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https://www.readbyqxmd.com/read/29165431/spinal-accessory-nerve-preservation-in-modified-neck-dissections-surgical-and-functional-outcomes
#1
V Popovski, A Benedetti, D Popovic-Monevska, A Grcev, A Stamatoski, J Zhivadinovik
The spinal accessory nerve (SAN) or XI cranial nerve is frequently encountered during neck surgery, and as such is at risk of iatrogenic injury, resulting in "shoulder syndrome". Modified neck dissection (MND) with preservation of the SAN is based on desire to minimise the functional deformity associated with section of the eleventh nerve. The aim of this study was to analyse the intra-operative variations of the spinal accessory nerve pathway and to evaluate shoulder dysfunction postoperatively. The cross-sectional demonstration analysis was created through the medical records retrospectively of 165 consecutive patients who underwent neck dissections at our institution in the past 5 years with attention to ultrasound and MRI preoperative findings, type of neck dissection, type of identification and dissection of SAN, postoperative morbidity and survival rate...
October 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29164183/removal-of-a-severely-impacted-mandibular-third-molar-minimizing-the-risks-of-compromised-periodontium-nerve-injury-and-mandibular-fracture
#2
Christos Tsamis, Stylianos Rodiou, Athanasios Stratos, Nikolaos Gkantidis
A technique is presented for severely impacted and dentigerous-cyst-related mandibular third molar removal, avoiding any associated risks. CASE PRESENTATION: A healthy patient complained about unpleasant smell and taste in the mouth and unilateral extraoral palpation of a protuberance, at the right corner of the mandible. Restricted field CBCT showed a severely impacted third molar, which penetrated the inferior cortical bone of the mandibular corner and was associated with a dentigerous cyst that had resorbed considerable bone in the region...
November 21, 2017: Quintessence International
https://www.readbyqxmd.com/read/29162367/arterial-reconstructions-for-chronic-lower-extremity-ischemia-in-preadolescent-and-adolescent-children
#3
Jonathan L Eliason, Dawn M Coleman, Adam Gumushian, James C Stanley
OBJECTIVE: Chronic lower extremity ischemia in pediatric patients is uncommon. The intent of this study was to better define the arterial reconstructive options and their long-term durability in preadolescent and adolescent children having clinically relevant arterial occlusions affecting the lower extremity. METHODS: The medical records of 33 consecutive pediatric patients who underwent lower extremity revascularization for chronic ischemia at the University of Michigan from 1974 to 2016 were reviewed...
November 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29161303/nonlinear-dynamics-of-early-atherosclerotic-plaque-formation-may-determine-the-efficacy-of-high-density-lipoproteins-hdl-in-plaque-regression
#4
Alexander D Chalmers, Christina A Bursill, Mary R Myerscough
We use a computational model to explore the effect of foam cell accumulation on plaque regression following an increase in high density lipoprotein (HDL) influx into the plaque. Atherosclerotic plaque formation is the outcome of cellular and cytokine responses to low density lipoproteins (LDL) that penetrate the artery wall following an injury to the endothelium and become modified. We modelled the cells and cytokines that are most important in plaque formation using partial differential equations. The model includes monocytes and macrophages, foam cells, macrophage chemoattractants, endothelium-stimulating cytokines, modified low density lipoproteins (mod LDL) and HDL...
2017: PloS One
https://www.readbyqxmd.com/read/29161213/laparoscopic-management-of-penetrating-thoracoabdominal-trauma
#5
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/29156063/traumatic-ruptured-globe-from-a-22-cartridge-casing-in-a-2-year-old-girl
#6
Jacob S Martin, Devasis N Reddy, Heather A D Potter, Cat N Burkat
The authors report the case of a 2-year-old girl who presented with an acute ruptured globe secondary to penetration by the casing of a .22 caliber cartridge that was ignited by a car cigarette lighter. Although penetrating injuries are a common mechanism of ocular trauma, open globe induced by cartridge casing represents an unusual and preventable cause. [J Pediatr Ophthalmol Strabismus. 2017;54:e88-e90.].
