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https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#1
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221152/distal-embolization-versus-combined-embolization-techniques-for-blunt-splenic-injuries-comparison-of-the-efficacy-and-complications
#2
Yon-Cheong Wong, Cheng-Hsien Wu, Li-Jen Wang, Huan-Wu Chen, Kuo-Ching Yuan, Being-Chuan Lin, Yu-Pao Hsu, Shih-Ching Kang
Comparable failure rates of distal or proximal transcatheter arterial embolization (TAE) techniques for blunt splenic injuries have been reported. This study is to investigate the efficacy and complication of combining both TAE techniques. We included 26 patients of blunt splenic injuries for TAE therapy and randomized them into distal TAE and combined TAE groups. A prospective study was performed to compare their demographics, clinical parameters, hemograms, post-TAE splenic infarct volumes, splenic abscess and pancreatitis between the two groups...
November 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29217902/magnitude-severity-and-outcome-of-traumatic-pancreatic-injury-at-a-level-i-trauma-center-in-india
#3
Amit Gupta, Subodh Kumar, Sanjay Kumar Yadav, Biplab Mishra, Maneesh Singhal, Atin Kumar, Pramod Garg
Pancreatic injury is an uncommon and frequently missed injury in abdominal trauma patients. However, missed pancreatic injury is associated with significant morbidity and mortality. This study was conducted to know the burden of pancreatic injury and its outcome in our setup. A retrospective analysis of 53 patients with pancreatic injury from January 2008 through March 2012 at the Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi. Pancreatic injuries were present in 1...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29217442/posterior-approach-for-revascularization-in-blunt-popliteal-vessel-injury
#4
Vladimir Makaloski, Arno Stellmes, Doerte Wyss, Salome Weiss, Daniel Becker, Thomas R Wyss, Juerg Schmidli
BACKGROUND: Popliteal vessel injuries are associated with traumatic knee injury often requiring emergency revascularization. Medial and posterior approaches to the popliteal space have been proposed. This study evaluates the outcome of patients treated for traumatic popliteal vessel injuries via a posterior approach. METHODS: Consecutive patients with traumatic vascular injuries in the popliteal segments II and III undergoing surgical repair via a posterior approach between October 2008 and December 2016 were analyzed...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29215711/triage-tools-for-detecting-cervical-spine-injury-in-pediatric-trauma-patients
#5
REVIEW
Annelie Slaar, M M Fockens, Junfeng Wang, Mario Maas, David J Wilson, J Carel Goslings, Niels Wl Schep, Rick R van Rijn
BACKGROUND: Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate in deciding whether or not diagnostic imaging is needed in adults presenting for blunt trauma screening at the emergency department...
December 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29209550/rare-case-of-large-bowel-injury-due-to-direct-blunt-trauma-to-a-preexisting-femoral-hernia
#6
C Tinner, M Odermatt, P Villiger
We report a case of an 85-year-old man with a known asymptomatic left femoral hernia who was admitted to the emergency ward a few hours after falling from a bicycle and suffering from blunt trauma of the handlebar to the left inguinal region. The clinical findings and a computed tomography (CT) scan detecting free air in the femoral hernia sac suggested bowel perforation. Emergency laparotomy 6 hours after the incident confirmed a tear of the sigmoid colon accompanied by free blood and faeces in the left inguinal region of the abdomen...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29207735/pattern-of-isolated-fatal-mechanical-injury-in-homicidal-deaths-a-cross-sectional-study
#7
Kiran Kumar Patnaik, Sudeepa Das, Sachidananda Mohanty, Hemanta Panigrahi
Introduction: Homicide is the death of one human being as a result of conduct of another. Multiple assaults on the body are seen in 70% cases, which indicate determination on the part of the accused to end the life of the victim. Aim: To identify the pattern, distribution and means of inflicting fatal isolated mechanical injury on the body in cases of homicide. Materials and Methods: This cross-sectional study was conducted on total 728 homicide deaths, out of which 63 cases had an isolated fatal mechanical injury over the body and the rest 665 cases had multiple injuries...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29204237/pediatric-adrenal-trauma-evaluation-and-follow-up-with-contrast-enhanced-ultrasound-ceus
#8
Vasileios Rafailidis, Annamaria Deganello, Maria E Sellars, Erica Makin, Paul S Sidhu
Adrenal trauma is rarely encountered in the pediatric population, often as a component of multi-organ injury and often presenting with hematoma formation. Contrast-enhanced computed tomography (CECT) is the established imaging modality both for initial evaluation and follow-up of patients with blunt abdominal trauma. In children, radiation exposure should be minimized and alternative imaging strategies are needed. Contrast-enhanced ultrasound (CEUS) has recently been successfully used for evaluation of patients with hepatic, renal and splenic injury...
