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https://www.readbyqxmd.com/read/28224077/electrical-impedance-tomography-and-trans-pulmonary-pressure-measurements-in-a-patient-with-extreme-respiratory-drive
#1
Atsuko Shono, Peter Somhorst, Diederik Gommers
Preserving spontaneous breathing during mechanical ventilation prevents muscle atrophy of the diaphragm, but may lead to ventilator induced lung injury (VILI). We present a case in which monitoring of trans-pulmonary pressure and ventilation distribution using Electrical Impedance Tomography (EIT) provided essential information for preventing VILI.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28223038/nanoconjugate-bound-adenosine-a1-receptor-antagonist-enhances-recovery-of-breathing-following-acute-cervical-spinal-cord-injury
#2
Zeljka Minic, Sharowyn Wilson, Fangchao Liu, Abdulghani Sankari, Guangzhao Mao, Harry Goshgarian
Respiratory complications in patients with spinal cord injury (SCI) are common and can have a negative impact on the quality of patients' lives. Previously, we found that intradiaphragmatic administration of the nanoconjugate-bound A1 adenosine receptor antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) induced recovery of diaphragm function following SCI in rats. When administered immediately following the injury, recovery was observed as early as 3days following SCI and it persisted until the end of the study, 28days after the drug delivery...
February 18, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28215550/evaluation-of-unenhanced-post-mortem-computed-tomography-to-detect-chest-injuries-in-violent-death
#3
I Sifaoui, C Nedelcu, G Beltran, V Dupont, J Lebigot, A Gaudin, C Ridereau Zins, C Rouge Maillard, C Aubé
PURPOSE: The aim of this study was to assess the performances of unenhanced post-mortem computed tomography (CT) to detect thoracic injuries in violent death. MATERIALS AND METHODS: Retrospectively, we conducted a review of unenhanced CT scans of 67 victims of violent deaths with thoracic injuries and compared CT findings with the results of clinical autopsy. Our gold standard was a comparison of CT scans with autopsy discussed in a monthly forensic radiology multidisciplinary team meeting (MDTM)...
February 16, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28184363/a-comparison-of-self-inflicted-stab-wounds-versus-assault-induced-stab-wounds
#4
Sanghyun Ahn, Dong Jin Kim, Kwang Yeol Paik, Jae Hee Chung, Woo-Chan Park, Wook Kim, In Kyu Lee
BACKGROUND: Although self-inflicted and assault-induced knife injuries might have different mortality and morbidity rates, no studies have actually evaluated the importance of the cause of knife injuries in terms of patient outcomes and treatment strategies. OBJECTIVES: The aims of this study were to assess the difference between the outcomes of patients presenting with self-inflicted stab wounds (SISW) versus assault-induced stab wounds (AISW). PATIENTS AND METHODS: A retrospective review of the relevant electronic medical records was performed for the period between January 2000 and December 2012 for patients who were referred to the department of surgery for stab wounds by the trauma team...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28162133/restricted-nutrition-induced-low-birth-weight-low-number-of-nephrons-and-glomerular-mesangium-injury-in-japanese-quail
#5
H Nishimura, E Yaoita, M Nameta, K Yamaguchi, M Sato, C Ihoriya, L Zhao, H Kawachi, T Sasaki, Y Ikezumi, Y Ouchi, N Kashihara, T Yamamoto
Insufficient nutrition during the perinatal period causes structural alterations in humans and experimental animals, leading to increased vulnerability to diseases in later life. Japanese quail, Coturnix japonica, in which partial (8-10%) egg white was withdrawn (EwW) from eggs before incubation had lower birth weights than controls (CTs). EwW birds also had reduced hatching rates, smaller glomeruli and lower embryo weight. In EwW embryos, the surface condensate area containing mesenchymal cells was larger, suggesting that delayed but active nephrogenesis takes place...
February 6, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28139108/-late-presentation-of-traumatic-diaphragmatic-hernia
#6
J R Leiva Flores, J I Ramírez Rivera, M E Ramírez Rivera
Four years old male, who was operated four months ago to present chest injuries caused by a firearm projectile, where injuries in the diaphragm were not observed. Now is admitted because of an intestinal obstruction. By medial laparotomy, a defect of 3 cm in diameter was exposed in the left diaphragm, containing a transverse colonic segment of 5 cm and omentum. The treatment performed is described.
