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Thoracic trauma

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https://www.readbyqxmd.com/read/29040207/trauma-pneumonectomy-for-major-thoracic-bleeding-when-should-we-consider-about-it
#1
Martin L Tonglet, Didier Moens, Vincenzo D'Orio, Alexandre Ghuysen
No abstract text is available yet for this article.
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29035924/rotational-therapy-in-thoracic-injuries-what-is-the-evidence
#2
Philipp Störmann, Ingo Marzi, Sebastian Wutzler
PURPOSE OF REVIEW: To review the current use of continuous lateral rotational therapy (CLRT) in patients with thoracic injuries and its impact on clinical course, complications and outcome. RECENT FINDINGS: Patient positioning is a key factor in the treatment of severe thoracic injuries and CLRT, and intermittent supine and prone position are basic options. There is a lack of randomized controlled studies for trauma patients with chest injury undergoing kinetic therapy as standard of care...
October 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29033151/is-it-adequate-to-carry-out-a-chest-ct-in-patients-with-mild-moderate-chest-trauma
#3
V García de Pereda de Blas, M Carreras Aja, S Carbajo Azabal, E Arana-Arri
Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan...
October 12, 2017: Radiología
https://www.readbyqxmd.com/read/28993912/the-utility-of-magnetic-resonance-imaging-in-addition-to-computed-tomography-scans-in-the-evaluation-of-cervical-spine-injuries-a-study-of-obtunded-blunt-trauma-patients
#4
Bernard Puang Huh Lau, Hwee Weng Dennis Hey, Eugene Tze-Chun Lau, Pei Yi Nee, Kimberly-Anne Tan, Wah Tze Tan
PURPOSE: Evidence guiding the use of CT and MRI scans in blunt trauma patients who are obtunded remains controversial. This study aims to determine and predict if computed tomography (CT) scans alone can be performed without risking oversight of substantial injuries found on follow-up magnetic resonance imaging (MRI). METHODS: This is a retrospective cohort study of 63 blunt trauma patients with a Glasgow Coma Scale of < 8. Data were collated from electronic medical records and included patient demographics, premorbid mobility, mechanism of injury, suspected level of injury and neurological examination findings...
October 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28989838/sacral-fractures-and-associated-injuries
#5
REVIEW
Ricardo Rodrigues-Pinto, Mark F Kurd, Gregory D Schroeder, Christopher K Kepler, James C Krieg, Jörg H Holstein, Carlo Bellabarba, Reza Firoozabadi, F Cumhur Oner, Frank Kandziora, Marcel F Dvorak, Conor P Kleweno, Luiz R Vialle, S Rajasekaran, Klause J Schnake, Alexander R Vaccaro
STUDY DESIGN: Literature review. OBJECTIVE: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome. METHODS: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures. RESULTS: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated...
October 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28984515/surgical-timing-for-cervical-and-upper-thoracic-injuries-in-patients-with-polytrauma
#6
Daniel Lubelski, Suzanne Tharin, John J Como, Michael P Steinmetz, Heather Vallier, Timothy Moore
OBJECTIVE Few studies have investigated the advantages of early spinal stabilization in the patient with polytrauma in terms of reduction of morbidity and mortality. Previous analyses have shown that early stabilization may reduce ICU stay, with no effect on complication rates. METHODS The authors prospectively observed 340 polytrauma patients with an Injury Severity Score (ISS) of greater than 16 at a single Level 1 trauma center who were treated in accordance with a protocol termed "early appropriate care," which emphasizes operative treatment of various fractures within 36 hours of injury...
October 6, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28979634/delayed-brachial-artery-reconstruction-after-traumatic-injury-a-case-for-sustainment-of-surgical-intervention
#7
Kelechi Emmanuel Okonta, Emmanuel Ossai Ocheli, Tombari Joseph Gbeneol
The brachial artery is the commonest artery injured in the extremities. Although the patients present late, nevertheless reconstructions is advocated in other to salvage the limb and maintain function of the hand. We retrospectively examined 25 consecutive patients with vascular injuries treated at The Cardiovascular and Thoracic Surgery Unit of a tertiary health centre over a period of 4 years. We assessed the pre-tertiary methods of stopping of bleeding injured brachial arteries, mechanisms of injury, associated injuries, treatment and the outcome following vascular repair in terms of functionality of the forearm and the volume of the radial pulsation...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28973104/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-proximal-aortic-control-in-patients-with-severe-hemorrhage-and-arrest
#8
Megan Brenner, William Teeter, Melanie Hoehn, Jason Pasley, Peter Hu, Shiming Yang, Anna Romagnoli, Jose Diaz, Deborah Stein, Thomas Scalea
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis, often instead of emergency department thoracotomy. The ability to perform aortic occlusion (AO) with an intravascular device allows focused occlusion at the most distal level to perfuse proximal regions while slowing hemorrhage to injured areas. Objective: To describe what is to date the largest single-institution experience with REBOA in the United States...
