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https://www.readbyqxmd.com/read/29115646/a-new-perspective-on-life-saving-procedures-in-a-battlefield-setting-emergency-cricothyroidotomy-needle-thoracostomy-and-chest-tube-thoracostomy-with-night-vision-goggles
#1
Sedat Bilge, Attila Aydın, Meltem Bilge, Cemile Aydın, Erdem Çevik, Mehmet Eryılmaz
BACKGROUND: In the patients with multiple and serious trauma, early applications of life-saving procedures are related to improved survival. We tried to experimentally determine the feasibility of life-saving interventions that are performed with the aid of night vision goggles (NVG) in nighttime combat scenario. METHODS: Chest tube thoracostomy (CTT), emergency cricothyroidotomy (EC), and needle thoracostomy (NT) interventions were performed by 10 combatant medical staff...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29114998/early-and-delayed-post-pneumonectomy-empyemas-microbiology-management-and-prognosis
#2
Jean-Baptiste Stern, Ludovic Fournel, Benjamin Wyplosz, Philippe Girard, Malik AlNakib, Dominique Gossot, Agathe Seguin-Givelet
INTRODUCTION: Post-pneumonectomy empyema (PPE) is the most severe complication of pneumonectomy. Microbiology and its impact on management and prognosis have rarely been reported Methods: We retrospectively reviewed the files of a series of 37 consecutive patients with PPE over a 10-year period with a special focus on microbiology, means used to treat empyema, and prognosis. RESULTS: PPE occurred within 14 days of pneumonectomy in 17 cases (early PPE) and after postoperative day 16 in 20 patients (delayed PPE)...
November 8, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29111081/timing-of-mortality-in-pediatric-trauma-patients-a-national-trauma-data-bank-analysis
#3
Cory McLaughlin, Jessica A Zagory, Michael Fenlon, Caron Park, Christianne J Lane, Daniella Meeker, Randall S Burd, Henri R Ford, Jeffrey S Upperman, Aaron R Jensen
BACKGROUND/PURPOSE: The classic "trimodal" distribution of death has been described in adult patients, but the timing of mortality in injured children is not well understood. The purpose of this study was to define the temporal distribution of mortality in pediatric trauma patients. METHODS: A retrospective cohort of patients with mortality from the National Trauma Data Bank (2007-2014) was analyzed. Categorical comparison of 'dead on arrival', 'death in the emergency department', and early (≤24h) or late (>24h) inpatient death was performed...
October 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29109057/broncho-pleural-fistula-after-pneumonectomy-risk-factors-and-management-focusing-on-open-window-thoracostomy
#4
Antonio Mazzella, Alessandro Pardolesi, Patrick Maisonneuve, Francesco Petrella, Domenico Galetta, Roberto Gasparri, Lorenzo Spaggiari
OBJECTIVE: We evaluated principal risk factors and different therapeutic approaches for post-pneumonectomy broncho-pleural fistula (BPF), focusing on open window thoracostomy (OWT). METHODS: We have retrospectively reviewed all patients treated by pneumonectomy for lung cancer from 1999 to 2014; we evaluated preoperative, operative and postoperative data, time between operation and fistula formation, size, treatment and predicting factors of BPF. Cumulative incidence curves for the development of BPF were drawn according to the Kaplan-Meier Method...
November 3, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29099006/a-26-year-old-man-with-dyspnea-and-chest-pain
#5
Saurabh Mittal, Akanksha Jain, Sudheer Arava, Vijay Hadda, Anant Mohan, Randeep Guleria, Karan Madan
A 26-year-old smoker male presented with a history of sudden onset dyspnea and right-sided chest pain. Chest radiograph revealed large right-sided pneumothorax which was managed with tube thoracostomy. High-resolution computed tomography thorax revealed multiple lung cysts, and for a definite diagnosis, a video-assisted thoracoscopic surgery-guided lung biopsy was performed followed by pleurodesis. This clinicopathologic conference discusses the clinical and radiological differential diagnoses, utility of lung biopsy, and management options for patients with such a clinical presentation...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29089729/sensitivity-of-computed-tomography-guided-transthoracic-biopsies-in-a-nigerian-tertiary-institution
#6
Sunday Adoga Edaigbini, Muhammad Balarabe Aminu, Ibrahim Zira Delia, Ndubuisi Anumenechi, Ikechukwuka Ifeanyichukwu Alioke, Benjamine Fomete, Modupeola Omotara A Samaila
INTRODUCTION: The indications for open biopsies for intrathoracic lesions have become almost negligible. This development was made possible by less invasive maneuvers such as computed tomography-guided (CT-guided) biopsy, thoracoscopy or video-assisted thoracoscopy, and bronchoscopy. CT-guided percutaneous lung biopsy was first reported in 1976. AIM OF STUDY: The aim of the study is to report our experience with CT-guided transthoracic biopsy. MATERIALS AND METHODS: Patients with clinical and radiological evidence of intrathoracic mass were counseled and consent obtained for the procedure...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29078686/uniportal-video-assisted-thoracoscopic-surgery-in-hemothorax
