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https://www.readbyqxmd.com/read/29340811/a-word-of-caution-never-use-tacks-for-mesh-fixation-to-the-diaphragm
#1
F Köckerling, C Schug-Pass, R Bittner
BACKGROUND: The mesh fixation technique used in repair of hiatal hernias and subxiphoid ventral and incisional hernias must meet strenuous requirements. In the literature, there are reports of life-threatening complications with cardiac tamponade and a high mortality rate on using tacks. The continuing practice of tack deployment for mesh fixation to the diaphragm and esophageal hiatus should be critically reviewed. METHODS: In a systematic search of the available literature in May 2017, 23 cases of severe penetrating cardiac complications were identified...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29319015/a-practical-technique-in-laparoscopic-diaphragm-pacing-surgery-retrospective-analyse-of-43-patients
#2
Volkan Karacam, Aydin Sanli, Kemal Can Tertemiz, Ilknur Ulugun
INTRODUCTION: Diaphragm pacing stimulation (DPS) is a treatment method used in respiratory failure occurs in diseases such as high-level cervical spinal cord injury, central hypoventilation syndrome and amyotrophic lateral sclerosis. MATERIALS AND METHODS: A total of 43 patients, who had undergone DPS implantation surgery were evaluated retrospectively. The patients were divided into two groups according to the surgical technique (Group 1: classical surgical technic and Group 2: modified surgical technic) applied...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29295654/integration-of-transplanted-neural-precursors-with-the-injured-spinal-cord
#3
Victoria Marie Spruance, Lyandysha Viktorovna Zholudeva, Kristiina M Hormigo, Margo L Randelman, Tatiana Bezdudnaya, Vitaliy Marchenko, Michael A Lane
Cervical spinal cord injuries (SCI) result in devastating functional consequences, including respiratory dysfunction. This is largely due to the disruption of phrenic pathways, which control the diaphragm. Recent work has identified spinal interneurons as possible contributors to respiratory neuroplasticity. The present work investigated whether transplantation of developing spinal cord tissue, inherently rich in interneuronal progenitors, could provide a population of new neurons and growth permissive substrate to facilitate plasticity and formation of novel relay circuits to restore input to the partially denervated phrenic motor circuit...
January 2, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29247545/neurally-adjusted-ventilatory-assist-can-be-used-to-wean-infants-with-congenital-diaphragmatic-hernias-off-respiratory-support
#4
Arata Oda, Liisa Lehtonen, Hanna Soukka
Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation that triggers, cycles and delivers assistance in response to the electrical activity of the diaphragm (EAdi). The EAdi signal is measured with an EAdi catheter (Maquet, Solna, Sweden) that includes nine miniaturised electrodes and is positioned in the oesophagus at the level of the diaphragm. NAVA has been shown to decrease peak inspiratory pressures, which are potentially harmful for immature lungs (1,2) and, therefore, it may decrease ventilator induced lung injury, particularly pulmonary hypoplasia in congenital diaphragmatic hernia (CDH)...
December 16, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29227052/laparoscopy-or-clinical-follow-up-to-detect-occult-diaphragm-injuries-following-left-sided-thoracoabdominal-stab-wounds-a-pilot-randomized-controlled-trial
#5
G F Malherbe, P H Navsaria, A J Nicol, S Edu, S Chowdhury
BACKGROUND: The purpose of this study was to determine whether patients with left-sided thoracoabdominal (TA) stab wounds can be safely treated with clinical and chest X-ray follow up. METHOD: A prospective, randomized control study was conducted at Groote Schuur Hospital from September 2009 through to November 2014. Patients with asymptomatic left TA stab wounds included in the trial were randomized into two groups. Group A underwent diagnostic laparoscopy and Group B underwent clinical and radiological follow-up...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29223604/robot-assisted-retrohepatic-inferior-vena-cava-thrombectomy-first-or-second-porta-hepatis-as-an-important-boundary-landmark
#6
Baojun Wang, Hongzhao Li, Qingbo Huang, Kan Liu, Yang Fan, Cheng Peng, Liangyou Gu, Xintao Li, Gang Guo, Rong Liu, Minggen Hu, Guodong Zhao, Hongguang Wang, Fengyong Liu, Jiang Xiong, Xu Zhang, Xin Ma
BACKGROUND: Robot-assisted retrohepatic inferior vena cava (IVC) thrombectomy (RA-R-IVCTE) has been reported only for limited series. OBJECTIVE: To describe in detail the techniques for RA-R-IVCTE with regard to the relationship of a proximal thrombus to either the first porta hepatis (FPH) or second porta hepatis (SPH). DESIGN, SETTING, AND PARTICIPANTS: From May 2013 to July 2016, 22 patients with R-IVC tumor thrombi were admitted to our hospital...
