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https://www.readbyqxmd.com/read/28346475/treatment-of-blunt-thoracic-aortic-injury-in-germany-assessment-of-the-traumaregister-dgu%C3%A2
#1
Alexander Gombert, Mohammad E Barbati, Martin Storck, Drosos Kotelis, Paula Keschenau, Hans-Christoph Pape, Hagen Andruszkow, Rolf Lefering, Frank Hildebrand, Andreas Greiner, Michael J Jacobs, Jochen Grommes
PURPOSE: Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS: Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries. RESULTS: 821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35...
2017: PloS One
https://www.readbyqxmd.com/read/28346232/the-future-is-now-neuroprotection-during-cardiopulmonary-resuscitation
#2
Johanna C Moore, Jason A Bartos, Timothy R Matsuura, Demetris Yannopoulos
PURPOSE OF REVIEW: Survival with favorable neurological function after cardiac arrest remains low. The purpose of this review is to identify recent advances that focus on neuroprotection during cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Multiple strategies have been shown to enhance neuroprotection during CPR. Brain perfusion during CPR is increased with therapies such as active compression decompression CPR and intrathoracic pressure regulation that improve cardiac preload and decrease intracranial pressure...
March 24, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28346007/lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#3
Michael R Fettiplace, Daniel J McCabe
INTRODUCTION: The Lipid Emulsion Therapy workgroup, organized by the American Academy of Clinical Toxicology, recently conducted a systematic review, which subjectively evaluated lipid emulsion as a treatment for local anesthetic toxicity. We re-extracted data and conducted a meta-analysis of survival in animal models. METHODS: We extracted survival data from 26 publications and conducted a random-effect meta-analysis based on odds ratio weighted by inverse variance...
February 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28345064/pneumocephalus-in-a-patient-with-multiple-stab-wounds
#4
Yusuf Savran, Volkan Karacam, Basak Bayram, Erdem Yaka, Nuri Karabay
Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28344950/impalement-head-injury-with-a-spear
#5
B I Akhiwu, A S Adoga, O P Binitie, C C Ani, M Iweagwu, O Adetutu, T Ureme, D D George, P D Didamson, E Oseni-Momodu, B T Ugwu
Impalement injuries to the craniofacial region are uncommon due to the fact that the face is a smaller target in relation to the rest of the body. We report a case of a 26-year old man who was attacked on the face with a spear. He was promptly evaluated and resuscitated; the blade of the spear was successfully extracted under general anaesthesia. He was discharged home after 2 weeks hospitalization; he has been followed up for three months with good outcome.
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28344186/omission-of-predilation-in-balloon-expandable-transcatheter-aortic-valve-implantation-retrospective-analysis-in-a-large-volume-center
#6
Karsten Hamm, Wilko Reents, Michael Zacher, Philipp Halbfass, Sebastian Kerber, Anno Diegeler, Bernhard Schieffer, Sebastian Barth
AIMS: We aimed to evaluate the effect of omitting predilation on feasibility, procedural results and safety in balloon-expandable TAVI. METHODS AND RESULTS: We performed an analysis of all 680 patients scheduled for a balloon expandable TAVI prosthesis between january 2011 and august 2016. Patients treated with or without predilation were compared. Procedure times decreased from 85.6±42.9 to 56.7±26.1 minutes (p<0.001), fluoroscopy times from 9.5±5.7 to 6...
March 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28343957/adult-out-of-hospital-cardiac-arrest-in-philadelphia-from-2008-2012-an-epidemiological-study
#7
David F Gaieski, Anish K Agarwal, Benjamin S Abella, Robert W Neumar, Crawford Mechem, Sarah Wallace Cater, Frances S Shofer, Marion Leary, William P Pajerowski, Lance B Becker, Brendan Carr, Raina Merchant, Roger A Band
BACKGROUND: Wide variation in out-of-hospital cardiac arrest (OHCA) survival has been reported, with low survival in urban settings. We sought to describe the epidemiology of OHCA in Philadelphia, Pennsylvania, the fifth largest U.S. city, and identify potential areas for targeted interventions to improve survival. METHODS AND RESULTS: Retrospective chart review of adult, non-traumatic, OHCA occurring in Philadelphia between 2008 and 2012. We determined incidence and epidemiological factors including: demographics, initial cardiac rhythm, bystander cardiopulmonary resuscitation, automated external defibrillator use, return of spontaneous circulation and 30-day survival...
