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Thoracic emergency

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https://www.readbyqxmd.com/read/28105481/-thoracic-injuries-in-severely-injured-children-association-with-increased-injury-severity-and-a-higher-number-of-complications
#1
Philipp Störmann, Julia Nadine Weber, Heike Jakob, Ingo Marzi, Dorien Schneidmueller
BACKGROUND: Severely injured children and adolescents in clinical practice are rare. For adequate treatment of these patients, detailed knowledge of anatomical and physiological peculiarities, as well as abundant injury patterns, are indispensable. Traumatic brain injuries are known to lead to an unfavorable outcome. In addition, thoracic trauma is regarded as prognostically unfavorable. OBJECTIVES: This study depicts epidemiology and injury patterns of severely injured children and adolescents focusing on peculiarities in the severely injured with associated thoracic injuries...
January 19, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28103513/interventional-radiology-in-the-management-of-thoracic-duct-injuries-anatomy-techniques-and-results
#2
REVIEW
Mohammad Toliyat, Kanwar Singh, Robert C Sibley, Murthy Chamarthy, Sanjeeva P Kalva, Anil K Pillai
Disruption of the thoracic duct can have devastating consequences and be associated with a high morbidity and mortality. Conservative therapies have been attempted to treat chylothorax without much success. Surgical management has traditionally been necessary to provide definitive treatment at the expense of increased morbidity. Lymphatic interventions have recently emerged as a new frontier for interventional radiologists to add value and provide minimally invasive therapies for debilitating conditions. The goal of this manuscript is to review the anatomy of the thoracic duct, describe various percutaneous techniques for accessing the duct, and briefly discuss outcomes as reported in the literature...
January 3, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28100060/boerhaave-s-syndrome-diagnostic-gastroscopy
#3
Rocío Ferreiro-Iglesias, Manuel Narciso Blanco Freire, Manuel Paz Novo, J Enrique Domínguez Muñoz
A 47-year-old man was attended at the emergency room for severe chest pain after eating sausage with subsequent vomiting and mild upper gastrointestinal bleeding. In the chest radiography we could not see abnormalities. He referred previous episodes of choking without consulting. The urgent gastroscopy detected tertiary contractile activity (nutcracker esophagus) and a foreign body in the lower third of the esophagus. After removing the food bolus, we observed a 4 cm longitudinal tear compatible with esophageal rupture or Boerhaave's syndrome in the right posterior wall of the lower esophagus, proximal to the gastroesophageal junction...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28098044/-an-acutely-dyspnoeic-woman-after-acupuncture
#4
B J J van Tienoven, L Becude, W Thijs
A 42-year-old woman without a medical history presented herself to the emergency room with sudden onset of dyspnoea and progressive tachypnoea. The X-ray showed a bilateral pneumothorax. Additional anamnesis suggested this was caused by thoracic acupuncture she had received that afternoon because of her chronic low back pain.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28079662/recognition-of-a-thoracic-epidural-hematoma-in-the-setting-of-transient-paralysis-a-case-report
#5
Beth VanderWielen, Lindsay Rubenstein, Marc Shnider, Cindy Ku, Jason Wakakuwa
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28077473/a-joint-ers-ats-policy-statement-what-constitutes-an-adverse-health-effect-of-air-pollution-an-analytical-framework
#6
George D Thurston, Howard Kipen, Isabella Annesi-Maesano, John Balmes, Robert D Brook, Kevin Cromar, Sara De Matteis, Francesco Forastiere, Bertil Forsberg, Mark W Frampton, Jonathan Grigg, Dick Heederik, Frank J Kelly, Nino Kuenzli, Robert Laumbach, Annette Peters, Sanjay T Rajagopalan, David Rich, Beate Ritz, Jonathan M Samet, Thomas Sandstrom, Torben Sigsgaard, Jordi Sunyer, Bert Brunekreef
The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies...
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28076350/emergence-of-rare-species-of-nontuberculous-mycobacteria-as-potential-pathogens-in-saudi-arabian-clinical-setting
#7
Bright Varghese, Mushira Enani, Mohammed Shoukri, Sahar AlThawadi, Sameera AlJohani, Sahal Al-Hajoj
BACKGROUND: Clinical relevance of nontuberculous mycobacteria (NTM) is increasing worldwide including in Saudi Arabia. A high species diversity of NTM's has been noticed in a recent study. However, the identification in diagnostic laboratories is mostly limited to common species. The impact of NTM species diversity on clinical outcome is so far neglected in most of the clinical settings. METHODOLOGY/PRINCIPAL FINDINGS: During April 2014 to September 2015, a nationwide collection of suspected NTM clinical isolates with clinical and demographical data were carried out...