September 27, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28967243/blunt-thoracic-trauma-and-cardiac-injury-in-the-athlete-contemporary-management
#9
Cesare DE Gregorio, Ludovico Magaudda
INTRODUCTION: Commotion cordis and cardiac injuries are rare events usually following a chest blunt trauma during sports activities. EVIDENCE ACQUISITION AND SYNTHESIS: Various aetiologies have been identified to cause electrical (commotion cordis) and/or structural (contusion and further injuries) damage, but high-velocity tools such as baseballs or hockey pucks (also called projectiles) have been chiefly identified. Clinical consequences are challenging, varying from uncomplicated supraventricular arrhythmias to cardiac wall rupture...
September 29, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28962715/fast-tracking-patients-through-the-diagnostic-and-therapeutic-pathways-of%C3%A2-intrathoracic-conditions-the-role-of-uniportal-video-assisted-thoracic-surgery
#10
REVIEW
Mahmoud Ismail, Marc Swierzy, Dania Nachira, Jens C Rückert
Fast-tracking patients in surgery has become standard in many hospitals. This allows for a shorter hospital stay and a complete organized pathway for treating patients. The operative trauma has an important role in the patient's recovery, as has the increasing use of minimally invasive procedures. In thoracic surgery, video-assisted thoracic surgery (VATS) procedures are aimed at reducing the operative trauma. One of the latest developments of VATS is represented by the uniportal approach, whose purpose is to reduce postoperative pain and morbidity...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962714/training-in-uniportal-video-assisted-thoracic-surgery
#11
REVIEW
Alberto Sandri, Alan D L Sihoe, Michele Salati, Diego Gonzalez-Rivas, Alessandro Brunelli
Interest in uniportal video-assisted thoracic surgery (VATS) is rapidly growing worldwide because it represents the surgical approach to the lung with the least possible trauma. Specific training in this surgical approach is crucial due to its technical implications, to perform it safely while upholding the required therapeutic radicality. Novel strategies, such as interactive learning technologies, simulators, high-volume preceptorships, and targeted proctorships, play important roles in the training for uniportal VATS which, ideally, should be standardized, governed, and credentialed by national and international surgical societies to ensure patient safety and academic responsibility...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28958467/experts-results-in-blunt-thoracic-aortic-injury-are-reproducible-in-lower-volume-tertiary-institutions-early-and-mid-term-results-of-an-observational-study
#12
Tamer Ghazy, Sandra Mikulasch, Christian Reeps, Ralf-Thorsten Hoffmann, Kasia Wijatkowska, Abdel-Hannan Diab, Utz Kappert, Klaus Matschke, Norbert Weiss, Adrian Mahlmann
OBJECTIVES: The aim of this study was to evaluate the early and mid-term clinical results, the device performance, and the mid-term re-intervention rates of patients suffering blunt thoracic aortic injury (BTAI) managed by a multidisciplinary team in a low-volume BTAI centre. METHODS: This was a retrospective observational study in a tertiary hospital setting. From December 2005 to March 2016, all patients over 18 years old admitted with BTAI were included in the study...
September 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28958357/thoracic-trauma
#13
REVIEW
Bradley M Dennis, Seth A Bellister, Oscar D Guillamondegui
Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28956660/traumatic-axonal-injury-despite-clinical-phenotype-of-mild-traumatic-brain-injury-a-case-report
#14
Sung Ho Jang, Han Do Lee
OBJECTIVES: We report on a patient who suffered traumatic axonal injury (TAI) of various neural tracts despite airbag deployment following mild traumatic brain injury (TBI), which was demonstrated by diffusion tensor tractography (DTT). CASE DESCRIPTION: A 58-year-old female patient suffered from head trauma resulting from an in-car traffic accident. At the time of head trauma, her head and face hit the deployed airbag after flexion-hyperextension-rotation injury...
