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https://www.readbyqxmd.com/read/29472964/functional-outcomes-of-thoracolumbar-junction-spine-fractures
#1
Bradford A Wall, Alan Moskowitz, M Camden Whitaker, Teresa L Jones, Ryan M Stuckey, Catherine L Carr-Maben, Alexander Cm Chong
Introduction: Few studies have evaluated the functional outcomes of traumatic thoracic and lumbar vertebral body fractures. This study evaluated the functional and clinical outcomes of patients, who sustained a fracture to the thoracolumbar area of the spine (T10 to L2 region), with ≥ 25° kyphosis versus those with less kyphotic curvature. Methods: The trauma registry records of two level 1 trauma centers using ICD-9 codes for fracture to the thoracolumbar juncture (T10 to L2 region) were reviewed...
May 2017: Kansas Journal of Medicine
https://www.readbyqxmd.com/read/29464219/typical-pericarditis-ecg-findings-after-falling-from-height-the-pr-segment-depression-or-st-segment-elevation
#2
Murat Sucu, Gokhan Altunbas, Fatma Yilmaz Coskun
Acute pericarditis (AP) following blunt thoracic trauma is rare and difficult to diagnosis. A 43-year-old man with offered to the emergency department (ED) after falling from height before a week ago. The ECG performed in the ED was abnormal, ECG revealed PR segment depression in leads DII, DIII, aVF, and V3-6 and a preliminary diagnosis of acute inferolateral STEMI was presumed. Patients have evidence of systemic inflammation, including leukocytosis, elevated erythrocyte sedimentation rate. We are reporting a case of post-traumatic acute pericarditis presenting with PR-segment depression and normal cardiac enzymes mimicking acute STEMI...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455490/-clinical-application-of-anterior-thoracoscopically-assisted-surgery-with-posterior-one-stage-total-en-block-spondylectomy-for-thoracic-spinal-tumor
#3
Wen Xue, Xiao-Li Guan, Zeng-Ping Wang, Zhong-Yu Hao, Lin Liu, Yao-Wen Qian
OBJECTIVE: To investigate the clincial effects and feasibility of anterior thoracoscopically assisted surgery (TAS) with posterior one-stage total en block spondylectomy(TES) for thoracic spinal tumour. METHODS: From October 2014 to January 2016, 4 patients with thoracic spinal tumour were treated by anterior thoracoscopically assisted surgery with posterior one-stage total en block spondylectomy. There were 2 males and 2 females, aged 16, 35, 46, 60 years. Courses of disease were 1, 4, 6, 9 months...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29455010/long-term-outcomes-of-tevar-focused-on-bird-beak-and-oversizing-in-blunt-traumatic-thoracic-aortic-injury
#4
Marvin Ernesto García Reyes, Gabriela Gonçalves Martins, Valentín Fernández Valenzuela, José Manuel Domínguez González, Jordi Maeso Lebrun, Sergi Bellmunt Montoya
INTRODUCTION: The acute aortic arch angle and narrow aortic diameter in young patients may lead to bird-beak configuration and excessive oversizing of the stent-graft in TEVAR for blunt traumatic thoracic aortic injury. Little is known about the association of these factors and complications in long-term follow-up. We evaluated the long-term outcomes in terms of complications, reinterventions and survival, focusing on the effects of bird-beak configuration and oversizing. METHODS: This prospective cohort study included patients who underwent TEVAR for blunt traumatic thoracic aortic injury in our department between October 1999 and January 2015...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29447895/total-congenital-sternal-cleft-isolated-in-a-newborn-of-20-days-rare-case
#5
Dounia Basraoui, Badia Bannar, Mohamed Ouladsaiad, Hicham Jalal
Sternal clefts are rare malformations, especially in their complete form, which results from a lack of fusion of the sternal bars, which is normally done at the 9th week of intra uterine life. The incomplete form is often associated with other malformations of the chest wall, or falling within the framework of a polymalformative syndrome, the diagnosis is easy, being done with the inspection and the palpation, the paraclinical examinations are useful for confirming the diagnosis. We report the case of a total congenital sternal cleft isolated in an asymptomatic 20-day-old newborn...
