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thorax AND trauma

Sinan Akay, Mehmet Burak Aşık, Sami Eksert
BACKGROUND: The aim of this study was to investigate the characteristics of shrapnel distribution in the body and a possible relationship to the type of weapon and type of location of the conflict. METHODS: The records of 246 patients admitted to a level-III trauma center with any kind of firearm injury were examined retrospectively. Ninety patients who had at least 1 radiologically-proven piece of shrapnel in their body were included in the study. For the purposes of the study, the body was divided into 5 regions (head/neck, thorax/back, abdomen/pelvis/waist, upper extremities, and lower extremities) and shrapnel distribution was noted according to these divisions...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Abhishek Chaturvedi, Prabhakar Rajiah, Alexender Croake, Sachin Saboo, Apeksha Chaturvedi
Thoracic hernias are characterised by either protrusion of the thoracic contents outside their normal anatomical confines or extension of the abdominal contents within the thorax. Thoracic hernias can be either congenital or acquired in aetiology. They can occur at the level of the thoracic inlet, chest wall or diaphragm. Thoracic hernias can be symptomatic or fortuitously discovered on imaging obtained for other indications. Complications of thoracic hernias include incarceration, trauma and strangulation with necrosis...
November 27, 2018: Insights Into Imaging
Eva-Corina Caragounis, Monika Fagevik Olsén, Hans Granhed, Rauni Rossi Norrlund
AIM: To estimate and compare lung volumes from pre- and post-operative computed tomography (CT) images and correlate findings with post-operative lung function tests in trauma patients with flail chest undergoing stabilizing surgery. PATIENTS AND METHODS: Pre- and post-operative CT images of the thorax were used to estimate lung volumes in 37 patients who had undergone rib plate fixation at least 6 months before inclusion for flail chest due to blunt thoracic trauma...
October 16, 2018: Injury
L P H Leenen
No abstract text is available yet for this article.
December 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem
Purpose: The aim of this study was to determine the incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Patients and methods: This retrospective cohort study was approved by the medical ethical committee, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Thailand. Data of 19,683 trauma patients who received anesthesia between January 2007 and December 2016, such as patient characteristics, surgery procedures, anesthesia information, anesthetic drugs, and cardiac arrest outcomes, were analyzed...
2018: Risk Management and Healthcare Policy
Susanne Morf
CME: Significance of Thoracic Sonography in Thoracic Trauma Abstract. Trauma patients should be treated according to international guidelines. Depending on the severity of the trauma, an immediate threat to life must be ruled out and sonography is part of the complementation of diagnostics. The EFAST investigation includes the exclusion of fluid in the thorax, the exclusion of pneumothorax and the exclusion of fluid in the pericardium. Thorax ultrasound is becoming increasingly important in the evaluation of the outcome in thoracic trauma patients as well as in the control of the initiated therapy...
November 2018: Praxis
Raymond L. Kao, Weixiong Huang, Claudio M. Martin, Tao Rui
Background: Acute lung contusion from blunt chest trauma (BCT) is characterized by an intense inflammatory response in the pulmonary parenchyma, which is associated with acute lung injury (ALI), acute respiratory distress syndrome and ventilator-associated pneumonia. We hypothesized that aerosolized indomethacin may reduce pulmonary inflammation and ALI in a rat model of BCT. Methods: Sprague-Dawley rats were anesthetized and received a tracheotomy for administration of aerosolized medication through a catheter...
December 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Bellal Joseph, Muhammad Khan, Faisal Jehan, Rifat Latifi, Peter Rhee
Background: Advancement in trauma care has led to the evolution of emergency resuscitative thoracotomy (ERT) for the revival of trauma patients. We now have more precise understanding of selecting suitable patients for achieving optimal outcomes. The aim of our study was to analyze the utilization and survival trends during the past 5 years, as well as factors that influence survival after ERT. Methods: A 5-year (2010-2014) analysis of all trauma patients ≥18 years who underwent ERT in the American College of Surgeons Trauma Quality Improvement Program...
