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Thoracic trauma

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https://www.readbyqxmd.com/read/29656630/etiopathogenesis-of-traumatic-spinal-epidural-hematoma
#1
Francesco Ciro Tamburrelli, Maria Concetta Meluzio, Giulia Masci, Andrea Perna, Aaron Burrofato, Luca Proietti
Spinal epidural hematoma (SEH) is a rare cause of nerve root or cord compression; its pathogenesis is not always clearly recognizable. The aim of this paper was to investigate possible etiopathological factors in a consecutive series of patients affected by traumatic SEH treated at our institution. Seven patients with neurologic impairment due to traumatic SEH were retrospectively analyzed after diagnosis and surgical treatment. Thoracic localization was found in 5 cases, and lumbar and cervical localization were found in 1 patient each...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29652785/clinical-prediction-rule-for-heterotopic-ossification-of-the-hip-in-patients-with-spinal-cord-injury
#2
Eduardo M Suero, Mustafa Citak
STUDY DESIGN: Case-control study; clinical prediction rule. OBJECTIVE: To construct and internally validate a clinical prediction rule to identify patients at high risk of developing heterotopic ossification (HO) after spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA: HO after SCI can lead to loss of joint mobility, loss of function, peripheral nerve entrapment, and pressure sores. HO is usually diagnosed based on clinical symptoms, as no laboratory tests are yet available to identify patients with early HO formation...
April 12, 2018: Spine
https://www.readbyqxmd.com/read/29651513/-chest-trauma-from-a-surgical-perspective
#3
Philipp Lichte, Sebastian Kalverkamp, Jan Spillner, Frank Hildebrand, Philipp Kobbe
Patients with multiple injuries in particular frequently also suffer from chest trauma. During the initial phase the identification and treatment of life-threatening injuries is essential and tension pneumothorax is of particular importance during this phase. The Advanced Trauma Life Support (ATLS) algorithm should be followed for structured treatment. In most cases treatment by insertion of a chest tube is sufficient but for some injuries an emergency thoracotomy is unavoidable as a life-saving intervention...
April 12, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29644869/pearls-and-pitfalls-in-imaging-of-blunt-traumatic-thoracic-aortic-injury-a-pictorial-review
#4
Neeral R Patel, Elizabeth Dick, Nicola Batrick, Michael Jenkins, Elika Kashef
Blunt thoracic aortic injury (TAI) occurs most frequently as a sequelae of high impact deceleration such as high velocity road traffic accidents and falls from height. The burden of mortality and morbidity is high, however advances in pre-hospital care, diagnostic imaging and endovascular therapies have improved outcomes in this group of patients. Emergent treatment depends on accurate, early diagnosis by the radiologist. It is therefore of paramount importance that radiologists are familiar with both the direct (intimal flap, pseudoaneurysm, aortic contour irregularity and contrast extravasation) and indirect (periaortic haematoma) imaging findings of TAI...
April 12, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#5
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29629200/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-preoperative-optimisation
#6
REVIEW
Antonio D'Andrilli, Domenico Massullo, Erino A Rendina
Preoperative patient optimisation is a key point of enhanced recovery after thoracic surgery pathways. This could be particularly advantageous when considering video-assisted thoracic surgery (VATS) lobectomy, because reduced trauma related to minimally invasive techniques is one of the main factors favouring improved postoperative outcome. Main specific interventions for clinical optimisation before major lung resection include assessment and treatment of comorbidities, minimizing preoperative hospitalization, optimisation of pharmacological prophylaxis (antibiotic and thromboembolic) and minimizing preoperative fasting...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29622335/pediatric-thoracic-trauma-recognition-and-management
#7
REVIEW
Stacy L Reynolds
Thoracic injuries account for less than one-tenth of all pediatric trauma-related injuries but comprise 14% of pediatric trauma-related deaths. Thoracic trauma includes injuries to the lungs, heart, aorta and great vessels, esophagus, tracheobronchial tree, and structures of the chest wall. Children have unique anatomic features that change the patterns of observed injury compared with adults. This review article outlines the clinical presentation, diagnostic testing, and management principles required to successfully manage injured children with thoracic trauma...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29618325/chylopericardium-in-a-child-with-iga-nephropathy-a-case-report
#8
Yu-Lin Kang, Yun Cui, Ying Wu, Shen Hao, Xin-Yu Kuang, Yu-Cai Zhang, Wen-Yan Huang, Guang-Hua Zhu
BACKGROUND: Chylopericardium effusion is characterized by the accumulation of milky effusion in the pericardium. It is often idiopathic but it can be secondary to trauma, chest radiation, tuberculosis and malignancy. If cardiac tamponade ensues, it becomes life-threatening. Herein we describe chylopericardium tamponade in a child with IgA nephropathy. To the best of our knowledge, this is the first reported case of chylopericardium tamponade in IgA nephropathy. CASE PRESENTATION: A 6 years old boy with IgA nephropathy presented with dyspnea, orthopnea, pretibial pitting edema, ascites and fever...
