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vascular AND trauma

Ekaterina V Medvedeva, Ekaterina A Grebenik, Svetlana N Gornostaeva, Vladimir I Telpuhov, Aleksey V Lychagin, Peter S Timashev, Andrei S Chagin
Articular hyaline cartilage is extensively hydrated, but it is neither innervated nor vascularized, and its low cell density allows only extremely limited self-renewal. Most clinical and research efforts currently focus on the restoration of cartilage damaged in connection with osteoarthritis or trauma. Here, we discuss current clinical approaches for repairing cartilage, as well as research approaches which are currently developing, and those under translation into clinical practice. We also describe potential future directions in this area, including tissue engineering based on scaffolding and/or stem cells as well as a combination of gene and cell therapy...
August 11, 2018: International Journal of Molecular Sciences
J F Cornelius, J Schipper, A Tortora, Z Krause-Molle, M Smuga, A K Petridis, H J Steiger
OBJECTIVE: To evaluate a new surgical tool combining suction and monopolar neurostimulation ("stimulation-sucker") for tumors of the cerebello-pontine angle (CPA). The usefulness for continuous (time) and dynamic (space) facial nerve mapping was studied. METHODS: Patients operated with the stimulation-sucker for a CPA tumor between April 2016 and May 2017 in a tertiary care center were identified. Clinical charts were retrospectively evaluated. The minimum follow-up time of patients was 12 months...
August 9, 2018: World Neurosurgery
Elizabeth George, Ashish Khandelwal, Christopher Potter, Aaron Sodickson, Srinivasan Mukundan, Diego Nunez, Bharti Khurana
Cerebrovascular injury is increasingly identified in patients presenting after blunt trauma due to the implementation of screening criteria and advances in noninvasive angiographic imaging by CT. The variable latent time before onset of secondary stroke presents a window of opportunity for prevention, reinforcing the importance of detection of asymptomatic patients via screening. Furthermore, the high morbidity and mortality associated with secondary stroke makes it imperative that radiologists recognize these challenging injuries...
August 10, 2018: Emergency Radiology
Antonia F Chen, Andrew Fleischman, Matthew S Austin
Intrawound antibiotics have been used in orthopaedic surgery procedures to prevent the development of surgical site infections. Local delivery of antibiotic powder has demonstrated a notable reduction in surgical site infection in rabbit and rodent in vivo models, as well as in other surgical fields, including vascular, colorectal, cardiothoracic, and dermatologic surgery. Intrawound antibiotic powder has been used in many orthopaedic applications, including spine surgery, total joint arthroplasty, trauma, foot and ankle reconstruction, and elbow surgery...
August 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
Cecilia L Dalle Ore, Robert C Rennert, Alexander J Schupper, Brandon C Gabel, David Gonda, Bradley Peterson, Lawrence F Marshall, Michael Levy, Hal S Meltzer
OBJECTIVE Pediatric traumatic subarachnoid hemorrhage (tSAH) often results in intensive care unit (ICU) admission, the performance of additional diagnostic studies, and ICU-level therapeutic interventions to identify and prevent episodes of neuroworsening. METHODS Data prospectively collected in an institutionally specific trauma registry between 2006 and 2015 were supplemented with a retrospective chart review of children admitted with isolated traumatic subarachnoid hemorrhage (tSAH) and an admission Glasgow Coma Scale (GCS) score of 13-15...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Lakshmikanth Halegubbi Karegowda, Tadigadapa Keerthi, Taruna Rathore, Kadavigere Rajagopal
No abstract text is available yet for this article.
August 8, 2018: BMJ Case Reports
Yiu Ming Wong
Fibrosis of skeletal muscle following acupuncture is an iatrogenic disorder. The present case illustrates a patient with a unilateral fibrotic formation on a thumb muscle after acupuncture injection therapy with red sage. The patient in the present case was a counter-terrorism police officer with right-handedness; he noted a palpable nodule three months after injection therapy at his left first dorsal interosseous in which the acupuncture point LI4 (He Gu) is located. He also found a reduction in the strength of his left pinch grip that noticeably affected his left handgun marksmanship...
