class IIB indication. CASE PRESENTATION: We present a case of a 66-year-old male who underwent emergent CABG surgery after receiving out-of-hospital resuscitation as a result of myocardial infarction using the LUCAS system...
September 7, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28870847/bundle-of-care-for-blunt-chest-trauma-patients-improves-analgesia-but-increases-rates-of-intensive-care-unit-admission-a-retrospective-case-control-study
#9
Cédric Carrie, Laurent Stecken, Elsa Cayrol, Vincent Cottenceau, Laurent Petit, Philippe Revel, Matthieu Biais, François Sztark
INTRODUCTION: This single-centre retrospective case-control study aimed to assess the effectiveness of a multidisciplinary clinical pathway for blunt chest trauma patients admitted in emergency department (ED). PATIENTS AND METHODS: All consecutive blunt chest trauma patients with more than 3 rib fractures and no indication of mechanical ventilation were compared to a retrospective cohort over two 24-month periods, before and after the introduction of the bundle of care...
September 1, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28861425/single-incision-video-assisted-thoracoscopic-evaluation-and-emergent-surgery-for-severe-lung-and-chest-wall-injury-after-thoracic-trauma-in-a-water-park
#10
Julio Sesma, Melodie Alvarez, Francisco Lirio, Carlos Galvez, Maria Galiana, Benno Baschwitz, Francisca Fornes, Sergio Bolufer
Thoracic trauma is a challenging situation with potential severe chest wall and intrathoracic organ injuries. We present a case of emergent surgery in a 23-year-old man with hemorrhagic shock due to massive lung and chest wall injury after thoracic trauma in a water slide. We performed a SI-VATS approach in order to define intrathoracic and chest wall injuries, and once checked the extension of the chest wall injury, we added a middle size thoracotomy just over the affected area in order to stabilize rib fractures with Judet plates, that had caused massive laceration in left lower lobe (LLL) and injured the pericardium causing myocardical tear...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28855775/studying-morbidity-and-predicting-mortality-in-patients-with-blunt-chest-trauma-using-a-novel-clinical-score
#11
Priyadarshini Manay, Rajeev R Satoskar, V Karthik, Ram P Prajapati
BACKGROUND: A departmental audit in March 2015 revealed significant mortality rate of 40% in blunt chest trauma patients (much greater than the global 25%). A study was thus planned to study morbidity and predictors of mortality in blunt chest trauma patients admitted to our hospital. METHODS: This study was a prospective observational study of 139 patients with a history of blunt chest trauma between June 2015 and November 2015 after the Institutional Ethics Committee approval in April 2015...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28855492/multiple-pseudofractures-due-to-fanconi-s-syndrome-associated-with-wilson-s-disease
#12
Mai Tsuchiya, Ryusuke Takaki, Fumikazu Kobayashi, Takamura Nagasaka, Kazumasa Shindo, Yoshihisa Takiyama
We report a 40-year-old man who presented with multiple bone pseudofractures after about 20 years from the onset of Wilson's disease (WD). At age 36, he first noticed pain in his left shoulder. At age 39, he had multiple chest pain. On neurologic examinations, dysarthria and dysphagia due to pseudobulbar palsy, rigidity and tremor on right upper lim were observed. WD was confirmed because of low levels of plasma cupper and ceruloplasmin in addition to ATP7B gene mutation. The chest X-ray revealed multiple fractures of the several ribs...
August 31, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28852836/indications-for-surgical-stabilization-of-rib-fractures-in-patients-without-flail-chest-surveyed-opinions-of-members-of-the-chest-wall-injury-society
#13
Fredric M Pieracci, Suresh Agarwal, Andrew Doben, Adam Shiroff, Larwence Lottenberg, Sarah Ann Whitbeck, Thomas W White
PURPOSE: There are currently no evidence-based indications for surgical stabilization of rib fractures (SSRF) in patients without flail chest. The purpose of this survey was to identify patients for whom there is relative equipoise (operative vs. non-operative) in order to assist in designing a randomized clinical trial. METHODS: Members of the Chest Wall Injury Society were sent an online survey, in which 18 patient scenarios were presented. The baseline patient had ≥ three displaced, contiguous fractures and had no other contraindications for surgery...
