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https://www.readbyqxmd.com/read/28538630/the-evolution-of-care-improves-outcome-in-blunt-thoracic-aortic-injury-a-western-trauma-association-multicenter-study
#1
Steven R Shackford, Casey E Dunne, Riyad Karmy-Jones, William Long, Desarom Teso, Martin A Schreiber, Justin Watson, Cheri Watson, Robert C McIntyre, Lisa Ferrigno, Mark L Shapiro, Kevin Southerland, Julie A Dunn, Paul Reckard, Thomas M Scalea, Megan Brenner, William A Teeter
BACKGROUND: The management of blunt thoracic aortic injury (BTAI) has evolved radically in the last decade with changes in the processes of care and the introduction of thoracic endovascular repair (TEVAR). These changes have wrought improved outcome, but the direct effect of TEVAR on outcome remains in question as previous studies have lacked vigorous risk adjustment and long-term follow-up. To address these knowledge gaps, we compared the outcomes of TEVAR, open surgical repair, and nonoperative management for BTAI...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538286/any-cortical-bridging-predicts-healing-of-supracondylar-femur-fractures-after-treatment-with-locked-plating
#2
Patrick K Strotman, Madhav A Karunakar, Rachel Seymour, William D Lack
OBJECTIVES: To determine the accuracy and reliability of radiographic cortical bridging criteria in predicting the final healing of supracondylar femur fractures after treatment with locked plating. DESIGN: Retrospective review SETTING:: Two level 1 trauma centers PATIENTS/PARTICIPANTS:: We retrospectively reviewed the records at two level 1 trauma centers for patients who presented with supracondylar femur fractures (AO/OTA 33A, C) and were treated with locking plate fixation between 1/1/2004 and 1/1/2011...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28534652/a-review-of-the-evidence-of-zolpidem-efficacy-in-neurological-disability-after-brain-damage-due-to-stroke-trauma-and-hypoxia-a-justification-of-further-clinical-trials
#3
J A Sutton, R P Clauss
During 15 years, 23 clinical reports and 6 studies have demonstrated associations between sub-sedative doses of zolpidem and recoveries from brain damage due to strokes, trauma and hypoxia. Clinical findings include unexpected awakenings from vegetative states and regressions of stroke symptoms after dosing that disappear during elimination and reappear on repeat dosing. Initially single-photon emission computed tomography scans showed improved perfusion within, around and distant from infarctions. Then positron emission tomography scans and electroencephalography detected renewed metabolic and neuronal activity...
May 23, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28533989/iatrogenic-spinal-subdural-extra-arachnoid-hygroma-following-uncomplicated-lumbar-decompression
#4
Benjamin D Elder, Wataru Ishida, Rory C Goodwin, Ali Bydon
Intradural spinal arachnoid cysts (ISACs) have been reported in the current literature as either an idiopathic disease or exceedingly rare sequelae after lumbar puncture, spinal trauma, or meningitis. Other studies have more appropriately termed the iatrogenic pathology as a spinal subdural extra-arachnoid hygroma (SSEH), as there is not often a clear cyst wall as in a true arachnoid cyst. However, to the best of our knowledge, none of the previous studies described an SSEH following uncomplicated posterior lumbar surgery, as they have previously involved clear durotomies during the initial operation...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28530261/a-rare-case-of-embryonal-rhabdomyosarcoma-of-the-parapharyngeal-space
#5
G Iannella, M De Vincentiis, A Corsi, A Greco, G Magliulo
