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Thoracic emergency

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https://www.readbyqxmd.com/read/28447145/-recommendations-for-education-in-ultrasound-in-medical-intensive-care-and-emergency-medicine-position-paper-of-dgiin-degum-and-dgk
#1
G Michels, H Zinke, M Möckel, D Hempel, C Busche, U Janssens, S Kluge, R Riessen, M Buerke, M Kelm, R S von Bardeleben, F Knebel, H-J Busch
Point-of-care ultrasound in acute care medicine is a prerequisite for diagnosis and therapy monitoring of critically ill patients. There is currently no uniform education strategy for medical intensive care and emergency medicine. As part of the basic level, the trainee takes theoretical and clinical training covering abdominal and thoracic ultrasonography and focused cardiovascular ultrasound. In a second step, special knowledge and skills can be acquired at an expert level. This two-stage concept is intended to guarantee quality assurance in ultrasound education in medical intensive care and emergency medicine...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28442204/out-of-hospital-thoracotomy-for-cardiac-arrest-after-penetrating-thoracic-trauma
#2
Mark G Van Vledder, Oscar J F Van Waes, Fabian O Kooij, Joost H Peters, Esther M M Van Lieshout, Michael H J Verhofstad
INTRODUCTION: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated thoracotomy on the accident scene. The aim of this study was to determine the proportion of patients with return of spontaneous circulation and subsequent survival after out of hospital thoracotomy in the Netherlands...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28441375/primary-adrenal-angiosarcoma-a-rare-and-potentially-misdiagnosed-tumor
#3
Ariel Grajales-Cruz, Francis Baco-Viera, Ernesto Rive-Mora, Carlos Ramirez-Tanchez, David Tasso, Norma Arroyo-Portela, Elizabeth Calderon, Ilean Joan Padua-Octaviani, William Caceres-Perkins
A man aged 69 years presented with acute right flank pain secondary to a hemorrhagic large adrenal tumor. En bloc resection was performed to repair the inferior vena cava. Immunoperoxidase levels in the tumor were positive for factor VIII and CD31 and negative for S100, protein Melan-A, CD34, synaptophysin, chromogranin, desmin, muscle specific actin, ETFA (EMA), KRT20 (CK20), CDX2, TTF1, LNPEP (PLAP), inhibin, ?-fetoprotein, CD30, hepatocyte paraffin, and aberrant expression of cytokeratin 7 and pankeratin...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28438878/surgical-management-of-non-small-cell-lung-cancer-with-solitary-hematogenous-metastases
#4
Grigorios Karagkiouzis, Eleftherios Spartalis, Demetrios Moris, Demetrios Patsouras, Athanasios Athanasiou, Ioannis Karathanasis, Alexios Verveniotis, Froso Konstantinou, Ilias A Kouerinis, Konstantinos Potaris, Dimitrios Dimitroulis, Periklis Tomos
BACKGROUND/AIM: The treatment of patients with solitary hematogenous metastases from non-small cell lung cancer (NSCLC) remains controversial, although numerous retrospective studies have reported favorable results for patients offered combined surgical therapy. Our aim was to determine the role of surgical resection in the management of NSCLC with solitary extrapulmonary metastases and to investigate for possible prognostic factors. PATIENTS AND METHODS: Between January 2004 and December 2012, 12 patients with NSCLC, from two Institutions, underwent metastasectomy for their solitary metastatic lesion...
May 2017: In Vivo
https://www.readbyqxmd.com/read/28438078/ten-year-follow-up-of-a-case-of-necrotizing-fasciitis-successfully-treated-with-negative-pressure-wound-therapy-dermal-regeneration-template-application-and-split-thickness-skin-autograft
#5
Sagi Martinov, Soccoro Ortiz
INTRODUCTION: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the fasciae and subcutaneous tissues. PATIENT AND METHODS: In this case report, we present the treatment of a 63-year-old patient suffering from diabetes mellitus, who was admitted to the emergency unit for severe right gluteal pain, which had begun 24 hours before admission. Cutaneous symptoms, oliguria, metabolic acidosis, acute renal failure, severe hypotension, and tachycardia occurred, and the patient was admitted to Intensive Care a few hours after initial admission...