November 17, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29155117/pediatric-non-missile-penetrating-head-injury-case-series-and-literature-review
#7
REVIEW
Evangelos Drosos, Dimitrios Giakoumettis, Alexandros Blionas, Andreas Mitsios, Georgios Sfakianos, Marios Themistocleous
BACKGROUND: Pediatric non-missile penetrating head injury (NMPHI) is usually accidental attributed mainly to the softer skulls of growing children. However, it is a rather rare entity and therefore no consensus exists regarding treatment, in order to effectively prevent the immediate and long-term complications. Throughout the literature practice, essentials are mostly discussed in case reviews and case series in general population. No data originating from randomized studies are available due to ethical and practical limitations...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29150222/retrospective-study-of-thoracotomy-performed-in-a-french-level-1-trauma-center
#8
A Mancini, A Bonne, A Pirvu, P Porcu, P Bouzat, J Abba, C Arvieux
OBJECTIVE: Resuscitative thoracotomy, a potentially life-saving procedure, is used exceptionally, and essentially for penetrating trauma. Most of the available literature is American while reports from Europe are sparse. We report our experience in a French level 1-trauma center. MATERIAL AND METHODS: Patient records (patient age, gender, mechanism of injury, indication for emergency thoracotomy, anatomic injuries, interventions and survival) for all patients who underwent emergency thoracotomy between January 2005 and December 2015 were analyzed...
November 14, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#9
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29141906/keratolimbal-allograft-for-limbal-stem-cell-deficiency-after-severe-corneal-chemical-injury-a-systematic-review
#10
Swapna S Shanbhag, Hajirah N Saeed, Eleftherios I Paschalis, James Chodosh
PURPOSE: To review the published literature on outcomes of keratolimbal allograft (KLAL) for the surgical treatment of limbal stem cell deficiency (LSCD) and corneal blindness after severe corneal chemical injury. METHODS: Literature searches were conducted in the following electronic databases: MEDLINE, EMBASE, Science Citation Index, CINAHL, LILACS and the Cochrane Library. Standard systematic review methodology was applied. The main outcome measure was the proportion of eyes with best-corrected visual acuity (BCVA) ≥20/200 at last follow-up...
November 15, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29141200/phosgene-oxime-injury-and-associated-mechanisms-compared-to-vesicating-agents-sulfur-mustard-and-lewisite
#11
Dinesh Giri Goswami, Rajesh Agarwal, Neera Tewari-Singh
Phosgene Oxime (CX, Cl2CNOH), a halogenated oxime, is a potent chemical weapon that causes immediate acute injury and systemic effects. CX, grouped together with vesicating agents, is an urticant or nettle agent with highly volatile, reactive, corrosive, and irritating vapor, and has considerably different chemical properties and toxicity compared to other vesicants. CX is absorbed quickly through clothing with faster cutaneous penetration compared to other vesicating agents causing instantaneous and severe damage...
November 12, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/29139308/the-impact-of-deployment-and-traumatic-brain-injury-on-the-health-and-behavior-of-children-of-us-military-service-members-and-veterans
#12
Tracey A Brickell, Louis M French, Sara M Lippa, Rael T Lange
This study examined the impact of service member/veteran (SMV) combat deployment and traumatic brain injury (TBI) on the health and behavior of his or her children. Participants were 104 female spouse caregivers of US SMVs who had sustained a mild, severe, or penetrating TBI. Participants completed the Children's Health and Behavior Questionnaire (CHBQ; r = .758 to .881) that evaluates school grades, behavior, medical health, emotional health, and social participation: (a) prior to the first combat deployment, (b) in the month prior to the TBI, (c) within 2 years after the TBI, and (d) 2 or more years after the TBI...
