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https://www.readbyqxmd.com/read/27911066/-conservative-management-of-liver-trauma-and-its-complications-current-gold-standard
#1
R Gander, J A Molino, S Santiago, A Laín, G Guillén, C Giné, G Royo, S López, M Pérez, I Díez, S Cañadas, J Lloret, J Bueno
INTRODUCTION: The liver is the second most frequently involved organ in abdominal trauma in children. The aim of this study was to review the characteristics of liver traumas (LT) in children, its treatment and complications. MATERIAL AND METHODS: Retrospective study of patients with LT treated between 2010-2014. We analyzed data regarding diagnosis, conservative management (CM), complications and treatment. RESULTS: Twenty-four patients of LT with a mean age of 9...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27903481/hybrid-repair-of-complex-left-subclavian-artery-injury-with-partial-transection-and-complete-thrombosis-in-an-unstable-patient-following-blunt-trauma
#2
Ilitch Diaz-Gutierrez, Muhammad A Rana, Barkat Ali, John M Marek, Mark Langsfeld
Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27895441/a-retrospective-analysis-of-postoperative-patients-admitted-to-the-intensive-care-unit
#3
S Uzman, Y Yilmaz, M Toptas, I Akkoc, Y G Gul, H Daskaya, Y Toptas
BACKGROUND: The aim of this retrospective study was to evaluate postoperative patients admitted to the intensive care unit (ICU) and to describe their characteristics and outcomes. METHODS: We performed a retrospective chart review of 1,756 postoperative patients admitted to the ICU of a tertiary referral hospital from January 2008 to December 2012. For each patient we recorded: demographic data, reason for admission to the ICU, duration of mechanical ventilation, elective versus emergency surgery, type of anaesthesia, American Society of Anesthesiologists (ASA) physical status, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow Coma Score (GCS), and outcome...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27895320/clinical-experience-with-pancreas-graft-rescue-from-severe-thrombus-after-simultaneous-pancreas-kidney-transplantation-by-early-detection-with-doppler-ultrasound-a-case-report
#4
Mitsunobu Takeda, Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Kunihito Goto, Koichi Kawamoto, Yutaka Takeda, Masahiro Tanemura, Toshinori Ito, Masaki Mori, Yuichiro Doki
BACKGROUND Graft thrombosis is the main cause of early graft loss after transplantation. In Japan, pancreases available for transplantation are frequently from marginal donors due to diverse backgrounds in the population. However, marginal tissues increase the risk of early thrombosis in the graft. CASE REPORT Here, we describe a 41-year-old woman with type 1 diabetes mellitus who underwent a simultaneous pancreas-kidney transplantation. The pancreas was retrieved from a 34-year-old man who had experienced severe hemodynamic instability...
November 29, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27894498/noncompressible-torso-hemorrhage
#5
REVIEW
Jonathan J Morrison
Noncompressible torso hemorrhage (NCTH) constitutes a leading cause of potentially preventable trauma mortality. NCTH is defined by high-grade injury present in one or more of the following anatomic domains: pulmonary, solid abdominal organ, major vascular or pelvic trauma; plus hemodynamic instability or the need for immediate hemorrhage control. Rapid operative management, as part of a damage control resuscitation strategy, remains the mainstay of treatment. However, endovascular techniques are evolving and may become more mainstream with the advent of hybrid rooms that can deliver concurrent open and radiologic/endovascular management of traumatic hemorrhage...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27876104/a-cohort-study-of-unstable-overdose-patients-treated-with-intravenous-lipid-emulsion-therapy
#6
Shazma Mithani, Kathryn Dong, Ashlea Wilmott, Heather Podmoroff, Nadim Lalani, Rhonda J Rosychuk, Ryan Chuang, Mark C Yarema
OBJECTIVES: Intravenous lipid emulsion (ILE) has been used increasingly over the last decade for a range of drug overdoses. Although the use of ILE in local anesthetic toxicity (LAST) is well established, the hemodynamic effectiveness of ILE in non-LAST poisonings is still unclear. Thus, the primary objective of this study was to examine a cohort of poisoned patients in whom ILE was administered. METHODS: Consecutive patients were identified by calls to a regional poison center from May 1, 2012 to May 30, 2014...
