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Renal trauma

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https://www.readbyqxmd.com/read/28935009/acute-occlusion-of-the-abdominal-aorta-with-sudden-paraplegia-in-a-captive-mustached-tamarin-saguinus-mystax
#1
Carmen R Michaud, Richard Herbert, William R Elkins, Alfonso S Gozalo
A wild-caught, research-naïve, adult male mustached tamarin (Saguinus mystax) experienced sudden onset of bilateral hindlimb paresis. Physical examination established the presence of paralysis and the lack of femoral pulses and deep pain in both legs. There were no signs of external trauma and, due to a poor prognosis, euthanasia was elected. Necropsy findings included pleural effusion, partial pulmonary atelectasis and congestion, dilatatory cardiomyopathy, a renal hemorrhagic infarct, and a thromboembolus located at the trifurcation of the distal abdominal aorta...
October 1, 2017: Comparative Medicine
https://www.readbyqxmd.com/read/28932700/endovascular-management-of-arterial-injuries-after-blunt-or-iatrogenic-renal-trauma
#2
REVIEW
Romaric Loffroy, Olivier Chevallier, Sophie Gehin, Marco Midulla, Pierre-Emmanuel Berthod, Christophe Galland, Pascale Briche, Céline Duperron, Nabil Majbri, Christiane Mousson, Nicolas Falvo
The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28930961/impact-of-a-novel-phosphoinositol-3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#3
George Edward Black, Kyle K Sokol, Donald M Moe, Jon D Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhaylo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental phosphoinositol-3 kinase (PI3-K) inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage-associated molecular patterns (DAMPs)...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28926966/augmented-renal-clearance-in-critical-illness-an-important-consideration-in-drug-dosing
#4
REVIEW
Sherif Hanafy Mahmoud, Chen Shen
Augmented renal clearance (ARC) is a manifestation of enhanced renal function seen in critically ill patients. The use of regular unadjusted doses of renally eliminated drugs in patients with ARC might lead to therapy failure. The purpose of this scoping review was to provide and up-to-date summary of the available evidence pertaining to the phenomenon of ARC. A literature search of databases of available evidence in humans, with no language restriction, was conducted. Databases searched were MEDLINE (1946 to April 2017), EMBASE (1974 to April 2017) and the Cochrane Library (1999 to April 2017)...
September 16, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28902945/distinct-patterns-and-aetiology-of-chromonychia
#5
Soo Hyeon Bae, Min Young Lee, Jee-Bum Lee
Abnormal colouring of the nails may be a sign of underlying systemic or local disorders. This study investigated the prevalence and causes of chromonychia as a whole, as well as of each subtype. Among 163 patients with chromonychia, trauma was the pathogenesis in up to 20.9% (34/163) of cases. The most common subtype was melanonychia (54.0%; 88/163), followed by leukonychia (23.9%), red (8.6%), green (6.7%), yellow (4.9%) and blue (1.8%) nails. Nail matrix naevus (33.3%; 29/88) was the most common cause of melanonychia, while skin diseases (41...
September 13, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/28899768/missed-opportunities-to-decrease-radiation-exposure-in-children-with-renal-trauma
#6
Thomas W Gaither, Mohannad A Awad, Natalia V Leva, Gregory P Murphy, Benjamin N Breyer, Hillary L Copp
BACKGROUND: Efforts have been made to reduce computed tomography (CT) scans in children with blunt abdominal injury. CT scans may be over utilized in pediatric patients with renal trauma. METHODS: We performed a retrospective chart review of all renal trauma cases (<18 years old) in two urban trauma centers from 2002-2016. We collected patient demographic and clinical characteristics, renal trauma grades, urologic interventions, and the timing and utilization of CT scans and renal ultrasounds...
September 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28894376/operative-and-nonoperative-management-for-renal-trauma-comparison-of-outcomes-a-systematic-review-and-meta-analysis
#7
REVIEW
Andrea Mingoli, Marco La Torre, Emanuele Migliori, Bruno Cirillo, Martina Zambon, Paolo Sapienza, Gioia Brachini
INTRODUCTION: Preservation of kidney and renal function is the goal of nonoperative management (NOM) of renal trauma (RT). The advantages of NOM for minor blunt RT have already been clearly described, but its value for major blunt and penetrating RT is still under debate. We present a systematic review and meta-analysis on NOM for RT, which was compared with the operative management (OM) with respect to mortality, morbidity, and length of hospital stay (LOS). METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed for this study...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#8
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28870883/percutaneous-renal-artery-revascularization-after-prolonged-ischemia-secondary-to-blunt-trauma-pooled-cohort-analysis
#9
Younes Jahangiri, Zachary Ashwell, Khashayar Farsad
PURPOSE: We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma. METHODS: All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success...
September 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28859750/acquired-idiopathic-true-transverse-leukonychia
#10
Ali Hadi, Dana Stern
A 34-year-old man from Djibouti presented with a 14-year history of relapsing and remitting transverse white bands on the fingernails with sparing of the toenails. Examination revealed several transverse, white bands following the contour of the lunula on seven of his fingernails that did not fade upon compression of the digits (Figure). There was no onycholysis. No other skin lesions were noted. The patient reported having lived for 4 years (2000-2004) in a house that had well water as its primary water supply...