December 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/29203574/blunt-chest-trauma-a-clinical-chameleon
#9
REVIEW
Kaveh Eghbalzadeh, Anton Sabashnikov, Mohamed Zeriouh, Yeong-Hoon Choi, Alexander C Bunck, Navid Mader, Thorsten Wahlers
The incidence of blunt chest trauma (BCT) is greater than 15% of all trauma admissions to the emergency departments worldwide and is the second leading cause of death after head injury in motor vehicle accidents. The mortality due to BCT is inhomogeneously described ranging from 9% to 60%. BCT is commonly caused by a sudden high-speed deceleration trauma to the anterior chest, leading to a compression of the thorax. All thoracic structures might be injured as a result of the trauma. Complex cardiac arrhythmia, heart murmurs, hypotension, angina-like chest pain, respiratory insufficiency or distention of the jugular veins may indicate potential cardiac injury...
December 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#10
Richard L Purcell, Michael A Donohue, Sameer K Saxena, Wade T Gordon, Louis L Lewandowski
INTRODUCTION: Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29202854/neuronal-ccl2-expression-drives-inflammatory-monocyte-infiltration-into-the-brain-during-acute-virus-infection
#11
Charles L Howe, Reghann G LaFrance-Corey, Emma N Goddery, Renee K Johnson, Kanish Mirchia
BACKGROUND: Viral encephalitis is a dangerous compromise between the need to robustly clear pathogen from the brain and the need to protect neurons from bystander injury. Theiler's murine encephalomyelitis virus (TMEV) infection of C57Bl/6 mice is a model of viral encephalitis in which the compromise results in hippocampal damage and permanent neurological sequelae. We previously identified brain-infiltrating inflammatory monocytes as the primary driver of this hippocampal pathology, but the mechanisms involved in recruiting these cells to the brain were unclear...
December 4, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29201808/management-of-traumatic-liver-and-bile-duct-laceration
#12
Charu Tiwari, Hemanshi Shah, Mukta Waghmare, Kiran Khedkar, Pankaj Dwivedi
Posttraumatic major bile leak in children is uncommon, with few cases reported in the literature. These injuries are seen in high-grade liver trauma and are difficult to diagnose and manage. We describe a 7-year-old boy with grade IV hepatic trauma and bile leak following blunt abdominal trauma. The leak was successfully managed by percutaneous drainage and endoscopic retrograde cholangiopancreatography (ERCP) stenting of the injured hepatic duct. How to cite this article: Tiwari C, Shah H, Waghmare M, Khedkar K, Dwivedi P...
July 2017: Euroasian journal of hepato-gastroenterology
https://www.readbyqxmd.com/read/29201481/cystic-lymphangioma-of-the-chest-wall-in-a-5-year-old-male-patient-a-rare-and-atypical-localization-a-case-report-and-comprehensive-review-of-the-literature
#13
Dimitrios Patoulias, Ioannis Patoulias, Christos Kaselas, Maria Kalogirou, Chatzopoulos Kyriakos, Farmakis Konstantinos, Thomas Feidantsis, Papacrivou Eleni
Lymphangioma is a benign congenital malformation. The extremely rare and atypical localization of a lymphangioma in the chest wall was the real motive for the present case study. A 5-year-old boy was admitted to the Emergency Department of the 1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, due to the presence of a mildly painful swelling in the left lateral chest wall, which was first noticed three months ago, after a blunt injury during sport. Physical examination revealed the presence of a palpable, spherical, painful, nut-sized subcutaneous lesion in the left lateral chest wall, respectively, with the anterior axillary line, at the height of the 6th to 7th intercostal space...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29200479/management-of-sub-axial-cervical-spine-injuries
#14
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29200204/thyroid-hormone-inhibits-lung-fibrosis-in-mice-by-improving-epithelial-mitochondrial-function
#15
Guoying Yu, Argyris Tzouvelekis, Rong Wang, Jose D Herazo-Maya, Gabriel H Ibarra, Anup Srivastava, Joao Pedro Werneck de Castro, Giuseppe DeIuliis, Farida Ahangari, Tony Woolard, Nachelle Aurelien, Rafael Arrojo E Drigo, Ye Gan, Morven Graham, Xinran Liu, Robert J Homer, Thomas S Scanlan, Praveen Mannam, Patty J Lee, Erica L Herzog, Antonio C Bianco, Naftali Kaminski
Thyroid hormone (TH) is critical for the maintenance of cellular homeostasis during stress responses, but its role in lung fibrosis is unknown. Here we found that the activity and expression of iodothyronine deiodinase 2 (DIO2), an enzyme that activates TH, were higher in lungs from patients with idiopathic pulmonary fibrosis than in control individuals and were correlated with disease severity. We also found that Dio2-knockout mice exhibited enhanced bleomycin-induced lung fibrosis. Aerosolized TH delivery increased survival and resolved fibrosis in two models of pulmonary fibrosis in mice (intratracheal bleomycin and inducible TGF-β1)...