2018: Trauma surgery & acute care open
Tamara Merz, Britta Lukaschewski, Daniela Wigger, Aileen Rupprecht, Martin Wepler, Michael Gröger, Clair Hartmann, Matthew Whiteman, Csaba Szabo, Rui Wang, Christiane Waller, Peter Radermacher, Oscar McCook
BACKGROUND: Both the hydrogen sulfide/cystathionine-γ-lyase (H2 S/CSE) and oxytocin/oxytocin receptor (OT/OTR) systems have been reported to be cardioprotective. H2 S can stimulate OT release, thereby affecting blood volume and pressure regulation. Systemic hyper-inflammation after blunt chest trauma is enhanced in cigarette smoke (CS)-exposed CSE-/- mice compared to wildtype (WT). CS increases myometrial OTR expression, but to this point, no data are available on the effects CS exposure on the cardiac OT/OTR system...
October 19, 2018: Intensive Care Medicine Experimental
Abhishek Chaturvedi, Prabhakar Rajiah, Apeksha Chaturvedi
Acquired diaphragmatic defects occur secondary to trauma, infection, surgery or neoplasm. These defects can lead to abnormal thoraco-abdominal fistulous communications also. Examples of surgically created diaphragmatic defects are omental, colonic interposition and vascular grafts. Regardless of etiology, these transdiaphragmatic communications provide a direct path for spread of pathology between the abdomen and thorax. If left untreated and unrecognized, these fistulae portend a high morbidity and mortality...
October 6, 2018: Clinical Imaging
Xinpu Tang, Hongxu Chen, Chaoyue Chen, Jianguo Xu
INTRODUCTION: Impalement injury is an uncommon presentation, and penetrating chest injuries account for 1% to 13% of thoracic trauma hospital admissions. The vast majority of patients with penetrating thoracic trauma who survive to reach the hospital alive can be managed nonoperatively. Nevertheless, in 10% to 15% of cases, emergency operation is necessary due to the associated hemorrhagic shock and visceral injury. CASE PRESENTATION: Here, we report on a 39-year-old male, a construction worker, who fell down from a height of a construction site, landing ventrally on a clump of iron rods with 4 projecting heavy metallic rods penetrating into his thorax and head (scalp pierced only)...
October 2018: Medicine (Baltimore)
Luis Servia, José C E Serrano, Reinald Pamplona, Mariona Badia, Neus Montserrat, Manuel Portero-Otin, Javier Trujillano
Though circulating antioxidant capacity in plasma is homeostatically regulated, it is not known whether acute stressors (i.e. trauma) affecting different anatomical locations could have quantitatively different impacts. For this reason, we evaluated the relationship between the anatomical location of trauma and plasma total antioxidant capacity (TAC) in a prospective study, where the anatomical locations of trauma in polytraumatic patients (n = 66) were categorized as primary affecting the brain -traumatic brain injury (TBI)-, thorax, abdomen and pelvis or extremities...
2018: PloS One
Lisa Wrba, J Josephine Ohmann, Philipp Eisele, Shinjini Chakraborty, Sonja Braumüller, Christian K Braun, Bettina Klohs, Anke Schultze, Heike von Baum, Annette Palmer, Markus Huber-Lang, Rebecca Halbgebauer
Dysfunction of the gut-blood barrier plays an important role in many diseases, such as inflammatory bowel disease, hemorrhagic shock (HS) or burn injury. However, little is known about gut barrier dysfunction after hemodynamically instable polytrauma (PT). Therefore, we aimed to evaluate the effects of PT and HS on remote intestinal damage and barrier dysfunction, especially regarding the role of Zonula occludens protein 1 (ZO-1) as an important tight junction protein.Male C57BL/6 mice were subjected to either PT (thorax trauma, closed head injury, soft tissue injury and distal femoral fracture), 60 min of pressure-controlled HS (30 ± 5 mmHg), or PT+HS, or sham procedures...
October 4, 2018: Shock
Reinier B Beks, Mirjam B de Jong, Roderick M Houwert, Arthur A R Sweet, Ivar G J M De Bruin, Geertje A M Govaert, Karlijn J P Wessem, Rogier K J Simmermacher, Falco Hietbrink, Rolf H H Groenwold, Luke P H Leenen
PURPOSE: Rib fixation for flail chest has been shown to improve in-hospital outcome, but little is known about treatment for multiple rib fractures and long-term outcome is scarce. The aim of this study was to describe the safety, long-term quality of life, and implant-related irritation after rib fixation for flail chest and multiple rib fractures. METHODS: All adult patients with blunt thoracic trauma who underwent rib fixation for flail chest or multiple rib fractures between January 2010 and December 2016 in our level 1 trauma facility were retrospectively included...