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28127711/how-to-manage-tension-gastrothorax-a-case-report-of-tension-gastrothorax-with-multiple-trauma-due-to-traumatic-diaphragmatic-rupture
#7
Naofumi Bunya, Keigo Sawamoto, Shuji Uemura, Takashi Toyohara, Yukino Mori, Ryoko Kyan, Kei Miyata, Hideto Irifune, Keisuke Harada, Eichi Narimatsu
BACKGROUND: Tension gastrothorax is a kind of obstructive shock with prolapse and distention of the stomach into the thoracic cavity. Progressive gastric distension leads to mediastinal shift, reduced venous return, decreased cardiac output, and ultimately cardiac arrest. Therefore, it is crucial to decompress the stomach distension for the initial resuscitation of tension gastrothorax. CASE PRESENTATION: A 75-year-old female was transported to our resuscitation bay due to motor vehicle crash...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#8
Josh Luftig, Daniel Mantuani, Andrew A Herring, Arun Nagdev
The America Society of Anesthesiology guidelines recommend multimodal analgesia that combines regional anesthetic techniques with pharmacotherapy to improve peri-procedural pain management and reduce opioid related complications. Commonly performed emergency procedures of the upper extremity such as fracture and dislocation reduction, wound debridement, and abscess incision and drainage are ideal candidates for ultrasound-guided (USG) regional anesthesia of the brachial plexus. However, adoption of regional anesthesia by emergency practitioners has been limited by concerns for potential complications and perceived technical difficulty...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28112381/notoginsenoside-r1-attenuates-glucose-induced-podocyte-injury-via-the-inhibition-of-apoptosis-and-the-activation-of-autophagy-through-the-pi3k-akt-mtor-signaling-pathway
#9
Guodong Huang, Bingyu Zou, Jianzhen Lv, Tongyu Li, Guoli Huai, Shaowei Xiang, Shilong Lu, Huan Luo, Yaping Zhang, Yi Jin, Yi Wang
Injury to terminally differentiated podocytes contributes ignificantly to proteinuria and glomerulosclerosis. The aim of this study was to examine the protective effects of notoginsenoside R1 (NR1) on the maintenance of podocyte number and foot process architecture via the inhibition of apoptosis, the induction of autophagy and the maintenance pf podocyte biology in target cells. The effects of NR1 on conditionally immortalized human podocytes under high glucose conditions were evaluated by determining the percentage apoptosis, the percentage autophagy and the expression levels of slit diaphragm proteins...
March 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28099382/failure-of-nonoperative-management-of-pediatric-blunt-liver-and-spleen-injuries-a-prospective-atomac-study
#10
Maria E Linnaus, Crystal S Langlais, Nilda M Garcia, Adam C Alder, James W Eubanks, R Todd Maxson, Robert W Letton, Todd A Ponsky, Shawn D St Peter, Charles Leys, Amina Bhatia, Daniel J Ostlie, David W Tuggle, Karla A Lawson, Alexander R Raines, David M Notrica
BACKGROUND: Nonoperative management (NOM) is standard of care for most pediatric blunt liver and spleen injuries (BLSI); only 5% of patients fail NOM in retrospective reports. No prospective studies examine failure of NOM of BLSI in children. The aim of this study was to determine the frequency and clinical characteristics of failure of NOM in pediatric BLSI patients. METHODS: A prospective observational study was conducted on patients ≤18 years presenting to any of ten level 1 pediatric trauma centers April 2013 and January 2016 with BLSI on computed tomography...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28087340/electrophysiological-alterations-in-diaphragm-muscle-caused-by-abdominal-ischemia-reperfusion
#11
Seckin Tuncer, Nizamettin Dalkilic, Ilksen Burat
Ischemia-reperfusion injury is the major complication of abdominal aortic surgery, and it mainly affects the lower extremities and remote organs. In the present study, the electrophysiological alterations in diaphragm that underlie the post-operative respiratory dysfunction were investigated. Wistar Albino rats were randomly divided into two groups: SHAM (only laparotomy was performed) and IR (abdominal aorta was clamped for 30min and reperfused for 2h). Following the operational period diaphragm muscles were isolated and electrophysiological experiments were carried out in-vitro...
January 10, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28066670/image-guided-thoracoscopic-surgery-with-dye-localization-in-a-hybrid-operating-room
#12
Shun-Mao Yang, Wei-Chun Ko, Mong-Wei Lin, Hsao-Hsun Hsu, Chih-Yang Chan, I-Hui Wu, Yeun-Chung Chang, Jin-Shing Chen
BACKGROUND: The rate of detection of small pulmonary nodules (SPNs) has increased. Thoracoscopic resection following image-guided localization had been a reliable alternative in their treatment. We present our experience with image-guided dye localization using robotic C-arm computed tomography (CT) followed by immediate video-assisted thoracoscopic surgery (VATS) for SPNs in a hybrid operating room (OR). METHODS: From July 2015 to July 2016, 25 consecutive patients with SPNs smaller than 2 cm underwent robotic C-arm CT-guided blue dye tattooing followed by immediate VATS in a hybrid OR...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28035466/a-rare-postoperative-complication-of-anterior-lower-thoracic-instrumentation-diaphragmatic-laceration-with-hemothorax
#13
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/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#14
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
March 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28012765/impotence-following-radical-prostatectomy-insight-into-etiology-and-prevention
#15
Patrick C Walsh, Pieter J Donker
This study was undertaken to identify the cause of impotence in men undergoing radical prostatectomy, with the hope that this information may provide insight into the possible prevention of this complication. The autonomic innervation of the corpora cavernosa in the male fetus and newborn was traced to determine the topographical relationship between the pelvic nerve plexus, and the prostate, urethra and urogenital diaphragm. We have demonstrated that the branches of the pelvic plexus that innervate the corpora cavernosa are situated between the rectum and urethra, and penetrate the urogenital diaphragm near or in the muscular wall of the urethra...