December 4, 2017: Nature Medicine
https://www.readbyqxmd.com/read/29199182/delayed-diagnosis-and-treatment-of-high-grade-blunt-pancreatic-trauma-case-report-and-review-of-literature
#16
Myftar Torba, Arben Gjata, Francesco Rulli, Ilir Kajo, Sotir Ceka, Tajar Asqeri
INTRODUCTION: Despite technological advancement, high grade pancreatic injuries following blunt abdominal trauma continues to remain a disease that is associated with high morbidity and mortality rates, particularly in cases of delayed diagnosis. The aim of this paper was the presentation of delayed diagnosis and treatment peculiarities of high grade pancreatic trauma and a review of literature. CASE REPORT: A 55-years old man, involved in motor vehicle crashes, was referred to our level I trauma center...
November 29, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29196237/melatonin-protects-diabetic-heart-against-ischemia-reperfusion-injury-role-of-membrane-receptor-dependent-cgmp-pkg-activation
#17
Li-Ming Yu, Wen-Cheng Di, Xue Dong, Zhi Li, Yong Zhang, Xiao-Dong Xue, Yin-Li Xu, Jian Zhang, Xiong Xiao, Jin-Song Han, Yu Liu, Yang Yang, Hui-Shan Wang
It has been demonstrated that the anti-oxidative and cardioprotective effects of melatonin are, at least in part, mediated by its membrane receptors. However, the direct downstream signaling remains unknown. We previously found that melatonin ameliorated myocardial ischemia-reperfusion (MI/R) injury in diabetic animals, although the underlying mechanisms are also incompletely understood. This study was designed to determine the role of melatonin membrane receptors in melatonin's cardioprotective actions against diabetic MI/R injury with a focus on cGMP and its downstream effector PKG...
November 30, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29195627/ethyl-pyruvate-is-renoprotective-against-ischemia-reperfusion-injury-under-hyperglycemia
#18
Ji Hae Jun, Jong Wook Song, Eun-Jung Shin, Young-Lan Kwak, Nakcheol Choi, Jae-Kwang Shim
BACKGROUND: Hyperglycemia (HG) is common in cardiovascular surgeries due to diabetes, inflammation, and the neuroendocrine stress response. HG aggravates renal ischemia-reperfusion (I/R) injury through an increased inflammatory response, and blunts the protective effect of various measures. Ethyl pyruvate (EP) provides anti-inflammatory effects against I/R injury via inhibition of high-mobility group box 1 protein (HMGB1) release. This study aimed to determine the renoprotective effect of EP against I/R injury under HG...
November 1, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29194339/risk-factors-for-the-development-of-acute-respiratory-distress-syndrome-following-hemorrhage
#19
Bryce R H Robinson, Mitchell J Cohen, John B Holcomb, Timothy A Pritts, Dina Gomaa, Erin E Fox, Richard D Branson, Rachael A Callcut, Bryan A Cotton, Martin A Schreiber, Karen J Brasel, Jean-Francois Pittet, Kenji Inaba, Jeffery D Kerby, Thomas M Scalea, Charlie E Wade, Eileen M Bulger
BACKGROUND: The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) study evaluated the effects of plasma and platelets on hemostasis and mortality after hemorrhage. The pulmonary consequences of resuscitation strategies that mimic whole blood, remain unknown. METHODS: A secondary analysis of the PROPPR study was performed. Injured patients predicted to receive a massive transfusion were randomized to 1:1:1 vs. 1:1:2 plasma-platelet-RBC ratios at 12 Level I North American trauma centers...
November 30, 2017: Shock
https://www.readbyqxmd.com/read/29194321/variability-in-management-of-blunt-liver-trauma-and-contribution-of-level-of-acs-cot-verification-status-on-mortality
#20
Christopher J Tignanelli, Bellal Joseph, Jill L Jakubus, Gaby A Iskander, Lena M Napolitano, Mark R Hemmila
BACKGROUND: Patients who sustain blunt liver trauma and are treated at an ACS-COT verified level 1 trauma center have an overall lower risk of mortality compared with patients admitted to a level 2 trauma center. However, elements contributing to these differences are unknown. We hypothesize that practice variation exists between trauma centers in management of blunt liver injury. Our objective is to identify practice variations and their effect on clinical outcomes. METHODS: Data from a statewide collaborative quality initiative for trauma was utilized...
December 1, 2017: Journal of Trauma and Acute Care Surgery
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