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Thoracic emergency

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https://www.readbyqxmd.com/read/28643792/smarca4-deficient-thoracic-sarcoma-a-distinctive-clinicopathological-entity-with-undifferentiated-rhabdoid-morphology-and-aggressive-behavior
#1
Jennifer L Sauter, Rondell P Graham, Brandon T Larsen, Sarah M Jenkins, Anja C Roden, Jennifer M Boland
A distinct subset of thoracic sarcomas with undifferentiated rhabdoid morphology and SMARCA4 inactivation has recently been described, and potential targeted therapy for SMARC-deficient tumors is emerging. We sought to validate the clinicopathological features of SMARCA4-deficient thoracic sarcomas. Clinicopathological information was gathered for 40 undifferentiated thoracic tumors with rhabdoid morphology (mediastinum (n=18), lung (n=14), pleura (n=8)). Thymic carcinomas (n=11) were used as a comparison group...
June 23, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#2
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28631162/core-curriculum-case-illustration-blunt-traumatic-thoracic-aortic-pseudo-aneurysm
#3
Muhammad Mubashir Ramzan, Shaimaa Abdelhassib Fadl, Jeffrey D Robinson
Core Curriculum Illustration: [blunt thoracic aortic pseudo aneurysm]. This is the [40th] installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.aseronline.org/curriculum/toc.html...
June 19, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28625277/the-diagnosis-and-treatment-of-hemoptysis
#4
Harald Ittrich, Maximilian Bockhorn, Hans Klose, Marcel Simon
BACKGROUND: Hemoptysis, i.e., the expectoration of blood from the lower airways, has an annual incidence of approximately 0.1% in ambulatory patients and 0.2% in inpatients. It is a potentially life-threatening medical emergency and carries a high mortality. METHODS: This review article is based on pertinent publications retrieved by a selective search in PubMed. RESULTS: Hemoptysis can be a sign of many different diseases. Its cause remains unknown in about half of all cases...
June 5, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28623121/radiomics-based-assessment-of-radiation-induced-lung-injury-after-stereotactic-body-radiotherapy
#5
Angel Moran, Megan E Daly, Stephen S F Yip, Tokihiro Yamamoto
BACKGROUND: Over 50% of patients who receive stereotactic body radiotherapy (SBRT) develop radiographic evidence of radiation-induced lung injury. Radiomics is an emerging approach that extracts quantitative features from image data, which may provide greater value and a better understanding of pulmonary toxicity than conventional approaches. We aimed to investigate the potential of computed tomography-based radiomics in characterizing post-SBRT lung injury. METHODS: A total of 48 diagnostic thoracic computed tomography scans (acquired prior to SBRT and at 3, 6, and 9 months post-SBRT) from 14 patients were analyzed...
May 25, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28622920/post-9-11-sarcoidosis-in-wtc-exposed-firefighters-and-emergency-medical-service-workers
#6
Mayris P Webber, Jennifer Yip, Rachel Zeig-Owens, William Moir, Patompong Ungprasert, Cynthia S Crowson, Charles B Hall, Nadia Jaber, Michael D Weiden, Eric L Matteson, David J Prezant
INTRODUCTION: The World Trade Center (WTC) disaster released a huge quantity and variety of toxicants into the environment. To-date, studies from each of the three major cohorts of WTC-exposed workers have suggested "greater than expected" numbers of post-9/11 cases in some workers. We undertook this study to estimate the incidence of post-9/11 sarcoidosis in ∼13,000 male firefighters and EMS workers enrolled in The Fire Department of the City of New York (FDNY) WTC Health Program; to compare FDNY incidence to rates from unexposed, demographically similar men in the Rochester Epidemiology Project (REP); and, to examine rates by level of WTC exposure...
June 7, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28622886/five-year-outcomes-of-an-oropharynx-directed-treatment-approach-for-unknown-primary-of-the-head-and-neck
#7
Kenneth Shung Hu, Waleed Fouad Mourad, Mauricio E Gamez, Wilson Lin, Adam Saul Jacobson, Mark Stephen Persky, Mark L Urken, Bruce E Culliney, Zujun Li, Theresa Nguyen Tran, Stimson Pryor Schantz, Juskaran Chadha, Louis Benjamin Harrison
PURPOSE: Squamous cell carcinoma of unknown primary (SCCHNUP) is commonly treated with comprehensive radiation to the laryngopharynx and bilateral necks. In 1998, we established a departmental policy to treat SCCHNUP with radiation directed to the oropharynx and bilateral neck. METHODS: From 1998-2011, 60 patients were treated - N1: 18%, N2: 75% and N3: 7%. 82% underwent neck dissection. 55% received IMRT and 62% underwent concurrent chemoradiotherapy. RESULTS: At median follow-up of 54months, 5 patients failed regionally and 4 emerged with a primary (tongue base, hypopharynx and thoracic esophagus)...
