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https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#1
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29238278/role-of-metcalfa-pruinosa-as-a-vector-for-pseudomonas-syringae-pv-actinidiae
#2
Irene Donati, Sofia Mauri, Giampaolo Buriani, Antonio Cellini, Francesco Spinelli
After 20 years of steady increase, kiwifruit industry faced a severe arrest due to the pandemic spread of the bacterial canker, caused by Pseudomonas syringae pv. actinidiae (Psa). The bacterium penetrates the host plant primarily via natural openings or wounds, and its spread is mainly mediated by atmospheric events and cultural activities. Since the role of sucking insects as vectors of bacterial pathogens is widely documented, we investigated the ability of Metcalfa pruinosa Say (1830), one of the most common kiwifruit pests, to transmit Psa to healthy plants in laboratory conditions...
December 2017: Plant Pathology Journal
https://www.readbyqxmd.com/read/29227340/corneal-transplantation-in-new-zealand-2000-to-2009
#3
Alexandra Z Crawford, Thiyagaraj Krishnan, Susan E Ormonde, Dipika V Patel, Charles N McGhee
PURPOSE: To quantify all minor/major adverse events in a large cohort of consecutive corneal transplants, particularly in respect to penetrating keratoplasty (PKP). METHODS: All corneal transplants in the Auckland region over a 10-year period (2000-2009) were identified through the New Zealand National Eye Bank. Relevant clinical records were assessed for this period and 2 years after. All intraoperative or postoperative adverse events/complications, visual acuity, and graft outcomes were recorded...
December 8, 2017: Cornea
https://www.readbyqxmd.com/read/29210725/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#4
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#5
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/29201478/historical-case-of-cervical-penetrating-wound-from-first-aid-to-surgical-intervention
#6
Koné Fatogoma Issa, Keïta Mohamed Amadou, Soumahoro Siaka, Konaté N'faly, Diarra Kassim, Timbo Samba Karim
Objective: We report a case of cervical penetrating wound by posing the problem of its support and by analyzing the chain of survival of a patient to human sacrifice. Case Report: It was an 11-year-old boy admitted to the hosting service of cervical penetrating wound emergency occurring in a context of human sacrifice by weapon (knife). On admission, the conscious patient had a left cervical hematoma at the level of the cervical zone II and severe signs of acute anemia...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29197193/negative-pressure-therapy-alone-or-with-irrigation-in-the-management-of-severe-peritonitis
#7
Mauro Andreano, Vito D'Ambrosio, Guido Coretti, Paolo Bianco, Simona Ruggiero, Umberto Robustelli, Maurizio Castriconi
BACKGROUND: Ogilvie was the first to publish on open abdomen (OA) for the treatment of the damages caused by penetrating abdominal wounds in war events. Research improved those devices that allow a controlled, homogeneous and continuous extraction of contaminated fluids from all abdominal recesses, which are nowadays the base of the "Open Abdomen" technique. MATERIALS AND METHODS: From August 2012 to February 2016 at the Department of Emergency Surgery of Cardarelli Hospital in Naples, 40 patients affected by Severe Peritonitis have been treated with OA technique...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29194100/hematomas-in-tiger-territory-an-endovascular-alternative-to-wading-in
#8
Desarom Teso, Benjamin J Rogoway, Yolanda L Vea, Judson E Threlkeld, George R Dulabon, Riyad C Karmy-Jones
A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy...