September 18, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Mikko Heinänen, Tuomas Brinck, Rolf Lefering, Lauri Handolin, Tim Söderlund
PURPOSE: Serious thoracic injuries are associated with high mortality, morbidity, and costs. We compared patient populations, treatment, and survival of serious thoracic injuries in southern Finland and Germany. METHODS: Mortality, patient characteristics and treatment modalities were compared over time (2006-2015) in all patients with Abbreviated Injury Scale (AIS) thorax ≥ 3, Injury Severity Score (ISS) > 15, age > 15 years, blunt trauma mechanism, and treatment in Intensive Care Unit (ICU) in Level 1 hospitals included in the Helsinki Trauma Registry (HTR) and the TraumaRegister DGU® (TR-DGU)...
September 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Mark M Hammer, Jacob C Mandell
Standard computed tomography windows are limited in the thorax because they can only display 1 tissue at a time. Computed tomography window blending allows for simultaneous viewing of all 3 tissues in a single image, which may improve evaluation of diseases that contiguously affect multiple compartments. In this article, we use examples to illustrate the utility of window blending in aggressive infections, metastatic cancer, and penetrating trauma.
November 2018: Journal of Computer Assisted Tomography
Antonio C Marttos, Mariana Fernandes Juca Moscardi, Rossano Kepler Alvim Fiorelli, Gerd Daniel Pust, Enrique Ginzburg, Carl Ivan Schulman, April Anne Grant, Nicholas Namias
Uniformity in surgical education is challenging because surgical experience is based on rotation assignments. With work hour restrictions, the likelihood of residents being exposed to rare or unusual cases is diminished. Telemedicine may create a new learning paradigm for surgical education and supplement exposure for rare or unusual cases. A retrospective review (2010-2016) of teleconferences involving trauma centers worldwide was conducted. Participating hospitals included centers from underdeveloped countries to first world nations...
August 1, 2018: American Surgeon
Sinan Karacabey, Erkman Sanri, Bayram Metin, Fatih Erkoc, Sener Yildirim, Yavuz Selim Intepe, Sercan Yalcinli
PURPOSE: Modern lung ultrasound (US) is mainly applied not only in critical care, emergency medicine, and trauma surgery, but also in pulmonary and internal medicine. In some cases, pneumothorax (PTX) distinguishes with bullous diseases. In this study, we aimed to discuss the success of US on detecting PTX versus bullae. METHODS: We performed a prospective blinded study. Patients underwent thorax computed tomography (CT) if bullae or pneumothorax could not be differentiated from the chest radiography...
September 3, 2018: Emergency Radiology
Jörn Zwingmann, Rolf Lefering, Dirk Maier, Lisa Hohloch, Helge Eberbach, Mirjam Neumann, Peter C Strohm, Norbert P Südkamp, Thorsten Hammer
Injuries in the pelvic region in children and adolescents are very rare and often associated with a high energy trauma. Aim of this prospective multicenter study was, by analyzing the data from the TraumaRegister Deutsche Gesellschaft für Unfallchirurgie (TR-DGU), to evaluate any correlation between the severity of pelvic fractures and resulting mortality in different age groups.These study findings are based on a large pool of data retrieved from the prospectively-setup pelvic trauma registry established by the German Trauma Society (DGU) and the German Section of the Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) International in 1991...
August 2018: Medicine (Baltimore)
I Auñón-Martín, P Caba-Doussoux, V Jiménez-Díaz, M Del Oro-Hitar, D Lora-Pablos, D Cecilia-López
INTRODUCTION: Traumatic pathology continues to represent an important socio-health problem. The aim of the study was to assess the clinical predictors of total expenditure, as well as to analyze which components of the cost are modified with each clinical parameter of the polytraumatized patient. MATERIAL AND METHODS: Retrospective study of 131 polytrauma patients registered prospectively. A statistical analysis was carried out to assess the relationship between clinical parameters, the total cost and the cost of various treatment components...
August 20, 2018: Revista Española de Cirugía Ortopédica y Traumatología
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