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https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#1
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28917706/the-effects-of-needle-damage-on-annulus-fibrosus-micromechanics
#2
Claudio Vergari, Jessica C Mansfield, Daniel Chan, Andrew Clarke, Judith R Meakin, Peter C Winlove
Needle puncture of the intervertebral disc can initiate a mechanical and biochemical cascade leading to disc degeneration. Puncture's mechanical effects have been shown near the puncture site, mechanical effects should be observed far, relative to needle size, from the puncture site, given the disc-wide damage induced by the stab. The aim of this work was to quantify these far-field effects, and to observe the local structural damage provoked by the needle. Strips of cow tail annulus fibrosus underwent two consecutive mechanical loadings to 5% tensile strain; fifteen samples were punctured in a radial direction with a randomly assigned needle between the two loadings (needle gauges between 19 and 23)...
September 13, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28916875/traumatic-injuries-to-the-pregnant-patient-a-critical-literature-review
#3
REVIEW
P Petrone, P Jiménez-Morillas, A Axelrad, C P Marini
INTRODUCTION: Trauma during pregnancy is the leading non-obstetrical cause of maternal death and a significant public health burden. This study reviews the most common causes of trauma during pregnancy, morbidity, and mortality, and the impact upon perinatal outcomes associated with trauma, providing a management approach to pregnant trauma patients. MATERIALS AND METHODS: A systematic review of the current literature from January 2006 to July 2016 was performed...
September 15, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28912997/laparoscopic-repair-of-diaphragmatic-rupture-a-case-report-with-radiological-and-surgical-correlation
#4
Patrick Nguyen, Bonnie Davis, Daniel D Tran
The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28882409/assessment-of-growth-of-aspergillus-spp-from-agricultural-soils-in-the-presence-of-glyphosate
#5
Cecilia S Carranza, Carla L Barberis, Stella M Chiacchiera, Carina E Magnoli
Agriculture is one of the bases of the Argentine economy. Glyphosate is undoubtedly one of the most important herbicides used. The increasing consumption and the efficiency of glyphosate-based herbicides have encouraged several studies on their persistence in soils, their effects on soil microbiota and their degradation processes. Fungi have been reported as being the main herbicide-degrading microorganisms as well as the most tolerant to environmental stress conditions. This study evaluated the growth performance of Aspergillus section Flavi and Aspergillus niger aggregate strains on Czapek Dox media supplied with a commercial glyphosate formulation as sole source of carbon (CZC), phosphorus (CZP) or nitrogen (CZN)...
September 4, 2017: Revista Argentina de Microbiología
https://www.readbyqxmd.com/read/28877185/feet-deformities-are-correlated-with-impaired-balance-and-postural-stability-in-seniors-over-75
#6
Ewa Puszczalowska-Lizis, Przemyslaw Bujas, Jaroslaw Omorczyk, Slawomir Jandzis, Marek Zak
OBJECTIVE: Understanding the factors and mechanisms that determine balance in seniors appears vital in terms of their self-reliance and overall safety. The study aimed to determine the relationship between the features of feet structure and the indicators of postural stability in the elderly. METHODS: The study group comprised 80 seniors (41F, 39M; aged 75-85 years). CQ-ST podoscope and the CQ-Stab 2P two-platform posturograph were used as primary research tools...
