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diaphragm injury

F Marzona, N Parri, A Nocerino, M Giacalone, E Valentini, S Masi, L Bussolin
PURPOSE: Traumatic diaphragm rupture (TDR) is a rare complication of trauma in pediatric age and may be easily missed by the severity of associated injuries so that delayed emergent presentation can occur with increased rate of morbidity and mortality. No review has been available to guide clinicians through the pitfalls and the initial diagnostic approach to pediatric TDR. METHODS: A Medline thorough search on TDR was conducted using different queries. English language citations were identified during the period of January 2000 through December 2014 limiting the search to pediatric age (0-18 years)...
October 21, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Gisele de A Padilha, Lucas F B Horta, Lillian Moraes, Cassia L Braga, Milena V Oliveira, Cíntia L Santos, Isalira P Ramos, Marcelo M Morales, Vera Luiza Capelozzi, Regina C S Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. METHODS: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks...
December 2016: Intensive Care Medicine Experimental
Metin Ercan, Mehmet Aziret, Kerem Karaman, Birol Bostancı, Musa Akoğlu
INTRODUCTION: Diaphragmatic hernia secondary to traumatic rupture is a rare entity which can occur after stab wound injuries or blunt abdominal traumas. We aimed to report successfully management of dual mesh repair for a large diaphragmatic defect. CASE REPORT: A 66-year-old male was admitted with a right sided diaphragmatic hernia which occurred ten years ago due to a traffic accident. He had abdominal pain with worsened breath. Chest X-ray showed an elevated right diaphragm...
October 11, 2016: International Journal of Surgery Case Reports
Argyrios Chronopoulos, Gabriele Thumann, James Schutz
Positive vitreous pressure (PVP) occurs during anterior segment intraocular surgery associated with acute hypotony and is characterized by forward displacement of the lens-iris diaphragm with shallowing of the anterior chamber resistant to reformation, repeated iris prolapse, and, in severe cases, zonular rupture and vitreous or lens prolapse that can lead to a cascade of intraoperative complications. PVP is particularly common during penetrating keratoplasty (PK), conventional nuclear expression cataract extraction, and repair of anterior open globe injury...
October 14, 2016: Survey of Ophthalmology
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high tidal volume and high transpulmonary pressure. As an alternative to high dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
Guang-Tong Chen, Min Yang, Bing-Bing Chen, Yan Song, Wei Zhang, Yan Zhang
2,3,5,4'-Tetrahydroxystilbene-2-O-β-d-glucoside (TSG), an active component from the functional and medicinal herb Polygonum multiflorum Thunb, has the capacity of blocking angiotensin II (ANG II) signaling, a pathway within the renin-angiotensin system (RAS) which plays a critical role in the development of diabetic nephropathy (DN), and blockade of the RAS is currently used for the treatment of DN. Here we investigated the beneficial effect of TSG therapy on renal damage in the streptozotocin (STZ)-induced diabetes model...
October 17, 2016: Food & Function
Beom Jin Lim, Jae Won Yang, Woo Sung Do, Agnes B Fogo
Focal segmental glomerulosclerosis (FSGS) is characterized by focal and segmental obliteration of glomerular capillary tufts with increased matrix. FSGS is classified as collapsing, tip, cellular, perihilar and not otherwise specified variants according to the location and character of the sclerotic lesion. Primary or idiopathic FSGS is considered to be related to podocyte injury, and the pathogenesis of podocyte injury has been actively investigated. Several circulating factors affecting podocyte permeability barrier have been proposed, but not proven to cause FSGS...
October 16, 2016: Journal of Pathology and Translational Medicine
Zachary N London
Discomfort is an unavoidable part of electrodiagnostic (EDX) studies. The most readily modifiable mediator of electromyography (EMG)-associated pain is muscle selection. Interventions that may reduce pain include vapocoolant spray, ibuprofen, and techniques such as slapping or stretching the skin. Needlestick injuries to health care workers carry the risk of transmitting bloodborne illnesses, but other Infectious complications of EDX studies are very rare. EMG probably contributes to asymptomatic hemorrhage in about 1% of patients, but clinically significant bleeding has only been reported a few times...