November 23, 2016: CJEM
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#7
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867865/perioperative-hemodynamic-instability-in-patients-undergoing-laparoscopic-adrenalectomy-for-pheochromocytoma
#8
REVIEW
Magdalena Pisarska, Michał Pędziwiatr, Andrzej Budzyński
Perioperative hemodynamic instability still remains the biggest surgical and anesthetic challenge in surgery for pheochromocytoma. The aim of this review was to discuss pre-, intra- and postoperative factors that may impact on hemodynamic condition of a patient. It describes patients' preparation with appropriate medication, principles of surgical technique as well as risk factors for development of hemodynamic instability in postoperative period. Currently the gold standard in the treatment of pheochromocytoma is preoperative use of alpha-blockers and laparoscopic surgery...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27867330/use-of-caudal-analgesia-supplemented-with-low-dose-of-morphine-in-children-who-undergo-renal-surgery
#9
Boris Chertin, Alexander Zeldin, Stanislav Kocherov, Alexander Ioscovich, Israel A Ostrovsky, Yaacov Gozal
INTRODUCTION: To test the efficacy and safety of caudal anesthesia (CA) supplemented by low dose morphine in children who undergo renal surgery. MATERIALS AND METHODS: Forty patients aged 2 months-14 years were enrolled and randomly divided into two groups of 20 patients each: Group A (bupivacaine 0.2% with fentanyl); Group B (bupivacaine with morphine). The duration of surgery and hospitalization time were recorded. Postoperative pain score was measured by Face Legs Activity Cry Consolability scale and Wong-Baker Faces scale for those who are older...
October 2016: Current Urology
https://www.readbyqxmd.com/read/27865476/endobronchial-and-endoscopic-ultrasound-guided-transvascular-biopsy-of%C3%A2-mediastinal-hilar-and-lung-lesions
#10
Jordan Kazakov, Pravachan Hegde, Mehdi Tahiri, Vicky Thiffault, Pasquale Ferraro, Moishe Liberman
BACKGROUND: Endoscopic techniques, including endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS), are the initial approach for the diagnosis and staging of lung cancer and the diagnosis of mediastinal and hilar lesions. Historically, the transvascular approach has been avoided because of concerns of bleeding. Here we review our experience with EBUS and EUS transvascular biopsy of mediastinal, hilar, and lung lesions. METHODS: A prospective research database was used to retrospectively identify and review the records 33 consecutive patients who underwent EBUS and EUS transvascular biopsy in an outpatient setting over 4 years...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27861907/factors-predictive-of-failure-to-complete-planned-intraoperative-breast-radiation-using-the-intrabeam%C3%A2-system
#11
Lesly A Dossett, Andrea M Abbott, Weihong Sun, Loretta Loftus, Marie Catherine Lee, Roberto Diaz, Christine Laronga
PURPOSE: Intraoperative radiation therapy (IORT) is a form of breast irradiation that is delivered in a single session at the time of partial mastectomy. In up to 10% of patients, planned IORT is not completed; this leads to wasted resources and decreased patient satisfaction. Our objective was to evaluate factors associated with failure to complete planned IORT. METHODS AND MATERIALS: An IRB-approved review of planned IORT cases from 2011 to 2015 was conducted...
November 11, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27860173/novel-use-of-the-medtronic-micro-vascular-plug-for-pda-closure-in-preterm-infants
#12
Elizabeth W Wang-Giuffre, John P Breinholt
OBJECTIVES: To describe a single institution experience with a new endovascular occlusion device used for transcatheter patent ductus arteriosus (PDA) closure in preterm infants. BACKGROUND: The PDA is a defect largely treated via cardiac catheterization except for the smallest patients. METHODS: Medical records and catheterization reports of all premature neonates who underwent PDA device closure with the Medtronic Micro Vascular Plug (MVP) (Medtronic, Minneapolis, MN) between September 2015 and June 2016 were reviewed...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27856172/feasibility-of-selective-non-operative-management-for-penetrating-abdominal-trauma-in-france
#13
G Goin, D Massalou, T Bege, C Contargyris, J-P Avaro, G Pauleau, P Balandraud
INTRODUCTION: In France, non-operative management (NOM) is not the widely accepted treatment for penetrating wounds. The aim of our study was to evaluate the feasibility of NOM for the treatment of penetrating abdominal traumas at 3 hospitals in the Southeast of France. METHODOLOGY: Our study was multicentric and retroprospective from January, 2010 to September, 2013. Patients presenting with a penetrating abdominal stab wound (SW) or gunshot wound (GSW) were included in the study...
