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Thoracic emergency

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https://www.readbyqxmd.com/read/28733432/should-bilateral-internal-thoracic-artery-grafting-be-used-in-patients-after-recent-myocardial-infarction
#1
Dan Loberman, Dmitry Pevni, Rephael Mohr, Yosef Paz, Nahum Nesher, Mohamad Khaled Midlij, Yanai Ben-Gal
BACKGROUND: Bilateral internal thoracic artery grafting (BITA) is associated with improved survival. However, surgeons do not commonly use BITA in patients after myocardial infarction (MI) because survival is good with single internal thoracic artery grafting (SITA). We aimed to compare the outcomes of BITA with those of SITA and other approaches in patients with multivessel disease after recent MI. METHODS AND RESULTS: In total, 938 patients with recent MI (<3 months) who underwent BITA between 1996 and 2011 were compared with 682 who underwent SITA...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28732024/4-nitrophenylsulfonyl-piperazines-mitigate-radiation-damage-to-multiple-tissues
#2
Ewa D Micewicz, Kwanghee Kim, Keisuke S Iwamoto, Josephine A Ratikan, Genhong Cheng, Gayle M Boxx, Robert D Damoiseaux, Julian P Whitelegge, Piotr Ruchala, Christine Nguyen, Prabhat Purbey, Joseph Loo, Gang Deng, Michael E Jung, James W Sayre, Andrew J Norris, Dörthe Schaue, William H McBride
Our ability to use ionizing radiation as an energy source, as a therapeutic agent, and, unfortunately, as a weapon, has evolved tremendously over the past 120 years, yet our tool box to handle the consequences of accidental and unwanted radiation exposure remains very limited. We have identified a novel group of small molecule compounds with a 4-nitrophenylsulfonamide (NPS) backbone in common that dramatically decrease mortality from the hematopoietic acute radiation syndrome (hARS). The group emerged from an in vitro high throughput screen (HTS) for inhibitors of radiation-induced apoptosis...
2017: PloS One
https://www.readbyqxmd.com/read/28724783/intra-and-intersegmental-influences-among-central-pattern-generating-networks-in-the-walking-system-of-the-stick-insect
#3
Charalampos Mantziaris, Till Bockemühl, Philip Holmes, Anke Borgmann, Silvia Daun, Ansgar Bueschges
In order to efficiently move around, animals need to coordinate their limbs. Proper, context-dependent coupling among the neural networks underlying leg movement is necessary for generating intersegmental coordination. In the slow-walking stick insect local sensory information is very important for shaping coordination. However, central coupling mechanisms among segmental central pattern generators (CPGs) may also contribute to this. Here, we analyzed the interactions between contralateral networks that drive the depressor trochanteris muscle of the legs in both isolated and interconnected deafferented thoracic ganglia of the stick insect upon application of pilocarpine, a muscarinic acetylcholine receptor agonist...
July 19, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28715511/endovascular-treatment-of-genetically-linked-aortic-diseases
#4
D Böckler, K Meisenbacher, A S Peters, C Grond-Ginsbach, M S Bischoff
BACKGROUND: The most important structural proteins of the vascular wall are collagen and elastin. Genetically linked connective tissue diseases lead to degeneration, aneurysm formation and spontaneous dissection or rupture of arteries. The most well-known are Marfan syndrome, vascular Ehlers-Danlos syndrome (type IV), Loeys-Dietz syndrome and familial aortic aneurysms and dissections. OBJECTIVE: This review article addresses the current status of endovascular treatment options for important connective tissue diseases...
2017: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
https://www.readbyqxmd.com/read/28712683/-stratification-of-thoracic-pain-with-modified-heart-score-and-its-relationship-to-short-term-cardiovascular-events
#5
Manuel Chacón-Diaz, Jorge Salinas, Rafael Doig
OBJECTIVE: Chest pain is a major reason for emergency room care worldwide. The relationship between the Modified Heart Score and the presence of major cardiac events at 30 days after emergency admission was evaluated. METHODS: Retrospective, observational study in a single center. In patients older than 18 years old, who were treated for chest pain, in whom the Modified HEART Score was applied at admission and related to the presence of major cardiac events (myocardial infarction, death, hospitalization due to cardiac causes and percutaneous coronary revascularization Or surgical) at 30 days of follow-up...