#7
REVIEW
Stefano Sanna, Luca Bertolaccini, Jury Brandolini, Desideria Argnani, Marta Mengozzi, Alessandro Pardolesi, Piergiorgio Solli
The management of hemothorax (spontaneous or, more often, due to thoracic trauma lesions), follows basic tenets well-respected by cardiothoracic surgeons. In most, a non-operative approach is adequate and safe, with a defined group of patients requiring only tube thoracostomy. Only a minority of patients need a surgical intervention due to retained hemothorax, persistent bleeding or incoming complications, as pleural empyema or entrapped lung. In the early 1990s, the rapid technological developments determined an increase of diagnostic and therapeutical indications for multiport video-assisted thoracoscopic surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing an earlier diagnosis, total clots removal and better tubes placement with less morbidity, reduced post-operative pain and shorter hospital stay...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078677/uniportal-video-assisted-thoracoscopic-surgery-vats-technique-is-associated-with-decreased-narcotic-usage-over-traditional-vats-lobectomy
#8
Scott Gregory Louis, William James Gibson, Chase Lynn King, Nirmal Kumar Veeramachaneni
BACKGROUND: Uniportal video-assisted thoracoscopic surgery (VATS) is gaining popularity internationally, but remains an uncommon practice in the United States. One proposed benefit is a decrease in narcotic usage and peri-operative pain when compared to traditional multiple incision VATS. The purpose of this study was to determine the post-operative narcotic usage between patients undergoing anatomic lobectomy via traditional VATS as compared to patients undergoing uniportal VATS. METHODS: All consecutive patients undergoing anatomic lobectomy for presumed malignancy by a single surgeon at an academic medical institution were recorded between July 2013 and September 2015...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29077240/training-and-assessing-critical-airway-breathing-and-hemorrhage-control-procedures-for-trauma-care-live-tissue-versus-synthetic-models
#9
Danielle Hart, Robert Rush, Gregory Rule, Joseph Clinton, Gregory Beilman, Shilo Anders, Rachel Brown, Mary Ann McNeil, Troy Reihsen, Jeffrey Chipman, Robert Sweet
INTRODUCTION: Optimal teaching and assessment methods and models for emergency airway, breathing and hemorrhage interventions are not currently known. The University of Minnesota Combat Casualty Training consortium (UMN CCTC) was formed to explore the strengths and weaknesses of synthetic training models (STMs) versus Live tissue (LT) models. In this study, we compare the effectiveness of best in class STMs versus an anesthetized caprine (goat) model for training and assessing 7 procedures: Junctional hemorrhage control, Tourniquet (TQ) placement, Chest seal, Needle thoracostomy (NCD), Nasopharyngeal airway (NPA), Tube thoracostomy, and Cricothyrotomy (Cric)...
October 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29062481/surgical-and-nonsurgical-outcomes-for-treating-a-cohort-of-empyema-thoracis-patients-a-monocenteric-retrospective-cohort-study
#10
Mohsen Sokouti, Morteza Ghojazadeh, Massoud Sokouti, Babak Sokouti
BACKGROUND: There are several studies reporting high success rates for surgical and nonsurgical treatments of empyema separately. The aim of current retrospective cohort study is to find the best treatment in low socio-economic areas. MATERIAL AND METHODS: A total of 149 patients were treated in the referring hospital from January 2002 to December 2008. The current retrospective cohort study was carried out by nonsurgical (medically & thoracenthesis & chest tube drainage with or without fibrinolytic agents) and surgical (VATS &open thoracotomy decortication methods) procedures in single center performed in thoracic and respiratory medicine wards...
December 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29037449/open-thoracostomy-as-treatment-of-chronic-empyema-with-bronchopleural-fistula
#11
M N Solís-Marquínez, J F López-Caleya
No abstract text is available yet for this article.
October 13, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28975363/decompression-of-tension-pneumothoraces-in-asian-trauma-patients-greater-success-with-lateral-approach-and-longer-catheter-lengths-based-on-computed-tomography-chest-wall-measurements
#12
S Goh, W R Xu, L T Teo
INTRODUCTION: Our study aims to compare the anterior and lateral approaches for needle thoracostomy (NT) and determine the adequacy of catheter lengths used for NT in Asian trauma patients based on computed tomography chest wall measurements. METHODOLOGY: A retrospective review of chest computed tomography scans of 583 Singaporean trauma patients during period of 2011-2015 was conducted. Four measurements of chest wall thickness (CWT) were taken at the second intercostal space, midclavicular line and fifth intercostal space, midaxillary line bilaterally...