April 5, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29618191/delayed-massive-hemothorax-requiring-surgery-after-blunt-thoracic-trauma-over-a-5-year-period-complicating-rib-fracture-with-sharp-edge-associated-with-diaphragm-injury
#9
Sung Wook Chang, Kyoung Min Ryu, Jae-Wook Ryu
Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29616352/efast-for-the-diagnosis-of-a-perioperative-complication-during-percutaneous-nephrolithotomy
#10
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined...
April 3, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29616328/thoracoscopic-anterior-stabilization-for-thoracolumbar-fractures-in-patients-without-spinal-cord-injury-quality-of-life-and-long-term-results
#11
Arjen J Smits, Arwin Noor, Fred C Bakker, Jaap Deunk, Frank W Bloemers
PURPOSE: To determine the health-related quality of life (QOL), safety and radiologic parameters after thoracoscopic treatment of traumatic thoracolumbar fractures using a distractible cage in patients without spinal cord injury (SCI). METHODS: Retrospective cohort study of patients treated between 2004 and 2012 in a university level-one trauma center. Patient and treatment characteristics were collected from the hospital information system. All available radiographic material was assessed for fracture characteristics and Cobb angle at consecutive times...
April 3, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29615517/the-nociceptin-receptor-inhibits-axonal-regeneration-and-recovery-from-spinal-cord-injury
#12
Yuichi Sekine, Chad S Siegel, Tomoko Sekine-Konno, William B J Cafferty, Stephen M Strittmatter
Axonal growth after traumatic spinal cord injury is limited by endogenous inhibitors, selective blockade of which promotes partial neurological recovery. The partial repair phenotypes suggest that compensatory pathways limit improvement. Gene expression profiles of mice deficient in Ngr1 , which encodes a receptor for myelin-associated inhibitors of axonal regeneration such as Nogo, revealed that trauma increased the mRNA expression of ORL1 , which encodes the receptor for the opioid-related peptide nociceptin...
April 3, 2018: Science Signaling
https://www.readbyqxmd.com/read/29613959/evaluation-and-management-of-traumatic-diaphragmatic-injuries-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#13
Amy A McDonald, Bryce R H Robinson, Louis Alarcon, Patrick L Bosarge, Heath Dorion, Elliott R Haut, Jeremy Juern, Firas Madbak, Srinivas Reddy, Patricia Weiss, John J Como
BACKGROUND: Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. METHODS: The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29610732/thoracic-perforations-surgical-techniques
#14
REVIEW
Atilla Eroglu, Yener Aydin, Omer Yilmaz
Esophageal perforation may occur spontaneously, iatrogenically or in connection with traumas. Sepsis may develop in connection with mediastinal and pleural exposure in a very short time as a consequence of disintegration of the esophagus. Esophageal perforation is an emergency accompanied with a high level of mortality and morbidity. Rate of mortality for the perforations in the thoracic region is higher than that in the cervical and abdominal regions. Delay in diagnosis and treatment is the most important factor to affect the mortality...