July 2017: Oral Oncology
https://www.readbyqxmd.com/read/28621182/-non-intubated-uniportal-video-assisted-thoracic-surgery-vats-lobectomy-as-a-new-procedure-in-our-department
#8
József Furák, Zsolt Szabó, Theodor Horváth, Tibor Géczi, Balázs Pécsy, Tibor Németh, Aurél Ottlakán, Zsolt Molnár, György Lázár
AIM: Due to the emerging experience in VATS (video assisted thoracic surgery) lobectomies, in some centers the so called "non-intubated" VATS lobectomies (NITS - non-intubated thoracic surgery) gained increased authority, during which endotracheal intubation and muscle relaxation of the patient is not carried out, thus surgery is being performed with the patient breathing spontaneously. The recent study deals with our initial experience gained during uniportal NITS VATS lobectomies. PATIENTS AND METHOD: Between 24...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28618854/verification-of-organ-doses-calculated-by-a-dose-monitoring-software-tool-based-on-monte-carlo-simulation-in-thoracic-ct-protocols
#9
Nika Guberina, Saravanabavaan Suntharalingam, Kai Naßenstein, Michael Forsting, Jens Theysohn, Axel Wetter, Adrian Ringelstein
Background The importance of monitoring of the radiation dose received by the human body during computed tomography (CT) examinations is not negligible. Several dose-monitoring software tools emerged in order to monitor and control dose distribution during CT examinations. Some software tools incorporate Monte Carlo Simulation (MCS) and allow calculation of effective dose and organ dose apart from standard dose descriptors. Purpose To verify the results of a dose-monitoring software tool based on MCS in assessment of effective and organ doses in thoracic CT protocols...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28616378/primary-ciliary-dyskinesia-presenting-with-spontaneous-pneumothorax-case-report-and-review-of-the-literature
#10
Jia Hou, Yanan Zhang, Ri Gong, Xiwei Zheng, Xia Yang
BACKGROUND: Primary ciliary dyskinesia (PCD) is an autosomal recessive heterogeneous group of conditions with variable clinical findings. CASE PRESENTATION: A 36-year-old nonsmoking Chinese man present to the emergency department of our hospital with acute-onset breathlessness and sudden-onset left-sided chest pain. The patient had 6 years primary infertility and suffered from recurrent episodes of respiratory tract infections since childhood. Chest X-ray was performed, which showed a left-sided pneumothorax with lung collapse...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28616346/emergent-aortic-surgery-in-octogenarians-is-the-advanced-age-a-contraindication
#11
REVIEW
Mario Castaño, Javier Gualis, Jose M Martínez-Comendador, Elio Martín, Pasquale Maiorano, Laura Castillo
Surgery of both the ascending and descending aortic segments in the context of an acute aortic syndrome is one of the greatest challenges for the cardiac surgeon. In the case of surgery of the descending aorta, surgical risk increases due to the technical complexity, the required aggressive approach and because surgical indication is usually established as a result of complications and therefore involves, almost always, critically ill patients. The aging of the population is causing such surgery to be considered in an increasing number of octogenarians...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614862/-thoracic-trauma-prehospital-treatment
#12
Michael Hansen, Thomas Hachenberg
Penetrating thoracic injuries are rare in Germany and common in urban regions. 10 percent of the patients in Emergency Departments suffer from blunt thoracic trauma. Mechanism of trauma can predict the severity of the injuries. Very fast life-threatening injuries with hemodynamic problems like tension pneumothorax or cardiac tamponade have to be diagnosed. Prehospital emergency physicians need skills in ultrasound for diagnosis and in invasive therapy like chest tube or pericardium drainage tube. The application of an algorithm in exploration of a thoracic trauma seems to be useful...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28611156/clinical-prediction-rule-for-delayed-hemothorax-after-minor-thoracic-injury-a-multicentre-derivation-and-validation-study
#13
Marcel Émond, Chantal Guimont, Jean-Marc Chauny, Raoul Daoust, Éric Bergeron, Laurent Vanier, Lynne Moore, Miville Plourde, Batomen Kuimi, Valérie Boucher, Nadine Allain-Boulé, Natalie Le Sage
BACKGROUND: About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department. METHODS: We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury)...