November 14, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27850712/1074-severity-of-hemodynamic-instability-around-high-dose-vasoactive-syringe-changes-in-the-picu
#14
Roman Gusztak, Susan Hamilton, Mary-Jeanne Manning, Patricia Lincoln, Brian Walsh, Daniel Kohane, Nilesh Mehta
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27836647/corrective-effect-of-diaphragm-pacing-on-the-decrease-in-cardiac-output-induced-by-positive-pressure-mechanical-ventilation-in-anesthetized-sheep
#15
Hicham Masmoudi, Romain Persichini, Jérôme Cecchini, Julie Delemazure, Martin Dres, Julien Mayaux, Alexandre Demoule, Jalal Assouad, Thomas Similowski
Positive pressure ventilation (PPV) is a fundamental life support measure, but it decreases cardiac output (CO). Diaphragmatic contractions produce negative intrathoracic and positive abdominal pressures, promoting splanchnic venous return. We hypothesized that: 1) diaphragm pacing alone could produce adequate ventilation without decreasing CO; 2) diaphragm pacing on top of PPV could improve CO. Of 11 anesthetized and mechanically ventilated ewes (39.6±5.9kg), 3 were discarded from analysis because of hemodynamic instability during the experiment, and 8 retained for analysis...
November 9, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27833921/management-of-patient-care-in-hemodialysis-while-focusing-on-cardiovascular-disease-events-and-the-atypical-role-of-hyper-and-or-hypotension-a-systematic-review
#16
REVIEW
Amjad Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Siew Hua Gan, Irfanullah Khan
Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27833687/application-of-circumferential-compression-device-binder-in-pelvic-injuries-room-for-improvement
#17
Rahul Vaidya, Matthew Roth, Bradley Zarling, Sarah Zhang, Christopher Walsh, Jessica Macsuga, John Swartz
INTRODUCTION: The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve pelvic stabilization by both decreasing pelvic volume and limiting inter-fragmentary motion has become commonplace, and is a well-established component of Advanced Trauma Life Support (ATLS) protocol in the treatment of pelvic ring injuries. The purpose of this study was to evaluate the following: 1) how consistently a PCCD was placed on patients who arrived at our hospital with unstable pelvic ring injuries; 2) if they were placed in a timely manner; and 3) if hemodynamic instability influenced their use...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27832152/urocortin-treatment-improves-acute-hemodynamic-instability-and-reduces-myocardial-damage-in-post-cardiac-arrest-myocardial-dysfunction
#18
Chien-Hua Huang, Chih-Hung Wang, Min-Shan Tsai, Nai-Tan Hsu, Chih-Yen Chiang, Tzung-Dau Wang, Wei-Tien Chang, Huei-Wen Chen, Wen-Jone Chen
AIMS: Hemodynamic instability occurs following cardiac arrest and is associated with high mortality during the post-cardiac period. Urocortin is a novel peptide and a member of the corticotrophin-releasing factor family. Urocortin has the potential to improve acute cardiac dysfunction, as well as to reduce the myocardial damage sustained after ischemia reperfusion injury. The effects of urocortin in post-cardiac arrest myocardial dysfunction remain unclear. METHODS AND RESULTS: We developed a preclinical cardiac arrest model and investigated the effects of urocortin...
2016: PloS One
https://www.readbyqxmd.com/read/27830321/an-update-on-the-variations-of-the-orbital-blood-supply-and-hemodynamic
#19
REVIEW
Eugenio Bertelli, Marì Regoli, Sandra Bracco
PURPOSE: Several variations of the arterial blood supply of the orbit have been reported over the years. This review is aimed to provide an update focusing on three important issues: (a) variations of the ophthalmic artery origin; (b) contribution of the external carotid artery to the orbital blood supply; (c) orbital hemodynamic. METHODS: A PubMed and Google search was carried out with the following keywords: ophthalmic artery origin, ophthalmic artery anastomoses and ophthalmic artery anatomy...
November 9, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27829937/the-effect-of-oversewing-the-staple-line-in-laparoscopic-sleeve-gastrectomy-randomized-control-trial
#20
Andrzej Kwiatkowski, Michał R Janik, Krzysztof Paśnik, Edward Stanowski
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is one of the most popular bariatric procedures. The procedure is associated with serious staple-line complications such as bleeding, leaks, and stenosis. AIM: To determine whether oversewing the staple line, compared with clipping, in LSG reduces the incidence of postoperative bleeding. MATERIAL AND METHODS: We conducted a parallel-group, prospective, randomized controlled trial (RCT) of 100 patients who underwent LSG for obesity at a single institution between May 2014 and August 2015...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
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