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https://www.readbyqxmd.com/read/30023435/bilateral-distal-ureteral-transection-in-the-setting-of-blunt-trauma
#1
Desiree Raygor, James Cunningham, Joseph Costa, Marie Crandall, David Skarupa
A 69-year-old obese man was involved in a high-speed head-on motor vehicle collision. He was tachycardic and normotensive on arrival. He subsequently developed hemodynamic instability requiring blood transfusion. On examination he had bilateral pneumothoraces, an anterior-posterior compression (APC) pelvic fracture, an open wound at the left groin, and gross hematuria after Foley catheter placement.CT imaging revealed hemoperitoneum, right hepatic lobe grade II lacerations, splenic laceration, mesenteric root injury with extravasated contrast, intraperitoneal and extraperitoneal bladder rupture, bilateral ureteral injuries at the level of the pelvic inlet (see figure 1), APC pelvic fracture, bilateral rib fractures, pneumothoraces, and pulmonary contusions...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/30007210/splenectomy-had-no-significant-impact-on-lipid-metabolism-and-atherogenesis-in-apoe-deficient-mice-fed-on-a-severe-atherogenic-diet
#2
Ying Zhang, Xiangbo An, Qiuyue Lin, Jie Bai, Feng Wang, Jiawei Liao
BACKGROUND: For a long time, our major understanding of the spleen is to function as a blood filter for the removal of aged erythrocytes and circulating microorganisms. Splenectomy, therefore, has been widely performed in case of trauma and a variety of hematologic disorders. Although some studies have indicated an increased rate of developing hyperlipidemia and atherosclerotic cardiovascular diseases in splenectomized patients, our recognition of the splenic regulation on lipid metabolism and atherogenesis is still lacking...
June 23, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/29998462/hepatic-steatosis-is-highly-prevalent-across-the-paediatric-age-spectrum-including-in-pre-school-age-children
#3
J Dhaliwal, G B Chavhan, E Lurz, A Shalabi, N Yuen, B Williams, I Martincevic, A Amirabadi, P W Wales, W Lee, S C Ling, M Mouzaki
BACKGROUND: The prevalence of non-alcoholic fatty liver disease (NAFLD) in children is 8% in the general population, and 34% in the context of obesity. There is a paucity of data on the prevalence of hepatic steatosis in healthy children in Ontario. AIMS: To determine the prevalence of hepatic steatosis using abdominal computed tomography (CT) scans in a cohort of previously healthy children across the paediatric age spectrum in Ontario, Canada, and to determine association between measures of abdominal adiposity and hepatic steatosis...
July 11, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29995696/overview-of-prescription-opioid-deaths-in-the-oklahoma-state-medicaid-population-2012-2016
#4
Timothy T Pham, Grant H Skrepnek, Christopher Bond, Thomas Alfieri, Terry J Cothran, Shellie L Keast
BACKGROUND: Medicaid members are predisposed to unintentional prescription opioid overdose. However, little is known about their individual risk factors. OBJECTIVES: To describe demographic and clinical characteristics, medical utilization, opioid use, concurrent use of benzodiazepines, risk factors, and substances involved in death for Oklahoma's Medicaid members who died of unintentional prescription opioid poisoning. SUBJECTS: Decedents who were Medicaid eligible in Oklahoma during the year of death, had an opioid recorded in cause of death, and had ≥1 opioid prescription claim between January 1, 2011 and June 30, 2016 were cases...
August 2018: Medical Care
https://www.readbyqxmd.com/read/29977623/lethal-end-of-spectrum-of-clots-thrombotic-storm
#5
Muhammad Asim Rana, Ahmed F Mady, Abdullah Ali Lashari, Rehab Eltreafi, Nicola Fischer-Orr, Kamal Naser
Thrombotic storm (TS) is a rare, acute, hypercoagulable state characterized by multiple thromboembolic events affecting at least two different areas of the vascular system/organs over a short period of time. Typical triggers include inflammation, infections, minor trauma, surgery, pregnancy, and the puerperium. A single thrombotic event can set off a number of thromboembolic events, often including unusual locations like hepatic, portal, or renal veins, skin (purpura fulminans) , adrenal glands, and cerebral sinus venous thrombosis...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29975292/what-s-new-in-pediatric-orthopaedic-trauma-the-lower-extremity
#6
Kathleen D Rickert, Pooya Hosseinzadeh, Eric W Edmonds
BACKGROUND: Skeletal trauma is a primary tenet of pediatric orthopaedics. Many high-quality studies have been published over the last few years with substantial relevance to the clinical practice of pediatric orthopaedic trauma. Because of the volume of literature on the subject, this review excludes upper extremity trauma and focuses on the publications affecting the lower extremity. METHODS: An electronic search of the PubMed database was performed utilizing keywords for pediatric lower extremity trauma: pelvic injuries, femur fractures, tibial shaft fractures, femur fractures, ankle fractures, and foot fractures...
