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https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#1
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29782242/case-254-posttraumatic-migrating-fat-embolus-causing-fat-emboli-syndrome
#2
Sébastien Molière, Stéphane Kremer, Guillaume Bierry
History An otherwise healthy 18-year-old man was admitted to the emergency department with a closed displaced fracture of the left femoral shaft ( Fig 1 ) after a high-velocity motorbike accident. At admission, other physical examination findings were unremarkable. Initial unenhanced and contrast material-enhanced (120 mL of Iomeron 400; Bracco Imaging, Milan, Italy) computed tomography (CT) was performed in the arterial and venous phases from the head to the knees. No abnormalities were noted in the brain or chest at initial CT...
June 2018: Radiology
https://www.readbyqxmd.com/read/29779449/continuous-cytokine-haemoadsorption-incorporated-into-a-venoarterial-ecmo-circuit-for-the-management-of-postcardiotomy-cardiogenic-and-septic-shock-a-case-report
#3
Endre Nemeth, Szabolcs Szigeti, Tamas Varga, Laszlo Daroczi, Zoltan Barati, Bela Merkely, Janos Gal
INTRODUCTION: The acute surgical treatment of infective endocarditis (IE) carries a high risk of postoperative mortality. Most complications are linked to uncontrolled sepsis and inflammatory processes. Cytokine haemoadsorption is an extracorporeal technique which has benefits reported in haemodynamic stability and inflammatory response. CASE REPORT: A 46-year-old male patient underwent emergency cardiac surgery due to progressive IE. Postcardiotomy cardiogenic shock associated with cardiac surgery required the implantation of venoarterial (VA)-ECMO...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29775966/an-enigmatic-case-presentation-of-budd-chiari-syndrome-with-pulmonary-embolism-an-unusual-syndrome-with-an-uncommon-complication
#4
A M Al-Sharydah, A H Al-Abdulwahhab, H A Abu AlOla
INTRODUCTION: In patients with a hypercoagulable state, such as patients with pulmonary embolism and/or Budd-Chiari syndrome, the complications from multiple gene mutations are more numerous than those from a single mutation. The authors present a woman with no major prior medical history who presented with pulmonary embolism and Budd-Chiari syndrome; this enigmatic co-occurrence has never been solely reported without underlying aetiology in a patient without prior medical conditions...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29772254/effect-of-interferon-alpha-and-cyclosporine-treatment-separately-and-in-combination-on-middle-east-respiratory-syndrome-coronavirus-mers-cov-replication-in-a-human-in-vitro-and-ex-vivo-culture-model
#5
H S Li, Denise I T Kuok, M C Cheung, Mandy M T Ng, K C Ng, Kenrie P Y Hui, J S Malik Peiris, Michael C W Chan, John M Nicholls
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) has emerged as a coronavirus infection of humans in the past 5 years. Though confined to certain geographical regions of the world, infection has been associated with a case fatality rate of 35%, and this mortality may be higher in ventilated patients. As there are few readily available animal models that accurately mimic human disease, it has been a challenge to ethically determine what optimum treatment strategies can be used for this disease. We used in-vitro and human ex-vivo explant cultures to investigate the effect of two immunomodulatory agents, interferon alpha and cyclosporine, singly and in combination, on MERS-CoV replication...
May 14, 2018: Antiviral Research
https://www.readbyqxmd.com/read/29769190/pneumoperitoneum-in-a-neonate-weighing-less-than-500-g-what-do-we-really-know-about-it
#6
Audrienne Sammut, Miguel Soares Oliveira, Claire Jackson, Cristine Sortica da Costa
Pneumoperitoneum in preterm infants is a surgical emergency as it is usually indicative of intestinal perforation. Rare cases of idiopathic pneumoperitoneum have been described in the literature, the underlying causes and pathophysiology of which remain uncertain. We present a case of pneumoperitoneum in an extremely preterm infant with severe growth restriction. This occurred while she was receiving high frequency oscillatory ventilation. She had respiratory distress syndrome with pulmonary interstitial emphysema...
May 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#7
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29765783/multiorgan-failure-and-refractory-lactic-acidosis-due-to-pasteurella-multocida-septicemia-in-a-patient-with-no-animal-exposure
#8
Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Introduction: Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock. Case Presentation: A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29764553/-interposed-abdominal-pulling-pressing-cardiopulmonary-resuscitation-improve-the-resuscitation-effect-for-patients-with-cardiac-arrest
#9
Dabing Wang, Xiaonan Feng, Yujuan Han
OBJECTIVE: To study the impact of interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) for patients with cardiac arrest (CA). METHODS: A prospective study was conducted. A total of 122 CA patients admitted to Department of Emergency of Shandong Provincial Mining Industry Group Company Central Hospital from July 2013 to December 2017 were enrolled. They were divided into standard cardiopulmonary resuscitation (S-CPR) group (n = 62) and IAPP-CPR group (n = 60) according to order of admission...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#10
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29760857/retrospective-chart-review-of-synthetic-cannabinoid-intoxication-with-toxicologic-analysis
#11
Payal Sud, Miles Gordon, Laura Tortora, Matthew Stripp, Damon Borg, Adam Berman
Introduction: Use of synthetic cannabinoids (SC) has recently emerged as a new drug epidemic. Our emergency departments (EDs) received a surge of SC users presenting with lethargy and bradycardia, contrasting prior reports of SC-induced tachycardia and agitation. Our goal was to describe these novel presentations and characterize the compounds. Methods: We present a case series of patients with SC intoxication who presented to our toxicology service covering two tertiary care EDs between 2/11/2015 and 6/23/2015...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29755094/-giant-intrathoracic-goiter-requiring-emergency-airway-management-report-of-a-case
#12
Marina Shiikawa, Kazuki Hayasaka, Kei Yarimizu, Katsuyuki Suzuki, Makoto Endo, Naoki Yanagawa, Satoshi Shiono
An 81-year-old woman with acute respiratory distress was referred to our hospital. Computed tomography showed a large mass in the upper mediastinum with severe tracheal stenosis. Endotracheal intubation was performed under the preparation of extracorporeal membrane oxygenation and high-frequency jet ventilation, and the tumor was completely removed. The pathologic diagnosis was a goiter. Post-operatively, respiratory distress disappeared. No tumor recurrences have been noted for more than 2 years after surgery...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755078/-re-expansion-pulmonary-edema-after-surgery-for-spontaneous-tension-hemopneumothorax-report-of-a-case
#13
Masanobu Hayakawa, Kazuyuki Oda
A 23-year-old man was admitted to our hospital because of chest pain and dyspnea. X-ray and computed tomography showed left tension hemopneumothorax. After the emergent surgery, re-expansion pulmonary edema (RPE) occurred. Non-invasive positive pressure ventilation (NPPV) was applied to control RPE and RPE was successfully recovered. NPPV may be useful in managing RPE.
