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https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#1
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/27896321/comparison-of-the-c-mac-video-laryngoscope-to-the-macintosh-laryngoscope-for-intubation-of-blunt-trauma-patients-in-the-ed
#2
Erkan Goksu, Taylan Kilic, Gunay Yildiz, Aslihan Unal, Mutlu Kartal
OBJECTIVES: We aimed to compare the performance of the C-MAC video laryngoscope (C-MAC) to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED. MATERIAL AND METHODS: This was a prospective randomized study. The primary outcome measure is overall successful intubation. Secondary outcome measures are first attempt successful intubation, Cormack-Lehane (CL) grade, and indicators of the reasons for unsuccessful intubation at the first attempt with each device...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27878270/alteration-of-histone-h3-lysine-9-dimethylation-in-peripheral-white-blood-cells-of-septic-patients-with-trauma-and-cancer
#3
Linghui Jiang, Yiqin Wang, Duming Zhu, Zhanggang Xue, Hailei Mao
The present study aimed to investigate the clinical significance of histone methylation in sepsis. A total of 43 blood samples from trauma and esophageal cancer patients with or without sepsis were collected. Immunofluorescence staining of isolated peripheral white blood cells (WBCs) was conducted. Co‑stained 293T cells served as a reference, to allow the levels of histone methylation in different types of WBCs from patients to be determined. Immunostaining analyses revealed different levels of histone 3 lysine 9 dimethylation (H3K9me2) in neutrophils (Neu), lymphocytes (Lym), and monocytes (Mon) from trauma patients...
November 22, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27871595/a-comparison-of-king-vision-video-laryngoscopy-and-direct-laryngoscopy-as-performed-by-residents-a-randomized-controlled-trial
#4
Jose A Valencia, Katherine Pimienta, Darwin Cohen, Daniel Benitez, David Romero, Oswaldo Amaya, Enrique Arango
STUDY OBJECTIVE: For more than 40 years, direct laryngoscopy (DL) has been used to assure the airway during endotracheal intubation. The King Vision video laryngoscope is one of the latest devices introduced for endotracheal intubation. We hypothesize that, relative to direct laryngoscopy, it improves the intubation success rate with fewer intubation attempts and no difference in intubation time or complications. DESIGN: This randomized controlled clinical trial included...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27805997/this-too-shall-pass-a-study-of-ingested-sharp-foreign-bodies
#5
Kirellos R Zamary, James W Davis, Emily E Ament, Rachel C Dirks, John E Garry
BACKGROUND: Gastrointestinal foreign body (GFB) ingestion is a common problem and often results in surgical consultation. Current literature is limited to case reports and fails to provide data regarding the management of sharp GFB ingestion. We hypothesized that patients who ingest sharp objects rarely have perforation or obstruction requiring surgical intervention. METHODS: Patients presenting with GFBs from 1/05-12/15 at a level 1 trauma center with an acute care surgery program were retrospectively reviewed...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27785145/cervical-esophageal-rupture-after-blunt-trauma-resulting-from-a-car-accident
#6
Piotr Misiak, Sławomir Jabłoński, Artur Terlecki
Traumatic perforation of the cervical esophagus due to blunt trauma is a very rare condition which continues to be associated with significant mortality rates. The symptoms and signs of this injury are often masked by or ascribed to more common blunt thoracic injuries. This paper presents a case of cervical esophageal perforation secondary to blunt trauma resulting from a car accident. The injury was diagnosed early by computed tomography examination, and the patient underwent prompt and successful surgical repair performed to prevent the development of descending mediastinitis...
September 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27780007/diaphragmatic-hernia-of-the-stomach-with-gastric-rupture-in-a-domestic-pig
#7
Lori R Hill, Steven Y Huang, Mihai Gagea
A 5.5-mo-old castrated, male Red Duroc pig presented acutely with depression and abdominal pain 9 d after an altercation with another pig. A CT examination indicated right pneumothorax and herniation of the stomach into the thoracic cavity. Due to a poor prognosis, the pig was euthanized. A necropsy and gross examination revealed a tear of the diaphragmatic muscle in the region of the esophageal hiatus through which the stomach was displaced into the right side of the thoracic cavity. In addition, the herniated stomach had a rupture of the stomach wall through which the gastric mucosa was everted and exposed into the right thoracic cavity...