December 6, 2017: European Urology
https://www.readbyqxmd.com/read/29214629/targeting-early-pkc%C3%AE-dependent-t-cell-infiltration-of-dystrophic-muscle-reduces-disease-severity-in-a-mouse-model-of-muscular-dystrophy
#7
Biliana Lozanoska-Ochser, Anna Benedetti, Giuseppe Rizzo, Valeria Marrocco, Rosanna Di Maggio, Piera Fiore, Marina Bouche
Chronic muscle inflammation is a critical feature of Duchenne muscular dystrophy and contributes to muscle fibre injury and disease progression. Although previous studies have implicated T cells in the development of muscle fibrosis, little is known about their role during the early stages of muscular dystrophy. Here, we show that T cells are among the first cells to infiltrate mdx mouse dystrophic muscle, prior to the onset of necrosis, suggesting an important role in early disease pathogenesis. Based on our comprehensive analysis of the kinetics of the immune response, we further identify the early pre-necrotic stage of muscular dystrophy as the relevant time frame for T cell-based interventions...
December 7, 2017: Journal of Pathology
https://www.readbyqxmd.com/read/29205354/podocytes-are-new-cellular-targets-of-haemoglobin-mediated-renal-damage
#8
Alfonso Rubio-Navarro, Maria Dolores Sanchez-Niño, Melania Guerrero-Hue, Cristina García-Caballero, Eduardo Gutiérrez, Claudia Yuste, Ángel Sevillano, Manuel Praga, Javier Egea, Elena Román, Pablo Cannata, Rosa Ortega, Isabel Cortegano, Belén de Andrés, María Luisa Gaspar, Susana Cadenas, Alberto Ortiz, Jesús Egido, Juan Antonio Moreno
Recurrent and massive intravascular haemolysis induces proteinuria, glomerulosclerosis, and progressive impairment of renal function, suggesting podocyte injury. However, the effects of haemoglobin (Hb) on podocytes remain unexplored. Our results show that cultured human podocytes or podocytes isolated from murine glomeruli bound and endocytosed Hb through the megalin-cubilin receptor system, thus resulting in increased intracellular Hb catabolism, oxidative stress, activation of the intrinsic apoptosis pathway, and altered podocyte morphology, with decreased expression of the slit diaphragm proteins nephrin and synaptopodin...
December 4, 2017: Journal of Pathology
https://www.readbyqxmd.com/read/29204186/percutaneous-transesophageal-gastro-tubing-pteg-as-an-alternative-long-term-tube-feeding-procedure-when-gastrostomy-is-not-feasible
#9
Ezekiel Wong Toh Yoon, Kazuki Nishihara
Background: Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. Methods: A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study...
December 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29195690/completed-fda-feasibility-trial-of-surgically-placed-temporary-diaphragm-pacing-electrodes-a-promising-option-to-prevent-and-treat-respiratory-failure
#10
Raymond P Onders, Alan Markowitz, Vanessa P Ho, Jeff Hardacre, Yuri Novitsky, Christopher Towe, MaryJo Elmo, Cindy Kaplan, Robert Schilz
BACKGROUND: Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS: A prospective FDA feasibility trial evaluated temporary DP electrodes implanted in each hemi-diaphragm during a subject's primary procedure. Objectives included: ability to provide ventilation, stability analysis with diaphragm electromyography, and adverse event monitoring...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29191982/case-studies-in-physiology-exercise-induced-diaphragm-fatigue-in-a-paralympic-champion-rower-with-spinal-cord-injury
#11
Nicholas B Tiller, Thomas R Aggar, Christopher R West, Lee M Romer
INTRODUCTION: The aim of this case report was to determine whether maximal upper-body exercise was sufficient to induce diaphragm fatigue in a Paralympic champion adaptive rower with low-lesion spinal cord injury (SCI). CASE PRESENTATION: An elite arms-only oarsman (age 28 y, stature 1.89 m, mass 90.4 kg) with motor-complete SCI (T12) performed a 1000 m time-trial on an adapted rowing ergometer. Exercise measurements comprised pulmonary ventilation and gas exchange, diaphragm EMG-derived indices of neural respiratory drive and intrathoracic pressure-derived indices of respiratory mechanics...
November 30, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29185785/functional-outcomes-of-motor-vehicle-crash-thoracic-injuries-in-pediatric-and-adult-occupants
#12
Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, Gretchen Baker, Joel D Stitzel, Mark R Zonfrillo
OBJECTIVE: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs), and compare the functional outcomes between the pediatric and adult populations. METHODS: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2-5 thoracic injuries...
November 29, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29183138/-experimental-model-for-cardiogenic-shock-with-pericardial-tamponade
#13
Gábor Bari, Szilárd Szűcs, Dániel Érces, Melinda Ugocsai, Noémi Bozsó, Dóra Balog, Mihály Boros, Gabriella Varga
INTRODUCTION: Pericardial tamponade (PT) is a life-threatening condition, with low cardiac output. The hemodynamic consequences of PT can severely affect the circulation of all tissues, including the microcirculation of the kidneys and the intestinal mucosa. Our aim was to develop a hemodynamically stable and controllable large animal model of PT to study the consequences of cardiogenic shock. METHODS: Two groups of anesthetized vietnamese minipigs (n = 6, both groups) were used...
