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Thoracic trauma

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https://www.readbyqxmd.com/read/28723778/thoracic-splenosis-mimicking-a-pleuropneumonia-a-case-report
#1
Aurélie Baldolli, Solène Coeuret, Vincent Le Pennec, Denis Agostini, Renaud Verdon
RATIONALE: Splenosis is the development of one or more heterotopic splenic tissue autoimplants following rupture of the spleen and remains mostly asymptomatic. PATIENT CONCERNS: We report a case of a 50-year old post-traumatic splenectomized man admitted for a left side community acquired pneumonia resistant to antibiotics. DIAGNOSES: The diagnosis of intrathoracic ectopic spleen was suspected because of the history of spleen trauma with diaphragm rupture and the absence of Howell-Jolly bodies...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28717983/evaluation-of-acute-kidney-injury-aki-with-rifle-akin-ck-and-kdigo-in-critically-ill-trauma-patients
#2
F Ülger, M Pehlivanlar Küçük, A O Küçük, N K İlkaya, N Murat, B Bilgiç, H Abanoz
PURPOSE: The aim of our study was to evaluate the effects of AKI development on mortality with four different classification systems (RIFLE, AKIN, CK, KDIGO) in critically ill trauma patients followed in the intensive care unit. METHODS: A retrospective review of 2034 patients in our intensive care unit was conducted between July 2010 and August 2013. A total of 198 patients with primary trauma were included in the study to evaluate the development of AKI. RESULTS: When the presence of AKI was investigated according to the four criteria (RIFLE, AKIN, CK, and KDIGO), the highest incidence of AKI was found according to the KDIGO classification (74...
July 17, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28717905/analysis-of-injury-and-mortality-patterns-in-deceased-patients-with-road-traffic-injuries-an-autopsy-study
#3
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717556/thorax-computed-tomography-findings-in-patients-with-erectile-dysfunction
#4
Mustafa Resorlu, Muhammet Arslan, Ozan Karatag, Gurhan Adam
OBJECTIVE: Diabetes mellitus, smoking, dyslipidemia, and obesity play an important role in the etiology of erectile dysfunction, particularly in cases with vascular insufficiency. These risk factors also target the lungs due to their systemic effects. MATERIALS AND METHODS: Patients with penile vascular insufficiency determined at Doppler ultrasonography and undergoing thoracic computerized tomography for various reasons were included in this study. A history of acute thoracic trauma, pneumonic consolidation, or pelvic surgery and trauma were regarded as exclusion criteria...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28715125/acute-alcohol-binge-deteriorates-metabolic-and-respiratory-compensation-capability-after-blunt-chest-trauma-followed-by-hemorrhagic-shock-a-new-research-model
#5
Nils Wagner, Niklas Franz, Scott Dieteren, Mario Perl, Katharina Mörs, Ingo Marzi, Borna Relja
BACKGROUND AND PURPOSE: The clinical relevance of blunt (thoracic) chest trauma (TxT) and hemorrhagic shock is indisputable due to the high prevalence of this injury type, as well as its close association with mortality and/or preventable deaths. Furthermore, there is an ongoing discussion about the influence of alcohol in trauma patients. Thus, we established a model of TxT followed by hemorrhagic shock and resuscitation (H/R) in alcohol-intoxicated rats. EXPERIMENTAL APPROACH: Depending on group allocation, twelve (sub-acute) or two (acute) hours before experimentation, the animals received a single oral dose of alcohol (ethanol, EtOH) or saline (NaCl) followed by TxT, hemorrhagic shock (35 ± 3 mm Hg) and resuscitation (TxT+H/R)...
July 17, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28705484/is-it-all-about-the-money-not-all-surgical-subspecialization-leads-to-higher-lifetime-revenue-when-compared-to-general-surgery
#6
Maria Baimas-George, Brian Fleischer, Douglas Slakey, Emad Kandil, James R Korndorffer, Christopher DuCoin
OBJECTIVE: It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. DESIGN: Data were collected from the Medical Group Management Association's 2015 report of average annual salaries...