June 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28611139/unrecognised-diaphragmatic-hernia-in-a-refugee-child-an-incidental-diagnosis
#14
Dimitri Poddighe, Tiziana Boggini, Salvatore Savasta, Gian Luigi Marseglia
A 4-year-old boy from Syria was evaluated at the emergency department because of an upper airway viral illness. His physical examination showed a significant intensity reduction of all heart sounds in the absence of any other pathological signs. As the child was affected with Down's syndrome and had suffered thoracic and abdominal trauma because of bombardments, a diaphragmatic hernia was immediately suspected and was confirmed through a simple chest X-ray. A careful clinical examination is crucial in refugee children and adolescents, as several medical and surgical disorders could have escaped previously...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28608012/the-advent-of-ultra-high-volume-thoracic-surgical-centers-in-shanghai
#15
Alan D L Sihoe, Baohui Han, Timothy Y Yang, Changqing Pan, Gening Jiang, Vincent W T Fang
BACKGROUND: A core principle in surgery is that high surgical volumes are conducive toward better outcomes. Ultra-high volume centers (UHVCs) have now emerged in thoracic surgery in China that now perform a volume of thoracic operations far greater than even traditional international centers of excellence. METHODS: In 2016, two hospitals in Shanghai performed over 10,000 major pulmonary, esophageal and mediastinal resections each. A qualitative analysis of the lessons learned in achieving such large operation volumes was undertaken...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#16
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28595218/-disruption-of-matsui-kitamura-stent-graft-six-years-after-treatment-for-rupture-of-thoracic-aortic-aneurysm
#17
Takahiro Ishigaki, Hitoshi Matsuda, Ryuta Kawasaki, Soichiro Henmi, Hidekazu Nakai, So Izumi, Masamichi Matsumori, Hirohisa Murakami, Tasuku Honda, Masato Yoshida, Nobuhiko Mukohara
Matsui-Kitamura stent-graft (MKSG) is a home-made device for thoracic endovascular aortic repair (TEVAR) developed in Japan. A 76-year-old man who had been treated by TEVAR (zone 3) with a MKSG for ruptured thoracic aortic aneurysm was diagnosed as having type Ia endoleak caused by suture disruption and aneurysmal sac expansion 6 years later. He underwent TEVAR (zone 1) with debranching and type Ia endoleak disappeared. MKSG had been the effective device especially for acute aortic emergencies in the descending thoracic aorta until the stent-grafts became commercially available, but careful observation and appropriate re-intervention is mandatory for the continued life-saving contribution...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28593009/ultrasound-as-point-of-care-in-management-of-polytrauma-and-its-complication
#18
Saverio Latteri, Giulia Malaguarnera, Maurizio Mannino, Antonio Pesce, Giuseppe Currò, Stefania Tamburrini, Mario Scuderi
PURPOSE: Traumatic injuries constitute a major risk for patients in emergency units. Point-of-care ultrasound may be a determinant in reducing the deleterious impact of complications and in prognosis. METHODS: We describe the case of a 28-year-old female who reported cranial trauma, abdominal and thoracic trauma, and suspected bilateral fracture of the femur. RESULTS: Ultrasound was useful for evaluating and monitoring multiple organ failure...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28585119/the-effectiveness-of-hybrid-treatment-for-sever-multiple-trauma-a-case-of-multiple-trauma-for-damage-control-laparotomy-and-thoracic-endovascular-repair
#19
Naofumi Bunya, Keisuke Harada, Yosuke Kuroda, Tsubasa Toyohara, Takashi Toyohara, Narumi Kubota, Ryuichiro Kakizaki, Hideto Irifune, Shuji Uemura, Eichi Narimatsu
BACKGROUND: Time is a crucial factor for the successful early management of the multi-trauma patient. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. CASE PRESENTATION: We describe the early successful treatment of a 54-year-old male who sustained multiple injuries when he was hit by a 1000 kg bale of wheat that fell from a height...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28580205/solid-variant-of-an-aneurysmal-bone-cyst-of-the-thoracic-spine
#20
Varshil Mehta, Pravin Padalkar, Maya Kale, Ambadas Kathare
The solid variant of an aneurysmal bone cyst (ABC) has been observed very rarely, especially those involving the spine. In this case report, we present a very unusual tumour of the thoracic spine which was managed by 360˚ decompression via posterior-only approach and stabilization. A 16-year-old boy presented to us with a sudden onset of weakness in both lower limbs leading to paraplegia. He also had a history of back and chest pain over the past one year. A collapse of the T5 vertebrae on plain radiograph was observed...
May 1, 2017: Curēus
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