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https://www.readbyqxmd.com/read/28079832/usefulness-of-low-dose-chest-ct-for-initial-evaluation-of-blunt-chest-trauma
#1
Sung Jung Kim, Anjali Basnyat Bista, Young Gi Min, Eun Young Kim, Kyung Joo Park, Doo Kyoung Kang, Joo Sung Sun
We aimed to compare the diagnostic performance and inter-observer consistency between low dose chest CT (LDCT) and standard dose chest CT (SDCT) in the patients with blunt chest trauma.A total of 69 patients who met criteria indicative of blunt chest trauma (77% of male; age range, 16-85) were enrolled. All patients underwent LDCT without intravenous (IV) contrast and SDCT with IV contrast using parameters as following: LDCT, 40 mAs with automatic tube current modulation (ATCM) and 100 kVp (BMI <25, n = 51) or 120 kVp (BMI>25, n = 18); SDCT, 180 mAs with ATCM and 120 kVp...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28066906/causes-and-mechanisms-of-death-in-fatal-water-buffalo-attacks
#2
Roger W Byard
Deaths due to buffalo attack have not been well described. A 72-year-old man was trampled by a water buffalo (Bubalus bubalis) while attempting to move the animal within an enclosed area at an abattoir. At autopsy, there were numerous injuries involving the chest, head, neck, and left upper arm. Blunt force injury had resulted in multiple rib fractures with a flail chest and fracture/dislocation of the mid-cervical vertebrae caused either by physical crushing by the animal against the walls of the enclosure or by stomping...
January 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#3
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28028415/scapular-fractures-in-blunt-chest-trauma-self-experience-study
#4
Tabet A Al-Sadek, Desislav Niklev, Ahmed Al-Sadek, Lina Al-Sadek
AIM: The aim of this retrospective study was to report the scapular fractures in patients with blunt chest trauma and to present the type and the frequency of associated thoracic injuries. MATERIAL AND METHODS: Nine patients with fractures of the scapula were included in the study. The mechanisms of the injury, the type of scapular fractures and associated thoracic injuries were analysed. RESULTS: Scapular fractures were caused by high-energy blunt chest trauma...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28000769/characterization-of-blunt-chest-trauma-in-a-long-term-porcine-model-of-severe-multiple-trauma
#5
K Horst, T P Simon, R Pfeifer, M Teuben, K Almahmoud, Q Zhi, S Aguiar Santos, C Castelar Wembers, S Leonhardt, N Heussen, P Störmann, B Auner, B Relja, I Marzi, A T Haug, M van Griensven, M Kalbitz, M Huber-Lang, R Tolba, L K Reiss, S Uhlig, G Marx, H C Pape, F Hildebrand
Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock)...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27998635/predictors-of-intrathoracic-injury-after-blunt-torso-trauma-in-children-presenting-to-an-emergency-department-as-trauma-activations
#6
Caitlin McNamara, Irina Mironova, Erik Lehman, Robert P Olympia
BACKGROUND: Thoracic injuries are a major cause of death associated with blunt trauma in children. Screening for injury with chest x-ray study, compared with chest computed tomography (CT) scan, has been controversial, weighing the benefits of specificity with the detriment of radiation exposure. OBJECTIVE: To identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27994332/thoracotomy-for-traumatic-diaphragmatic-hernia
#7
Zhang Fangbiao, Zheng Chunhui, Zhao Chun, Shi Hongcan, Zhang Xiangyan, Tu Shaosong
The aim of this retrospective study is to review our experience in the diagnosis and role of thoracotomy for traumatic diaphragmatic hernia (TDH). Between January 2008 and June 2014, 23 patients from Yangzhou Medical College (Yangzhou China) and Lishui Center Hospital (Lishui China), who underwent thoracotomy for TDH, were analyzed. The clinical features, imaging findings, operative findings, and outcome of treatment in these patients are presented. There were 23 patients (18 males and 5 females) who underwent surgical procedures due to TDH...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27986273/traumatic-pulmonary-pseudocyst-an-underreported-entity
#8
REVIEW
B Phillips, J Shaw, L Turco, D McDonald, J Carey, M Balters, M Wagner, R Bertellotti, D L Cornell, D K Agrawal, J A Asensio
BACKGROUND: Traumatic pulmonary pseudocysts (TPP) are underreported cavitary lesions of the pulmonary parenchyma that can develop following blunt chest trauma. Although the occurrence of traumatic pulmonary pseudocyst is rare, this condition should be considered in the differential diagnosis of any cavitary lesion. Awareness of this injury and its clinical significance is important for successful management in order to avoid medical errors in the course of treatment. METHODS: A literature search was conducted through Medline using the key phrases "traumatic pulmonary pseudocyst" and "traumatic pneumatocele...
