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Rib fractures

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https://www.readbyqxmd.com/read/28525509/analgesic-choice-in-management-of-rib-fractures-paravertebral-block-or-epidural-analgesia
#1
Mahdi Malekpour, Ammar Hashmi, James Dove, Denise Torres, Jeffrey Wild
BACKGROUND: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). METHODS: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28523160/do-low-profile-implants-provide-reliable-stability-in-fixing-the-sternal-fractures-as-a-fourth-vertebral-column-in-sternovertebral-injuries
#2
Sebastian Krinner, Sina Grupp, Pascal Oppel, Andreas Langenbach, Friedrich F Hennig, Stefan Schulz-Drost
BACKGROUND: Flexion and compression forces to the trunk can cause severe instability of the vertebral column and the anterior chest wall, mostly associated with an unstable fracture of the sternum. In combination, the worst case would be a complete disruption of the trunk. Some authors consider the sternum-rib-complex to be the fourth vertebral column. This study discusses the possibilities to treat instable trunk injuries with sternal fractures concomitant to vertebral spine fractures through anterior sternal plating employing a locked plate osteosynthesis in a low profile design instead of the use of bulky implants...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522279/-stereotactic-lung-radiotherapy-technical-setting-up-on-novalis-tx-%C3%A2-and-single-centre-prospective-study-of-the-100-first-malignant-pulmonary-nodules-treated-at-centre-jean-perrin
#3
A Bellière-Calandry, G Dupic, F Magnier, V Chassin, V Dedieu, M Lapeyre
PURPOSE: Description of the treatment technique of stereotactic lung radiotherapy on Novalis Tx(®) and prospective study of the first 100 pulmonary nodules treated at centre Jean-Perrin (France). MATERIAL AND METHODS: From October 2012 to December 2015, 100 inoperable pulmonary nodules (62 stage I non-small-cell lung cancer and 38 metastases) of 90 patients with a mean age of 68.2 years (range: 46-89 years) were prospectively treated with dynamic arctherapy on Novalis Tx(®)...
May 15, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28497637/successful-use-of-rivaroxaban-in-inferior-vena-cava-thrombosis-provoked-by-multiple-traumatic-injuries-and-surgeries-a-case-report
#4
K Kido, E Noyes, L Gutnik
WHAT IS KNOWN AND OBJECTIVES: There is a lack of consensus regarding optimal anticoagulation regimen and duration for inferior vena cava (IVC) thrombus due to the paucity of clinical evidence. A case of IVC thrombus treated with 3 months of rivaroxaban therapy is reported. CASE DESCRIPTION: Fifty-two-year-old male Caucasian presented following a motorcycle accident, with multiple left rib fractures requiring emergent amputation surgeries. During the hospitalization, he developed IVC thrombosis and completed 3 months of rivaroxaban treatment without any complication...
May 11, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28494679/first-rib-fracture-treatment-should-focus-on-other-injuries
#5
(no author information available yet)
Management of patients with fractures of the first rib should focus on identifying and treating associated life-threatening injuries, says a study in Emergency Medicine Journal.
May 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28493077/lung-protective-effects-of-low-volume-resuscitation-and-pharmacologic-treatment-of-swine-subjected-to-polytrauma-and-hemorrhagic-shock
#6
Vahagn C Nikolian, Baihong Pan, Tomaz Mesar, Isabel S Dennahy, Patrick E Georgoff, Xiuzhen Duan, Baoling Liu, Xizi Wu, Michael J Duggan, Hasan B Alam, Yongqing Li
Hemorrhage is a common cause of death in the battlefield. Valproic acid (VPA) has been associated with improved outcomes in multiple models of trauma, when combined with isotonic fluid resuscitation. However, isotonic fluid administered in this setting is logistically impractical and may be associated with complications. In this study, we sought to evaluate the feasibility and immunologic impact of combining VPA treatment with low-volume hypertonic saline (HTS). In vivo: female Yorkshire swine were subjected to hemorrhage (40% total blood volume) and polytrauma (rib fracture and delayed liver injury)...
May 10, 2017: Inflammation
https://www.readbyqxmd.com/read/28490265/crush-asphyxia-and-ride-on-lawn-mowers
#7
Roger W Byard, Neil Ei Langlois
Search of files at Forensic Science SA, Australia, over the past 20 years (1997-2016) revealed three cases of death due to crush asphyxia associated with the use of ride-on lawn mowers. (1) A 61-year-old man was trapped under a ride-on mower that had rolled over. Autopsy examination revealed congestion and petechial haemorrhages of the face and chest, and markings on the chest associated with underlying rib fractures. (2) A 78-year-old man was trapped under a ride-on mower that had also rolled over. Autopsy examination revealed petechial haemorrhages of the face and chest and markings on the chest...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28474111/ct-guided-transosseous-soft-tissue-biopsy-techniques-outcomes-and-complications-in-50-cases
#8
Monzer Chehab, Stephen Zintsmaster, Syed Zafar Jafri, Mark Richards, Anindya Roy
PURPOSE: To describe the techniques, outcomes and complications of CT-guided transosseous biopsy of soft tissue lesions via multiple different routes. MATERIALS AND METHODS: Clinical and radiologic data from all consecutive soft tissue biopsies performed via a transosseous approach between April 2009 and July 2015 were retrospectively compiled. Fifty biopsies performed in 50 patients (n = 17 males, n = 33 females) were included. Biopsies were performed using a 13-gauge biopsy needle which was advanced through the selected bone to the lesion margin followed by coaxial placement of either an 18- or 20-gauge biopsy gun...