March 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29447814/spontaneous-retropharyngeal-and-mediastinal-thoracic-duct-cyst-in-an-infant-with-respiratory-distress
#6
Vidur Bhalla, Thomas Schrepfer, Adam McCann, Pamela Nicklaus, Brenton Reading
Thoracic duct cysts (TDC) within the retropharyngeal space and mediastinum are exceedingly rare lesions, with the majority related to trauma or neoplasm. We describe a case of an otherwise healthy 8-month-old boy who presented with severe respiratory distress, which was found to be caused by a large, spontaneous TDC occupying most the retropharyngeal and mediastinal space. To our knowledge, this is the youngest patient to date presenting with TDC. Ultimately, his TDC was completely resolved with sclerotherapy, however the patient's age and size presented unique challenges to his medical management, which we describe below...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29445590/enhanced-recovery-after-surgery-eras-and-fast-track-in-video-assisted-thoracic-surgery-vats-lobectomy-preoperative-optimisation-and-care-plans
#7
REVIEW
Antonio D'Andrilli, Erino A Rendina
Main specific interventions for preoperative clinical optimisation of patients undergoing lung cancer surgery include assessment and treatment of comorbidities, minimizing preoperative hospitalization, minimizing preoperative fasting, and optimisation of antibiotic and thrombo-embolic prophylaxis. Preoperative patient optimisation is considered a crucial part of enhanced recovery after thoracic surgery pathways. Potentially, advantages of this fast-track management could be even higher when considering video-assisted thoracic surgery (VATS) major lung resection, because reduced trauma related to minimally invasive techniques is one of the main factors improving postoperative outcome...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29444919/tracheal-replacement
#8
REVIEW
Harry Etienne, Dominique Fabre, Abel Gomez Caro, Frederic Kolb, Sacha Mussot, Olaf Mercier, Delphine Mitilian, Francois Stephan, Elie Fadel, Philippe Dartevelle
Tracheal reconstruction is one of the greatest challenges in thoracic surgery when direct end-to-end anastomosis is impossible or after this procedure has failed. The main indications for tracheal reconstruction include malignant tumours (squamous cell carcinoma, adenoid cystic carcinoma), tracheoesophageal fistula, trauma, unsuccessful surgical results for benign diseases and congenital stenosis. Tracheal substitutes can be classified into five types: 1) synthetic prosthesis; 2) allografts; 3) tracheal transplantation; 4) tissue engineering; and 5) autologous tissue composite...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29444600/extracorporeal-membrane-oxygenation-as-a-rescue-measure-after-thoracic-surgery
#9
Dwight D Harris, Sibu P Saha
Background Extracorporeal membrane oxygenation is used for many different conditions including respiratory distress, cardiogenic shock, and trauma. In these patient groups, extracorporeal membrane oxygenation has been extensively studied. Recently, it has been used as a rescue measure in patients experiencing acute respiratory distress after thoracic surgery. The goal of our study was to examine the efficacy and cost-effectiveness of extracorporeal membrane oxygenation as a rescue measure after thoracic surgery at a single center...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29441442/internal-patterned-injuries-in-trauma
#10
Lucia Tattoli, Michael Tsokos, Claas Buschmann
Patterned bruising of the internal organs is unusual. In these cases a cutaneous pattern of bruising is not observed but the underlying tissue may show unusual injuries that may even be recognizable as a tramline pattern. We report the suicide of a 23-year-old man by jumping off a bridge. At autopsy, an unusual finding was "tramline" bruising of the right liver lobe. The "blunt objects" that inflicted the bruising were determined to be the right ribs which were pushed against the liver capsule as a consequence of the extensive thoracic and vertebral trauma after a fall from a height with intermediate impact...
February 13, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29440235/do-patients-with-blunt-thoracic-aortic-injury-present-to-hospital-with-unstable-vital-signs-a-systematic-review-and-meta-analysis
#11
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
February 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29438587/managing-penetrating-renal-trauma-experience-from-two-uk-major-trauma-centres
#12
Marios Hadjipavlou, Edmund Grouse, Robert Gray, Denosshan Sri, Dean Huang, Christian Brown, Davendra Sharma
OBJECTIVES: To present our series of patients with penetrating renal trauma from two urban major trauma centres and discuss contemporary management of these injuries. METHODS: We reviewed prospective urological trauma databases for all patients presenting with penetrating renal trauma between January 2005 and October 2016. Patient demographics, clinical characteristics, imaging, management and follow-up data were analysed. RESULTS: Over the 11 year period, 63 patients presented with penetrating renal injuries...
February 13, 2018: BJU International
https://www.readbyqxmd.com/read/29428212/computed-tomography-window-blending-feasibility-in-thoracic-trauma
#13
Jacob C Mandell, Jeremy R Wortman, Tatiana C Rocha, Les R Folio, Katherine P Andriole, Bharti Khurana
RATIONALE AND OBJECTIVES: This study aims to demonstrate the feasibility of processing computed tomography (CT) images with a custom window blending algorithm that combines soft-tissue, bone, and lung window settings into a single image; to compare the time for interpretation of chest CT for thoracic trauma with window blending and conventional window settings; and to assess diagnostic performance of both techniques. MATERIALS AND METHODS: Adobe Photoshop was scripted to process axial DICOM images from retrospective contrast-enhanced chest CTs performed for trauma with a window-blending algorithm...