September 2017: Journal of Pharmacopuncture
Ewelina Biskup
Cold and White - Hypothenar Hammer Syndrome Abstract. Hypothenar hammer syndrome (HHS) is a condition caused by digital ischemia as a result of repeated trauma to the little finger. Routine diagnosis should include a detailed medical history and a physical examination including Allen's test. Imaging of vascular lesions can be done initially by acral plethysmography and duplex sonography, or directly in the context of angiography (gold standard). Early diagnosis enables effective therapeutic strategies and preventing permanent sequelae...
August 2018: Praxis
Richard W Nicolay, Akhil A Tawari, Harish Kempegowda, Michael Suk, Brian Mullis
This study analyzes adherence to an evidence-based protocol established at two level I trauma centers to determine its effect on clinical decision making. The centers' trauma databases were retrospectively studied and 51 patients with long bone fractures were identified who required revascularization and orthopaedic intervention and survived long enough to receive an index intervention. An arterial shunt was the protocol's first step; the preprotocol rate of shunting was 9.5%, while the postprotocol rate of shunting was 3...
2018: Journal of Surgical Orthopaedic Advances
Jed T Ritter, Chadd K Kraus
Blunt traumatic cervical vascular injury (BCVI) is challenging to recognize, but it is a potentially devastating entity that warrants attention from emergency physicians. Injury to the vertebral or carotid artery can result in a delayed manifestation of neurologic injury that may be preventable if promptly recognized and treated. The modified Denver Criteria are frequently used to guide imaging decisions for BCVI; however, injuries can still be missed. We present a case of BCVI in a trauma patient whose initial presentation evaded standard screening criteria, illustrating the need for a high index of suspicion for BCVI in blunt trauma...
August 2018: Clinical practice and cases in emergency medicine
Liam R Harris, Alexandre Arkader, Alexander Broom, John Flynn, Joseph Yellin, Patrick Whitlock, Ashley Miller, Jeffrey Sawyer, John Roaten, David L Skaggs, Paul D Choi
BACKGROUND: Optimal management for a pulseless supracondylar humerus fracture associated with anterior interosseous nerve (AIN) or median nerve injury is unclear. The purpose of this study was to determine the incidence of pulseless supracondylar humerus fractures associated with AIN or median nerve injury, to assess open versus closed surgical management, to determine factors associated with the need for neurovascular intervention, and to report the outcome. METHODS: A retrospective review was performed at 4 pediatric trauma hospitals on all patients who sustained a Gartland III or IV supracondylar humerus fracture with the combination of absent distal palpable pulses and AIN or median nerve injury between 2000 and 2014...
August 4, 2018: Journal of Pediatric Orthopedics
Hironori Matsumoto, Jun Takeba, Kensuke Umakoshi, Satoshi Kikuchi, Muneaki Ohshita, Suguru Annen, Naoki Moriyama, Yuki Nakabayashi, Norio Sato, Mayuki Aibiki
Background: We conducted a prospective observational study for investigating coagulofibrinolytic changes and mechanisms of antithrombin (AT) alternations in trauma. Methods: Trauma patients hospitalized for more than seven days were analyzed for coagulofibrinolytic biomarkers. The patients were stratified into two groups according to AT activity level on admission (day 0), comprising normal AT and low AT patients. Results: Thirty-nine patients (median Injury Severity Score 20) exhibited initial coagulatory activation and triphasic fibrinolytic changes...
2018: Thrombosis Journal
Andrzej Loesch, Michael R Dashwood
The saphenous vein (SV) is the most commonly used conduit for revascularization in patients undergoing coronary artery bypass surgery (CABG). The patency rate of this vessel is inferior to the internal thoracic artery (ITA). In the majority of CABG procedures the ITA is removed with its outer pedicle intact whereas the (human) SV (hSV) is harvested with pedicle removed. The vasa vasorum, a microvessel network providing the adventitia and media with oxygen and nutrients, is more pronounced and penetrates deeper towards the lumen in veins than in arteries...