December 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/29161213/laparoscopic-management-of-penetrating-thoracoabdominal-trauma
#14
Megan C Prunty, Siddharth Kudav, Jacob A Quick
BACKGROUND: Traumatic thoracoabdominal injuries can involve multiple organs and multiple cavities, which increases the complexity of surgical management. Traditionally, these injuries required laparotomy and thoracotomy. However, minimally invasive intervention may be reasonable for stable patients. MATERIALS AND METHODS: We present a case of a thoracoabdominal gunshot wound resulting in multiorgan, multicavity injury to the lung, diaphragm, and liver. We performed hepatorrhaphy and diaphragm repair, and addressed a retained hemothorax through a transabdominal laparoscopic approach...
November 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29124026/risk-factors-for-pneumonia-in-ventilated-trauma-patients-with-multiple-rib-fractures
#15
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29052830/diaphragmatic-rupture-a-single-institution-experience-and-literature-review
#16
Carlo Corbellini, Stefano Costa, Tiberio Canini, Roberta Villa, Ettore Contessini Avesani
BACKGROUND: Diaphragmatic rupture (DR) is a rare and potentially life-threatening event caused by trauma or spontaneously. DR occasionally occurs several months after the injury. Chest X-ray and computed tomography are the most effective diagnostic methods. Delay in DR diagnosis occurs frequently. This study aimed to examine and improve our understanding of the etiology, clinical presentation, and management of DR. METHODS: This study was performed at the Emergency and General Surgery Department of Fondazione I...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29045834/a-latent-propriospinal-network-can-restore-diaphragm-function-after-high-cervical-spinal-cord-injury
#17
Jared M Cregg, Kevin A Chu, Lydia E Hager, Rachel S J Maggard, Daimen R Stoltz, Michaela Edmond, Warren J Alilain, Polyxeni Philippidou, Lynn T Landmesser, Jerry Silver
Spinal cord injury (SCI) above cervical level 4 disrupts descending axons from the medulla that innervate phrenic motor neurons, causing permanent paralysis of the diaphragm. Using an ex vivo preparation in neonatal mice, we have identified an excitatory spinal network that can direct phrenic motor bursting in the absence of medullary input. After complete cervical SCI, blockade of fast inhibitory synaptic transmission caused spontaneous, bilaterally coordinated phrenic bursting. Here, spinal cord glutamatergic neurons were both sufficient and necessary for the induction of phrenic bursts...
October 17, 2017: Cell Reports
https://www.readbyqxmd.com/read/29029335/cortical-reorganization-in-dual-innervation-by-single-peripheral-nerve
#18
Mou-Xiong Zheng, Yun-Dong Shen, Xu-Yun Hua, Ao-Lin Hou, Yi Zhu, Wen-Dong Xu
BACKGROUND: Functional recovery after peripheral nerve injury and repair is related with cortical reorganization. However, the mechanism of innervating dual targets by 1 donor nerve is largely unknown. OBJECTIVE: To investigate the cortical reorganization when the phrenic nerve simultaneously innervates the diaphragm and biceps. METHODS: Total brachial plexus (C5-T1) injury rats were repaired by phrenic nerve-musculocutaneous nerve transfer with end-to-side (n = 15) or end-to-end (n = 15) neurorrhaphy...
September 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29022109/interaction-of-cd80-with-neph1-a-potential-mechanism-of-podocyte-injury
#19
Bhavya Khullar, Renu Balyan, Neelam Oswal, Nidhi Jain, Amita Sharma, Malik Z Abdin, Arvind Bagga, Shinjini Bhatnagar, Nitya Wadhwa, Uma Chandra Mouli Natchu, Anna George, Satyajit Rath, Vineeta Bal, Shailaja Sopory
BACKGROUND: The induction of CD80 on podocytes has been shown in animal models of podocyte injury and in certain cases of nephrotic syndrome. In a lipopolysaccharide (LPS)-induced mouse model of albuminuria, we have recently shown a signalling axis of LPS-myeloid cell activation-TNFα production-podocyte CD80 induction-albuminuria. Therefore, in this report, we investigated the cellular and molecular consequences of TNFα addition and CD80 expression on cultured podocytes. METHODS: A murine podocyte cell line was used for TNFα treatment and for over-expressing CD80...
October 11, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29018139/shca-adaptor-protein-promotes-nephrin-endocytosis-and-is-upregulated-in-proteinuric-nephropathies
#20
Claire E Martin, Kelly A Petersen, Lamine Aoudjit, Manali Tilak, Vera Eremina, W Rod Hardy, Susan E Quaggin, Tomoko Takano, Nina Jones
Nephrin is a key structural component of the podocyte slit diaphragm, and proper expression of nephrin on the cell surface is critical to ensure integrity of the blood filtration barrier. Maintenance of nephrin within this unique cell junction has been proposed to require dynamic phosphorylation events and endocytic recycling, although the molecular mechanisms that control this interplay are poorly understood. Here, we investigated the possibility that the phosphotyrosine adaptor protein ShcA regulates nephrin turnover...
October 10, 2017: Journal of the American Society of Nephrology: JASN
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