July 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29963409/portal-vein-thrombosis-what-surgeons-need-to-know
#7
REVIEW
Ricardo Quarrie, Stanislaw P Stawicki
Key points: (a) The lifetime risk of portal vein thrombosis (PVT) is approximately 1%; (b) The portal vein is formed by the union of the splenic and superior mesenteric veins posterior to the pancreas; (c) Imaging modalities most frequently used to diagnose PVT include sonography, computed tomography, and magnetic resonance imaging; (d) Malignancy, hepatic cirrhosis, surgical trauma, and hypercoagulable conditions are the most common risk factors for the development of PVT; (e) PVT eventually leads to the formation of numerous collateral vessels around the thrombosed portal vein; (f) First-line treatment for PVT is therapeutic anticoagulation-it helps prevent the progression of the thrombotic process; (g) Other therapeutic options include surgery and interventional radiographic procedures including mechanical thrombectomy and thrombolysis; (h) Portal biliopathy is a clinicopathologic entity characterized by biliary abnormalities due to portal hypertension secondary to PVT and appears to be more common in cases of extrahepatic PVT...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29953577/acquired-haemophilia-a-imitating-uterine-tumour-in-a-patient-with-de-novo-diagnosis-of-hepatitis-c
#8
Piotr Filip Czempik, Łukasz J Krzych
AHA is an extremely rare disorder, with annual incidence of 1.5 cases per million population. This clinical entity is caused by autoantibodies directed against coagulation factor VIII, what leads to decreased serum activity of thereof, and is characterized by spontaneous or induced by trauma, or invasive procedure bleeding. Approximately 50% of cases are idiopathic in origin, affecting both sexes, with median age at diagnosis of 74 years. We present a case report of a patient diagnosed with acquired haemophilia A (AHA) in the perioperative period...
2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29943746/early-presentation-of-ruptured-post-traumatic-hepatic-artery-pseudoaneurysm
#9
M S Patel, V Shetty, A Shelake, A A Deshpande
Visceral artery aneurysms (VAA) are an uncommon but well recognized condition. Hepatic artery aneurysms (HAA) represent 14-20% of all visceral artery aneurysms. Post traumatic hepatic artery pseudoaneurysm is an uncommon delayed complication of blunt liver trauma. Here we present a case of a 27 year old male with blunt abdominal trauma who developed a post traumatic pseudoaneurysm of the hepatic artery just proximal to its bifurcation into the left and right branches. The pseudoaneurysm ruptured within 12 hours of injury and he required double ligation of the hepatic artery as well as right and left hepatic arteries ...
June 25, 2018: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/29914487/blunt-liver-trauma-a-descriptive-analysis-from-a-level-i-trauma-center
#10
Ibrahim Afifi, Sheraz Abayazeed, Ayman El-Menyar, Husham Abdelrahman, Ruben Peralta, Hassan Al-Thani
BACKGROUND: We aimed to review liver injury experience in a level 1 trauma center; namely clinical presentation, grading, management approach and clinical outcomes. METHODS: It is a retrospective analysis to include all blunt liver injury patients who were admitted at the Level 1 trauma center over a 3-year period. Data were compared and analyzed based on the liver injury grades and management approaches. RESULTS: Blunt liver injury accounted for 38% of the total blunt abdominal trauma cases with a mean age of 31 ± 13 years...
