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https://www.readbyqxmd.com/read/27916349/pediatric-pyoderma-gangrenosum-is-it-just-big-wounds-on-little-adults
#1
Tahereh Soleimani, Sarah E Sasor, Leigh Spera, Barry E Eppley, Juan Socas, Michael W Chu, Sunil S Tholpady
BACKGROUND: Pyoderma gangrenosum (PG) is an uncommon, ulcerative, cutaneous condition, often caused by surgical trauma that can masquerade as a pyogenic disease process requiring debridement and antibiotics. Treatment is, however, medical, with delay leading to significant morbidity. In addition, medical workup for coincident disorders has been suggested. The purpose of this study was to test the hypothesis that pediatric PG has differing disease associations and therefore requires a differing medical workup...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916016/penetrating-neck-trauma-and-the-need-for-surgical-exploration-six-year-experience-within-a-regional-trauma-centre
#2
A V Kasbekar, E J Combellack, S G Derbyshire, A C Swift
BACKGROUND: There has been a shift towards conservative management of penetrating neck trauma in selected patients. METHODS: A retrospective case note review of the management of penetrating neck trauma (2007-2013) was undertaken at our large teaching hospital and compared against best-evidenced practice. RESULTS: Sixty-three patients were admitted over six years. The incidence of penetrating neck trauma is reducing, contrary to our belief...
December 5, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27911229/c-2-arteriovenous-fistula-presenting-as-a-pathologic-hangman-s-fracture-case-report
#3
Rajeev D Sen, Carolina Gesteira Benjamin, Howard A Riina, Donato Pacione
The authors report on an 81-year-old woman with a pathologic hangman's fracture secondary to a complex arteriovenous fistula (AVF). The patient presented with severe, unremitting neck pain and was found to have fractures bilaterally through the pars interarticularis of C-2 with significant anterior subluxation of C-2 over C-3 along with widening of the left transverse foramen. Due to an abnormally appearing left vertebral artery (VA) on CT angiography, the patient underwent conventional angiography, which revealed a complex AVF stemming from the left VA at the level of C-2 with dilated posterior cervical veins and a large venous varix...
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27911067/-vascular-interventional-radiology-a-fundamental-procedure-for-the-management-of-paediatric-trauma
#4
E Bordón Cabrera, A Laín, R Gander, M Pérez Lafuente, I Díez Miranda, C G Fontecha, L Seidler, I Delgado, S Cañadas Palazón, J Lloret
INTRODUCTION: The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. AIM: The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. METHODS: Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27909609/emergency-difficult-airway-management-in-a-patient-with-severe-epidermolysis-bullosa
#5
Ahmet Selim Özkan, Gülay Erdoğan Kayhan, Sedat Akbaş, Osman Kaçmaz, Mahmut Durmuş
Epidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27908375/treatment-of-radiation-induced-urethral-strictures
#6
REVIEW
Matthias D Hofer, Joceline S Liu, Allen F Morey
Radiation therapy may result in urethral strictures from vascular damage. Most radiation-induced urethral strictures occur in the bulbomembranous junction, and urinary incontinence may result as a consequence of treatment. Radiation therapy may compromise reconstruction due to poor tissue healing and radionecrosis. Excision and primary anastomosis is the preferred urethroplasty technique for radiation-induced urethral stricture. Principles of posterior urethroplasty for trauma may be applied to the treatment of radiation-induced urethral strictures...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#7
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904758/penetrating-thoracic-spinal-cord-injury-with-ice-pick-extending-into-the-aorta-a-technical-note-and-review-of-the-literature
#8
Rani Nasser, Jonathan Nakhla, Saadat Sharif, Merritt Kinon, Reza Yassari