2017: PloS One
https://www.readbyqxmd.com/read/28876671/screening-for-an-occult-penetrating-cardiac-injury-using-transoesophageal-echcardiography-toe-a-prospective-study
#7
A Nicol, K Steur, R Bent, R Myburgh, G Sudwarts, F Roodt, S Edu, P Navsaria
BACKGROUND: 30% of patients with a cardiac injury will present with a penetrating chest wound and be haemodynamically stable, the so-called "occult cardiac injury". Current international practice is to screen for occult cardiac injuries using ultrasound (US) of the pericardial sac. If the US confirms the presence of fluid, then the patient undergoes a subxiphoid pericardial window (SPW) under general anaesthetic. In our experience, US Results in a large number of false positives and unnecessary operations...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876670/foley-catheter-balloon-tamponade-fcbt-for-penetrating-neck-injuries-pni-at-groote-schuur-hospital-an-update
#8
M F Scriba, P H Navsaria, A J Nicol, S Edu, A Al-Sayari
BACKGROUND: A previous study from Groote Schuur Hospital (GSH) highlighted the success of FCBT (PNI). METHOD: The records of all patients with PNI requiring FCBT for a neck injury presenting to GSH within an 11-month study period were reviewed. Prospectively captured data on the Electronic Trauma Health Record Application (eTHRApp), was retrospectively analysed. Analysed data included demographics, clinical signs on admission, imaging, management and major outcomes...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#9
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876663/the-use-of-computed-tomographic-angiography-in-the-evaluation-of-upper-digestive-tract-injuries-in-penetrating-neck-trauma
#10
J P B Maritz, J A Lubbe
BACKGROUND: Patients who present with penetrating neck injuries undergo both a computed tomographic angiogram (CTA) of the neck to diagnose vascular injuries and a contrasted swallow to diagnose aerodigestive tract injuries. In a resource constrained setting this algorithm is questionable. METHOD: A chart review was performed of all patients who presented to Tygerberg Hospital's trauma unit with penetrating neck injury between 1 January 2013 and 1 January 2016. All unstable patients taken directly to theatre were excluded...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876638/hepatobiliary-factors-influencing-morbidity-rates-after-pancreatic-stab-wounds
#11
H L Bookholane, J E J Krige, E Jonas, U Kotze, M Bernon, S Burmeister, P Navsaria, A Nicol
BACKGROUND: Penetrating injuries of the pancreas may result in serious complications. METHOD: A retrospective univariate cohort analysis was done of all pancreatic stab wounds documented in a prospective dedicated departmental pancreatic injury database of 475 patients treated between 1982 and 2016. RESULTS: Eighty-seven (80 men) patients, median age 26 years (range 16-62) had stab wounds of the pancreas. Median RTS was 7.8 (range 2.0-7.8)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876601/laparoscopic-management-of-retroperitoneal-injuries-in-penetrating-abdominal-injuries
#12
F Mosai
PURPOSE: Laparoscopy in penetrating abdominal injuries is now accepted and practiced in many modern trauma centres. However its role in evaluating and managing retroperitoneal injuries is not yet well established. The aim of this study was to document our experience in using laparoscopy in a setting of penetrating abdominal injuries with suspected retroperitoneal injury in haemodynamically stable patients. METHOD: A retrospective descriptive study of prospectively collected data from a trauma unit at Dr George Mukhari Academic Hospital (DGMAH) was done...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28868591/early-ct-scanning-in-the-emergency-department-in-patients-with-penetrating-injuries-does-it-affect-outcome
#13
W J van den Hout, G M van der Wilden, F Boot, F J Idenburg, S J Rhemrev, R Hoencamp
BACKGROUND: To be a level I trauma center in the Netherlands a computed tomography (CT) scanner in the emergency department (ED) is considered desirable, as it is presumed that this optimizes the diagnostic process and that therapy can be directed based on these findings. Aim of this study was to assess the effects of implementing a CT scanner in the ED on outcomes in patients with penetrating injuries. METHODS: In this retrospective descriptive study, patients with penetrating injuries (shot and/or stab wounds), presented between 2000 and 2014 were analysed using the hospital's electronic database, and data from the West Netherlands trauma registry and the financial department...
September 4, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28855047/a-stabbing-injury-to-the-chest-from-a-letter-opener
#14
Holger Rupprecht, Harald Dormann, Katharina Gaab
No abstract text is available yet for this article.
August 21, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28842726/laparoscopic-d2-total-gastrectomy-and-en-mass-splenectomy-and-distal-pancreatectomy-for-locally-advanced-proximal-gastric-cancer
#15
Bin Chet Toh, Jaideepraj Rao
BACKGROUND: Safety and efficacy of laparoscopy surgery in locally Advanced Gastric Cancers (AGC) have not been proven by randomized control trials. Therefore, standard of care for AGC is still open surgery. Here, we are presenting a 64-year-old female with proximal gastric adenocarcinoma (close to cardio-oesophageal junction) adherent to tail of pancreas, who underwent D2 total gastrectomy en-mass distal pancreatectomy and splenectomy. METHODS: Five ports are entered into the peritoneal cavity (Three 10-12 mm and two 5 mm ports)...
