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https://www.readbyqxmd.com/read/29153772/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-patients-with-porcelain-aorta
#1
Fernando Ramirez-Del Val, Sameer A Hirji, Maroun Yammine, Julius I Ejiofor, Siobhan McGurk, Anthony Norman, Prem Shekar, Sary Aranki, Deepak L Bhatt, Pinak Shah, Lawrence H Cohn, Tsuyoshi Kaneko
Surgical aortic valve replacement (SAVR) in patients with porcelain aorta is considered a high-risk procedure. Hence, transcatheter aortic valve implantation (TAVI) is emerging as the intervention of choice. However, there is a paucity of data directly comparing TAVI with SAVR in patients with porcelain aorta. We compared outcomes of TAVI versus SAVR in high-risk patients with porcelain between March 2012 and June 2015. The TAVI group included 54 patients, whereas 130 SAVR patients with porcelain aorta were identified (operated on between 2004 and 2015)...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29147809/application-of-actuator-driven-pulsed-water-jet-for-coronary-artery-bypass-grafting-assessment-in-a-swine-model
#2
Tomoyuki Suzuki, Shunsuke Kawamoto, Atsuhiro Nakagawa, Toshiki Endo, Teiji Tominaga, Masatoshi Akiyama, Osamu Adachi, Kiichiro Kumagai, Yoshikatsu Saiki
Actuator-driven pulsed water-jet (ADPJ) dissection is an emerging surgical method for dissecting tissue without heat and mechanical injury to vessels. We elucidated the mechanical properties of the piezo ADPJ and evaluated its usefulness and safety in coronary artery bypass grafting procedures. The relationship between the input voltage (10-100 V) and peak pressure of the pulsed water jet was evaluated. The tissue strengths of swine internal thoracic and coronary arteries and the surrounding tissues were measured to assure tissue-selective dissection...
November 16, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29146418/diagnostic-accuracy-of-the-extended-focused-abdominal-sonography-for-trauma-e-fast-performed-by-emergency-physicians-compared-to-computed-tomography
#3
Haldun Akoglu, Omer Faruk Celik, Ali Celik, Rabia Ergelen, Ozge Onur, Arzu Denizbasi
INTRODUCTION: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29143503/-lung-and-pleural-space-ultrasonography-for-pulmonologist
#4
Leslie Noirez, Laurent P Nicod
In the past twenty years ultrasound has been the subject of renewed interest in lung exploration in the broad sense. The necessity of accessing a means of rapid exploration at the bed of the patient in a critical situation has led to the development of a pleuro-pulmonary ultrasound semiology to make it a diagnostic tool of choice which exceeds the strict framework intensive care units and emergency services. With the diagnosis of thoracic tumors or the exploration of interstitial syndromes, it tends to integrate more into the daily practice of the pulmonologist...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#5
Alon Ben Nun, David Simansky, Merav Rokah, Nona Zeitlin, Nir Golan, Ramez Abu Khalil, Michalle Soudack
BACKGROUND: Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3-8%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro-pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142793/a-ruptured-extra-dural-spinal-arterio-venous-malformation-presenting-as-horner-s-syndrome-the-first-case-report
#6
Sunil Munakomi
We report the first case of a young patient who presented with the features of Horner's syndrome following a spinal extradural hematoma resulting from a ruptured arterio-venous malformation (AVM). Since there were features of early compressive myelopathy as well, urgent magnetic resonance imaging (MRI) scan of the spine revealed features suggestive of an extradural hematoma in the cervico-thoracic junction. The patient underwent an emergent laminectomy with an evacuation of the hematoma. The histological features were consistent with that of an AVM...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29138649/-clinical-and-electrocardiographic-aspect-of-pulmonary-embolism-masking-aortic-dissection-revealed-by-thoracic-ct-angiography
#7
Daniella Rakotoniaina Masinarivo, Jenny Larissa Rakotomanana
We here report the case of a 52-year old hypertensive, obese woman (BMI 32,46 kg/m(2)) with a past history of smoking and without evidence-based risk factors of venous thromboembolism, hospitalized for left chest pain radiating to the dorsolumbar region associated with dyspnoea. Clinical examination on hopitalization showed left blood pressure 100/60 mmHg, tachycardia 100/min, oxygen desaturation index at 88% with the patient breathing ambient air, normal cardiopulmonary auscultation, peripheral pulses palpable and no symptoms of phlebitis of the lower limbs...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29137907/primary-aortoesophageal-fistula-a-fatal-outcome
#8
Yang Yang, Die Hu, Daoquan Peng
Aortoesophageal fistula is a rare but life-threatening cause of massive gastrointestinal bleeding. We reported a case of primary aortoesophageal fistula associated with thoracic aortic pseudoaneurysm. Esophagogastroduodenoscopy demonstrated a bulging erosive lesion coated with fibrin. The patient was therefore diagnosed as malignant esophageal mesenchymoma initially. An emergency contrast-enhanced computed tomography revealed an out-pouching saccular aneurysm protruding toward the esophagus at the level of T8-9...
