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https://www.readbyqxmd.com/read/28203439/evolutional-trends-in-the-management-of-tracheal-and-bronchial-injuries
#1
REVIEW
Brendan Patrick Madden
Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28202294/point-of-care-lung-ultrasound-in-children-with-community-acquired-pneumonia
#2
Hayri Levent Yilmaz, Ahmet Kağan Özkaya, Sinem Sarı Gökay, Özlem Tolu Kendir, Hande Şenol
OBJECTIVES: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. METHODS: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings...
February 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#3
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28185691/thoracic-ultrasound-technique-applications-and-interpretation
#4
REVIEW
Suraj H Rambhia, Catherine A D'Agostino, Ali Noor, Robert Villani, Jason J Naidich, John S Pellerito
Thoracic ultrasound is used at the bedside in emergency and critical care settings. Advantages of ultrasound include rapid real-time, low-cost, diagnostic information that can direct patient care without the use of ionizing radiation. We describe methods on how to perform lung ultrasound, with the intent to educate the radiologist who might otherwise be relatively unfamiliar with thoracic sonography. We describe and depict the normal sonographic appearance of lung anatomy. We also show the sonographic appearance of a wide range of lung and pleural pathologies such as pneumonia, pneumothorax, as well as lung and pleural masses...
December 15, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28185519/-seize-every-opportunity
#5
Layla Haidrani
What is your job? I am a lecturer practitioner and senior charge nurse in the emergency department (ED) at King's College Hospital NHS Foundation Trust, London. My role focuses on clinical practice, education, research and management. I am also undertaking a PhD investigating the effect of complex interventions on long-term outcomes for patients with significant blunt thoracic trauma.
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28185394/characteristics-and-outcomes-of-re-do-percutaneous-paravalvular-leak-closure-re-do-percutaneous-paravalvular-leak-closure
#6
Mohammed A Al-Hijji, Mohamad Alkhouli, Mohammad Sarraf, Chad J Zack, Joseph F Malouf, Vuyisile T Nkomo, Allison K Cabalka, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Percutaneous paravalvular leak (PVL) closure is an alternative treatment option for severely symptomatic, high-surgical risk patients with PVL. Some patients require multiple percutaneous PVL closure procedures. However, the procedural characteristics and success rate of re-do PVL closure have not been well studied. AIMS: The aim of this study is to investigate the indications, procedural characteristics, technical success rate, and 30-day major adverse cardiovascular events (MACE) in patients who underwent re-do PVL closure...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28169084/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-lower-surgical-risk-scores-a-systematic-review-and-meta-analysis-of-early-outcomes
#7
Sameer Arora, Paula D Strassle, Cassandra J Ramm, Jeremy A Rhodes, Satyanarayana R Vaidya, Thomas G Caranasos, John P Vavalle
BACKGROUND: The results from the PARTNER 2 trial showed the feasibility of transcatheter aortic valve replacement (TAVR) in intermediate surgical risk patients. Although low risk clinical trials will take time to conclude, some data has emerged comparing TAVR with surgical aortic valve replacement (SAVR) in lower risk patients. METHODS: A Medline search was conducted using standard methodology to search for studies reporting results comparing TAVR and SAVR. Studies were included if the overall mean Society of Thoracic Surgeons Score was less than 4% (or equivalent Euroscore)...
January 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28167758/microrna-10a-is-crucial-for-endothelial-response-to-different-flow-patterns-via-interaction-of-retinoid-acid-receptors-and-histone-deacetylases
#8
Ding-Yu Lee, Ting-Er Lin, Chih-I Lee, Jing Zhou, Yi-Hsuan Huang, Pei-Ling Lee, Yu-Tsung Shih, Shu Chien, Jeng-Jiann Chiu
Histone deacetylases (HDACs) and microRNAs (miRs) have emerged as two important epigenetic factors in the regulation of vascular physiology. This study aimed to elucidate the relationship between HDACs and miRs in the hemodynamic modulation of endothelial cell (EC) dysfunction. We found that miR-10a has the lowest expression among all examined shear-responsive miRs in ECs under oscillatory shear stress (OS), and a relatively high expression under pulsatile shear stress (PS). PS and OS alter EC miR-10a expression to regulate the expression of its direct target GATA6 and downstream vascular cell adhesion molecule (VCAM)-1...