February 2017: Journal of Urology
https://www.readbyqxmd.com/read/28004760/angiotensin-ii-increases-glomerular-permeability-by-%C3%AE-arrestin-mediated-nephrin-endocytosis
#16
Eva Königshausen, Ulf M Zierhut, Martin Ruetze, Sebastian A Potthoff, Johannes Stegbauer, Magdalena Woznowski, Ivo Quack, Lars C Rump, Lorenz Sellin
Glomerular permeability and subsequent albuminuria are early clinical markers for glomerular injury in hypertensive nephropathy. Albuminuria predicts mortality and cardiovascular morbidity. AT1 receptor blockers protect from albuminuria, cardiovascular morbidity and mortality. A blood pressure independent, molecular mechanism for angiotensin II (Ang II) dependent albuminuria has long been postulated. Albuminuria results from a defective glomerular filter. Nephrin is a major structural component of the glomerular slit diaphragm and its endocytosis is mediated by β-arrestin2...
December 22, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27965930/a-case-of-severe-thoracoabdominal-impalement-by-a-steel-bar
#17
Ki Tae Kim, Pil Won Seo
A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27934791/comparison-of-single-incision-and-multi-incision-diagnostic-laparoscopy-on-evaluation-of-diaphragmatic-status-after-left-thoracoabdominal-penetrating-stab-wounds
#18
Mehmet Ilhan, Ali Fuat Kaan Gök, Süleyman Bademler, Ömer Cenk Cücük, Yiğit Soytaş, Hakan Teoman Yanar
AIM: Single incision diagnostic laparoscopy (SIDL) may be an alternative procedure to multi-incision diagnostic laparoscopy (MDL) for penetrating thoracoabdominal stab wounds. The purpose of this study is sharing our experience and comparing two techniques for diaphragmatic status. MATERIALS AND METHODS: Medical records of 102 patients with left thoracoabdominal penetrating stab injuries who admitted to Istanbul School of Medicine, Trauma and Emergency Surgery Clinic between February 2012 and April 2016 were examined...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27932705/possible-role-for-glomerular-derived-angiotensinogen-in-nephrotic-syndrome
#19
Mihoko Yamazaki, Yoshiyasu Fukusumi, Mutsumi Kayaba, Yukina Kitazawa, Sayuri Takamura, Ichiei Narita, Hiroshi Kawachi
BACKGROUND AND OBJECTIVE: Renin-angiotensin system (RAS) inhibitors reduce glomerular injury and proteinuria, indicating that angiotensin II (Ang II) is involved in glomerular diseases. Although the local RAS is reported to play an essential role in maintaining local tissue functions, the role of the local RAS in regulating glomerular function is not well evaluated. In this study, we analyzed the glomerular expression of RAS components in nephrotic models and the effect of Ang II receptor blockers (ARB) on the expression of angiotensinogen (AGT)...
October 2016: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/27932480/magi2-mutations-cause-congenital-nephrotic-syndrome
#20
Agnieszka Bierzynska, Katrina Soderquest, Philip Dean, Elizabeth Colby, Ruth Rollason, Caroline Jones, Carol D Inward, Hugh J McCarthy, Michael A Simpson, Graham M Lord, Maggie Williams, Gavin I Welsh, Ania B Koziell, Moin A Saleem
Steroid-resistant nephrotic syndrome (SRNS), a heterogeneous disorder of the renal glomerular filtration barrier, results in impairment of glomerular permselectivity. Inheritance of genetic SRNS may be autosomal dominant or recessive, with a subset of autosomal recessive SRNS presenting as congenital nephrotic syndrome (CNS). Mutations in 53 genes are associated with human SRNS, but these mutations explain ≤30% of patients with hereditary cases and only 20% of patients with sporadic cases. The proteins encoded by these genes are expressed in podocytes, and malfunction of these proteins leads to a universal end point of podocyte injury, glomerular filtration barrier disruption, and SRNS...
December 8, 2016: Journal of the American Society of Nephrology: JASN
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