A 24-year-old man was admitted to our Otolaryngology Department following a head and neck CT scan performed for cranial trauma that showed a bulky neoformation in the right parapharyngeal space. Magnetic resonance imaging confirmed the presence of an oval formation with sharp margins and colliquative areas of necrosis involving the right parapharyngeal space. The mass was completely excised by a latero-cervical approach. Based on histological features and immunohistochemical analysis, a diagnosis of embryonal rhabdomyosarcoma of the parapharyngeal space was made...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28530073/-red-herring-complaints-in-an-eighteen-years-old-female-with-a-hydatid-cyst-of-the-lung
#6
Nasser Nadim
Brain and eye hydatid cysts are early symptomatic, as opposed to those developing in other organs, including lungs, where they remain asymptomatic through adolescence, even to adulthood, due to their slow growth. Hence, discovering that patients have lung hydatid cyst occurs, frequently, during random chest imaging. Up to thirty percent of pulmonary echinococcal cysts may rupture spontaneously, after chest or abdominal trauma. The main lung hydatidosis complaints, such as dyspnea and chest pain, are caused by the reduction of the functional area of the lung, expectoration of the tapeworm cystoides into the bronchial tree, or by compression of surrounding structures...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#7
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28526902/retroclival-epidural-haematoma-a-diagnosis-to-suspect-report-of-three-cases-and-review-of-the-literature
#8
Gorka Zabalo, Rodrigo Ortega, Jorge Díaz, Alfonso Vázquez, Daniel de Frutos, Juan Carlos García, Idoya Zazpe
Retroclival epidural haematoma (REDH) has been reported infrequently. It is a rare entity which is probably underdiagnosed. It is most commonly seen in the paediatric population and is generally associated with high-velocity injuries. We report three cases of paediatric patients diagnosed with REDHs: two of them secondary to high-energy trauma related to a motor-vehicle accident and the other a low-energy trauma after a slip while playing football. All three patients were managed conservatively by cervical immobilisation with favourable outcome...
May 20, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28525467/analysis-of-cervical-angiograms-in-cervical-spine-trauma-patients-does-it-make-a-difference
#9
Tina Dreger, Howard Place, Theresa Mattingly, Christine Piper, Jennifer Brechbuehler
STUDY DESIGN: Retrospective review. OBJECTIVE: To evaluate computed tomography angiogram (CTA) use for diagnosing blunt vertebral artery injury (BVAI) at a single institution, to assess the incidence of BVAI in the studied population, and determine if diagnosis affected care. We also wanted to evaluate if testing and treatment resulted in complications. SUMMARY OF BACKGROUND DATA: BVAI is an example of a previously underdiagnosed injury. Ease of CTA has simplified vertebral artery evaluation...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28523439/magnetic-resonance-imaging-of-painful-swollen-legs-in-the-emergency-department-a-pictorial-essay
#10
REVIEW
Ashish Chawla, Niraj Dubey, Kian Ming Chew, Dinesh Singh, Vishal Gaikwad, Wilfred Cg Peh
Patients presenting with a painful swollen leg are not infrequently encountered at the emergency department and can pose a diagnostic dilemma for attending physicians. The potential causes of leg pain and swelling include trauma, infection, inflammation, and neurogenic, vascular, and iatrogenic conditions; with magnetic resonance imaging (MRI) being an important tool in evaluation. We describe the MRI features of various conditions causing painful swollen legs. We also discuss the differential diagnosis and the useful clinical and laboratory findings that radiologists should be aware of, in order to arrive at an accurate diagnosis...