February 6, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28165436/management-of-acute-spontaneous-thoracic-spinal-epidural-hematoma-causing-paraplegia
#9
Fahrudin Alić, Hakija Bečulić, Aldin Jusić, Rasim Skomorac, Mirza Moranjkić, Lejla Hrvat, Lejla Tandir
Aim To emphasize the importance of early recognition, diagnostic processing and emergent surgical treatment of spontaneous spinal epidural hematoma (SSEH). Methods A 39-year-old female presented with sudden onset of severe pain between the shoulder blades followed by paraparesis and alerted sensibility in the lower extremities. An hour later she developed paraplegia with sensory deficits below ThIV level, absence of patellar reflex, ankle jerk reflex and sphincter dysfunction. Results Magnetic resonance imaging (MRI) demonstrated acute extensive epidural mass of thoracic spinal segments (ThI-ThIII)...
February 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/28161564/management-of-vascular-trauma-during-the-paris-terrorist-attack-of-november-13-2015
#10
Philippe Tresson, Joseph Touma, Julien Gaudric, Quentin Pellenc, Marielle Le Roux, Charles Pierret, Hicham Kobeiter, Pierre Julia, Olivier Goeau-Brissonniere, Pascal Desgranges, Fabien Koskas, Yves Castier
OBJECTIVES: On November 13, 2015, Paris and Saint-Denis were the targets of terrorist attacks. The hospitals of the Public Hospitals of Paris Organization (AP-HP) and the Percy Armed Forces Instruction Hospitals were mobilized to face the mass casualty situation. The objective of this study was to analyze the management of the victims presenting with a non-thoracic vascular trauma (NTVT). MATERIAL AND METHODS: All the data relating to the victims of NTVT who required a specific vascular open or endovascular treatment were analyzed retrospectively...
February 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#11
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28147437/analysis-of-risk-factors-in-the-development-of-bronchopleural-fistula-after-major-anatomic-lung-resection-experience-of-a-single-centre
#12
Dania Nachira, Marco Chiappetta, Leonello Fuso, Francesco Varone, Ilaria Leli, Maria T Congedo, Stefano Margaritora, Pierluigi Granone
BACKGROUND: The bronchopleural fistula (BPF) is a rare but potentially fatal complication of major thoracic surgery. The purpose of this work is to investigate the risk factors associated with the development of fistulas after lobectomy and pneumonectomy. METHODS: We retrospectively reviewed the records of 835 patients who underwent major anatomic lung resection at our centre from January 2003 to December 2013. Of these, 49 underwent pneumonectomy (P group) and 786 lobectomy (L group)...
February 1, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28147248/prolonged-stimulation-of-a-brainstem-raphe-region-attenuates-experimental-autoimmune-encephalomyelitis
#13
Pernille M Madsen, Stephanie S Sloley, Alberto A Vitores, Melissa M Carballosa-Gautam, Roberta Brambilla, Ian D Hentall
Multiple sclerosis (MS), a neuroinflammatory disease, has few treatment options, none entirely adequate. We studied whether prolonged electrical microstimulation of a hindbrain region (the nucleus raphe magnus) can attenuate experimental autoimmune encephalomyelitis, a murine model of MS induced by MOG35-55 injection. Eight days after symptoms emerged, a wireless electrical stimulator with an attached microelectrode was implanted cranially, and daily intermittent stimulation was begun in awake, unrestrained mice...
January 29, 2017: Neuroscience
https://www.readbyqxmd.com/read/28143506/utilization-of-ct-scanning-associated-with-complex-spine-surgery
#14
Vikas V Patel, Gunnar B J Andersson, Steven R Garfin, Donald L Resnick, Jon E Block
BACKGROUND: Due to the risk associated with exposure to ionizing radiation, there is an urgent need to identify areas of CT scanning overutilization. While increased use of diagnostic spinal imaging has been documented, no previous research has estimated the magnitude of follow-up imaging used to evaluate the postoperative spine. METHODS: This retrospective cohort study quantifies the association between spinal surgery and CT utilization. An insurance database (Humana, Inc...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28133141/-a-case-of-aortoesophageal-fistula-rupture-due-to-descending-thoracic-aortic-dissection-with-recurrent-colon-cancer-during-chemotherapy-containing-bevacizumab
#15
Takamaru Koda, Junichi Koike, Hiroshi Masuhara, Akiharu Kurihara, Hiroyuki Shiokawa, Mitsunori Ushigome, Tomoaki Kaneko, Takayuki Suzuki, Yuko Sawaguchi, Tomoyuki Katayanagi, Takerou Fujii, Yoshinori Watanabe, Kimihiko Funahashi, Hideaki Shimada, Hironori Kaneko
We report a case of aortoesophageal fistula rupture during the course of chemotherapy following colon cancer resection. The patient was a 77-year-old woman. Following recurrence of cancer of the sigmoid colon, the patient received a course of XELOX plus bevacizumab(Bmab)to treat peritoneal dissemination and lung metastases. She was brought by ambulance to our hospital's emergency department 55 days after the last dose of Bmab, with a chief complaint of hematemesis. Hematolo- gy results showed severe anemia with a hemoglobin level of 4...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131733/spinal-cord-ischemia-in-scheuermann-disease-a-report-of-three-cases
#16
Léa Chiche, Robert-Yves Carlier, Dan Siahou, Arnaud Nataf, Caroline Hugeron, Clémence Palazzo
BACKGROUND: Neurological complications in Scheuermann's disease are rare but serious. CASE REPORTS: We report three cases of severe neurological deficit due to medullar ischemia attributable to the compression of a radiculomedullar artery by thoracic (two cases) and lumbar (one case) disc herniations associated with Scheuermann's disease. They were not treated surgically because of the absence of direct spinal cord compression or definitive spinal cord ischemia...