January 11, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28072687/the-negative-chronotropic-effect-during-lumbar-spine-surgery-a-systemic-review-and-aggregation-of-an-emerging-model-of-spinal-cardiac-reflex
#8
Tumul Chowdhury, Bernhard Schaller
BACKGROUND: Hemodynamic perturbations in spine surgeries are predominantly reported in cervical and thoracic level procedures. The literature related to negative cardiovascular changes (decrease of heart rate and blood pressure) in lumbar spine procedures is still scarce and only highlighted in few case reports/letters until now. METHODS: With the help of a systematic literature review with predefined criteria, we, therefore, examined and synthesized here the probable underlying common cause of these hemodynamic disturbances in lumbar spine surgeries...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28066677/applications-of-indocyanine-green-based-near-infrared-fluorescence-imaging-in-thoracic-surgery
#9
REVIEW
Jian Zhou, Fan Yang, Guanchao Jiang, Jun Wang
Near-infrared (NIR) fluorescence guided surgery is an emerging technique. This technique uses the combination of dyes and NIR imaging devices to expand the visible spectrum. Thus it can provide more anatomic and functional information, and may facilitate a more complete resection of cancer, or better protection of important normal structures. Recently, significant progress has been made in the field of NIR fluorescence guided thoracic surgery. This may lead to better prognosis and health-economic outcomes. In this article, the current studies of indocyanine green (ICG) based NIR fluorescence guided thoracic surgeries are reviewed...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28056991/severe-fracture-dislocation-of-the-thoracic-spine-without-any-neurological-deficit
#10
Shuai Zhang, Ting-Bin Yan
BACKGROUND: Fracture-dislocations of the thoracic spine without spinal cord injury are very rare. CASE PRESENTATION: A 35-year-old woman presented to our emergency department with complete T6-7 fracture-dislocation without any neurological loss had undergone a surgical reduction and fixation. CONCLUSIONS: The radiological severity of fracture-dislocation pattern doesn't correlate sometimes with the clinical manifestation.
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28048542/we-ab-bra-06-4dct-ventilation-a-novel-imaging-modality-for-thoracic-surgical-evaluation
#11
Y Vinogradskiy, M Jackson, L Schubert, B Jones, R Castillo, E Castillo, T Guerrero, J Mitchell, B Kavanagh, M Miften
PURPOSE: The current standard-of-care imaging used to evaluate lung cancer patients for surgical resection is nuclear-medicine ventilation. Surgeons use nuclear-medicine images along with pulmonary function tests (PFT) to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung that would be lost with surgery. 4DCT-ventilation is an emerging imaging modality developed in radiation oncology that uses 4DCT data to calculate lung ventilation maps...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043480/the-integrated-comprehensive-care-program-a-novel-home-care-initiative-after-major-thoracic-surgery
#12
Yaron Shargall, Wael C Hanna, Laura Schneider, Colin Schieman, Christian J Finley, Anna Tran, Shantel Demay, Carolyn Gosse, James M Bowen, Gord Blackhouse, Kevin Smith
The objective of the study was to evaluate the Integrated Comprehensive Care (ICC) program, a novel health system integration initiative that coordinates home care and hospital-based clinical services for patients undergoing major thoracic surgery relative to traditional home care delivery. Methods included a pilot retrospective cohort analysis that compared the intervention cohort (ICC), composed of all patients undergoing major thoracic surgery in the 2012-2013 fiscal year with a control cohort, who underwent surgery in the year before the initiation of ICC...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043436/endovascular-repair-of-type-a-aortic-dissection-current-experience-and-technical-considerations
#13
Joshua D Horton, Tilo Kölbel, Stephan Haulon, Ali Khoynezhad, Richard M Green, Michael A Borger, Firas F Mussa
Dissection of the ascending aorta, type A aortic dissection (TAAD), represents a surgical emergency with high morbidity and mortality. Current open surgical techniques, although state-of-the-art procedures and having improved outcomes for patients with TAAD over the last decades, confer significant risk of complications and death. Recently, endovascular techniques for repair of both the abdominal and thoracic aorta have gained acceptance within the vascular and cardiovascular surgical communities as a useful tool in select pathologies and patient populations...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040765/classification-and-outcomes-of-extended-arch-repair-for-acute-type-a-aortic-dissection-a-systematic-review-and-meta-analysis
#14
REVIEW
Holly N Smith, Munir Boodhwani, Maral Ouzounian, Richard Saczkowski, Alexander J Gregory, Eric J Herget, Jehangir J Appoo
OBJECTIVES: Distal extent of repair in patients undergoing surgery for acute Type A aortic dissection (ATAAD) is controversial. Emerging hybrid techniques involving open and endovascular surgery have been reported in small numbers by select individual centres. A systematic review and meta-analysis was performed to investigate the outcomes following extended arch repair for ATAAD. A classification system is proposed of the different techniques to facilitate discussion and further investigation...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28035466/a-rare-postoperative-complication-of-anterior-lower-thoracic-instrumentation-diaphragmatic-laceration-with-hemothorax
#15
Yat Wa Wong, Jason Pui Yin Cheung, Keith Dip Kei Luk, Kenneth Man Chee Cheung
PURPOSE: To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column. METHODS: A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness. However, after a bout of coughing, there was sudden increase in chest drain output, hemodynamic instability and massive fluid collection in the right chest cavity...