September 28, 2016: Muscle & Nerve
Ousmane Thiam, Ibrahima Konate, Mohamadou Lamine Gueye, Alpha Omar Toure, Mamadou Seck, Mamadou Cisse, Balla Diop, Elias Said Dirie, Ousmane Ka, Mbaye Thiam, Madieng Dieng, Abdarahmane Dia, Cheikh Tidiane Toure
INTRODUCTION: Diaphragmatic injuries include wounds and diaphragm ruptures, due to a thoracoabdominal blunt or penetrating traumas. Their incidence ranges between 0.8 and 15 %. The diagnosis is often delayed, despite several medical imaging techniques. The surgical management remains controversal, particularly for the choice of the surgical approach and technique. The mortality is mainly related to associated injuries. The aim of our study was to evaluate the incidence of diaphragmatic injuries occuring in thoraco-abdominal traumas, and to discuss their epidemiology, diagnosis and treatment...
2016: SpringerPlus
Mark M Hammer, Demetrios A Raptis, Vincent M Mellnick, Sanjeev Bhalla, Constantine A Raptis
Injuries to the diaphragm muscle occur in penetrating and severe blunt trauma and can lead to delayed hernia formation. Computed tomography is the mainstay in the diagnosis of these injuries, which may be subtle at presentation. Imaging findings differ between blunt and penetrating trauma. Key features in blunt trauma include diaphragm fragment distraction and organ herniation because of increased intra-abdominal pressure. In penetrating trauma, herniation is uncommon, and the trajectory of the object is critical in making the diagnosis of diaphragm injury in these patients...
September 19, 2016: Abdominal Radiology
Maria A Gonzalez Porras, Paul N Durfee, Ashley M Gregory, Gary C Sieck, C Jeffrey Brinker, Carlos B Mantilla
BACKGROUND: Trophic interactions between muscle fibers and motoneurons at the neuromuscular junction (NMJ) play a critical role in determining motor function throughout development, aging, injury, or disease. Treatment of neuromuscular disorders is hindered by the inability to selectively target motoneurons with pharmacological and genetic interventions. NEW METHOD: We describe a novel delivery system to motoneurons using mesoporous silica nanoparticles encapsulated within a lipid bilayer (protocells) and modified with the atoxic subunit B of the cholera toxin (CTB) that binds to gangliosides present on neuronal membranes...
September 15, 2016: Journal of Neuroscience Methods
Arif Ahmad, Jason Jorge Arellano, Ashish Agarwala, Zoe Ahmad, Zoha Ahmad
BACKGROUND: Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate exposure of the hiatus and the stomach. Currently used approaches utilize retractors that require additional incisions and prolong operative time. OBJECTIVES: A retrospective evaluation of the efficacy and safety of a percutaneous liver retractor in a large series of patients undergoing laparoscopic bariatric surgery. SETTING: Private practice, United States...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Chigozirim Ekeke, Stephen Noble, Robert E Merritt
Intrapleural foreign bodies are rare and there are few reports on the occurrence and management of this uncommon clinical presentation. We report a case of a patient with a history of ingesting multiple foreign bodies, which resulted in multiple laparotomy procedures for extraction. The patient recently required surgical removal of innumerable ingested foreign bodies from the stomach and developed a left empyema post-operatively. Subsequent imaging studies revealed evidence of a foreign object in the left pleural space without evidence of an esophageal perforation or diaphragm injury...
August 2016: Journal of Thoracic Disease
Jan Sulc, Krystof Slaby, Zuzana Hlinkova, Pavel Kolar, Jiri Kozak, Jiri Kriz
OBJECTIVES: Respiratory complications are most common cause of morbidity/mortality in patients with cervical spinal cord injury (cSCI) due to respiratory muscle weakness and lower diaphragm position resulting in limited availability of inspiration, reduced thorax mobility and limited forced expiration. Differences in respiratory dysfunctions (RDs) in patients with motor complete versus incomplete cSCI were assessed. DESIGN: Prospective longitudinal study, serial measurement...