January 25, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28122680/the-society-of-thoracic-surgeons-expert-consensus-for-the-resuscitation-of-patients-who-arrest-after-cardiac-surgery
#17
(no author information available yet)
The Society of Thoracic Surgeons Task Force on Resuscitation After Cardiac Surgery provides this professional society perspective on resuscitation in patients who arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation and includes information from existing guidelines, from the International Liaison Committee on Resuscitation, from our own structured literature reviews on issues particular to cardiac surgery, and from an international survey on resuscitation hosted by CTSNet...
January 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28118623/efficacy-of-whole-lung-lavage-in-pulmonary-alveolar-proteinosis-a-multicenter-international-study-of-gelf
#18
Pierre Gay, Benoit Wallaert, Stefan Nowak, Jonas Yserbyt, Stavros Anevlavis, Christophe Hermant, Alban Lovis, Olivier Menard, Bernard Maitre, Thomas Vandemoortele, Hervé Dutau, Amandine Briault, Arnaud Bourdin, Jean-Michel Vergnon, Marios E Froudarakis
BACKGROUND: New therapies have emerged in the treatment of pulmonary alveolar proteinosis (PAP) and, therefore, there is a real need to evaluate the efficacy of whole-lung lavage (WLL) in this rare disease. OBJECTIVES: The aim of this study was to assess the efficacy of WLL in patients with PAP. METHODS: We included 33 patients from 12 centers, which are members of the French-Speaking Thoracic Endoscopy Group, for analysis. Data collection concerned patients and disease characteristics, pulmonary function tests (PFTs) and technical information on the procedure...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28114979/impact-of-the-duration-of-antibiotics-on-clinical-events-in-patients-with-pseudomonas-aeruginosa-ventilator-associated-pneumonia-study-protocol-for-a-randomized-controlled-study
#19
Adrien Bouglé, Arnaud Foucrier, Hervé Dupont, Philippe Montravers, Alexandre Ouattara, Pierre Kalfon, Pierre Squara, Tabassome Simon, Julien Amour
BACKGROUND: Ventilator-associated pneumonia (VAP) accounts for 25% of infections in intensive care units. Compared to a long duration (LD) of antibiotic therapy, a short duration (SD) has a comparable clinical efficacy with less antibiotic use and less multidrug-resistant (MDR) pathogen emergence, with the exception of documented VAP of non-fermenting Gram-negative bacilli (NF-GNB), including Pseudomonas aeruginosa (PA). These results have led the American Thoracic Society to recommend SD therapy for VAP, except for PA-VAP...
January 23, 2017: Trials
https://www.readbyqxmd.com/read/28109713/utility-of-chest-ct-after-a-chest-x-ray-in-patients-presenting-to-the-emergency-department-with-non-traumatic-thoracic-emergencies
#20
Naciye Sinem Gezer, Pınar Balcı, Kemal Çağlar Tuna, Işıl Başara Akın, Mustafa Mahmut Barış, Neşe Çolak Oray
BACKGROUND: Chest radiography is the initial choice for thoracic imaging. However, the wide availability of computed tomography (CT) has led to a substantial increase in its use in the emergency department (ED). We evaluated the utility of chest CT after a chest X-ray in patients presenting to the ED with non-traumatic thoracic emergencies, and determined if the diagnosis and management decision changed after CT. METHODS: The study enrolled 500 consecutive patients with both chest X-rays and CT who presented to the ED with non-traumatic complaints...
January 18, 2017: American Journal of Emergency Medicine
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