June 19, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29852169/txnip-knockdown-alleviates-hepatocyte-ischemia-reperfusion-injury-through-preventing-p38-jnk-pathway-activation
#11
Yong Zhang, Liang-Sheng Miao, Ying-Min Cai, Jia-Xuan He, Zhen-Ni Zhang, Gang Wu, Juan Zheng
Hepatic ischemia and reperfusion (I/R) injury is a major cause of liver damage during liver transplantation, resection surgery, shock, and trauma. It has been reported that TXNIP expression was upregulated in a rat model of hepatic I/R injury. However, the role of TXNIP in the hepatic I/R injury is little known. In our study, we investigated the biological role of TXNIP and its potential molecular mechanism in the human hepatic cell line (HL7702 cells). Using oxygen-glucose deprivation and reoxygenation (OGD/R) to create a cell model of hepatic I/R injury, we found that the mRNA and protein expression levels of TXNIP were upregulated in HL7702 cells exposed to OGD/R...
July 20, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29851912/a-different-form-of-injury-prevention-successful-screening-and-referral-for-hiv-and-hepatitis-c-in-a-trauma-population
#12
Benjamin White, Alicia Privette, Pamela L Ferguson, E Douglas Norcross, Lauren E Richey
BACKGROUND: In the United States, millions of patients are living with HIV and Hepatitis C (0.44% and 1.5%) and many are currently undiagnosed. Since highly effective treatments are now available, early identification of these patients is extremely important to achieve improved clinical outcomes. Prior data and trauma-associated risk factors suggest a higher prevalence of both diseases in the trauma population. We hypothesized that a screening program could be successfully initiated amongst trauma activation patients and that a referral and linkage-to-care program could be developed...
May 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29849508/the-impact-of-septic-stimuli-on-the-systemic-inflammatory-response-and-physiologic-insult-in-a-preclinical-non-human-primate-model-of-polytraumatic-injury
#13
Diego A Vicente, Matthew J Bradley, Benjamin Bograd, Crystal Leonhardt, Eric A Elster, Thomas A Davis
Background: Established animal trauma models are limited in recapitulating the pathophysiology of human traumatic injury. Herein, we characterize the physiologic insult and inflammatory response in two clinically relevant non-human primate (NHP) trauma models. Methods: Mauritian Cynomolgus Macaques underwent either a laparoscopic closed abdomen liver injury (laparoscopic 60% left-lobe hepatectomy) in an established uncontrolled severe hemorrhage model (THM), or a polytrauma hemorrhage model (PHM) involving combined liver and bowel injury, uncontrolled severe hemorrhage as well as an open full-thickness cutaneous flank wound...
2018: Journal of Inflammation
https://www.readbyqxmd.com/read/29793813/umbilical-hernia-with-evisceration-two-cases-and-a-review-of-the-literature
#14
Eham Arora, Saurabh Gandhi, Ajay Bhandarwar, Abdul Haque M Quraishi, Amol Wagh, Amarjeet Tandur, Dhansagar Wakle
BACKGROUND: Evisceration of umbilical hernias is an uncommon occurrence whereby the hernial contents break through the skin overlying the sac and skin. Irrespective of cause, sudden evisceration of an umbilical hernia is associated with deterioration and a poor outcome. CASE REPORTS: Our first case was a 42-year-old woman who presented with sudden outpouring of fluid from the umbilicus with omental evisceration. Further evaluation revealed hepatic decompensation caused by hepatitis C infection belonging to Child-Turcotte-Pugh class C...
May 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29780616/multiple-intra-hepatic-and-abdominal-splenosis-an-easy-call-if-you-know-about-it
#15
Doriana Vergara, Francesco Ginolfi, Stefano Moscati, Beniamino Giordano, Nicola Ferrara, Camilla Panico, Massimo Imbriaco
Hepatic splenosis represents the heterotopic implantation of splenic tissue caused by the spillage of cells from the spleen usually after splenectomy or splenic trauma. This condition is usually an incidental finding during surgery and its real incidence is unknown. Splenic implants, which can be placed anywhere in the abdominal cavity, are usually multiple and may be confused with different benign and malignant conditions such as renal tumors, abdominal lymphomas, and endometriosis. We hereby report an unusual case of multiple abdominal splenosis, with a particular intra-hepatic location, that could be misinterpreted as an hepato-cellular carcinoma...