July 16, 2016: Neuro Endocrinology Letters
Ling Guo, Hongyan Zhang, Yinglong Hou, Tianshu Wei, Ju Liu
Endothelial subcellular structures, including caveolae, fenestrae and transendothelial channels, are crucial for regulating microvascular function. Plasmalemma vesicle-associated protein (PLVAP) is an endothelial cell-specific protein that forms the stomatal and fenestral diaphragms of blood vessels and regulates basal permeability, leukocyte migration and angiogenesis. Loss of PLVAP in mice leads to premature mortality due to disrupted homeostasis. Evidence from previous studies suggested that PLVAP is involved in cancer, traumatic spinal cord injury, acute ischemic brain disease, transplant glomerulopathy, Norrie disease and diabetic retinopathy...
September 2016: Experimental and Therapeutic Medicine
Walter Bugiantella, Federico Crusco, Nicola Avenia, Rondelli Fabio
UNLABELLED: Splenosis is the autoimplantation of splenic tissue to ectopic sites after spleen injury. Although splenosis most commonly occurs in the abdomen, it may occur in the thorax in case of diaphragm rupture. Thoracic splenosis (TS) is often asymptomatic and is diagnosed incidentally in the course of chest examination. We describe the case of a man, with a history of thoracoabdominal trauma, undergoing routine chest radiography with the evidence of radio-opaque images close to the inferior left curvature of the cardiac shadow, which resulted to be nodules of TS at the contrast enhanced CT scan...
2016: Annali Italiani di Chirurgia
Guodong Huang, Jianzhen Lv, Tongyu Li, Guoli Huai, Xiang Li, Shaowei Xiang, Longlong Wang, Zhenlin Qin, Jianli Pang, Bingyu Zou, Yi Wang
The present study was designed to examine the protective effect of notoginsenoside R1 (NR1) on podocytes in a rat model of streptozotocin (STZ)‑induced diabetic nephropathy (DN), and to explore the mechanism responsible for NR1-induced renal protection. Diabetes was induced by a single injection of STZ, and NR1 was administered daily at a dose of 5 mg/kg (low dose), 10 mg/kg (medium) and 20 mg/kg (high) for 16 weeks in Sprague-Dawley rats. Blood glucose levels, body weight and proteinuria were measured every 4 weeks, starting on the day that the rats received NR1...
October 2016: International Journal of Molecular Medicine
Parikshit S Sharma, Santosh K Padala, J Jenkins Thompson, Sampath Gunda, Jayanthi N Koneru, Kenneth A Ellenbogen
INTRODUCTION: The diaphragmatic compound motor action potentials (CMAPs) have been used to predict and prevent phrenic nerve injury (PNI) during cryoballoon ablation of right pulmonary veins. We sought to assess factors that influence the amplitude of the surface CMAP recordings. METHODS AND RESULTS: We analyzed CMAPs from consecutive patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation. CMAP recordings were obtained using ECG electrodes positioned in the "modified lead I" method while stimulating the right PN, until loss of capture (ascertained by palpation and fluoroscopy of the right hemi-diaphragm)...
August 25, 2016: Journal of Cardiovascular Electrophysiology
Irene Dot, Purificación Pérez-Teran, Manuel-Andrés Samper, Joan-Ramon Masclans
Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure...
August 20, 2016: Archivos de Bronconeumología
Dorota Toliczenko-Bernatowicz, Wojciech Dębek, Ewa Matuszczak
We present the case of a 13.5-year-old girl who was admitted to the Pediatric Surgery Department from the Pediatric Department of a district hospital, where she stayed because of stomachache and vomiting. Interview revealed blunt injury of the epigastrium a week ago. Chest X-ray revealed a loss of the right diaphragmatic outline, irregular radiolucency on the right side of the chest, collapsed right lung and mediastinal displacement to the left. The patient was operated on, and the surgery revealed herniation of the intestines and half of the stomach into the defect of the right dome of the diaphragm...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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