July 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28711467/retrospective-study-of-jellyfish-envenomation-in-emergency-wards-in-guadeloupe-between-2010-and-2016-when-to-diagnose-irukandji-syndrome
#6
Djoudi Bouyer-Monot, Stéphane Pelczar, Serge Ferracci, Denis Boucaud-Maitre
BACKGROUND: In Guadeloupe (French West Indies), many marine envenomation cases by jellyfish are observed. Some of them might induce an Irukandji syndrome (IS). The aim of this study was to analyse the clinical features of IS from the envenomation cases in the two public hospitals in Guadeloupe, and to compare them to non-IS stings. METHODS: All jellyfish envenomation cases between the 1st of January 2010 and the 1st of September 2016, from the emergencies data-base, have been extracted...
July 13, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28703064/guidance-on-oxygen-use-in-adults
#7
Kimberley Hackett
Essential facts Oxygen is one of the most commonly used drugs in emergency medicine and before publication of the first British Thoracic Society (BTS) 2008 guideline, emergency departments and ambulance services gave oxygen to almost all breathless or seriously ill patients.
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28699426/management-of-hemothorax-after-thoracic-endovascular-aortic-repair-for-ruptured-aneurysms
#8
Mila H Ju, Michael J Nooromid, Heron E Rodriguez, Mark K Eskandari
Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28694590/spinal-angiolipomas-a-puzzling-case-and-review-of-a-rare-entity
#9
REVIEW
Faris Shweikeh, Ajleeta Sangtani, Michael P Steinmetz, Peter Zahos, Bohdan Chopko
Patients with spinal epidural abscesses (SEAs) may have a variable presentation. Such an infection has a typical appearance on magnetic resonance imaging (MRI) and enhances with gadolinium. We present a case that was a diagnostic challenge where pre- and intra-operative findings resulted in conflicting impressions. The mimicker was a spinal angiolipoma (SAL). The authors then provide a thorough review of this rare spinal neoplasm. A 55-year-old man presented with back pain, paresis, paresthesia, and urinary retention...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28689502/intrauterine-growth-restriction-induced-deleterious-adaptations-in-endothelial-progenitor-cells-possible-mechanism-to-impair-endothelial-function
#10
V Oliveira, L V de Souza, T Fernandes, S D S Junior, M H C de Carvalho, E H Akamine, L C Michelini, E M de Oliveira, M D C Franco
Intrauterine growth restriction (IUGR) can induce deleterious changes in the modulatory ability of the vascular endothelium, contributing to an increased risk of developing cardiovascular diseases in the long term. However, the mechanisms involved are not fully understood. Emerging evidence has suggested the potential role of endothelial progenitor cells (EPCs) in vascular health and repair. Therefore, we aimed to evaluate the effects of IUGR on vascular reactivity and EPCs derived from the peripheral blood (PB) and bone marrow (BM) in vitro...
July 10, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28689484/transcatheter-aortic-valve-implantation-as-a-bailout-procedure-for-acute-aortic-valve-regurgitation-during-endovascular-arch-repair
#11
Adrien Hertault, Rachel E Clough, Thomas Modine, Jean-Luc Auffray, Mohamad Koussa, Stéphan Haulon
PURPOSE: To report emergent transcatheter aortic valve implantation (TAVI) to treat acute severe aortic regurgitation caused by valve cusp dysfunction following proximal migration of an endograft implanted in the ascending aorta during endovascular arch repair. CASE REPORT: A 65-year-old man had been previously treated with thoracic and fenestrated endografts in a 2-stage procedure for a chronic type B dissection. At 2-year follow-up, aneurysmal evolution of the distal arch led to development of a proximal type Ia endoleak...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28688081/collaborative-operation-with-cardiovascular-surgeons-in-general-thoracic-surgery
#12
Koichi Fukumoto, Koji Kawaguchi, Takayuki Fukui, Shota Nakamura, Shuhei Hakiri, Naoki Ozeki, Taketo Kato, Hideki Oshima, Akihiko Usui, Kohei Yokoi
OBJECTIVES: The aim of this study was to investigate the feasibility and safety of our surgical experiences conducted in collaboration with cardiovascular surgeons at our institution. METHODS: From May 2002 to December 2015, among 3595 general thoracic surgeries, 75 (2.1%) operations were carried out collaboratively with cardiovascular surgeons at Nagoya University Hospital. We investigated the surgical procedures, manipulated organs, morbidity and mortality, completeness of surgical resection, and prognosis of these 75 cases...