April 25, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#6
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429379/retrospective-evaluation-of-thoracic-computed-tomography-findings-in-dogs-naturally-infected-by-angiostrongylus-vasorum
#7
Mark E Coia, Gawain Hammond, Daniel Chan, Randi Drees, David Walker, Kevin Murtagh, Janine Stone, Nicholas Bexfield, Lizzie Reeve, Jenny Helm
Angiostrongylus vasorum (A. vasorum) is an important emerging disease of canidae. Cardiorespiratory signs are common in affected dogs, therefore thoracic imaging is critical for diagnosing and monitoring disease. Descriptions of thoracic computed tomography (CT) findings in dogs naturally infected with A. vasorum are currently lacking. Aims of this multicenter, retrospective study were to describe thoracic CT findings in a group of dogs with confirmed disease, determine whether any changes were consistent among dogs, and propose standardized terms for describing thoracic CT findings...
April 20, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28428519/-current-status-of-thoracic-endovascular-aortic-repair-in-our-institution
#8
Daisuke Fukui, Kenji Okada
Within 8-year period between 2009 and 2016, we treated 215 patient with a strategy of primary thoracic endovascular aortic repair( TEVAR). In-hospital mortality was 4.4%( 8 cases). Thirty-two emergency cases was included and we treated 23 cases of zone 0 debranching TEVAR with chimney techinique in this period. In recent 2-year period between 2015 and 2016, we treated 44 cases of TEVAR without type I a endoleaks with 0% mortality(most of the them was zone 2~3 TEVAR in this period) on the one hand, and the number of open surgery for thoracic aorta was 80 on the other...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#9
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28425846/alterations-to-adipose-tissue-morphology-during-inflammatory-arthritis-is-indicative-of-vasculopathology-in-dba-1-mice
#10
Katie Sime, Ernest H Choy, Anwen S Williams
The physiologic function of adipose tissue is altered by the host's inflammatory response; the implications for maintaining human health and regulating inflammation-associated disease progression are ill defined. However, this cannot be investigated in humans, therefore the use of animal models is required. With the aim to determine morphological and molecular alterations to perivascular and organ-associated adipose tissues during inflammatory arthritis, collagen-induced arthritis (CIA) was established in male DBA/1 mice...
February 21, 2017: Adipocyte
https://www.readbyqxmd.com/read/28421929/the-value-of-doing-your-best
#11
(no author information available yet)
Claire Matata is lead nurse for emergency and acute clinical research at Northumbria Specialist Emergency Care Hospital. She completed her degree in adult nursing at the University of Liverpool in 2010, and has worked in thoracic surgery, community and prison nursing and as a specialist research nurse and senior clinician in urgent care. In 2015, she spent three months in Sierra Leone during the Ebola crisis.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#12
Jeremy L Irvan, James R Elmore, Sarah L Flora, Evan J Ryer
BACKGROUND: Emergency treatment of complex aortic pathology is challenging in the setting of a right-sided aortic arch. We report the successful treatment of a ruptured thoracic aortic aneurysm (TAA) in the setting of a Stanford type B aortic dissection (TBAD) and right-sided aortic arch. PRESENTATION OF CASE: The patient is a 66-year-old male with chronic kidney disease (CKD) admitted with right sided chest pain and hypotension. Computed tomography angiography (CTA) revealed a 5cm ruptured TAA in the setting of a TBAD and right-sided aortic arch...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28405208/a-case-of-atypical-kawasaki-disease-with-giant-coronary-artery-aneurysm-containing-thrombus
#13
Eynaud S Micallef, Montalto S Attard, V Grech
INTRODUCTION: Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely challenging to manage. CASE PRESENTATION: A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of intermittent pyrexia and irritability...