2016: Comparative Medicine
https://www.readbyqxmd.com/read/27775292/-laryngotracheal-traumatic-injuries-lti-in-children-when-to-operate
#8
S Santiago-Martínez, A Laín, G Guillén, R Gander, S López-Fernández, F Pumarola, L Seidler, J Lloret
INTRODUCTION: Paediatric LTI is associated with significant morbid-mortality. Although historically first line treatment was surgical, conservative management is making headway. The purpose of this study was to analyze the management and surgical indications of LTI treated at our institution. MATERIAL AND METHODS: Retrospective study of patients with LTI treated between 2007 and 2014. RESULTS: Six out of seven patients, with a median age of 4 years (2-15), had blunt traumas and one had an open trauma...
October 10, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27700196/pediatric-blunt-neck-trauma-causing-esophageal-and-complete-tracheal-transection
#9
Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27680061/-evaluation-of-the-selection-between-thoracoscopic-and-open-esophagectomy
#10
Lijie Tan, Han Tang
Esophageal cancer is one of the most common digestive tract cancers in our country. Although multimodality therapy has been used in the treatment of esophageal cancer, such as radiotherapy, chemotherapy and targeted therapy, surgery plays its irreplaceable role. With the development of techniques and innovation of instruments, minimally invasive esophagectomy is introduced into practice worldwide. Due to its less trauma and fewer complications, minimally invasive esophagectomy draws great attention, however, controversy exists in the question whether minimally invasive esophagectomy has similar efficacy to open esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27579303/larynx-trauma-and-hyoid-bone-fracture-after-bite-injury-in-dog-case-report
#11
George Manchi, Mathias M Brunnberg, Muhammad Shahid, Ahmad Al Aiyan, Leo Brunnberg, Silke Stein
An 8-year-old male Jack Russell crossbreed dog was admitted to our hospital with dyspnea and shock following a dog-bite injury on the ventral neck. Radiographs revealed subcutaneous emphysema and bilateral thyrohyoid bone fractures. Intraoperatively, rupture of both sternohyoid muscles, both hyoepiglotticus muscles, both thyrohyoid muscles, and a partial cranial rupture of the superficial sphincter colli muscle were detected. Part of the epiglottis was detached from the thyroid cartilage. The patient's severed muscles and torn epiglottis were reattached using a simple interrupted suture pattern...
2016: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/27576447/association-between-off-hour-presentation-and-endotracheal-intubation-related-adverse-events-in-trauma-patients-with-a-predicted-difficult-airway-a-historical-cohort-study-at-a-community-emergency-department-in-japan
#12
Yuko Ono, Takuya Sugiyama, Yasuyuki Chida, Tetsuya Sato, Hiroaki Kikuchi, Daiji Suzuki, Masakazu Ikeda, Koichi Tanigawa, Kazuaki Shinohara
BACKGROUND: A reduction in medical staff such as occurs in hospitals during nights and weekends (off hours) is associated with a worse outcome in patients with several unanticipated critical conditions. Although difficult airway management (DAM) requires the simultaneous assistance of several appropriately trained medical caregivers, data are scarce regarding the association between off-hour presentation and endotracheal intubation (ETI)-related adverse events, especially in the trauma population...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27568459/supine-position-and-nonmodifiable-risk-factors-for-ventilator-associated-pneumonia-in-trauma-patients
#13
Christopher P Michetti, Heather A Prentice, Jennifer Rodriguez, Anna Newcomb
BACKGROUND: We studied trauma-specific conditions precluding semiupright positioning and other nonmodifiable risk factors for their influence on ventilator-associated pneumonia (VAP). METHODS: We performed a retrospective study at a Level I trauma center from 2008 to 2012 on ICU patients aged ≥15, who were intubated for more than 2 days. Using backward logistic regression, a composite of 4 factors (open abdomen, acute spinal cord injury, spine fracture, spine surgery) that preclude semiupright positioning (supine composite) and other variables were analyzed...
