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https://www.readbyqxmd.com/read/29054228/novel-airway-and-ventilator-management-of-tracheobronchial-disruption-after-blunt-trauma
#1
Nitin Mehdiratta, Michael Archer, Melissa Stewart, Bradley Dennis, Eric Grogan
Tracheobronchial injuries can be difficult to diagnose and manage, especially in the presence of polytrauma. A 50-year-old woman presented as a Level I trauma activation after being struck by a motor vehicle. Initial evaluation demonstrated intracranial hemorrhage and multiple chest injuries, including multilevel bilateral rib fractures, pneumomediastinum, and concern for tracheobronchial injury. After initial stabilization, bronchoscopy was performed and demonstrated an injury to the carina. We report a novel airway and ventilation strategy in the setting of concomitant tracheobronchial injury after severe blunt chest trauma in which extracorporeal support is contraindicated...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29053055/successful-surgical-repair-and-recovery-in-a-2-week-old-infant-after-birth-related-cervical-fracture-dislocation
#2
Sara Saleh, Kyle I Swanson, Taryn Bragg
Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma-induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient's birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury...
October 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29037487/-chronic-chest-pain-after-rib-fracture-it-can-cause-a-disability
#3
S Rabiou, Y Ouadnouni, M Lakranbi, A Traibi, F Antoini, M Smahi
INTRODUCTION: The rib fractures and instability of the chest wall are the main lesions of closed chest trauma. These lesions can be a source of chronic, often disabling with daily discomfort resulting limitation of some activities. The objective of this study was to assess the prevalence of this phenomenon in order to improve the quality of early care. METHODOLOGY: Through an observational retrospective cohort study on a number of 41 patients supported and monitored for traumatic rib fractures at the Military Hospital of Meknes during the period from October 2010 to March 2016...
October 13, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29036016/exercise-preserves-physical-function-in-prostate-cancer-patients-with-bone-metastases
#4
Daniel A Galvão, Dennis R Taaffe, Nigel Spry, Prue Cormie, David Joseph, Suzanne K Chambers, Raphael Chee, Carolyn Peddle-McIntyre, Nicolas H Hart, Freerk T Baumann, James Denham, Michael Baker, Robert U Newton
PURPOSE: The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the community setting due to concerns of fragility fracture. We examined the efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases. METHODS: Between 2012 and 2015, 57 prostate cancer patients (70.0±8.4 years; BMI 28.7±4.0 kg/m) with bone metastases (pelvis 75...
October 14, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/29033151/is-it-adequate-to-carry-out-a-chest-ct-in-patients-with-mild-moderate-chest-trauma
#5
V García de Pereda de Blas, M Carreras Aja, S Carbajo Azabal, E Arana-Arri
Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan...
October 12, 2017: Radiología
https://www.readbyqxmd.com/read/29023277/diagnosis-and-treatment-of-slipping-rib-syndrome
#6
Cassidy M Foley, Dai Sugimoto, David P Mooney, William P Meehan, Andrea Stracciolini
OBJECTIVE: (1) To investigate the clinical presentation, diagnosis, and treatment of slipping rib syndrome in athletes; (2) to investigate the hooking maneuver for diagnosis of slipping rib syndrome. DESIGN: Retrospective chart review of 362 athletes with rib pain. SETTING: Pediatric-based sports medicine clinic between January 1, 1999, and March 1, 2014. PATIENTS: Costochondritis, Tietze, fractures, rib tip syndrome, and unclear diagnoses were excluded...
October 6, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28965301/minimal-trauma-ankle-fractures-predominate-during-pregnancy-a-17-year-retrospective-study
#7
Madhuni Herath, Phillip Wong, Anne Trinh, Carolyn A Allan, Euan M Wallace, Peter R Ebeling, Peter J Fuller, Frances Milat
This study assessed all fractures occurring in pregnancy at a tertiary referral centre over a 17-year period. Most fractures were due to minimal trauma, and those involving the ankle were the most common. Women tended to fracture during their second and third trimesters and most required surgical intervention during pregnancy. PURPOSE: To characterise fractures in pregnancy over a 17-year period at a tertiary referral health service. METHODS: Medical records at the Monash Health in Australia were examined from 2000-2016 for fractures in pregnancy using the birthing outcome system database and the tenth revision of the International Statistical Classification of Diseases and Related Health Problems coding...
September 30, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28963613/cardiothoracic-injuries-after-cardiopump-cpr-a-report-of-two-cases-and-review-of-the-literature
#8
Martin Kolopp, Angélique Franchi, Patrick Grafiadis, Laurent Martrille
Although many clinical trials have demonstrated its efficacy during active compression-decompression cardiopulmonary resuscitation (ACD-CPR), the Ambu® CardioPump seems likely to cause severe and sometimes lethal injuries. In this paper, we report two cases observed at the Institute of Legal Medicine of Nancy, France. A 67-year-old man collapsed in the street, in the presence of witnesses, and without any sign of trauma. The autopsy revealed a flail chest, a wound of the left ventricle, a rupture of the right ventricle, and a wrenching of the inferior vena cava...
September 29, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28959133/traumatic-gastric-perforation-associated-with-cardiopulmonary-resuscitation-a-case-report
#9
Yosuke Arai, Soichiro Honjo, Syota Shimizu, Masaki Morimoto, Masataka Amisaki, Tomohiro Osaki, Naruo Tokuyasu, Teruhisa Sakamoto, Yoshihiko Maeta, Keigo Ashida, Hiroaki Saito, Yoshiyuki Fujiwara
Sternal and rib fractures are well-known complications of cardiopulmonary resuscitation (CPR). We experienced a rare case of traumatic gastric perforation associated with CPR that required emergency laparotomy. In this case, we examined whether surgery is essential for gastric perforation associated with CPR. A 67-year-old man experienced cardiopulmonary arrest in the workplace, and bystander CPR was performed by his colleagues. He was then transported by ambulance to our hospital. A large amount of free air was found in the peritoneal cavity on computed tomography at presentation, and perforation of the gastrointestinal tract was suspected...
