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https://www.readbyqxmd.com/read/29619500/early-stage-osteonecrosis-of-the-femoral-head-where-are-we-and-where-are-we-going-in-year-2018
#1
REVIEW
Eric Larson, Lynne C Jones, Stuart B Goodman, Kyung-Hoi Koo, Quanjun Cui
Osteonecrosis of the femoral head (ONFH) is a devastating condition affecting relatively young patients whereby the femoral head is necrotic, resulting in significant pain, articular surface collapse, and eventual osteoarthritis. This condition has been highly associated with chronic steroid use, alcoholism, and hip trauma, as well as other less common conditions. Without intervention, this condition has a high likelihood of progressing and developing into end-stage osteoarthritis. Unfortunately, ONFH is difficult to diagnose on plain radiographs in the early stages of the disease, and often requires more advanced imaging modalities such as MRI in order to fully assess for early degeneration...
April 4, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29503437/bilateral-pneumothoraces-in-a-trauma-patient-after-dobhoff-tube-insertion
#2
Ali Abidali, Alicia Mangram, Gina R Shirah, Whitney Wilson, Ahmed Abidali, Phillip Moeser, James K Dzandu
BACKGROUND Dobhoff tube insertion is a common procedure used in the clinical setting to deliver enteral nutrition. Although it is often viewed as an innocuous bedside procedure, there are risks for numerous complications such as tracheobronchial insertion, which could lead to deleterious consequences. We present to our knowledge the first reported case of bilateral pneumothoraces caused by the insertion of a Dobhoff tube. In addition, we also discuss common pitfalls for confirming the positioning of Dobhoff tubes, as well as risk factors that can predispose a patient to improper tube placement...
March 5, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29402426/thoracic-injury-rule-out-criteria-and-nexus-chest-in-predicting-the-risk-of-traumatic-intra-thoracic-injuries-a-diagnostic-accuracy-study
#3
Saeed Safari, Fatemeh Radfar, Alireza Baratloo
INTRODUCTION: This study aimed to compare the diagnostic accuracy of NEXUS chest and Thoracic Injury Rule out criteria (TIRC) models in predicting the risk of intra-thoracic injuries following blunt multiple trauma. METHODS: In this diagnostic accuracy study, using the 2 mentioned models, blunt multiple trauma patients over the age of 15 years presenting to emergency department were screened regarding the presence of intra-thoracic injuries that are detectable via chest x-ray and screening performance characteristics of the models were compared...
February 2, 2018: Injury
https://www.readbyqxmd.com/read/29229219/computer-assisted-navigation-for-intramedullary-nail-fixation-of-intertrochanteric-femur-fractures-a-randomized-controlled-trial
#4
Ryan J Lilly, Denise M Koueiter, Kelly C Graner, Gregory P Nowinski, Jason Sadowski, Kevin D Grant
INTRODUCTION: Lag screw cutout is one of the most commonly reported complications following intramedullary nail fixation of intertrochanteric femur fractures. However, its occurrence can be minimized by a well-positioned implant, with a short Tip-to-Apex Distance (TAD). Computer-assisted navigation systems provide surgeons with the ability to track screw placement in real-time. This could allow for improved lag screw placement and potentially reduce radiation exposure to the patient and surgeon...
February 2018: Injury
https://www.readbyqxmd.com/read/29207391/tooth-extraction-locally-stimulates-proliferation-of-multiple-myeloma-in-a-patient-with-mandibular-localizations
#5
Jean-Daniel Kün-Darbois, Léonie Quenel, Smaïl Badja, Daniel Chappard
OBJECTIVES: Multiple myeloma (MM) is characterized by the occurrence of osteolytic lesions. MM treatment usually involves antiresorptive drugs (mainly bisphosphonates). CASE REPORT: A patient with an MM presented osteolytic lesions of the mandible. Extraction of teeth 45 and 46 was performed 5 years after the diagnosis of periodontitis. Four months later, osteonecrosis of the jaw (ONJ) was diagnosed at the extraction site. X-ray showed an extension of osteolytic lesions on the right side, close to the extraction site, without modification of the lesions on the left side...
2017: Acta Haematologica
https://www.readbyqxmd.com/read/29187218/open-stent-graft-repair-with-upper-half-sternotomy-for-blunt-thoracic-aortic-injury-a-case-report
#6
Toshinori Komatsu, Tamaki Takano, Hiromu Kehara, Megumi Fuke, Takamitsu Terasaki, Masayuki Sakaguchi
BACKGROUND: Thoracic endovascular aortic repair is now widely applied to the treatment of blunt aortic injury. However, its long-term outcomes remain unclear. Endoleakage and migration might occur in the long term, especially when younger patients undergo endovascular aortic repair. In open stent grafting, the proximal end of the open stent graft is directly sutured to the native aorta, which may reduce the risk of endoleakage and migration. We applied open stent grafting to the treatment of blunt aortic injury in the subacute phase and herein report the patient's clinical course...