July 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28697227/postoperative-pyoderma-gangrenosum-following-video-assisted-thoracic-surgery
#7
Stanislav N Tolkachjov, Philip Y Sun, Alina G Bridges
<p>Pyoderma gangrenosum (PG) is a neutrophilic, ulcerative dermatosis that can develop at sites of cutaneous trauma, including surgical incisions, a phenomenon known as pathergy. The characteristic lesion is a painful, rapidly expanding ulceration with a violaceous undermined border.<sup>1</sup> A biopsy taken from the expanding violaceous border shows predominantly neutrophilic dermal inflammation with neutrophilic abscess formation.</p> <p>The etiology of PG appears to be variable among patients, as about a half of the reported cases are associated with systemic disease such as inflammatory bowel disease, rheumatoid arthritis, or myeloproliferative disorders, while the other half seem to be idiopathic...
July 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28687342/comparison-of-ultrasonography-and-radiography-in-diagnosis-of-rib-fractures
#8
Elham Pishbin, Koorosh Ahmadi, Molood Foogardi, Maryam Salehi, Farrokh Seilanian Toosi, Vafa Rahimi-Movaghar
PURPOSE: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. METHODS: In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography...
May 26, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28683912/blunt-trauma-of-the-aorta-current-guidelines
#9
REVIEW
Marc D Trust, Pedro G R Teixeira
Blunt thoracic aortic injury remains a major cause of prehospital deaths. For patients who reach the hospital alive, diagnosis and management have undergone dramatic changes over the last 50 years. Computed tomography scanning is the imaging modality of choice for injury diagnosis and repair planning. Medical management with antihypertensives dramatically decreases the risk of rupture, allowing for delayed repair, while abnormal physiology and more immediately life-threatening injuries can be addressed. Endovascular techniques and endograft technology have reduced significantly the risks associated with repair...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#10
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28670409/traumatic-spinal-cord-injury-long-term-motor-sensory-and-urinary-outcomes
#11
Rouzbeh Motiei-Langroudi, Homa Sadeghian
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28670065/aortic-valve-perforation-secondary-to-blunt-force-trauma
#12
Sachin Mehta, Gibbs Wilson, Keith Suarez, Christopher D Chiles
Blunt chest trauma has seldom been reported as a cause of rupture of an aortic valve cusp. We report the case of a 63-year-old man who had a motor vehicle collision resulting in transection of the descending thoracic aorta, splenic pseudoaneurysm, and rupture of an aortic valve cusp causing severe aortic regurgitation. Despite replacement of the aortic valve, he died of multiorgan failure.
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28667524/low-evaluation-rate-for-osteoporosis-among-patients-presenting-with-a-rib-fracture
#13
Whang Kim, Hyun Sik Gong, Seung Hoo Lee, Jin Woo Park, Kahyun Kim, Goo Hyun Baek
This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. INTRODUCTION: Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#14
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28660136/sternal-metastasis-the-forgotten-column-and-its-effect-on-thoracic-spine-stability
#15
REVIEW
Robert Pearse Piggott, Mark Curtin, Sudarshan Munigangaiah, Mutaz Jadaan, John Patrick McCabe, Aiden Devitt
Sternal metastases are not studied extensively in the literature. There is a paucity of information on their role in metastatic disease. The concept of the fourth column was described by Berg in 1993, and has been proven in case report, clinically and biomechanical studies. The role of the sternum as a support to the thoracic spine is well documented in the trauma patients, but not much is known about its role in cancer patients. This review examines what is known on the role of the fourth column. Following this we have identified two likely scenarios that sternal metastases may impact management: (1) sternal pathological fracture increases the mobility of the semi-rigid thorax with the loss of the biomechanical support of the sternum-rib-thoracic spine complex; and (2) a sternal metastasis increases the risk of fracture, and while being medical treated the thoracic spine should be monitored for acute kyphosis and neurological injury secondarily to the insufficiency of the fourth column...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28658339/tracheobronchial-injuries-in-chest-trauma-a-17-year-experience