August 4, 2018: Journal of Cell Communication and Signaling
Michael M Safaee, Ramin A Morshed, Jordan Spatz, Sujatha Sankaran, Mitchel S Berger, Manish K Aghi
OBJECTIVE Interfacility neurosurgical transfers to tertiary care centers are driven by a number of variables, including lack of on-site coverage, limited available technology, insurance factors, and patient preference. The authors sought to assess the timing and necessity of surgery and compared transfers to their institution from emergency departments (ED) and inpatient units at other hospitals. METHODS Adult neurosurgical patients who were transferred to a single tertiary care center were analyzed over 12 months...
August 3, 2018: Journal of Neurosurgery
Atsuhito Uneda, Koji Hirashita, Satoru Yabuno, Takahiro Kanda, Kenta Suzuki, Atsushi Matsumoto, Masatoshi Yunoki, Kimihiro Yoshino
BACKGROUND: In surgical treatment of acute subdural hematoma (ASDH), neurosurgeons frequently encounter bleeding from cortical arteries, which is usually controlled with bipolar coagulation. However, bipolar coagulation is associated with a risk of sacrificing the cortical artery, which may affect the prognosis of neurological symptoms when these cortical arteries supply critical areas. In this article, we describe microsurgical repair of damaged cortical arteries using a 10-0 nylon micro-suture in patients with arterial-origin ASDH...
July 31, 2018: Acta Neurochirurgica
Nathan R Manley, Louis J Magnotti, Timothy C Fabian, Michael B Cutshall, Martin A Croce, John P Sharpe
The purpose of this study was to evaluate the impact of management of venous injury on clinical outcomes in patients with combined lower extremity arterial and venous trauma. Patients with common and external iliac, common and superficial femoral, and popliteal artery injuries were identified. Patients who underwent vein repair and those who received vein ligation were compared. The analysis was repeated for those patients who required secondary intervention for their arterial injury and those who did not require secondary intervention...
July 1, 2018: American Surgeon
Nathan A Ludwig, Neal Bhutiani, Paul L Linsky, Amit J Dwivedi, Matthew C Bozeman
The optimal follow-up protocol for patients undergoing thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury remains unclear. The objective of this study was to assess follow-up patterns in such patients and present an approach to improve long-term follow-up in this cohort. The University of Louisville Trauma Registry was queried for patients who underwent TEVAR for traumatic thoracic aortic injuries between 2006 and 2016. Demographic, injury-specific, perioperative, and outcome measures were recorded for each patient...
July 1, 2018: American Surgeon
Jae C Chang
: Hemostasis is the most important protective mechanism for human survival following harmful vascular damage caused by internal disease or external injury. Physiological mechanism of hemostasis is partially understood. Hemostasis can be initiated by either intravascular injury or external bodily injury involving two different levels of damage [i.e., limited to the endothelium or combined with extravascular tissue (EVT)]. In intravascular injury, traumatic damage limited to local endothelium typically is of no consequence, but disease-induced endothelial damage associated with systemic endothelial injury seen in sepsis and other critical illnesses could cause generalized 'endotheliopathy'...
July 30, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Ioannis Christodoulides, Anastasios Giamouriadis, James Bashford, Konstantinos Barkas
Myoclonus describes a movement disorder characterised by brief, abrupt and involuntary contractions of muscles or groups of muscles, usually associated with intracranial lesions, with limited evidence linking it to spinal pathologies. The pathophysiology of spinal myoclonus is extensive and multifactorial. Infection, intramedullary and extramedullary space-occupying lesions, trauma, vascular abnormalities, degenerative processes and cervical spondylosis have been implicated with the disease, the latter been associated with cervical stenosis with no reported cases linking it to an underlying cervical disc herniation...
July 30, 2018: BMJ Case Reports
Robert E Luceri, Nina E Glass, Joanelle A Bailey, Ziad C Sifri, Anastasia Kunac, Stephanie L Bonne, Peter P Yonclas, Anne C Mosenthal, David H Livingston
BACKGROUND: Prior to routine CT scanning, first rib fractures (FRFs) were considered a harbinger of great vessel injuries. We hypothesized FRFs identified on screening CXR have significant associated injuries, while those identified on CT alone do not. METHODS: We reviewed adult blunt thoracic trauma patients 2014-2015 to identify all FRFs and then tabulated demographics, injury characteristics, and outcomes. RESULTS: Of 429 patients with chest trauma, 56 had a FRF...
July 24, 2018: American Journal of Surgery
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