November 1, 2017: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/29133650/epidemiology-clinical-profile-and-factors-predicting-final-visual-outcome-of-pediatric-ocular-trauma-in-a-tertiary-eye-care-center-of-central-india
#13
Satendra Singh, Bhavana Sharma, Kavita Kumar, Aditi Dubey, Kanchan Ahirwar
PURPOSE: Ocular trauma constitutes an important cause of preventable visual morbidity worldwide. This study was done to study the incidence, sociodemographic pattern, and clinical profile of ocular trauma in pediatric age group. Also to evaluate the factors influencing final visual outcome in these patients. METHODS: This was a prospective interventional study concerning ocular trauma in pediatric patients up to 16 years of age of either sex. Various variables having an impact on final visual outcome were studied, and results were analyzed using statistical indices - relative risk, Chi-square test, P value, and linear regression analysis...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29132576/management-of-major-vascular-injuries-neck-extremities-and-other-things-that-bleed
#14
REVIEW
Chris Evans, Tim Chaplin, David Zelt
Vascular injuries represent a significant burden of mortality and disability. Blunt injuries to the neck vessels can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiography and managed with either antiplatelet medications or anticoagulation. In contrast, patients with penetrating injuries to the neck vessels require airway management, hemorrhage control, and damage control resuscitation before surgical repair. The keys to diagnosis and management of peripheral vascular injury include early recognition of the injury; hemorrhage control with direct pressure, packing, or tourniquets; and urgent surgical consultation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#15
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29131915/visual-and-refractive-outcomes-of-children-after-early-secondary-cataract-extraction-following-wound-repair-for-penetrating-ocular-trauma
#16
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/29129753/nitrogen-mustard-induced-corneal-injury-involves-the-sphingomyelin-ceramide-pathway
#17
Georgia Charkoftaki, James Jester, David Thompson, Vasilis Vasiliou
PURPOSE: Nitrogen mustard (NM), which simulates the effects of sulfur mustard (SM), is a potent vesicant known to cause irreversible corneal damage. This study investigates the mechanisms by which NM induces corneal damage by examining the impact of NM exposure on the morphology and lipidome of the cornea. METHODS: Intact ex vivo rabbit eyes were placed in serum-free DMEM organ culture. NM (0, 1, 2.5, 5 or 10 mg/ml) was applied to the central cornea for 5, 10 or 15 min using a 5 mm filter disk and subsequently rinsed with DMEM...
November 9, 2017: Ocular Surface
https://www.readbyqxmd.com/read/29125266/decision-making-in-very-severe-traumatic-brain-injury-glasgow-coma-scale-3-5-a-literature-review-of-acute-neurosurgical-management-of-the-most-severely-threatened-brain-trauma-patients
#18
Jeroen van Dijck, Florence Reith, Inge van Erp, Thomas van Essen, Andrew Maas, Wilco C Peul, Godard de Ruiter
BACKGROUND: Patients presenting with an early GCS score of 3-5 after blunt or penetrating skull-brain assaults are categorized as having sustained a very severe Traumatic Brain Injury (vs-TBI). This category is often overlooked in literature. Impact on patients and families lives however is huge and the question "whether to surgically treat or not" frequently poses a dilemma to treating physicians. Little is known about mortality and outcome, compared to what is known for the group of severe TBI patients (s-TBI) (GCS 3- 8)...
November 10, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29125177/surgical-management-of-impalement-injuries-to-the-trunk-of-dogs-a-multicentre-retrospective-study
#19
M Matiasovic, Z J Halfacree, A Moores, P Nelissen, S Woods, B Dean, G Chanoit, D C Barnes
OBJECTIVES: To review a large series of dogs referred for treatment of traumatic impalement injuries to the thorax and/or abdomen and to report aetiologies, injury characteristics, management and long-term outcomes. MATERIALS AND METHODS: Previously collected data on dogs that were surgically treated for impalement injuries to the trunk at six veterinary specialist referral institutions in the UK over an 11-year period were reviewed. Data included patient signalment, physiological variables, injury-specific variables, diagnostic imaging reports, surgical procedures undertaken, duration of hospitalisation, antibiotic use, complications and outcomes...
November 10, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29124035/successful-tractotomy-technique-for-a-penetrating-lung-injury-in-a-patient-with-one-lung
#20
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
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