BACKGROUND: Penetrating spinal cord injuries pose a great challenge to both patients and the treating physicians. Although the overall incidence of penetrating spinal cord injury is the highest in the military, the ubiquity of guns in our society continues to make penetrating spinal cord injury prevalent in the civilian population. These types of injuries are particularly complicated because, beyond the trauma to the neural elements and supporting structures, other organs can be affected and a team approach is required for successful treatment...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904307/hybrid-transvaginal-notes-and-mini-laparoscopic-colectomy-benefit-through-synergy
#9
Jayson M Moloney, Philip S L Gan
BACKGROUND AND OBJECTIVES: Hybrid-natural orifice surgery combines the advantages of traditional transabdominal laparoscopic surgery, while limiting surgical trauma to the abdominal wall. Among various routes of intra-abdominal access, the transvaginal method is most appealing because of its utility and proven safety. We describe a series of 4 colonic resections performed with this approach, combined with minilaparoscopy and needlescopic approaches, and discuss the technical aspects, efficacy, and applicability of this technique...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27904004/delayed-diagnosis-of-blunt-carotid-trauma-in-a-seat-belt-syndrome-with-associated-abdominal-wall-injury-a-case-report
#10
Savino Occhionorelli, Dario Andreotti, Daniela Tartarini, Lorenzo Cappellari, Rocco Stano, Lucia Morganti, Giorgio Vasquez
: The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, involved in a traffic accident, arrived to Emergency Room hemodynamically stable, with a Glasgow Coma Scale of 15, complaining abdominal pain, without any neurological signs. She underwent Computed Tomography (CT) scan that showed a complete disruption of left abdominal wall muscles, associated with massive bowel loops herniation...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27903481/hybrid-repair-of-complex-left-subclavian-artery-injury-with-partial-transection-and-complete-thrombosis-in-an-unstable-patient-following-blunt-trauma
#11
Ilitch Diaz-Gutierrez, Muhammad A Rana, Barkat Ali, John M Marek, Mark Langsfeld
Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27900711/lacertus-fibrosus-augmentation-for-distal-biceps-brachii-rupture-repair-surgical-technique
#12
M Fontana, A Trimarchi, A Colozza
BACKGROUND: Repair of distal biceps tendon ruptures has become widely accepted. Unfortunately, care of retracted-degenerated injuries remains a challenge for orthopedic surgeons. Complication rates appear to increase when surgery is performed in chronic cases compared to those operated acutely. Multiple techniques for chronic reconstruction with the use of grafts have been described. Recently Morrey, from the Mayo Clinic, proposed a direct anatomic repair of retracted distal biceps tendon ruptures in extreme flexion (60°-90°) to avoid grafting...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900325/giant-idiopathic-renal-arteriovenous-fistula-managed-by-coils-and-amplatzer-device-case-report-and-literature-review
#13
Prashant Nagpal, Girish Bathla, Sachin S Saboo, Ashish Khandelwal, Abhishek Goyal, Frank J Rybicki, Michael L Steigner
An idiopathic renal arteriovenous (AV) fistula is a rare malformation of the kidney that may present insidiously with heart failure or hematuria. The treatment may be challenging due to large fistula size that may limit endovascular management. The authors report a case of an 85-year-old Caucasian woman who presented with acute heart failure and was found to have a right renal AV fistula. Since she had no prior history of renal intervention or trauma, a diagnosis of idiopathic renal AV fistula was made. She was managed by endoluminal occlusion using multiple stainless steel coils and Amplatzer vascular plug II device...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27896450/extremity-cta-for-penetrating-trauma-10-year-experience-using-a-64-detector-row-ct-scanner
#14
Charles G Colip, Varun Gorantla, Christina A LeBedis, Jorge A Soto, Stephan W Anderson
PURPOSE: The purpose of this study is to assess the performance of CT angiography (CTA) in the evaluation of penetrating vascular trauma to the extremities in a large cohort of patients at our level I trauma center. METHODS: A retrospective, IRB-approved review of consecutive CTAs for the evaluation of penetrating trauma to the extremities in 446 patients (M/F = 396:50, mean age = 27 years) from 1/1/2005 to 5/1/2015 was performed. Medical records were reviewed to correlate diagnostic imaging findings with clinical history and subsequent interventions...