November 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29134536/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-3-coronary-artery-bypass-surgery
#9
Aya Saito, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
OBJECTIVE AND METHODS: Data on isolated coronary artery bypass grafting (CABG) performed in 2013 and 2014, and registered in the Japan Cardiovascular Surgery Database were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery (LAD). RESULTS: Isolated CABG was performed off-pump in 54.7% of cases, and graft material for the LAD was left internal thoracic artery in 74.3% and right internal thoracic artery in 15...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#10
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29130015/jejunal-diverticular-perforation-causing-small-bowel-obstruction-in-a-type-4-hiatal-hernia-a-rare-case-report-of-a-nonagenarian-patient-and-review-of-relevant-literature
#11
Saptarshi Biswas, Shekhar Gogna, Prem Patel
Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29124005/massive-hemoptysis-from-rasmussen-s-aneurysm-in-active-pulmonary-tuberculosis-a-case-report-of-successful-treatment-with-bronchial-artery-embolization
#12
K V Rajamannar, Hemanth Kilaru, Srujana Aravelly, Ananta Ram Gudipati, Satish Chandra Kilaru
Rasmussen's aneurysm, a very rare complication of active pulmonary tuberculosis (TB), is a pulmonary artery aneurysm adjacent to or within a tuberculous cavity. It may lead to rupture and life threatening massive hemoptysis, an uncommon but challenging medico-surgical emergency. This complication warrants attention in view of the resurgence of tuberculosis and increasing occurrence of multi-drug resistant TB, especially in resource-poor, high-TB burden countries like India. We present a case of an elderly man who presented to the emergency room with low-grade fever, cough and hemoptysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29123864/right-sided-bochdalek-hernia-in-an-elderly-patient-a-case-review-of-adult-bochdalek-hernias-from-1982-to-2015-in-japan
#13
Yasuhiro Ohtsuka, Tiberiu H Suzuki
Case: An 89-year-old woman was admitted to our hospital because of dyspnea following abdominal pain and vomiting. According to chest computed tomography findings, a diagnosis of acute respiratory failure due to right-sided Bochdalek hernia was made. Outcome: Emergency laparotomy revealed that a bowel loop from the terminal ileum to the transverse colon had herniated into the right thoracic cavity through the foramen of Bochdalek. The herniated organs were reduced to the abdominal cavity and the foramen was repaired by direct suturing...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29115493/mir-92a-regulates-the-expression-levels-of-matrix-metalloproteinase-9-and-tissue-inhibitor-of-metalloproteinase-3-via-sirtuin-1-signaling-in-hydrogen-peroxide-induced-vascular-smooth-muscle-cells
#14
Peng Liu, Jianfang Su, Xixi Song, Shixiao Wang
Vascular smooth muscle cells (VSMCs) exhibit a notably increased rate of migration, which is one of the most common pathological changes in atherosclerosis. Investigations into the role of micro (mi)RNAs in the regulation of VSMC migration are beginning to emerge and additional miRNAs involved in VSMC migration modulation require identification. In the current study, VSMCs were primarily cultured from rat thoracic aortas, transfected with miR‑92a mimics and induced by hydrogen peroxide (H2O2) for 24 h. Total mRNA and protein were collected for quantitative polymerase chain reaction and western blot analysis...