July 7, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683909/type-b-aortic-dissections-current-guidelines-for-treatment
#13
REVIEW
Daniel B Alfson, Sung W Ham
Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Acute TBAD with complications should be repaired with emergent thoracic endovascular aortic repair (TEVAR). Uncomplicated TBAD with high-risk features should undergo TEVAR in the subacute phase...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28678546/mortality-prediction-using-serum-biomarkers-and-various-clinical-risk-scales-in-community-acquired-pneumonia
#14
Min Woo Kim, Jee Yong Lim, Sang Hoon Oh
We evaluated the predictive value of serum biomarkers and various clinical risk scales for the 28-day mortality of community-acquired pneumonia (CAP). Serum biomarkers including procalcitonin (PCT) and C-reactive protein (CRP) were evaluated in the emergency department. Scores for the pneumonia severity index (PSI); CURB65 (confusion, urea, respiration, blood pressure; age >65 years); Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) guidelines for severe CAP; Acute Physiology, Chronic Health Evaluation (APACHE) II; Sequential Organ Failure Assessment (SOFA); and quick SOFA (qSOFA) were calculated...
July 5, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28676203/-frequency-type-and-predictors-of-pleuropulmonary-complications-during-the-first-thirty-days-after-cardiopulmonary-bypass-surgery-in-children
#15
Jessica Jacqueline Hernández-López, Alejandro Solano-Gutiérrez, Flor Teresita Rosas-Aragón, Airam Gabriela Antúnez-Soto, Janet Flores-Lujano, Juan Carlos Nuñez-Enríquez
OBJECTIVE: To determine the frequency, type and predictors of pleuropulmonary complications in the first thirty postoperative days of patients undergoing surgery without cardiopulmonary bypass. METHODS: A retrospective cohort study was carried out between January 2013 and December 2014. It includes all patients with congenital heart disease who underwent cardiac surgery with a sternal or thoracic approach, without cardiopulmonary bypass with a registered admission to Neonatal or Pediatric Intensive Care...
July 1, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#16
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28673466/emergency-nurse-competence-in-electrocardiographic-interpretation-in-spain-a-cross-sectional-study
#17
Marina Coll-Badell, María F Jiménez-Herrera, Mireia Llaurado-Serra
INTRODUCTION: Electrocardiographic interpretation skills are key to provide a fast attention to patients with thoracic pain. The aim of the study was to determine the current level of competence in electrocardiographic interpretation of nurses in emergency departments. METHODS: Cross-sectional, multicenter study via an ad hoc questionnaire. Subjects were nurses from three Spanish emergency departments with at least a year experience in this area. A two-part questionnaire was created consisting of a professional profile, and 12 questions (2 theoretical questions and 10 questions on practical cases with electrocardiographic register [readout])...
June 30, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28673074/pediatric-pleural-empyema-one-of-the-management-challenges-in-children-of-democratic-republic-of-congo
#18
Kibwe Alphonse Simbi, Valentin Kazadi, Louis-Marie Aissi, François Mbahewaka Katsuva, Numbi Oscar Luboya, Léon Tshilolo, Vincenzo Zanardo
Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo...
June 23, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/28671499/focal-intramural-pericardial-effusion-and-cardiac-tamponade-associated-with-necrotic-adipose-tissue-in-a-dog
#19
Terence A Krentz, Robert J Schutrumpf, Julie C Zitz
CASE DESCRIPTION A 1-year-old castrated male German Shepherd Dog was examined because of an acute onset of lethargy, tachypnea, and inappetence. CLINICAL FINDINGS On initial physical examination, the dog was tachypneic with muffled heart sounds on thoracic auscultation and a palpable abdominal fluid wave. Transthoracic echocardiography revealed focal intramural pericardial effusion and cardiac tamponade. TREATMENT AND OUTCOME The patient underwent emergency therapeutic pericardiocentesis, followed by right lateral intercostal thoracotomy and subtotal pericardiectomy...
July 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28667524/low-evaluation-rate-for-osteoporosis-among-patients-presenting-with-a-rib-fracture
#20
Whang Kim, Hyun Sik Gong, Seung Hoo Lee, Jin Woo Park, Kahyun Kim, Goo Hyun Baek
This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. INTRODUCTION: Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture...
December 2017: Archives of Osteoporosis
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