September 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28958357/thoracic-trauma
#10
REVIEW
Bradley M Dennis, Seth A Bellister, Oscar D Guillamondegui
Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958283/guideline-driven-care-improves-outcomes-in-patients-with-traumatic-rib-fractures
#11
Kathleen Flarity, Whitney C Rhodes, Andrew J Berson, Brian E Leininger, Paul E Reckard, Keyan D Riley, Charles P Shahan, Thomas J Schroeppel
There is no established national standard for rib fracture management. A clinical practice guideline (CPG) for rib fractures, including monitoring of pulmonary function, early initiation of aggressive loco-regional analgesia, and early identification of deteriorating respiratory function, was implemented in 2013. The objective of the study was to evaluate the effect of the CPG on hospital length of stay. Hospital length of stay (LOS) was compared for adult patients admitted to the hospital with rib fracture(s) two years before and two years after CPG implementation...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28947526/management-of-amiodarone-extravasation-with-intradermal-hyaluronidase
#12
Ashley N Fox, Ruben Villanueva, Jamie L Miller
PURPOSE: The case of a patient who experienced extravasation while receiving amiodarone via a peripheral infusion and was treated with intradermal hyaluronidase is reported. SUMMARY: A 60-year-old Caucasian man arrived at the emergency department after a motor vehicle collision. The patient was noted to have a subdural hematoma, multiple rib fractures, sternal body fracture, abdominal wall injury, left clavicle fracture, right humerus fracture, and vertebral fractures...
October 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28929041/severe-late-toxicity-after-adjuvant-breast-radiotherapy-in-a-patient-with-a-germline-ataxia-telangiectasia-mutated-gene-future-treatment-decisions
#13
Maryam Dosani, Kasmintan A Schrader, Alan Nichol, Sophie Sun, Tamara Shenkier, Zoe Lohn, Gudrun Aubertin, Scott Tyldesley
Ataxia telangiectasia mutated (ATM) gene mutations may confer increased sensitivity to ionizing radiation and increased risk of late toxicity for cancer patients. We present the case of a 55-year-old female treated with adjuvant breast and regional nodal radiation following lumpectomy and axillary lymph node dissection for stage II invasive ductal carcinoma of the breast. She developed severe telangiectasia, fibrosis, induration, chest wall pain (with evidence of rib fractures on imaging), and painful limitation in her range of motion at the shoulder...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#14
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28912975/an-incidentally-detected-right-ventricular-pseudoaneurysm
#15
Vamsi C Gaddipati, Angel I Martin, Mauricio O Valenzuela, Asef Mahmud, Aarti A Patel
Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28906368/traumatic-fractures-as-a-result-of-falls-in-children-and-adolescents-a-retrospective-observational-study
#16
Hongwei Wang, Hailong Yu, Yue Zhou, Changqing Li, Jun Liu, Lan Ou, Yiwen Zhao, Guoli Song, Jianda Han, Yu Chen, Liangbi Xiang
The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height <2 m). The incidence and pattern were summarized with respect to different age groups, year of admission, etiologies, genders, and the neurological function...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905100/frequency-and-influencing-factors-of-cardiopulmonary-resuscitation-related-injuries-during-implementation-of-the-american-heart-association-2010-guidelines-a-retrospective-study-based-on-autopsy-and-postmortem-computed-tomography
#17
Rutsuko Yamaguchi, Yohsuke Makino, Fumiko Chiba, Suguru Torimitsu, Daisuke Yajima, Go Inokuchi, Ayumi Motomura, Mari Hashimoto, Yumi Hoshioka, Tomohiro Shinozaki, Hirotaro Iwase
AIM: To determine the frequency of cardiopulmonary resuscitation (CPR)-related injuries and factors involved in their occurrence, data based on forensic autopsy and postmortem computed tomography (PMCT) during implementation of the 2010 American Heart Association Guidelines for CPR were studied. METHODS: We retrospectively evaluated data on adult patients with non-traumatic deaths who had undergone manual CPR and autopsy from January 2012 to December 2014. CPR-related injuries were analyzed on autopsy records and PMCT images and compared with results of previous studies...
September 13, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#18
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28894371/radiologic-findings-of-thoracic-trauma
#19
Cihan Akgul Ozmen, Serdar Onat, Delal Aycicek
INTRODUCTION: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. METHODS: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28882147/unexpected-collateral-impact-after-out-of-hospital-resuscitation-using-lucas-system
#20
Jasmin Hasmik Shahinian, Jonas Quitt, Mark Wiese, Friedrich Eckstein, Oliver Reuthebuch
BACKGROUND: Mechanical chest compression using a piston device during reanimation is often the only way to ensure stable chest compression at a constant rate and force. However, its use can be associated with severe fractures of the thoracic rib cage and endanger the clinical course of the patient. Thus, the usage of such a piston device during the reanimation has currently been classified as a mere Class IIB indication. CASE PRESENTATION: We present a case of a 66-year-old male who underwent emergent CABG surgery after receiving out-of-hospital resuscitation as a result of myocardial infarction using the LUCAS system...
September 7, 2017: Journal of Cardiothoracic Surgery
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