August 29, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28852454/minimally-invasive-management-of-traumatic-lung-herniation
#14
Pablo Pérez Castro, Felipe Undurraga Machicao, Raimundo Santolaya Cohen, Raul Berrios Silva, Francisco Rivera
Post-traumatic pulmonary hernia can occur immediately after thoracic trauma or it may also appear months or even years after the onset. We report a case of a seventeen year-old male patient with thoracic blunt trauma secondary to high energy bicycle accident. Chest CT shows moderate hemothorax and pneumothorax, displaced fracture of the fifth left rib, and protusion of pulmonary tissue through a chest wall defect. In the Emergency Room the patient presents with chest pain (7/10 in Visual Analog Scale) and respiratory distress...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28812120/risk-adapted-robotic-stereotactic-body-radiation-therapy-for-inoperable-early-stage-non-small-cell-lung-cancer
#15
Susanne Temming, Martin Kocher, Erich Stoelben, Lars Hagmeyer, De-Hua Chang, Konrad Frank, Khosro Hekmat, Juergen Wolf, Wolfgang W Baus, Robert Semrau, Christian Baues, S Marnitz
PURPOSE: To evaluate efficacy and toxicity of stereotactic body radiation therapy (SBRT) with CyberKnife® (Accuray, Sunnyvale, CA, USA) in a selected cohort of primary, medically inoperable early-stage non-small cell lung cancer (NSCLC) patients. METHODS: From 2012 to 2016, 106 patients (median age 74 years, range 50-94 years) with primary NSCLC were treated with SBRT using CyberKnife®. Histologic confirmation was available in 87 patients (82%). For mediastinal staging, 92 patients (87%) underwent (18)F-fluorodeoxyglucose positron-emission tomography (18-FDG-PET) and/or endobronchial ultrasound (EBUS)-guided lymph node biopsy or mediastinoscopy...
August 15, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#16
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(®)), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28805782/-blunt-chest-trauma-possibilities-to-stabilize-multiple-and-floating-ribs-fractures
#17
A S Benyan
AIM: To improve surgical treatment of patients with multiple and flotating ribs fractures. MATERIAL AND METHODS: A comparative analysis of two groups of victims with rib fractures was carried out. 148 patients of the control group underwent conservative treatment, mechanical ventilation, skeletal traction. In 167 patients of the main group we used advanced surgical tactics based on differentiated, stepwise and combined chest stabilization including osteosynthesis of ribs and thoracoscopy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28797311/risk-factors-for-adverse-outcomes-in-older-adults-with-blunt-chest-trauma-a-systematic-review
#18
Jake Sawa, Robert S Green, Brent Thoma, Mete Erdogan, Philip J Davis
OBJECTIVES: The objective of this study was to systematically review the published literature for risk factors associated with adverse outcomes in older adults sustaining blunt chest trauma. METHODS: EMBASE and MEDLINE were searched from inception until March 2017 for prognostic factors associated with adverse outcomes in older adults sustaining blunt chest trauma using a pre-specified search strategy. References were independently screened for inclusion by two reviewers...
August 11, 2017: CJEM
https://www.readbyqxmd.com/read/28795675/-clinical-application-of-abdominal-lifting-and-compression-cardiopulmonary-resuscitation-method-for-treatment-of-patients-with-cardiac-arrest
#19
Haishan Li, Liu Ji, Jingjing Wang
OBJECTIVE: To investigate the clinical application of rhythmic abdominal lifting and compression cardiopulmonary resuscitation (ALC-CPR) in cardiac arrest (CA) patients with conventional cardiopulmonary resuscitation (CPR) contraindication (chest rib fracture, chest trauma, etc.). METHODS: The clinical data of patients with CA in emergency department of Hefei Second People's Hospital from June 2015 to December 2016 were analyzed retrospectively, and the patients with weights 40-150 kg and CA≤20 minutes, and resuscitated with ALC-CPR were selected...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795026/rib-fractures-to-fix-or-not-to-fix-an-evidence-based-algorithm
#20
REVIEW
Michael Bemelman, M W de Kruijf, Mark van Baal, Luke Leenen
Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
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