March 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/28343421/in-vitro-and-in-vivo-fitness-costs-associated-with-mycobacterium-tuberculosis-rpob-mutation-h526d
#8
Dalin Rifat, Victoria L Campodónico, Jing Tao, James A Miller, Alpaslan Alp, Yufeng Yao, Petros C Karakousis
AIM: There is controversy regarding the potential fitness costs of rifampicin (RIF) resistance-conferring mutations in the Mycobacterium tuberculosis (Mtb) rpoB gene. We characterized the pathogenicity of an Mtb RpoB H526D mutant. MATERIALS & METHODS: A mutant containing the RpoB H526D mutation was isolated from wild-type Mtb grown on RIF-containing plates and complemented for determination of in vitro and in vivo fitness costs. RESULTS: The RpoB H526D mutant showed reduced survival relative to control strains during progressive hypoxia and delayed growth following resuscitation from nutrient starvation (p < 0...
March 27, 2017: Future Microbiology
https://www.readbyqxmd.com/read/28341373/drugs-to-prevent-sudden-cardiac-death
#9
Julia W Erath, Stefan H Hohnloser
Sudden cardiac death (SCD) remains a major public health burden despite enormous advances in post-resuscitation care, management of structural heart diseases, and antiarrhythmic treatment modalities. Primary and secondary prevention of sudden cardiac death require understanding of the underlying substrate causing ventricular arrhythmias and its modification by pharmacological (i.e. heart failure therapy) or interventional (catheter ablation) methods. Antiarrhythmic drug therapy has experienced ups and downs during the last 30years balancing high antiarrhythmic potential, toxic side effects and pro-arrhythmic potency...
March 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28341188/features-of-hospital-and-emergency-medical-service-in-out-of-hospital-cardiac-arrest-patients-with-shockable-rhythm
#10
Shang-Li Tsai, Chung-Hsien Chaou, Chien-Hsiung Huang, I-Shiang Tzeng, Chan-Wei Kuo, Yi-Ming Weng, Cheng-Yu Chien
OBJECTIVE: Predicting the outcome of out-of-hospital cardiac arrest (OHCA) patients is crucial. We examined hospital characteristics and parameters of emergency medical service (including scene time interval and direct ambulance delivery to intensive heart hospitals) as survival or outcome predictors. STUDY DESIGN: Data from 546 consecutive OHCA shockable patients treated between January 2012 and December 2015 in Taoyuan City (Taiwan, ROC) were collected. In addition to demographic data, location of arrest, initial rhythm, availability of a hospital with or without 24/7 percutaneous coronary intervention (PCI), emergency medical service (EMS) time, provision of cardiopulmonary resuscitation by a bystander, presence of a witness at collapse, and level of life support were analysed...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28341187/persistent-hyperlactatemia-high-central-venous-arterial-carbon-dioxide-to-arterial-venous-oxygen-content-ratio-is-associated-with-poor-outcomes-in-early-resuscitation-of-septic-shock
#11
Juandi Zhou, Jia Song, Shijin Gong, Li Li, Haixiang Zhang, Minjia Wang
OBJECTIVE: Several studies reported Pv-aCO2/Ca-vO2 ratio as a surrogate of VCO2/VO2 to detect global tissue hypoxia. The present study aimed to evaluate the prognostic value of Pv-aCO2/Ca-vO2 ratio combined with lactate levels during the early phases of resuscitation in septic shock. METHODS: A retrospective study was conducted in 144 septic shock patients in a 30-bed mixed ICU. A Pv-aCO2/Ca-vO2 ratio>1.4 was considered abnormal. Patients were classified into four predefined groups according to lactate levels and Pv-aCO2/Ca-vO2 ratio after the first 6h of resuscitation...