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29609886/risk-factors-for-reinsertion-of-urinary-catheter-after-early-removal-in-thoracic-surgical-patients
#15
John Young, Travis Geraci, Steven Milman, Andrew Maslow, Richard N Jones, Thomas Ng
OBJECTIVES: To reduce the incidence of urinary tract infection, Surgical Care Improvement Project 9 mandates the removal of urinary catheters within 48 hours postoperatively. In patients with thoracic epidural anesthesia, we sought to determine the rate of catheter reinsertion, the complications of reinsertion, and the factors associated with reinsertion. METHODS: We conducted a prospective observational study of consecutive patients undergoing major pulmonary or esophageal resection with thoracic epidural analgesia over a 2-year period...
March 8, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29606678/resuscitative-endovascular-balloon-occlusion-of-the-aorta-a-bridge-to-flight-survival
#16
Carl Goforth, Matthew Bradley, Benilani Pineda, Suzanne See, Jason Pasley
Trauma endures as the leading cause of death worldwide, and most deaths occur in the first 24 hours after initial injury as a result of hemorrhage. Historically, about 90% of battlefield deaths occur before the injured person arrives at a theater hospital, and most are due to noncompressible hemorrhage of the torso. Resuscitative endovascular balloon occlusion of the aorta is an evolving technique to quickly place a balloon into the thoracic or abdominal aorta to efficiently block blood flow to distal circulation...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29595737/surgical-approach-to-injuries-of-the-cervical-plexus-and-its-peripheral-nerve-branches
#17
David L Brown, A Lee Dellon
BACKGROUND: Located in the neck beneath the sternocleidomastoid muscle, the cervical plexus comprises a coalition of nerves originating from C1 through C4, which provide input to four cutaneous, seven motor, and three cranial nerves and the sympathetic trunk. Sporadic instances of injury to these superficial nerves have been reported. Nevertheless, this specific anatomical cause of neurogenic pain remains incompletely described and underrecognized. METHODS: Twelve patients presented with pain and were diagnosed with various combinations of injury to the lesser occipital, great auricular, transverse cervical, and supraclavicular nerves...
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29593901/frequent-benign-nontraumatic-noninflammatory-causes-of-low-back-pain-in-adolescents-mri-findings
#18
Aikaterini Solomou, Pantelis Kraniotis, Aspasia Rigopoulou, Theodore Petsas
Introduction: Low back pain (LBP) is common in children and adolescents. There are many factors that cause LBP, including structural disorders, degenerative changes, Scheuermann's disease, fractures, inflammation, and tumors. Magnetic Resonance Imaging is the gold standard for diagnosing spinal abnormalities and is mandatory when neurological symptoms exist. The study focuses on common MRI findings in adolescents with persistent LBP, without history of acute trauma or evidence of either inflammatory or rheumatic disease...
2018: Radiology Research and Practice
https://www.readbyqxmd.com/read/29588297/intrathecal-spinal-abscesses-due-to-candida-albicans-in-an-immunocompetent-man
#19
John K Crane
Infections of the central nervous system due to Candida albicans are uncommon and are usually only observed in special circumstances, such as following neurosurgery or penetrating head trauma, in immunosuppressed patients, premature infants or in patients with ventriculoperitoneal shunts. The author reports a case of an immunocompetent man who presented with a thoracic intraspinal abscess due to C. albicans Despite surgical drainage and 6 weeks of high-dose fluconazole therapy, the abscess extended and recurred in the cervical spine, requiring a second operation to arrest the infection...
March 27, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29587948/-analysis-of-prolonged-hospitalizations-longer-than-7-days-115-lung-cancer-patients-after-video-assistant-thoracic-surgery-vats
#20
Liang Dai, Xiaozheng Kang, Wanpu Yan, Yongbo Yang, Peiliang Zhao, Hao Fu, Haitao Zhou, Zhen Liang, Hongchao Xiong, Yao Lin, Keneng Chen
BACKGROUND: Thoracoscopic surgery has gradually become the major procedure for lung cancer surgery in our department. Its characteristics are minimal trauma and quick recovery, which make approximately 90% of patients discharge from the hospital after surgery. However, the postoperative complications still happen now and then. We analyzed the patients who had been hospitalized for longer than 7 days after thoracoscopic lung cancer surgery, aiming to summarize the types and risk factors of complications, and improve postoperative safety of patients...
March 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
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