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754094/active-green-wall-plant-health-tolerance-to-diesel-smoke-exposure
#14
Naomi J Paull, Peter J Irga, Fraser R Torpy
Poor air quality is an emerging world-wide problem, with most urban air pollutants arising from vehicular emissions. As such, localized high pollution environments, such as traffic tunnels pose a significant health risk. Phytoremediation, including the use of active (ventilated) green walls or botanical biofilters, is gaining recognition as a potentially effective method for air pollution control. Research to date has tested the capacity of these systems to remove low levels of pollutants from indoor environments...
May 10, 2018: Environmental Pollution
https://www.readbyqxmd.com/read/29753599/carbon-monoxide-poisoning-in-a-young-healthy-patient-a-case-study-of-heart-failure-recovery-after-hyperbaric-oxygenation-treatment
#15
Michael Kuniavsky, Yair Bechor, Marina Leitman, Shai Efrati
The effectiveness of hyperbaric oxygen treatment for acute cardiac diseases is unknown. Similarly, the effectiveness of hyperbaric oxygen treatment for carbon monoxide intoxication is also unknown, particularly for cases in which carboxyhemoglobin (COHb) levels return to normal. Our case study revolved around a healthy twenty-year-old male patient, who suffered from carbon monoxide intoxication. The patient presented to the Emergency Department unconscious. Blood workup revealed significant carbon monoxide intoxication and cardiac injury (COHb = 41%, troponin T = 0...
May 9, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29750427/evaluation-of-knowledge-of-students-in-paediatric-dentistry-concerning-cardiopulmonary-resuscitation-skills-in-children
#16
L M De Mauro, L B Oliveira, C De Cássia Bergamaschi, J C Ramacciato, R H L Motta
AIM: The study evaluated the theoretical knowledge and practical ability of students in paediatric dentistry concerning basic life support (BLS) and cardiopulmonary resuscitation (CPR) in children and babies. METHODS: Seventy paediatric dentistry students answered a questionnaire and also performed a simulation of the manoeuvres of BLS and CPR on baby and child manikins. RESULTS: The results showed that 41 (58%) students had never received BLS training...
May 10, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29745620/non-ventilatory-therapies-for-acute-respiratory-distress-syndrome
#17
Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29739651/nurses-reflections-about-caring-for-critically-ill-non-sedated-and-mechanically-ventilated-critically-ill-patients
#18
Ranveig Lind, Hilde-Irén Liland, Berit S Brinchmann, Inga Akeren
OBJECTIVE: The objective was to explore ICU nurses' experiences of caring for non-sedated, critically ill mechanically ventilated patients, when following a study protocol as part of a clinical trial. DESIGN: The study had a qualitative design with twelve nurses participating in two focus groups. The interviews were analysed using a thematic approach. FINDINGS: One overall theme emerged, "Cautious optimism", which suggests positive experiences but with a negative undertone...
May 5, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29735230/management-of-multiple-burned-patients-with-inhalation-injuries
#19
Kouhei Ishikawa, Youichi Yanagawa, Yukino Kato, Yoko Nozawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Kazuhiko Omori
The fire department in Atami received an emergency call at 6:17 am, with notification of 4 or 5 casualties because of a fire. Because there was only 1 ambulance (O) at the station, an additional ambulance (P) was also requested. Ambulance O transported 2 patients (A and B), and ambulance P transported 2 patients (C and D). These 4 patients were judged to have severe inhalation injuries at the scene and were transported to 2 local hospitals (X and Y). After patients C and D arrived at hospital Y, the medical staff decided to transfer them to the emergency medical service center...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29720508/the-role-of-cardiopulmonary-exercise-tests-in-pulmonary-arterial-hypertension
#20
REVIEW
Stefania Farina, Michele Correale, Noemi Bruno, Stefania Paolillo, Elisabetta Salvioni, Roberto Badagliacca, Piergiuseppe Agostoni
Despite recent advances in the therapeutic management of patients affected by pulmonary arterial hypertension (PAH), survival remains poor. Prompt identification of the disease, especially in subjects at increased risk of developing PAH, and prognostic stratification of patients are a necessary target of clinical practice but remain challenging. Cardiopulmonary exercise test (CPET) parameters, particularly peak oxygen uptake, end-tidal carbon dioxide tension and the minute ventilation/carbon dioxide production relationship, emerged as new prognostic tools for PAH patients...
June 30, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
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