March 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28341079/monitoring-of-nociception-reality-or-fiction
#12
A Abad-Gurumeta, J Ripollés-Melchor, R Casans-Francés, J M Calvo-Vecino
There are currently various projects underway that attempt to monitor the nociceptive responses caused by surgical stress and ensure patients the best analgesic conditions. The systemic response to surgical stress has repercussions in the postoperative period, such as worse pain control, delayed recovery, greater complications, longer stay in resuscitation and hospital units, and increased healthcare costs. However, treatment with higher doses of opioids than necessary may lead to slower awakening, increased drowsiness and adverse effects, as well as situations of postoperative opioid-induced hyperalgesia...
March 21, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#13
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#14
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/28343228/focal-brain-injury-associated-with-a-model-of-severe-hypoxic-ischemic-encephalopathy-in-nonhuman-primates
#15
Ryan M McAdams, Ronald J McPherson, Raj P Kapur, Sandra E Juul
Worldwide, hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity. To better understand the mechanisms contributing to brain injury and improve outcomes in neonates with HIE, better preclinical animal models that mimic the clinical situation following birth asphyxia in term newborns are needed. In an effort to achieve this goal, we modified our nonhuman primate model of HIE induced by in utero umbilical cord occlusion (UCO) to include postnatal hypoxic episodes, in order to simulate apneic events in human neonates with HIE...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28343206/-euthanasia-an-attempt-to-organize-issue
#16
Tomasz Kirmes, Mateusz Wilk, Czesław Chowaniec
This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28343180/oxygen-saturation-trends-in-normal-healthy-term-newborns-normal-vaginal-delivery-vs-elective-cesarean-section
#17
Rashi Bhargava, Madhu Mathur, Jyoti Patodia
OBJECTIVES: To study the normal oxygen saturation trends and fetomaternal correlates in healthy term newborns within 30 min of life born by normal vaginal delivery (NVD) and elective cesarean section (CS). MATERIALS AND METHODS: A cross-sectional study was conducted on 200 healthy term newborns born by NVD and elective CS at a tertiary care centre. Routine care as per the Neonatal Resuscitation Program (NRP) 2015 (Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al...
March 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28343161/fulminant-invasive-meningococcal-disease-due-to-serogroup-y-infection-a-highly-unusual-case-reflecting-worrying-increases-in-carriage-and-incidence
#18
Akash Maniam, Sriram Ravichandran
A young man presented to accident and emergency with a short history of diarrhoea and vomiting, with no medical history. He deteriorated rapidly during triage and never regained consciousness. He was pronounced dead after hours of attempted resuscitation. He was found to have organisms suggestive of diplococci on his blood film and subsequently had MenY found via PCR testing. This case illustrates a highly unusual presentation of invasive meningococcal disease caused by MenY which is quietly and dangerously increasing in incidence in the UK, particularly in young healthy patients...
March 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28342956/disparities-in-telephone-cpr-access-and-timing-during-out-of-hospital-cardiac-arrest
#19
Tomas Nuño, Bentley J Bobrow, Karen A Rogge-Miller, Micah Panczyk, Terry Mullins, Wayne Tormala, Antonio Estrada, Samuel M Keim, Daniel W Spaite
AIM: Spanish-only speaking residents in the United States face barriers to receiving potentially life-saving 911 interventions such as Telephone -cardiopulmonary resuscitation (TCPR) instructions. Since 2015, 911 dispatchers have placed an increased emphasis on rapid identification of potential cardiac arrest. The purpose of this study was to describe the utilization and timing of the 911 system during suspected OHCA by Spanish-speaking callers in Metropolitan Phoenix, Arizona. METHODS: The dataset consisted of suspected OHCA from 911 centers from October 10, 2010 through December 31, 2013...
March 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28340081/retroocular-and-subdural-hemorrhage-or-hemosiderin-deposits-in-pediatric-autopsies
#20
Marc R Del Bigio, Susan M Phillips
The presence of hemosiderin in the optic nerve sheath and/or retina is sometimes used to estimate the timing of injury in infants or children with suspected non-accidental head trauma. To determine the prevalence of hemosiderin in deaths not associated with trauma, we performed a prospective study of retroocular orbital tissue, cranial convexity, and cervical spinal cord dura mater in infants and children <2.5 years age. In 53 cases of non-traumatic death, approximately 70% had blood or hemosiderin within the orbital fat, ocular muscles, and parasagittal cranial and/or cervical spinal subdural compartment...
March 14, 2017: Journal of Neuropathology and Experimental Neurology
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