May 2018: Acta Radiologica Open
https://www.readbyqxmd.com/read/29769030/in-silico-simulation-of-liver-crack-detection-using-ultrasonic-shear-wave-imaging
#16
Erwei Nie, Jiao Yu, Debaditya Dutta, Yanying Zhu
BACKGROUND: Liver trauma is an important source of morbidity and mortality worldwide. A timely detection and precise evaluation of traumatic liver injury and the bleeding site is necessary. There is a need to develop better imaging modalities of hepatic injuries to increase the sensitivity of ultrasonic imaging techniques for sites of hemorrhage caused by cracks. In this study, we conduct an in silico simulation of liver crack detection and delineation using an ultrasonic shear wave imaging (USWI) based method...
May 16, 2018: BMC Medical Imaging
https://www.readbyqxmd.com/read/29763851/pancreaticoduodenal-arcades-as-salvage-route-for-transarterial-embolization-of-life-threatening-hepatic-hemorrhage-in-patients-with-severe-celiac-axis-stenosis-case-series
#17
Ali Barah, Ahmed Omar, Ayman El-Menyar, Omran Almokdad, Ahmed Sayedin, Ala Alsherbini, Ahmed Almuzrakshi, Hatem Khalaf, Hassan Al-Thani
INTRODUCTION: Various transarterial embolotherapies for different hepatic etiologies are performed through the celiac axis (CA). However, this pathway is not always patent due to the extensive stenosis or occlusion of the origin of CA. In such situations, the pancreaticoduodenal arcades (PDAs) catheterization is the main alternative to gain access to the hepatic arteries as demonstrated in clinical studies. PRESENTATION OF CASE: We report two cases of life-threating hepatic hemorrhage indicated for emergency transarterial embolization (TAE)...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29722563/damage-associated-molecular-patterns-damps-in-resuscitated-hemorrhagic-shock-are-mitigated-by-peritoneal-fluid-administration
#18
Paul J Matheson, Mark A Eid, Matthew A Wilson, Victoria S Graham, Samuel A Matheson, Jessica Lee Weaver, Cynthia D Downard, Jason W Smith
INTRODUCTION: Conventional resuscitation (CR) of hemorrhagic shock (HS), a significant cause of trauma mortality, is I.V. blood and fluids. CR restores central hemodynamics, but vital organ flow can drop causing hypoperfusion, hypoxia, Damage-Associated Molecular Patterns (DAMPs), and remote organ dysfunction (i.e., lung). CR plus Direct Peritoneal Resuscitation (DPR) prevents intestinal and hepatic hypoperfusion. We hypothesized that DPR prevents lung injury in HS/CR by altering DAMPs...
May 3, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29710288/the-drug-overdose-epidemic-and-deceased-donor-transplantation-in-the-united-states-a-national-registry-study
#19
Christine M Durand, Mary G Bowring, Alvin G Thomas, Lauren M Kucirka, Allan B Massie, Andrew Cameron, Niraj M Desai, Mark Sulkowski, Dorry L Segev
Background: The epidemic of drug overdose deaths in the United States has led to an increase in organ donors. Objective: To characterize donors who died of overdose and to analyze outcomes among transplant recipients. Design: Prospective observational cohort study. Setting: Scientific Registry of Transplant Recipients, 1 January 2000 to 1 September 2017. Participants: 138 565 deceased donors; 337 934 transplant recipients at 297 transplant centers...
May 15, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29707082/trans-hepatic-percutaneous-endoscopic-gastrostomy-tube-placement-a-case-report-of-a-rare-complication-and-literature-review
#20
Anuj Chhaparia, Muhammad Bader Hammami, Juri Bassuner, Christine Hachem
Percutaneous endoscopic gastrostomy (PEG) tubes have emerged as the standard of care for long-term enteral feeding. This procedure is relatively safe; however, complications do occur, and one of the most dreaded complications is trauma to the surrounding organs. Hepatic injury during PEG placement is an extremely rare complication of the PEG procedure, with a handful of cases described in the medical literature. We describe the case of an accidental trans-hepatic placement of a PEG tube in a 78-year-old morbidly obese female, even with excellent trans-illumination and manual external pressure achieved during endoscopic placement...
April 2018: Gastroenterology Research
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