November 29, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29049422/thoracic-trauma-now-and-then-a-10-year-experience-from-16-773-severely-injured-patients
#7
Klemens Horst, Hagen Andruszkow, Christian D Weber, Miguel Pishnamaz, Christian Herren, Qiao Zhi, Matthias Knobe, Rolf Lefering, Frank Hildebrand, Hans-Christoph Pape
BACKGROUND AND PURPOSE: Thoracic trauma remains to be a relevant injury to the polytraumatised patient. However, literature regarding how far changes in clinical guidelines for pre- and in-hospital trauma management and diagnostic procedures affect the outcome of multiple injured patients with severe chest injury during a long-term observation period is sparse. METHODS: Multiple traumatised patients (age≥16y) documented in the TraumaRegister DGU® (TR-DGU) from January 1st 2005 to December 31st 2014 with severe chest trauma (AIS≥3) were included in this study...
2017: PloS One
https://www.readbyqxmd.com/read/29042693/occult-sources-of-bleeding-in-blunt-trauma-a-narrative-review
#8
REVIEW
Tetsuya Yumoto, Yoshinori Kosaki, Yasuaki Yamakawa, Atsuyoshi Iida, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Hiromichi Naito, Takaaki Osako, Atsunori Nakao
Worldwide, hemorrhagic shock in major trauma remains a major potentially preventable cause of death. Controlling bleeding and subsequent coagulopathy is a big challenge. Immediate assessment of unidentified bleeding sources is essential in blunt trauma patients with hemorrhagic shock. Chest/pelvic X-ray in conjunction with ultrasonography have been established classically as initial diagnostic imaging modalities to identify the major sources of internal bleeding including intra-thoracic, intra-abdominal, or retroperitoneal hemorrhage related to pelvic fracture...
October 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28930942/surgical-residents-interpretation-of-diagnostic-radiologic-imaging-in-the-traumatically-injured-patient
#9
Elias Fakhoury, Daria Abolghasemi, Justin McKinney, Alena Naumova, Scott Wessner, Osama Elsawy, Jamshed Zuberi, Robert V Madlinger
BACKGROUND: Senior surgical residents are of paramount importance in directing further therapeutic modalities based on their interpretation of critical diagnostic imaging. We propose that senior surgical residents are proficient with interpreting radiologic imaging studies in the trauma patient. METHODS: A prospective cohort study was performed comparing surgery resident interpretations of computed tomography (CT) scans of the head, maxillofacial bones, spine (cervical, thoracic, lumbar), chest, abdomen, pelvis, and chest X-rays versus final radiologists' reports at a Level II trauma center from September 2014 to May 2015...
January 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#10
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28809633/the-potential-of-the-icuc%C3%A2-documentation-concept-to-improve-trauma-surgery
#11
P Regazzoni, A A Fernandez Dell'oca, S M Perren
Conventional documentation of surgical procedures using only pre- and postoperative X-ray images and possibly a few intra-operative pictures does not allow secondary analysis of the technical performance in detail. In particular, the quality of the handling of tissues and surgical tools cannot be judged «post hoc», i.e. after the end of the surgical procedure. The invasiveness of the surgical act cannot yet be quantified. Surrogate invasiveness indices have therefore been developed. Furthermore, conventional documentation does not allow evaluation of the proper use of the C-arm both technically and with regard to fluoroscopy time...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28711207/dual-energy-computed-tomography-applications-for-the-evaluation-of-the-spine
#12
REVIEW
Peter Komlosi, Max Wintermark
Capturing the energy-dependent x-ray attenuation of different tissues, dual-energy computed tomography offers multiple benefits in the imaging of the spine, such as bone and iodinated contrast removal, monosodium urate imaging, and robust reduction of beam-hardening artifacts. The emerging new applications of this technique include bone marrow imaging in acute trauma and myeloinfiltrative disorders, improved bone density determination, and noninvasive assessment of spinal gout.
August 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/28695555/adherence-to-osteoporosis-pharmacotherapy-one-year-after-osteoporotic-fracture-a-swiss-trauma-center-secondary-prevention-project
#13
Sabrina Morell, Christoph Hemmeler, Felix Amsler, Thomas Gross
AIMS OF THE STUDY: According to current evidence, one out of ten fracture patients with osteoporosis does not sustain another fracture if he or she is on adequate medication. However, epidemiological surveys show that only about 15 to 30% of affected patients avail themselves of the treatments. This cohort study investigated how many fracture patients with a recommendation for antiosteoporotic therapy effectively received treatment and the possible reasons why the treatment was not implemented...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#14
REVIEW
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading causes of accessing pediatric emergency departments; however, only a limited number of patients develops clinically relevant brain injuries. OBJECTIVES: The aim of this review is to provide physicians a clinical pathway for managing pediatric minor head trauma. METHODS: A Pubmed/Medline search was conducted through the following entries: "minor head trauma", "mild head trauma", "minor head injury", "mild head injury" or "acute head trauma"...