October 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28948295/routine-versus-selective-chest-and-abdominopelvic-ct-scan-in-conscious-blunt-trauma-patients-a-randomized-controlled-study
#13
N Moussavi, H Ghani, A Davoodabadi, F Atoof, A Moravveji, S Saidfar, H Talari
PURPOSE: CT-scan is increasingly used in blunt trauma, but the real impact on patient outcome is still unclear. This study was conducted to assess the effect of performing routine (versus selective) chest and abdominopelvic CT-scan on patient admission time and outcome in blunt trauma. METHODS: Conscious and hemodynamically stable high-energy trauma patients were included (n = 140). Routine chest and abdominopelvic CT-scan was requested in addition to the conventional radiography and ultrasound for the intervention group and selective CT-scan according to clinical presentation was done for the control group...
September 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28932968/external-validation-of-a-tube-thoracostomy-complication-classification-system
#14
Yoginee Sritharen, Matthew C Hernandez, Nadeem N Haddad, Victor Kong, Damian Clarke, Martin D Zielinski, Johnathon M Aho
BACKGROUND: Tube thoracostomy (TT) is a commonly performed procedure which is associated with significant complication rates. Currently, there is no validated taxonomy to classify and compare TT complications across different populations. This study aims to validate such TT complication taxonomy in a cohort of South African trauma patients. METHODS: Post hoc analysis of a prospectively collected trauma database from Pietermaritzburg Metropolitan Trauma Service (PMTS) in South Africa was performed for the period January 2010 to December 2013...
September 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28930941/thoracic-irrigation-prevents-retained-hemothorax-a-prospective-propensity-scored-analysis
#15
Nathan W Kugler, Thomas W Carver, David Milia, Jasmeet S Paul
BACKGROUND: Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. While optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28927984/limiting-thoracic-ct-a-rule-for-use-during-initial-pediatric-trauma-evaluation
#16
Caroline Q Stephens, Meredith C Boulos, Christopher R Connelly, Arvin Gee, Mubeen Jafri, Sanjay Krishnaswami
BACKGROUND: Despite increases in imaging guidelines for other body-regions during initial trauma assessment and the demonstrated utility of chest radiographs (CXR), guidelines for use of thoracic computed-tomography (TCT) are lacking. We hypothesized that TCT utilization had not decreased relative to other protocolized CTs, and mechanism and CXR could together predict significant injury independent of TCT. METHODS: We performed a retrospective review of blunt trauma patients ≤18 y...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28885373/age-adjusted-charlson-comorbidity-score-is-associated-with-the-risk-of-empyema-in-patients-with-copd
#17
Chung-Han Ho, Yi-Chen Chen, Chin-Chen Chu, Jhi-Joung Wang, Kuang-Ming Liao
Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of pneumonia than the general population due to their impaired lung defense. They also have a higher risk of empyema and more comorbidities than patients without COPD. This study aimed to evaluate the risk of empyema in patients with COPD after adjusting for age and comorbidities using the age-adjusted Charlson comorbidity index (ACCI).Data were retrieved from the National Health Insurance Research Database. COPD patients were defined as inpatients aged >40 years with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for COPD...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28884222/diagnostic-feasibility-and-safety-of-ct-guided-core-biopsy-for-lung-nodules-less-than-or-equal-to-8-mm-a-single-institution-experience
#18
Ying-Yueh Chang, Chun-Ku Chen, Yi-Chen Yeh, Mei-Han Wu
OBJECTIVES: This retrospective study evaluated the diagnostic yield and safety of CT-guided core biopsy of pulmonary nodules ≤8 mm. METHODS: We determined the diagnostic yield and safety profile of CT-guided lung biopsies for 125 pulmonary nodules ≤8 mm. Pathological diagnoses were made by a combination of histopathological examination and imprint cytology. Results were compared with biopsy results for 134 pulmonary nodules >8 and ≤10 mm. RESULTS: Final diagnoses were established in 94 nodules ≤8 mm...
September 7, 2017: European Radiology
https://www.readbyqxmd.com/read/28838021/-management-of-thoracic-trauma
#19
Bassam Redwan, Christian Biancosino, Katina Nikolova, Thorsten Greve, Servet Bölükbas
Patients with a thoracic trauma are commonly treated by large bore chest tube thoracostomy and appropriate analgesia. The initial treatment is determined by the assessment of the emergency doctor and/or trauma surgeon. Severe intrathoracic lesions in polytrauma patients are rare. However, such injuries may be acutely life-threating. After primary stabilisation of the patients, imaging studies should be performed to assess the extent of the injuries and determine the treatment of choice. Assessment of such injuries should always be performed in a multidisciplinary team of anaesthesiologists, general surgeons, trauma surgeons and thoracic surgeons...
August 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#20
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
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