2017: Skinmed
https://www.readbyqxmd.com/read/28857810/nationwide-procedural-trends-for-renal-trauma-management
#11
Marc Colaco, Roberto A Navarrete, Susan M MacDonald, Joel D Stitzel, Ryan P Terlecki
OBJECTIVE: To characterize national trends in procedural management of renal trauma. BACKGROUND: Management of renal trauma has evolved to favor a more conservative approach. For patients requiring intervention, there is a paucity of information to characterize the nature of procedural therapy administered. METHODS: A retrospective cross-sectional analysis was performed using data contained within the National Trauma Data Bank. The National Trauma Data Bank is a voluntary data repository managed by the American College of Surgeons, containing data regarding trauma admissions at 747 level I to V trauma centers throughout the United States and Canada...
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28855778/older-age-comorbid-illnesses-and-injury-severity-affect-immediate-outcome-in-elderly-trauma-patients
#12
Dvora Kirshenbom, Zila Ben-Zaken, Nehama Albilya, Eva Niyibizi, Miklosh Bala
INTRODUCTION: Trauma in elderly population is frequent and is associated with significant mortality, not only due to age but also due to complicated factors such as the severity of injury, preexisting comorbidity, and incomplete general assessment. Our primary aim was to determine whether age, Injury Severity Score (ISS), and preexisting comorbidities had an adverse effect on the outcome in patients aged 65 years and above following blunt trauma. METHODS: We included 1027 patients aged ≥65 years who were admitted to our Level I Trauma Center following blunt trauma...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28855777/characteristics-and-management-of-blunt-renal-injury-in-children
#13
Yuichi Ishida, Alan H Tyroch, Nader Emami, Susan F McLean
BACKGROUND: Renal trauma in the pediatric population is predominately due to blunt mechanism of injury. Our purpose was to determine the associated injuries, features, incidence, management, and outcomes of kidney injuries resulting from blunt trauma in the pediatric population in a single level I trauma center. METHODS: This was a retrospective chart and trauma registry review of all pediatric blunt renal injuries at a regional level I trauma center that provides care to injured adults and children...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28854479/-special-urological-traumatology-in-children-and-adolescents
#14
P Faé, A Schröder, W H Rösch, R Stein
Isolated injuries of the genitourinary tract are rare, with the kidney being the most frequently affected organ, especially in situations of polytrauma. Overall, the genitourinary tract is involved in approximately 3 % of all children suffering polytrauma accidents. The literature and international guidelines provide clear therapeutic concepts with a consensus on the diagnosis and treatment of renal trauma, both for the treatment of adults and for children and adolescents. However, the most common injuries to the external genitalia in children and adolescents are caused by blunt trauma, abrasion, bruising, and piling...
September 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28836750/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update-digest
#15
Whitney K Bryant, Sanjay Shewakramani, Milana Zaurova
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28828035/urine-flow-rate-monitoring-in-hypovolemic-multiple-trauma-patients
#16
Evgeni Brotfain, Yoram Klein, Ronen Toledano, Leonid Koyfman, Dmitry Frank, Micha Y Shamir, Moti Klein
BACKGROUND: The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. METHODS: The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28827507/presentation-coagulopathy-and-persistent-acidosis-predict-complications-in-orthopaedic-trauma-patients
#17
Benjamin R Childs, Daniel R Verhotz, Timothy A Moore, Heather A Vallier
OBJECTIVES: To evaluate the ability of measures of coagulopathy and acidosis to predict complications. We hypothesize that increased coagulopathy and acidosis over the first 60 hours of hospitalization will result in increased rates of infection and mortality. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred and seventy-six skeletally mature patients with an Injury Severity Score (ISS) greater than 16 who were surgically treated for high energy fractures of the femur, pelvic ring, acetabulum, and/or spine...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28822391/the-impact-of-hemodynamic-transesophageal-echocardiography-on-the-use-of-continuous-renal-replacement-therapy-in-trauma
#18
Madison Griffin, Brett Howard, Sam Devictor, Josh Ferenczy, Frances Cobb, D Benjamin Christie
Post-traumatic fluid management is a widely debated topic. No best-practice consensus exists. Adverse outcomes such as acute kidney injury or volume overload are common. Continuous renal replacement therapy (CRRT) is an adjunct therapy for severe acute renal failure and volume overload, but is costly and not without risk. Hemodynamic transesophageal echocardiography (hTEE) is widely accepted as a reliable way to monitor volume status of intensive care unit (ICU) patients. Although data exist evaluating hTEE and CRRT independently, there is a lack of research mutually inclusive of the two...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28810996/rhabdomyolysis-after-crawling-military-training
#19
Danit Atias-Varon, Haggai Sherman, Ran Yanovich, Yuval Heled
INTRODUCTION: Rhabdomyolysis is a syndrome characterized by muscle necrosis followed by release of intracellular muscle contents into the circulation. Exertional rhabdomyolysis (ER) occurs in response to nonfamiliar and/or excessive, prolonged, or repetitive exercises, with eccentric characteristics. In military populations, due to the type of intense, all out physical loads, ER is a significant threat, particularly when training under heat stress. However, many other etiologies exist, and clinical presentations vary greatly...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810980/risk-factors-for-rhabdomyolysis-in-the-u-s-army
#20
Owen T Hill, Dennis E Scofield, Jenna Usedom, Lakmini Bulathsinhala, Craig McKinnon, Paul Kwon, Timothy Haley, Robert Carter
The standardized mortality rate of rhabdomyolysis (RM) in Active Duty U.S. Army Soldiers is considerably higher than in the civilian population. RM occurs when large amounts of intracellular contents from damaged skeletal muscle escape into circulation, leading to serious sequelae (e.g., acute renal failure, hyperkalemia, compartment syndrome). Extended physical exertion, especially in hot environments, and trauma can precipitate RM. The aim of this study was to identify RM risk factors among U.S. Active Duty Army (ADA) Soldiers...
July 2017: Military Medicine
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