May 4, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28473090/acr-appropriateness-criteria-%C3%A2-suspected-physical-abuse-child
#9
Sandra L Wootton-Gorges, Bruno P Soares, Adina L Alazraki, Sudha A Anupindi, Jeffrey P Blount, Timothy N Booth, Molly E Dempsey, Richard A Falcone, Laura L Hayes, Abhaya V Kulkarni, Sonia Partap, Cynthia K Rigsby, Maura E Ryan, Nabile M Safdar, Andrew T Trout, Roger F Widmann, Boaz K Karmazyn, Susan Palasis
The youngest children, particularly in the first year of life, are the most vulnerable to physical abuse. Skeletal survey is the universal screening examination in children 24 months of age and younger. Fractures occur in over half of abused children. Rib fractures may be the only abnormality in about 30%. A repeat limited skeletal survey after 2 weeks can detect additional fractures and can provide fracture dating information. The type and extent of additional imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and social considerations...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28470673/delayed-haemothorax-and-fracture-of-titanium-plate-rib-fixation-following-oncologic-chest-wall-reconstruction
#10
Mansher Singh, Edward M Kobraei, Kristo Nuutila, Jon O Wee, Edward J Caterson
No abstract text is available yet for this article.
May 3, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28457826/the-clinical-implications-of-severe-low-rib-fracture-in-the-management-of-diaphragm-injury-a-case-control-study
#11
Seongyup Kim, Woo Jin Choi, Kawng Ho Lee, Chun Sung Byun, Keum Seok Bae, Il Hwan Park
BACKGROUND: The objective of this study was to analyze the differences in clinical presentation and characteristics with regard to diaphragmatic injury between blunt trauma patients with severe low rib fractures and those without severe low rib fractures. METHODS: The medical records of all patients with diaphragmatic injuries who were surgically treated at this level I trauma center, between January 2004 and December 2016 were reviewed. Patient notes, radiologic findings, and operative reports were evaluated...
April 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28457113/stereotactic-ablative-body-radiation-for-stage-i-lung-cancer-in-israel-a-retrospective-single-center-report
#12
Sarit Appel, Yaacov R Lawrence, Jeffery Goldstein, Raphael M Pfeffer, Ilana Weiss, Tatiana Rabin, Shira Felder, Maoz Ben-Ayun, Lev Tzvang, Dror Alezra, David Simansky, Alon Ben-Nun, Jair Bar, Zvi Symon
BACKGROUND: Stereotactic ablative radiation therapy (SABR) is the application of a very high radiation dose to a small treatment volume. It is the new standard of care in medically inoperable early-stage lung cancer. OBJECTIVES: To report the outcomes of SABR in stage I lung cancer at Sheba Medical Center since its introduction in 2009. METHODS: We conducted a retrospective chart review of patients with stage I lung cancer treated during the period 2009-2015...
January 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28454425/whole-body-low-dose-computed-tomography-in-multiple-myeloma-staging-superior-diagnostic-performance-in-the-detection-of-bone-lesions-vertebral-compression-fractures-rib-fractures-and-extraskeletal-findings-compared-to-radiography-with-similar-radiation-exposure
#13
Lukas Lambert, Petr Ourednicek, Zuzana Meckova, Giampaolo Gavelli, Jan Straub, Ivan Spicka
The primary objective of the present prospective study was to compare the diagnostic performance of conventional radiography (CR) and whole-body low-dose computed tomography (WBLDCT) with a comparable radiation dose reconstructed using hybrid iterative reconstruction technique, in terms of the detection of bone lesions, skeletal fractures, vertebral compressions and extraskeletal findings. The secondary objective was to evaluate lesion attenuation in relation to its size. A total of 74 patients underwent same-day skeletal survey by CR and WBLDCT...
April 2017: Oncology Letters
https://www.readbyqxmd.com/read/28446987/blunt-chest-trauma-is-there-a-place-for-rib-stabilization
#14
REVIEW
John D Mitchell
Rib fractures are a common and highly morbid finding in patients with blunt chest trauma. Over the past decade, a renewed interest in (and instrumentation for) rib fixation in this cohort has occurred. Stabilization of the chest wall in this setting, particularly when a flail segment is present, is associated with significant reductions in the rates of respiratory failure, pneumonia, ICU stay, and mortality. Thoracic surgeons should remain actively involved in this evolving area of our specialty to further optimize patient outcomes...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28446982/management-of-chest-trauma
#15
REVIEW
Corinna Ludwig, Aris Koryllos
Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#16
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#17
COMPARATIVE STUDY
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28420038/retrospective-evaluation-of-coyote-attacks-in-dogs-154-cases-1997-2012
#18
Virginia M Frauenthal, Philip Bergman, Robert J Murtaugh
OBJECTIVE: To describe the clinical presentation and outcome of known attacks in client-owned dogs caused by the common coyote, Canis latrans. DESIGN: Retrospective observational study. SETTING: Private referral hospital. ANIMALS: One hundred fifty-four client-owned dogs known to be attacked by coyotes. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Records from a private referral hospital from May 1997 through December 2012 were reviewed...
May 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28419479/sonographic-diagnosis-of-a-radiographically-occult-displaced-fracture-of-a-costal-cartilage
#19
Chandra Bortolotto, Egisto Federici, Ferdinando Draghi, Stefano Bianchi
We report the case of a 22-year-old athlete who sustained a blunt thoracic trauma to the right chest causing a costal cartilage fracture. Plain radiographs revealed no abnormalities while sonographic (US) examination performed a week later because of persistent pain led to the diagnosis of a displaced fracture of the right tenth costal cartilage. A follow-up US examination confirmed the healing of the fracture and allowed the patient to return to competitive sport activity. We recommend the use of US in patients with persisting pain after thoracic trauma with negative plain radiographs of the ribs to rule out radiographically occult costal cartilage fractures...
April 17, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28409141/intrathoracic-fracture-dislocation-of-the-humerus-case-report-and-literature-review
#20
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
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