May 18, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#11
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28523304/optical-coherence-tomography-applications-in-tooth-wear-diagnosis
#12
Veronica MercuŢ, Sanda Mihaela Popescu, Monica Scrieciu, Marina Olimpia Amărăscu, Mihaela Vătu, Oana Andreea Diaconu, Eugen Osiac, Ştefan Mugurel Ghelase
Dental wear represents an irreversible loss of dental hard tissue under the action of physical, chemical and mechanical factors, excluding dental caries and acute trauma. Four clinical forms of dental wear are described: erosion, attrition, abfraction, and abrasion. Most experts agree that in each clinical form multiple etiological factors are involved, one being predominant. Optical coherence tomography (OCT) is a non-invasive optical method characterized by a micronic resolution. The applications of this type of investigation are multiple in the medical field in recent years, and OCT is gaining a growing importance in dentistry...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523179/a-case-of-video-assisted-thoracoscopic-resection-of-malignant-transformation-of-pulmonary-recurrent-respiratory-papillomatosis
#13
Dana A Dominguez, David T Martin, Jeffrey B Velotta
Recurrent respiratory papillomatosis (RRP) is a disease of the respiratory tract caused by infection with the human papillomavirus (HPV) and is characterized by multiple recurring papillomas throughout the respiratory tract. Although rare, extra laryngeal involvement carries the risk of malignant transformation in 3-7% of adults. We report the case of a patient with unmonitored juvenile onset RRP with pulmonary involvement found to have malignant transformation to squamous cell carcinoma (SCC). Incidentally found on chest radiography for mild chest wall trauma, she was found to have a large left lower lobe mass with pathology consistent with SCC...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28521343/tarlov-cyst-causing-sacral-insufficiency-fracture
#14
Ross C Puffer, Marcus J Gates, William Copeland, William E Krauss, Jeremy Fogelson
BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521330/pediatric-penetrating-neck-trauma-hard-signs-of-injury-and-selective-neck-exploration
#15
Rober A Tessler, Huong Nguyen, Christoper Newton, James Betts
BACKGROUND: Selective neck exploration and computed tomography angiography (CTA) in penetrating neck trauma have been well described in adults. However, data in the pediatric population are sparse. The extent to which these practices have been adopted in pediatric patients is unknown. METHODS: Retrospective, single-center cohort study of pediatric penetrating neck trauma for the years 2001 to 2014 in a dedicated children's hospital/Level 1 pediatric trauma center...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#16
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28516467/lymph-vessel-thrombus-detection-in-cervical-lymphedema-a-case-series
#17
Georg Kunze, Martin Staritz
Although thrombosis in the terminal part of thoracic duct has been described in patients with head and neck cancer and upper vein thrombosis, normally medical imaging is not successful in depicting such lymphatic thrombosis. This case series is about three patients with acute onset of cervical lymphedema following minor trauma or exceptional physical strain. Using high-resolution ultrasound, it was possible to detect a thrombus formation in the terminal parts of the thoracic duct or the lymph duct. Within a few weeks all patients recovered without relapse for several years...
May 18, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28515563/secondary-eating-disorder-a-reality-case-report-of-post-brain-injury-sequelae
#18
Aparna Das, Deeksha Elwadhi, Manushree Gupta
Traumatic brain injury (TBI) can lead to changes in eating behavior patterns. This report describes the case of a patient with alcohol dependence presenting with behavioral changes and eating disorder following frontal lobe trauma. A 42-year-old male, premorbidly well-adjusted presented with alcohol use in dependent pattern for years. He sustained a subdural hematoma in the frontal lobe following a road traffic accident 10 years back. Post-TBI, the patient, started having low frustration tolerance, aggressive outbursts, disinhibition, difficulty in persisting with tasks, apathy, amotivation, and craving for food with inability to control intake on the sight of food...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28515283/anisomorphic-cortical-reorganization-in-asymmetric-sensorineural-hearing-loss
#19
Steven W Cheung, Craig Anthony Atencio, Eliott R J Levy, Robert C Froemke, Christoph E Schreiner
Acoustic trauma or inner ear disease may predominantly injure one ear, causing asymmetric sensorineural hearing loss (SNHL). While characteristic frequency (CF) map plasticity of primary auditory cortex (AI) contralateral to the injured ear has been detailed, there is no study that also evaluates ipsilateral AI to compare cortical reorganization across both hemispheres. We assess whether normal isomorphic mirror image relationship between the two hemispheres is maintained or disrupted in mild-to-moderate asymmetric SNHL of adult squirrel monkeys...
May 17, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28511233/-diagnostic-imaging-in-cases-of-acute-scrotum
#20
Natalie Ring, Gundula Staatz
Acute scrotum is one of the most common urologic emergencies in children and adolescents. This condition involves acute testicular pain, which is often accompanied by scrotal swelling and erythema. It is most important to distinguish between cases that require immediate surgery and those that can be treated conservatively. As patient history and physical findings may not always be unequivocal, ultrasound with Colour-Coded Doppler Sonography is the imaging modality of choice for further evaluation. Testicular torsion and other differential diagnoses such as epididymitis, appendiceal torsion, intratesticular haematoma after trauma, or complicated inguinal hernia have to be considered...
May 16, 2017: Aktuelle Urologie
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