November 30, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29177179/endovascular-management-of-a-penetrating-zone-iii-retroperitoneal-gunshot-wound-injury-a-case-report
#9
Saptarshi Biswas, Boris Hristov
Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical signs and symptoms years later. Open surgical repair can have prohibitive morbidity and mortality and endovascular techniques, an effective treatment alternative, can interrupt the abnormal vascular communication and preserve artery vein patency...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29176970/the-mitogen-activated-protein-kinase-cgmk1-governs-appressorium-formation-melanin-synthesis-and-plant-infection-of-colletotrichum-gloeosporioides
#10
Puhuizhong He, Yonglin Wang, Xiaolian Wang, Xiaolin Zhang, Chengming Tian
The fungus Colletotrichum gloeosporiodes infects plant hosts with a specialized cell called an appressorium, which is melanized and required for plant cell wall penetration. Here, we show that the mitogen-activated protein kinase CgMK1 governs appressorium formation and virulence in the poplar anthracnose fungus C. gloeosporioides. Deletion of CgMK1 impairs aerial hyphal growth and biomass accumulation, and CgMK1 is responsible for the expression of melanin biosynthesis-associated genes. CgMK1 deletion mutants are unable to form appressorium and lose the capacity to colonize either wounded or unwounded poplar leaves, leading to loss of virulence...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29170310/13%C3%A2-prophylactic-antibiotics-for-penetrating-injury-a-review-of-practice-at-a-major-trauma-centre-literature-review-and-recommendations
#11
Marharyta Kamarova, Richard Kendall
BACKGROUND: There is a lack of clarity regarding the use of prophylactic antibiotics for patients presenting with penetrating injuries. A structured literature review and review of penetrating injury records in an MTC was undertaken with a view to help guide clinical practice. METHOD: Searches were conducted on Medline (1946-2017), Embase (1974-2017), and Cochrane (up to 2017) using key words pertaining to penetrating trauma, prophylactic antibiotics and infection...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29161213/laparoscopic-management-of-penetrating-thoracoabdominal-trauma
#12
Megan C Prunty, Siddharth Kudav, Jacob A Quick
BACKGROUND: Traumatic thoracoabdominal injuries can involve multiple organs and multiple cavities, which increases the complexity of surgical management. Traditionally, these injuries required laparotomy and thoracotomy. However, minimally invasive intervention may be reasonable for stable patients. MATERIALS AND METHODS: We present a case of a thoracoabdominal gunshot wound resulting in multiorgan, multicavity injury to the lung, diaphragm, and liver. We performed hepatorrhaphy and diaphragm repair, and addressed a retained hemothorax through a transabdominal laparoscopic approach...
November 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29158275/a-simplified-derivative-of-human-defensin-5-with-potent-efficiency-against-multidrug-resistant-acinetobacter-baumannii
#13
Cheng Wang, Gaomei Zhao, Song Wang, Yin Chen, Yali Gong, Shilei Chen, Yang Xu, Mengjia Hu, Xinmiao Wang, Hao Zeng, Aiping Wang, Dengqun Liu, Yongping Su, Tianmin Cheng, Fang Chen, Junping Wang
The increasing incidence of multidrug-resistant Acinetobacter baumannii (MDRAb) infections worldwide has necessitated the development of novel antibiotics. Human defensin 5 (HD5) is an endogenous peptide with a complex architecture and antibacterial activity against MDRAb In the present study, we attempted to simplify the structure of HD5 by removing disulfide bonds. We found that the Cys2-4 bond was most indispensable for HD5 to inactivate MDRAb, although the antibacterial activity of the derivative was significantly attenuated...
November 20, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29140861/sealing-of-corneal-lacerations-using-photoactivated-rose-bengal-dye-and-amniotic-membrane
#14
Timothy A Soeken, Hong Zhu, Sheri DeMartelaere, Brett W Davies, Mirang Kim, Heuy-Ching Wang, James Aden, Rose Grimm, Clemens Alt, Irene E Kochevar, Anthony J Johnson
PURPOSE: Watertight closure of perforating corneoscleral lacerations is necessary to prevent epithelial ingrowth, infection, and potential loss of the eye. Complex lacerations can be difficult to treat, and repair with sutures alone is often inadequate. In this study, we evaluated a potentially sutureless technology for sealing complex corneal and scleral lacerations that bonds the amniotic membrane (AM) to the wound using only green light and rose bengal dye. METHODS: The AM was impregnated with rose bengal and then sealed over lacerations using green light to bond the AM to the deepithelialized corneal surface...