August 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28842607/retinal-cell-death-dependent-reactive-proliferative-gliosis-in-the-mouse-retina
#16
Sheik Pran Babu Sardar Pasha, Robert Münch, Patrick Schäfer, Peter Oertel, Alex M Sykes, Yiqing Zhu, Mike O Karl
Neurodegeneration is a common starting point of reactive gliosis, which may have beneficial and detrimental consequences. It remains incompletely understood how distinctive pathologies and cell death processes differentially regulate glial responses. Müller glia (MG) in the retina are a prime model: Neurons are regenerated in some species, but in mammals there may be proliferative disorders and scarring. Here, we investigated the relationship between retinal damage and MG proliferation, which are both induced in a reproducible and temporal order in organotypic culture of EGF-treated mouse retina: Hypothermia pretreatment during eye dissection reduced neuronal cell death and MG proliferation; stab wounds increased both...
August 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28840083/nervus-intermedius-neuralgia-treated-with-microvascular-decompression-a-case-report-and-review-of-the-literature
#17
Takuro Inoue, Ayako Shima, Hisao Hirai, Fumio Suzuki, Masayuki Matsuda
Nervus intermedius neuralgia is one of the craniofacial neuralgias, which is extremely rare compared with trigeminal or glossopharyngeal neuralgia. Despite its unique symptom, the aetiology remains unclear. We present a case of a surgically treated 36-year-old woman who suffered from paroxysmal stabbing deep-ear pain for over 10 years. Preoperative magnetic resonance imaging demonstrated a vascular loop compressing the root entry zone of the vestibulocochlear nerve between the seventh and eighth cranial nerves, suggesting nervus intermedius neuralgia as a cause of her pain...
July 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28834611/a-molecular-method-to-detect-wound-cells-in-bloodstains-resultant-of-sharp-force-injuries-for-crime-scene-reconstruction
#18
Donald J Johnson, David E Raymond, Cynthia Chen, Matthew Quon, Julian Lis, Mo Re Choi, Christopher Lopez, Aileen Han, Ray D de Leon, Cynthia Bir
Previous research by the authors on an animal model showed that bloodstains can contain additional information about their somatic origin in the form of wound cells. Bloodstains produced by a gunshot wound to the head were distinguished from bloodstains produced by a gunshot wound to the chest by testing the stains for a brain microRNA marker. In this study, the effectiveness of the technique was examined on blood drops shed externally from a stab wound to the liver of rat carcasses. Specifically, investigations were conducted on the liver microRNA marker, rno-mir-122-3p, with the QIAGEN miScript System, and PCR analysis...
August 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28828103/huge-traumatic-pulmonary-artery-pseudoaneurysm
#19
Dmitriy Shnayderman, Scott G Baginski, William B Lea, Scott J Erickson
Pulmonary artery pseudoaneurysm is a very rare complication of penetrating thoracic trauma. We present a case of a 27-year-old woman who developed a 6.5-cm traumatic pulmonary artery pseudoaneurysm after suffering multiple stab wounds to the chest and the abdomen. The pseudoaneurysm was successfully treated endovascularly with vascular plug occlusion and coil embolization.
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28826482/anti-nociceptive-action-of-peripheral-mu-opioid-receptors-by-g-beta-gamma-protein-mediated-inhibition-of-trpm3-channels
#20
Sandeep Dembla, Marc Behrendt, Florian Mohr, Christian Goecke, Julia Sondermann, Franziska M Schneider, Marlene Schmidt, Julia Stab, Raissa Enzeroth, Michael G Leitner, Paulina Nuñez-Badinez, Jochen Schwenk, Bernd Nürnberg, Alejandro Cohen, Stephan E Philipp, Wolfgang Greffrath, Moritz Bünemann, Dominik Oliver, Eleonora Zakharian, Manuela Schmidt, Johannes Oberwinkler
Opioids, agonists of µ-opioid receptors (µORs), are the strongest pain killers clinically available. Their action includes a strong central component, which also causes important adverse effects. However, µORs are also found on the peripheral endings of nociceptors and their activation there produces meaningful analgesia. The cellular mechanisms downstream of peripheral µORs are not well understood. Here, we show in neurons of murine dorsal root ganglia that pro-nociceptive TRPM3 channels, present in the peripheral parts of nociceptors, are strongly inhibited by µOR activation, much more than other TRP channels in the same compartment, like TRPV1 and TRPA1...
August 15, 2017: ELife
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