#16
Roberto Saad, Roberto Gonçalves, Vicente Dorgan, Jacqueline Arantes G Perlingeiro, Jorge Henrique Rivaben, Márcio Botter, José César Assef
Objective: to discuss the clinical and therapeutic aspects of tracheobronchial lesions in victims of thoracic trauma. Methods: we analyzed the medical records of patients with tracheobronchial lesions treated at the São Paulo Holy Home from April 1991 to June 2008. We established patients' severity through physiological (RTS) and anatomical trauma indices (ISS, PTTI). We used TRISS (Trauma Revised Injury Severity Score) to evaluate the probability of survival. Results: nine patients had tracheobronchial lesions, all males, aged between 17 and 38 years...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28652316/the-modified-jo-burg-technique-for-securing-intercostal-chest-drains
#17
Daniel J Ablett, L Navaratne, D Chua, C G Streets, N R M Tai
Insertion of an intercostal chest drain (ICD) is a common intervention in the management of either blunt or penetrating thoracic trauma. It is frequently performed by junior medical personnel as an emergency procedure during the initial resuscitation period and often within a stressful environment. Approximately one-fifth of all ICD insertions are associated with complications. In a retrospective review of over 1000 ICD insertions, 7% of the complications observed were due to inadequate fixation, resulting in dislodgement...
June 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28649221/notch-1-mutation-in-a-patient-with-spontaneous-and-recurrent-dissections-of-extracranial-arteries
#18
Carlos Guevara, Gonzalo Farias, Kateryna Bulatova, Pablo Alarcón, Wendy Soruco, Carlos Robles, Marcelo Morales
Dissections of extracranial arteries are estimated to account for only 2% of all ischemic strokes but for approximately 20% of strokes in patients younger than 45 years old. Most dissections of extracranial arteries involve some trauma stretch, mechanical stress, or connective tissue abnormalities. In the absence of these disorders, determining the etiology of recurrent extracranial dissections is quite challenging because the underlying nature of these cases is poorly understood. We report the case of a 44-year-old female with recurrent dissections of the vertebral and carotid arteries associated with a heterozygous mutation p...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28648782/traumatic-thoracic-burst-fracture-associated-with-bronchial-rupture
#19
Wei-Ting Lin, Shih-Yang Su, Cheng-Fang Hsieh, Chih-Cheng Lai, Chien-Ming Chao
BACKGROUND: Rupture of, or injury to, the tracheobronchial tree is a rare occurrence in blunt chest trauma. CASE REPORT: We present a case of bronchial rupture caused by fragmented bone from a spinal burst fracture after blunt chest trauma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although tracheobronchial injury is infrequent, clinicians should be aware of this possible complication after blunt chest trauma. Bronchoscopy can help in the diagnosis.
June 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28648673/clinical-evaluation-of-active-abdominal-lifting-and-compression-cardiopulmonary-resuscitation-in-patients-with-cardiac-arrest
#20
Min Li, Wei Song, Yan-Hong Ouyang, Duo-Hu Wu, Jun Zhang, Li-Xiang Wang, Jing Li
BACKGROUND: Chest compression is a standard recommendation during cardiopulmonary resuscitation (CPR). However, chest compression cannot be effectively applied under certain situations, such as chest wall deformity, rib fracture, or hemopneumothorax. An alternative method, abdominal compression, was reported to achieve better resuscitation outcomes in these patients. MATERIALS AND METHODS: A prospective study was performed in adult patients with cardiac arrest and anticipated ineffective chest compression (thoracic trauma, chest deformity, rib fracture, and hemopneumothorax)...
June 17, 2017: American Journal of Emergency Medicine
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