September 28, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28956075/-polytrauma-following-a-truck-accident-how-to-save-lives-by-guideline-oriented-emergency-care
#15
M Kippnich, Y Jelting, C Markus, M Kredel, T Wurmb, P Kranke
BACKGROUND: Identification and immediate treatment of life-threatening conditions is fundamental in patients with multiple trauma. In this context, the S3 guidelines on polytrauma and the S1 guidelines on emergency anesthesia provide the scientific background on how to handle these situations. CASE STUDY: This case report deals with a seriously injured driver involved in a truck accident. The inaccessible patient showed a scalping injury of the facial skeleton with massive bleeding and partially blocked airway but with spontaneous breathing as well as centralized cardiovascular circulation conditions and an initial Glasgow coma scale (GCS) of 8...
September 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28951274/spinal-metastasis-of-unknown-primary-accompanied-by-neurological-deficit-or-vertebral-instability
#16
Abdurrahman Aycan, Sebahattin Çelik, Fetullah Kuyumcu, Mehmet Edip Akyol, Mehmet Arslan, Erkan Doğan, Harun Arslan
INTRODUCTION AND AIM: Spinal bone metastases are highly common. They are mostly localized to the lumbar, thoracic, and cervical spine, respectively. The most common primaries to result in spinal metastases include lung, breast, and prostate carcinomas in adults as opposed to leukemia, Ewing's sarcoma, rhabdomyosarcoma, and neuroblastoma in children. In patients diagnosed with a cancer, bone metastases are found in 40% and spinal metastases in 10% of the patients. In this study, we aimed to present 25 patients diagnosed with a spinal metastasis of unknown primary who presented with a low back pain or acute-onset neurological deficits and underwent operative treatment...
September 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28947225/determinants-and-outcomes-of-nonoperative-management-for-blunt-traumatic-aortic-injuries
#17
Harleen K Sandhu, Samuel D Leonard, Alexa Perlick, Naveed U Saqib, Charles C Miller, Kristofer M Charlton-Ouw, Hazim J Safi, Ali Azizzadeh
OBJECTIVE: The natural history and parameters for successful nonoperative management of blunt traumatic aortic injuries (BTAIs) involving the descending aorta are poorly understood. We examined our experience with nonoperative BTAI treatment (anti-impulse, blood pressure) and evaluated for determinants of successful outcomes. METHODS: We performed a review of our institutional prospective trauma registry database for all BTAI patients from 1999 to 2015. Computed tomography angiography was used to classify aortic injuries on the basis of severity: grade I, intimal tear; grade II, intramural hematoma; grade III, aortic pseudoaneurysm; and grade IV, free rupture...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28941568/resuscitation-thoracotomy
#18
G Boddaert, E Hornez, H De Lesquen, A Avramenko, B Grand, T MacBride, J-P Avaro
Resuscitation thoracotomy is a rarely performed procedure whose use, in France, remains marginal. It has five specific goals that correspond point-by-point to the causes of traumatic cardiac arrest: decompression of pericardial tamponade, control of cardiac hemorrhage, performance of internal cardiac massage, cross-clamping of the descending thoracic aorta, and control of lung injuries and other intra-thoracic hemorrhage. This approach is part of an overall Damage Control strategy, with a targeted operating time of less than 60minutes...
September 20, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28932697/thoracic-wall-trauma-misdiagnosed-lesions-on-radiographs-and-usefulness-of-ultrasound-multidetector-computed-tomography-and-magnetic-resonance-imaging
#19
REVIEW
Xavier Tomas, Catherine Facenda, Nuno Vaz, Edgar Augusto Castañeda, Montserrat Del Amo, Ana Isabel Garcia-Diez, Jaime Pomes
Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has been done in computed tomography (CT) and multidetector CT (MDCT) imaging. This technique is considered the "gold-standard" for those traumatic patients, due to its fast acquisition covering the whole area of interest in axial plane, reconstructing multiplanar (2D, 3D) volume-rendered images with a superb quality and angiographic CT capabilities for evaluating vascular damage...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28930942/surgical-residents-interpretation-of-diagnostic-radiologic-imaging-in-the-traumatically-injured-patient
#20
Elias Fakhoury, Daria Abolghasemi, Justin McKinney, Alena Naumova, Scott Wessner, Osama Elsawy, Jamshed Zuberi, Robert V Madlinger
BACKGROUND: Senior surgical residents are of paramount importance in directing further therapeutic modalities based on their interpretation of critical diagnostic imaging. We propose that senior surgical residents are proficient with interpreting radiologic imaging studies in the trauma patient. METHODS: A prospective cohort study was performed comparing surgery resident interpretations of computerized tomography (CT) scans of the head, maxillofacial bones, spine (cervical, thoracic, lumbar), chest, abdomen, pelvis, and chest X-rays versus final radiologists' reports at a level II trauma center from September 2014 to May 2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
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