November 29, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27896177/anti-vascular-endothelial-growth-factor-bevacizumab-therapy-reduces-hypertrophic-scar-formation-in-a-rabbit-ear-wounding-model
#15
Do Hoon Kwak, Tae Hui Bae, Woo Seob Kim, Han Koo Kim
BACKGROUND: Hypertrophic scarring is a pathological condition that occurs after trauma or surgery. Angiogenesis occurs more often with hypertrophic scarring than with normotrophic scarring. The regulation of angiogenesis is one of the key factors in hypertrophic scar management. Vascular endothelial growth factor (VEGF) is an essential factor in the angiogenetic response. This study investigated whether decreasing the level of VEGF is effective for treating hypertrophic scarring. METHODS: Ten 8-week-old female New Zealand white rabbits were included...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27894859/brown-tumour-in-phalanx-of-the-ring-finger-due-to-chronic-kidney-failure-a-case-report
#16
J E Forigua V, R A Brunicardi H, C A Morales V, M Del P Archila, D M Chaparro Rivera
Brown tumours are highly vascular lytic bone lesions found in primary and secondary hyperparathyroidism. The brown term is given due to the red-brown colour of the tissue, which is due to the accumulation of hemosiderin. The case is presented of a 29 year-old male with chronic renal failure, who had a mass in the tip of the ring finger after a trauma of 4 months onset, which had increased progressively in size and pain. He was treated surgically, by amputation, with no recurrence 10 months after the surgery...
November 25, 2016: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/27894498/noncompressible-torso-hemorrhage
#17
REVIEW
Jonathan J Morrison
Noncompressible torso hemorrhage (NCTH) constitutes a leading cause of potentially preventable trauma mortality. NCTH is defined by high-grade injury present in one or more of the following anatomic domains: pulmonary, solid abdominal organ, major vascular or pelvic trauma; plus hemodynamic instability or the need for immediate hemorrhage control. Rapid operative management, as part of a damage control resuscitation strategy, remains the mainstay of treatment. However, endovascular techniques are evolving and may become more mainstream with the advent of hybrid rooms that can deliver concurrent open and radiologic/endovascular management of traumatic hemorrhage...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27893646/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#18
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. iNO lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure. METHODS: A hemorrhagic shock and pneumonectomy model was developed using sheep...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893542/safety-and-suitability-of-finger-replantations-as-a-residency-training-procedure-a-retrospective-cohort-study-with-analysis-of-the-initial-postoperative-outcomes
#19
Dimitra Kotsougiani, Felicitas Ringwald, Caroline A Hundepool, Florian Neubrech, Thomas Kremer, Berthold Bickert, Ulrich Kneser, Christoph Hirche
Finger replantations demand technical excellence in microsurgery and hand trauma care. The objective of this study was to determine whether finger replantations constitute an appropriate and safe procedure for residency training. Additionally, the prognostic risk factors for the need to take a replanted finger back to the operation room and replant failure were analyzed.All patients who underwent finger replantation after complete amputation between 2007 and 2015 were included in a retrospective comparative study...
November 23, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27891547/severe-pelvic-injury-vascular-lesions-detected-by-ante-and-post-mortem-contrast-medium-enhanced-ct-and-associations-with-pelvic-fractures
#20
Mahmoud Hussami, Silke Grabherr, Reto A Meuli, Sabine Schmidt
OBJECTIVES: The objectives of this study were to compare arterial and venous contrast medium extravasation in severe pelvic injury detected by ante- and post-mortem multi-detector CT (MDCT) and determine whether vascular injury is associated with certain types of pelvic fracture. METHODS: We retrospectively included two different cohorts of blunt pelvic trauma with contrast medium extravasation shown by MDCT. The first group comprised 49 polytrauma patients; the second included 45 dead bodies undergoing multi-phase post-mortem CT-angiography (MPMCTA)...
November 28, 2016: International Journal of Legal Medicine
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