February 7, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29428017/long-term-functional-outcomes-after-traumatic-thoracic-and-lumbar-spine-fractures
#14
Ashley P Marek, Jean Dominique Morancy, Jeffrey G Chipman, Rachel M Nygaard, Robert M Roach, Michele M Loor
The incidence of thoracolumbar spine fractures in blunt trauma is 4 to 5 per cent. These fractures may lead to neurologic injury, chronic back pain, and disability. Most studies from United States trauma centers focus on neurologic sequelae and/or compare treatment modalities. However, most patients with spine fractures do not have a neurologic deficit. Our primary objective was to determine the long-term outcome of traumatic thoracolumbar spine fractures, specifically addressing quality of life, chronic pain, and employment using a validated patient outcome survey...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29421694/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-resuscitative-thoracotomy-in-select-patients-with-hemorrhagic-shock-early-results-from-the-american-association-for-the-surgery-of-trauma-aortic-occlusion-in-resuscitation-for-trauma-and-acute-care
#15
Megan Brenner, Kenji Inaba, Alberto Aiolfi, Joseph DuBose, Timothy Fabian, Tiffany Bee, John B Holcomb, Laura Moore, David Skarupa, Thomas M Scalea
BACKGROUND: Aortic occlusion (AO) is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage. STUDY DESIGN: AAST AORTA registry identified trauma patients without penetrating thoracic injury undergoing AO at the level of the descending thoracic aorta (RT or Zone 1 REBOA) in the Emergency Department (ED). Survival outcomes relative to the timing of CPR need and admission hemodynamic status were examined...
February 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29420582/ethyl-pyruvate-ameliorates-hepatic-injury-following-blunt-chest-trauma-and-hemorrhagic-shock-by-reducing-local-inflammation-nf-kappab-activation-and-hmgb1-release
#16
Nils Wagner, Scott Dieteren, Niklas Franz, Kernt Köhler, Katharina Mörs, Luka Nicin, Julia Schmidt, Mario Perl, Ingo Marzi, Borna Relja
BACKGROUND: The treatment of patients with multiple trauma including blunt chest/thoracic trauma (TxT) and hemorrhagic shock (H) is still challenging. Numerous studies show detrimental consequences of TxT and HS resulting in strong inflammatory changes, organ injury and mortality. Additionally, the reperfusion (R) phase plays a key role in triggering inflammation and worsening outcome. Ethyl pyruvate (EP), a stable lipophilic ester, has anti-inflammatory properties. Here, the influence of EP on the inflammatory reaction and liver injury in a double hit model of TxT and H/R in rats was explored...
2018: PloS One
https://www.readbyqxmd.com/read/29419715/spine-trauma-from-personal-watercraft-usage
#17
Chester J Donnally, Gil Metser, Eric S Roth, Justin P Moo Young, Augustus J Rush, Motasem A Al Maaieh
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To identify patient characteristics and associated injuries in those sustaining a spine fracture from personal watercraft (PWC) usage. SUMMARY OF BACKGROUND DATA: There are few studies regarding PWC use and injuries, and even more scarce are studies evaluating PWC usage and spine injuries. Identifying high risk actions and individuals can help to effectively treat them, reduce mortality, and possibly avoid certain spine fractures...
February 6, 2018: Spine
https://www.readbyqxmd.com/read/29415765/double-non-contiguous-fractures-in-a-patient-with-spondylo-epiphyseal-dysplasia-with-spinal-ankylosis-treated-with-open-and-percutaneous-spinal-fixation-technique-a-case-report
#18
Takahiro Ushijima, Kenichi Kawaguchi, Tadashi Matsumoto, Masaki Takagi, Tatsuro Kondoh, Gen Nishimura, Aritoshi Iida, Shiro Ikegawa, Nobuhiko Haga, Go Kato
BACKGROUND: Patients with ankylosing spines are susceptible to developing spinal fractures even with minor trauma and can develop early or late neurological injuries. These fractures require early and aggressive surgical management to enable spinal stability and/or neural decompression. Being highly unstable by nature, they require relatively long segment instrumentation and fusion, which can increase paravertebral soft tissue damage and perioperative bleeding. The purpose of this report is to describe a rare case of traumatic double fractures at the cervico-thoracic and thoraco-lumbar transition zones in ankylosing spine with spondylo-epiphyseal dysplasia (SED) of unknown cause, which were successfully treated with a combined open and percutaneous spinal fusion procedure...
February 7, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29412065/a-simplified-treatment-algorithm-for-treating-thoracic-and-lumbar-spine-trauma
#19
Andrei F Joaquim, Alpesh A Patel, Gregory D Schroeder, Alexander R Vaccaro
Context Current treatment of TLST should consider injury morphology, neurological status, clinical status (pain and disability) and also multimodal radiological evaluation (MMRE) with CT, MRI and dynamic/ standing plain radiographs. Methods A narrative literature review was performed to propose a treatment algorithm to guide the management of thoracolumbar spinal trauma (TLST). In order to classify injuries and surgical indications, we utilized the two most recent classification systems (TLICS and new AO spine classification) and related recent literature...
February 7, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29408798/conservative-treatment-of-postoperative-chylothorax-a-case-report
#20
Sachinkumar Wagh, Sanjay Deshmukh, Shrikant Ankolikar
BACKGROUND: Chylothorax is a well-documented complication of thoracic trauma and is associated with high rates of morbidity and mortality. Treatment for chylothorax includes conservative measures (total parenteral nutrition, pleural drainage, and pleurodesis) and surgery (thoracic duct ligation). CASE PRESENTATION: We present the case of a 65-year-old man who developed chylothorax after an elective surgical procedure. In this report conservative treatment aims to reduce chyle flow, to drain the pleural cavity in an effective manner, and to prevent chronic sequelae...
February 6, 2018: Journal of Basic and Clinical Physiology and Pharmacology
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