December 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28034631/emergency-endovascular-management-of-acute-thoracic-aortic-pathology-a-safe-and-feasible-option
#16
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28030491/severe-injuries-associated-with-skiing-and-snowboarding-a-national-trauma-data-bank-study
#17
Amory de Roulet, Kenji Inaba, Aaron Strumwasser, Konstantinos Chouliaras, Demetrios Demetriades
BACKGROUND: Injuries following skiing and snowboarding accidents lead to an estimated 7,000 hospital admissions annually and present a significant burden to the health care system. The epidemiology, injury patterns, hospital resource utilization, and outcomes associated with these severe injuries need further characterization. METHODS: The National Trauma Data Bank was queried for the period 2007-2014 for admissions with injury severity score (ISS) >15 and ICD-9 codes 885...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28028447/spinal-epidural-abscess-in-a-patient-with-piriformis-pyomyositis
#18
Gerald S Oh, Hussam Abou-Al-Shaar, Gregory D Arnone, Ashley L Barks, Ziad A Hage, Sergey Neckrysh
BACKGROUND: Spinal epidural abscess resulting from piriformis pyomyositis is extremely rare. Such condition can result in serious morbidity and mortality if not addressed in a timely manner. CASE DESCRIPTION: The authors describe the case of a 19-year-old male presenting with a 2-week history of fever, low back pain, and nuchal rigidity. When found to have radiographic evidence of a right piriformis pyomyositis, he was transferred to our institution for further evaluation...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28019241/a-regenerative-approach-towards-recovering-the-mechanical-properties-of-degenerated-intervertebral-discs-genipin-and-platelet-rich-plasma-therapies
#19
Mohammad Nikkhoo, Jaw-Lin Wang, Masoud Abdollahi, Yu-Chun Hsu, Mohamad Parnianpour, Kinda Khalaf
Degenerative disc disease, associated with discrete structural changes in the peripheral annulus and vertebral endplate, is one of the most common pathological triggers of acute and chronic low back pain, significantly depreciating an individual's quality of life and instigating huge socioeconomic costs. Novel emerging therapeutic techniques are hence of great interest to both research and clinical communities alike. Exogenous crosslinking, such as Genipin, and platelet-rich plasma therapies have been recently demonstrated encouraging results for the repair and regeneration of degenerated discs, but there remains a knowledge gap regarding the quantitative degree of effectiveness and particular influence on the mechanical properties of the disc...
December 1, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28018508/fatal-hemorrhage-from-kidney-after-endovascular-repair-for-chronic-type-b-dissection-complicated-with-disseminated-intravascular-coagulation
#20
Takashi Yamauchi, Suguru Kubota, Kosei Hasegawa, Shinya Shirai
We report lethal hemorrhage from the kidney after thoracic endovascular repair for chronic type B dissection complicated by disseminated intravascular coagulation (DIC). A 70-year-old woman underwent thoracic endovascular repair to treat chronic DIC. Two weeks after surgery, refractory shock suddenly occurred and computed tomography showed a massive hematoma around the left kidney. Emergent renal artery angiography showed multiple bleeding points in the renal cortex. Immediate embolization of the renal artery was performed and her hemodynamic condition recovered...
2016: Annals of Vascular Diseases
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