November 14, 2017: Cornea
https://www.readbyqxmd.com/read/29131915/visual-and-refractive-outcomes-of-children-after-early-secondary-cataract-extraction-following-wound-repair-for-penetrating-ocular-trauma
#15
Kamaldeep Arora, Priyanka Arora, Suma Ganesh, Shriya Gupta, Rashmi Ranjan Das
PURPOSE: To evaluate the visual and refractive outcomes in children 8 years of age or younger with corneal laceration and cataract following penetrating ocular injuries who underwent primary corneal tear repair followed within 1 to 8 weeks by early secondary cataract extraction. METHODS: This retrospective, non-comparative case series reviewed the admission and operative charts of children 8 years of age or younger (range: 3 to 8 years) who underwent corneal wound repair as the primary surgical procedure followed within 1 to 8 weeks by cataract extraction with intraocular lens implantation, with a minimum follow-up period of 6 months...
November 11, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29124035/successful-tractotomy-technique-for-a-penetrating-lung-injury-in-a-patient-with-one-lung
#16
Dong Hoon Kang, Hyun Oh Park, Sung Ho Moon, In Seok Jang, Jung Hoon Byun, Sung Hwan Kim
We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29120063/systematic-sonography-for-detection-of-occult-wounds-in-trauma
#17
Jordan Rupp, Warren Cooper, Robinson Ferre
Treating victims of penetrating trauma is challenging, especially in a mass-casualty or resource-limited setting. The traditional focused assessment with sonography for trauma examination is a well-established clinical tool in the initial evaluation of trauma victims. This article describes a novel technique of systematic sonography of the abdomen to look for occult wounds, which is used in conjunction with the focused assessment with sonography for trauma examination to evaluate occult intraperitoneal injury and improve patient treatment and use of resources...
November 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29119221/preparing-japanese-surgeons-for-potential-mass-casualty-situations-will-require-innovative-and-systematic-programs
#18
H Uchino, V Y Kong, J L Bruce, G V Oosthuizen, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers...
November 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29115398/vibrio-vulnificus-infection-induces-the-maturation-and-activation-of-dendritic-cells-with-inflammatory-th17-polarizing-ability
#19
Arim Lee, Hui Xuan Lim, Myun Soo Kim, Daeho Cho, Kyung Ku Jang, Sang Ho Choi, Tae Sung Kim
Vibrio vulnificus (V. vulnificus) is a gram-negative bacterium, which causes life-threatening septicemia and gastroenteritis through the consumption of contaminated seafood or wound infection. In addition, V. vulnificus infection is known to stimulate the production of several pro-inflammatory cytokines, which are associated with inflammatory responses mediated predominantly by dendritic cells (DCs), functioning as antigen-presenting cells. The present study aimed to investigate whether V. vulnificus infection induced the maturation and activation of murine DCs, which have the ability to polarize T helper (Th) cells into Th17 cells...
November 1, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29109162/comparative-assessment-of-tedizolid-pharmacokinetics-and-tissue-penetration-between-diabetic-patients-with-wound-infections-and-healthy-volunteers-via-in-vivo-microdialysis
#20
Sean M Stainton, Marguerite L Monogue, Arlinda Baummer-Carr, Ashley K Shepard, James F Nugent, Joseph L Kuti, David P Nicolau
Herein, we present pharmacokinetic and tissue penetration data for oral tedizolid in hospitalized patients with diabetic foot infections (DFI) compared with healthy volunteers. Participants received oral tedizolid phosphate 200mg every 24 hours for 3 doses to achieve steady-state. A microdialysis catheter was inserted into the subcutaneous tissue near the margin of the wound for patients or into thigh tissue of volunteers. Following the 3(rd) dose, 12 blood and 14 dialysate fluid samples were collected over 24 hours to characterize tedizolid concentrations in plasma and interstitial extracellular fluid of soft tissue...
November 6, 2017: Antimicrobial Agents and Chemotherapy
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