November 2, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29106868/the-use-of-ct-scan-in-foreign-body-aspiration-in-children-a-6-years-experience
#15
Vincent Pitiot, Margaux Grall, Dominique Ploin, Eric Truy, Sonia Ayari Khalfallah
INTRODUCTION: A foreign body aspiration is a risky situation, common in pediatric emergency. The "gold standard" to rule out a foreign body or proceed to its extraction, is rigid bronchoscopy (RB) under general anesthesia. However, RB is an intrusive exam with possible complications. Depending on authors, RB in emergency is a procedure at risk of complications in 4-17% of cases. Advances in radiology allow CT-scanners of fast acquisition and high definition, which could be used as an alternative to RB...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29106452/acute-aortic-syndromes-diagnosis-and-management-an-update
#16
Eduardo Bossone, Troy M LaBounty, Kim A Eagle
Acute aortic syndromes (AAS) encompass a constellation of life-threatening medical conditions including classic acute aortic dissection (AAD), intramural haematoma, and penetrating atherosclerotic aortic ulcer. Given the non-specific symptoms and physical signs, a high clinical index of suspicion is necessary to detect the disease before irreversible lethal complications occur. In order to reduce the diagnostic time delay, a comprehensive flowchart for decision-making based on pre-test sensitivity of AAS has been designed by the European Society of Cardiology guidelines on aortic diseases and should be thus applied in the emergency scenario...
June 30, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29098123/point-of-care-ultrasound-diagnosis-of-a-massive-thoracoabdominal-aortic-aneurysm
#17
Allison M Yee, Cyrus V Etebari, Srikar Adhikari, Richard Amini
This report highlights an atypical presentation of extensive thoracoabdominal aortic aneurysm with intramural hematoma and transient paralysis of the lower extremities. Clinical suspicion for aortic pathology prompted a point of care ultrasound of the heart and aorta, which demonstrated a thoracic and abdominal aortic aneurysm with intraluminal pathology. Consultation and transfer to a tertiary care facility was based solely on the emergency physician's ultrasound. Subsequent computed tomography (CT) imaging confirmed the ultrasound findings and discovered a left common iliac artery thrombosis consistent with the patient's presentation...
August 26, 2017: Curēus
https://www.readbyqxmd.com/read/29097956/thoracic-spondylodiscitis-epidural-abscess-in-an-afebrile-navy-veteran-a-case-report
#18
Zachary A Cupler, Michael T Anderson, Thomas J Stancik
Objective: The purpose of this case study was to describe the differential diagnosis of a thoracic epidural abscess in a Navy veteran who presented to a chiropractic clinic for evaluation and management with acupuncture within a Veterans Affairs Medical Center. Clinical Features: An afebrile 59-year-old man with acute thoracic spine pain and chronic low back pain presented to the chiropractic clinic at a Veterans Affairs Medical Center for consideration for acupuncture treatment...
September 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29095319/malignant-pheochromocytoma-with-multiple-vertebral-metastases-causing-acute-incomplete-paralysis-during-pregnancy-literature-review-with-one-case-report
#19
REVIEW
Shuzhong Liu, An Song, Xi Zhou, Xiangyi Kong, William A Li, Yipeng Wang, Yong Liu
RATIONALE: We present a rare case of malignant pheochromocytoma with thoracic metastases during pregnancy that presented with symptoms of myelopathy and was treated with circumferential decompression, stabilization, and radiation. The management of this unique case is not well documented. The clinical manifestations, imaging results, pathological characteristics, treatment and prognosis of the case were analyzed. PATIENT CONCERNS: A 26-year-old pregnant woman with a history of paroxysmal hypertension during the second trimester presented with lower extremity weakness, numbness, urinary incontinence, and back pain...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095302/spontaneous-spinal-epidural-hematomas-one-case-report-and-rehabilitation-outcome
#20
Hang Xian, Li-Wei Xu, Cong-Han Li, Jian-Ming Hao, Wei-Xia Wan, Guo-Dong Feng, Ke-Jian Lian, Lin Li
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use...
November 2017: Medicine (Baltimore)
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