July 2016: Images in Paediatric Cardiology
https://www.readbyqxmd.com/read/28400069/diagnostic-accuracy-of-a-novel-software-technology-for-detecting-pneumothorax-in-a-porcine-model
#14
Shane M Summers, Eric J Chin, Michael D April, Ronald D Grisell, Joshua A Lospinoso, Bijan S Kheirabadi, Jose Salinas, Lorne H Blackbourne
INTRODUCTION: Our objective was to measure the diagnostic accuracy of a novel software technology to detect pneumothorax on Brightness (B) mode and Motion (M) mode ultrasonography. METHODS: Ultrasonography fellowship-trained emergency physicians performed thoracic ultrasonography at baseline and after surgically creating a pneumothorax in eight intubated, spontaneously breathing porcine subjects. Prior to pneumothorax induction, we captured sagittal M-mode still images and B-mode videos of each intercostal space with a linear array transducer at 4cm of depth...
April 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28395921/correction-correction-to-clinical-policy-critical-issues-in-the-evaluation-and-management-of-adult-patients-with-suspected-acute-nontraumatic-thoracic-aortic-dissection-annals-of-emergency-medicine-65-2015-32-42-e12
#15
Deborah B Diercks, Susan B Promes, Jeremiah D Schuur, Kaushal Shah, Jonathan H Valente, Stephen V Cantrill
Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in PubMed. This has now been corrected online. The publisher would like to apologize for any inconvenience caused.
April 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28391778/delayed-right-chylothorax-after-left-blunt-chest-trauma-a-case-report
#16
Jonggeun Lee, Jeong Su Cho, Hoseok I, Yeong Dae Kim
BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28391424/optimal-radiation-therapy-for-small-cell-lung-cancer
#17
REVIEW
Michael F Gensheimer, Billy W Loo
Radiation therapy plays an important role in the management of both limited stage and extensive stage small cell lung cancer. For limited stage disease, there has been a trend toward reduced size of thoracic radiation fields, which has the potential to reduce toxicity. FDG-PET staging helps make this possible by more accurately identifying areas of nodal and metastatic involvement. Trials have demonstrated similar outcomes using a range of radiation fractionation schedules, allowing flexibility in individualizing treatment...
April 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28390772/outcomes-of-thoracic-endovascular-repair-for-type-b-aortic-dissection-with-multichanneled-morphology
#18
Baolei Guo, Kai Hou, Daqiao Guo, Xin Xu, Zhenyu Shi, Yan Shan, Peng Lv, Weiguo Fu
OBJECTIVE: Clinical outcomes after thoracic endovascular aortic repair (TEVAR) for patients with multichanneled aortic dissection (MCAD) are poorly understood but seem substantially different from those for patients with double-channeled aortic dissection (AD). This study compared the anatomic and clinical factors for patients with MCAD who underwent TEVAR with or without full true lumen (TL) collapse. METHODS: From January 2012 to March 2016, 54 of 644 consecutive type B AD patients (8...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390002/a-tool-for-validating-mri-guided-strategies-a-digital-breathing-ct-mri-phantom-of-the-abdominal-site
#19
Chiara Paganelli, Paul Summers, Chiara Gianoli, Massimo Bellomi, Guido Baroni, Marco Riboldi
Dynamic magnetic resonance imaging (MRI) is emerging as the elected image modality for organ motion quantification and management in image-guided radiotherapy. However, the lack of validation tools is an open issue for image guidance in the abdominal and thoracic organs affected by organ motion due to respiration. We therefore present an abdominal four-dimensional (4D) CT/MRI digital phantom, including the estimation of MR tissue parameters, simulation of dedicated abdominal MR sequences, modeling of radiofrequency coil response and noise, followed by k-space sampling and image reconstruction...
April 8, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#20
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
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