2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28391778/delayed-right-chylothorax-after-left-blunt-chest-trauma-a-case-report
#15
Jonggeun Lee, Jeong Su Cho, Hoseok I, Yeong Dae Kim
BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28286834/thoracic-injury-rule-out-criteria-in-prediction-of-traumatic-intra-thoracic-injuries-a-validation-study
#16
Setareh Asgarzadeh, Bahareh Feizi, Farhad Sarabandi, Morteza Asgarzadeh
INTRODUCTION: Doing Chest X Ray (CXR) for all trauma patients is not efficient and cost effective due to its low diagnostic value. The present study was designed aiming to evaluate the diagnostic accuracy of thoracic injury rule out criteria (TIRC) in prediction of traumatic intra-thoracic injuries and need for CXR. METHOD: The present study is a prospective cross-sectional study that has been carried out to evaluate the accuracy of TIRC model in screening blunt multiple trauma patients in need of CXR for ruling out intra-thoracic injuries...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28255506/spinal-epidural-hematoma-related-to-vertebral-fracture-in-an-atypical-rigid-diffuse-idiopathic-skeletal-hyperostosis-a-case-report
#17
José Ramírez Villaescusa, Marcela Restrepo Pérez, David Ruiz Picazo
INTRODUCTION: Spinal epidural hematoma (SEH) is a rare disease that causes cord compression and neurologic deficit. Spontaneous SEH is related to minor trauma, bleeding disorders, and anticoagulant medications. Posttraumatic SEH has been associated with low-energy spine hyperextension injuries in patients with ankylosing spinal disorders such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). A variant named atypical DISH-like with SEH is reported. OBJECTIVE: To describe the management, diagnosis, and treatment of an unusual SEH case in a patient causing delayed neurologic deficit with rigid atypical DISH-like spine...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28247259/vertebral-fracture-assessment-in-patients-presenting-with-a-non-hip-non-vertebral-fragility-fracture-experience-of-a-uk-fracture-liaison-service
#18
Aina Capdevila Reniu, Terence Ong, Syed Ajmal, Opinder Sahota
Twenty-five percent of patients with a non-hip non-vertebral fragility fracture have an undiagnosed vertebral fracture detected by vertebral fracture assessment during bone densitometric assessment. The prevalence of an undiagnosed vertebral fracture is higher in older people, and they are more likely to have multiple vertebral fractures. PURPOSE: Most vertebral fragility fractures (VFF) have no history of trauma. Vertebral fracture assessment (VFA) during dual energy x-ray absorptiometry (DXA) can be used to detect these VFFs...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28222408/severe-osteoporosis-with-multiple-spontaneous-vertebral-fractures-in-a-young-male-carrying-triple-polymorphisms-in-the-vitamin-d-receptor-collagen-type-1-and-low-density-lipoprotein-receptor-related-peptide-5-genes
#19
Maria P Yavropoulou, Panagoulia Kollia, Dimitris Chatzidimitriou, Stavroula Samara, Lemonia Skoura, John G Yovos
Osteoporosis is a common disease with a strong genetic component. Several studies have reported the vitamin D receptor (VDR), collagen type I (COL1A1), and LDL receptor-related protein 5 (LRP5) genes as the most likely candidates. However, most of the studies have been carried out in postmenopausal women and older men and show inconsistent results. CASE PRESENTATION: We report a case of a 26-year old male who presented with severe back pain of acute onset, unrelated to any kind of trauma, and diffuse myalgia...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28114974/a-misdiagnosed-case-of-osteoid-osteoma-of-the-talus-a-case-report-and-literature-review
#20
REVIEW
Huan He, Hailin Xu, Hao Lu, Yu Dang, Wei Huang, Qing Zhang
BACKGROUND: Osteoid osteoma (OO) is a common benign bone tumour that is rarely found in the talus. Its nidus is difficult to detect on early imaging. The atypical symptoms of OO and the presence of concurrent trauma or sports injuries may lead to misdiagnosis and delayed treatment. We herein analyse a case of misdiagnosis of OO of the talus and discuss how to improve the early diagnosis of this rare lesion, thereby permitting rapid treatment. CASE PRESENTATION: A 23-year-old man with a history of left ankle sprains and chronic pain was diagnosed with another ankle sprain and managed conservatively based on normal X-ray findings...
January 23, 2017: BMC Musculoskeletal Disorders
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