July 28, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27541591/hybrid-ivor-lewis-esophagectomy-for-esophageal-cancer
#14
Marco E Allaix, Jason M Long, Marco G Patti
The last 25 years have witnessed a steady increase in the use of minimally invasive esophagectomy for the treatment of esophageal cancer. However, it is unclear which the optimal minimally invasive approach is: totally minimally invasive or hybrid (laparoscopic assisted or thoracoscopic assisted)? The current evidence from nonrandomized control trials suggests that hybrid laparoscopic-assisted esophagectomy couples the benefits of laparoscopy and the advantages of thoracotomy, leading to reduced surgical trauma without jeopardizing survival compared with open esophagectomy...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27331580/the-effects-of-pediatric-advanced-life-support-guidelines-on-pediatric-trauma-airway-management
#15
Jana Sperka, Sheila J Hanson, Raymond G Hoffmann, Mahua Dasgupta, Michael T Meyer
OBJECTIVE: Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations have altered practice. We sought to determine if a temporal change exists in the number of prehospital pediatric trauma intubations since the 2005 PALS guidelines update. METHODS: This is an institutional review board-approved, retrospective, single-center study. Reviewed all pediatric trauma activations where patients younger than 19 years were intubated at the scene, en route or at the level 1 trauma center during 2006 to 2011...
August 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27320840/are-esophagrams-indicated-in-pediatric-patients-with-spontaneous-pneumomediastinum
#16
Edward J Richer, Ramon Sanchez
BACKGROUND/PURPOSE: Spontaneous pneumomediastinum is an infrequent condition in pediatric patients. Presenting symptoms include chest pain, dysphagia, or vomiting, without initiating event. Patients may undergo esophagram because of concern for esophageal perforation as the source for pneumomediastinum, however, abnormalities are rarely demonstrated. The objective of this study is to identify whether esophagrams performed on pediatric patients for spontaneous pneumomediastinum are warranted...
June 6, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27290934/use-of-a-video-laryngoscope-to-facilitate-removal-of-a-long-sharp-pointed-blade-from-the-esophagus
#17
Kenneth N Hiller, Carin A Hagberg
Initial management of ingested esophageal foreign bodies involves airway assessment, determination of the requirement for and timing of therapeutic intervention, risk mitigation during removal, and identification of all indicated equipment for retrieval. Long, sharp-pointed objects lodged in the esophagus require emergent attention and should be retrieved endoscopically, if perforation has not occurred. Inducing general anesthesia and rapidly securing the airway can minimize the risk of aspiration, mitigate any effects of tracheal compression, avoid the potential of exacerbating existing trauma, and provide optimal conditions for removal of long, sharp-pointed esophageal foreign bodies...
August 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27258845/esophageal-perforation-caused-by-an-amplatzer-tm-vascular-plug-4-occlusion-device
#18
Gesa Wiegand, Christian Schlensak, Michael Hofbeck
The AMPLATZER(TM) Vascular Plug 4 (AVP4) is a self-expandable, replaceable occluder made of Nitinol wire mesh, which allows the safe and effective interventional occlusion of medium size vessels. This report describes an infant diagnosed with pulmonary atresia, ventricular septal defect, and multifocal collateral lung perfusion through four major aortopulmonary collateral arteries (MAPCAs). A central aorto-pulmonary shunt was performed at 4 months of age. Because of postoperative pulmonary hyperperfusion, one of the MAPCAs was closed interventionally using a 5 mm AVP4...
June 3, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27257696/the-american-association-for-the-surgery-of-trauma-grading-scale-for-16-emergency-general-surgery-conditions-disease-specific-criteria-characterizing-anatomic-severity-grading
#19
Gail T Tominaga, Kristan L Staudenmayer, Shahid Shafi, Kevin M Schuster, Stephanie A Savage, Steven Ross, Peter Muskat, Nathan T Mowery, Preston Miller, Kenji Inaba, Mitchell Jay Cohen, David Ciesla, Carlos V R Brown, Suresh Agarwal, Michel B Aboutanos, Garth H Utter, Marie Crandall
No abstract text is available yet for this article.
September 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27129918/four-cases-of-spontaneous-neoplasia-in-the-naked-mole-rat-heterocephalus-glaber-a-putative-cancer-resistant-species
#20
Kyle R Taylor, Nicholas A Milone, Carlos E Rodriguez
The naked mole-rat (Heterocephalus glaber) is widely acclaimed to be cancer-resistant and of considerable research interest based on a paucity of reports of neoplasia in this species. We have, however, encountered four spontaneous cases of neoplasia and one presumptive case of neoplasia through routine necropsy and biopsy of individuals in a zoo collection of nonhybrid naked mole-rats bred from a single pair. One case each of metastasizing hepatocellular carcinoma, nephroblastoma (Wilms' tumor), and multicentric lymphosarcoma, as well as presumptive esophageal adenocarcinoma (Barrett's esophagus-like) was identified postmortem among 37 nonautolyzed necropsy submissions of naked mole-rats over 1-year-old that were submitted for necropsy between 1998 and August 2015...
April 29, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
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