December 12, 2016: Injury
https://www.readbyqxmd.com/read/27984449/operative-treatment-of-rib-fractures-in-flail-chest-injuries-a-meta-analysis-and-cost-effectiveness-analysis
#9
Eric Swart, Joseph Laratta, Gerard Slobogean, Samir Mehta
OBJECTIVES: Flail chest is a common injury sustained by patients who suffer from high energy blunt chest trauma, and results in severe respiratory compromise due to altered mechanics of respiration. There has been increased interest in operative fixation of these injuries with the intention of restoring the mechanical integrity of the chest wall, and several studies have shown that ventilation requirements and pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate fixation of rib fractures in flail chest injuries using cost effectiveness analysis, supported by systematic review and meta-analysis...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27982326/analysis-of-the-revised-trauma-score-rts-in-200-victims-of-different-trauma-mechanisms
#10
Bruno Durante Alvarez, Danilo Mardegam Razente, Daniel Augusto Mauad Lacerda, Nicole Silveira Lother, Luiz Carlos VON-Bahten, Carla Martinez Menini Stahlschmidt
Objective: to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. Methods: we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27933327/traumatic-diaphragmatic-injuries-a-retrospective-review-of-the-12-year-experience-at-a-tertiary-trauma-centre
#11
Beng Leong Lim, Li Tserng Teo, Ming Terk Chiu, Marxengel L Asinas-Tan, Eillyne Seow
INTRODUCTION: Traumatic diaphragmatic injuries (TDIs) are clinically challenging. We aimed to review TDIs treated at a tertiary trauma centre over a 12-year period. METHODS: This was a single-centre retrospective review of adult patients with TDIs treated between 1 January 2003 and 31 December 2014. Primary outcomes were mortality rates and Injury Severity Scores (ISS) associated with each TDI subtype. Secondary outcomes included proportions of TDIs diagnosed radiologically, operatively or during autopsy...
December 9, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27928254/diagnosing-myocardial-contusion-after-blunt-chest-trauma
#12
REVIEW
Zahra Alborzi, Vahid Zangouri, Shahram Paydar, Zahra Ghahramani, Masih Shafa, Bizhan Ziaeian, Mohammad Reza Radpey, Armin Amirian, Shahin Khodaei
A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs) and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27900328/blunt-traumatic-tension-chylothorax-case-report-and-mini-review-of-the-literature
#13
Kamal Idris, Michael Sebastian, Ashraf F Hefny, Navidul Haq Khan, Fikri M Abu-Zidan
Tension chylothorax following blunt thoracic trauma is an extremely rare condition. Here we report such a case and review its management. A 31-year-old man was involved in a road traffic collision. The car rolled over and the patient was ejected from the vehicle. On arrival at the Emergency Department the patient was conscious and haemodynamically stable. Clinical examination of the chest and abdomen was normal. The patient had sustained fractures of the sixth cervical vertebra and the tenth thoracic vertebra, left pleural effusion, haematoma around the descending aorta and fracture of the right clavicle...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27889903/a-case-report-hemothorax-caused-by-rupture-of-the-left-atrial-appendage
#14
Hiroaki Oizumi, Kenji Suzuki, Hironobu Hoshino, Takahiro Tatsumori, Hideomi Ichinokawa
Cardiac rupture is defined as a full-thickness myocardial tear; this injury after blunt chest trauma is rare, and is associated with high mortality. Blunt cardiac rupture typically presents with either cardiac tamponade or massive hemothorax, and is often unrecognized in the context of blunt chest trauma. It is a little known fact that pericardial effusions can decrease due to pericardial lacerations. Hence, cardiac rupture with pericardial lacerations may be easily overlooked especially by chest surgeons. We herein report a case of hemothorax caused by rupture of the left atrial appendage...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27867441/the-role-of-computed-tomography-in-the-diagnostics-of-diaphragmatic-injury-after-blunt-thoraco-abdominal-trauma
#15
Agata Gmachowska, Ryszard Pacho, Agnieszka Anysz-Grodzicka, Leopold Bakoń, Maria Gorycka, Wawrzyniec Jakuczun, Waldemar Patkowski
BACKGROUND: Diaphragmatic injuries occur in 0.8-8% of patients with blunt trauma. The clinical diagnosis of diaphragmatic rupture is difficult and may be overshadowed by associated injuries. Diaphragmatic rupture does not resolve spontaneously and may cause life-threatening complications. The aim of this study was to present radiological findings in patients with diaphragmatic injury. MATERIAL/METHODS: The analysis of computed tomography examinations performed between 2007 and 2012 revealed 200 patients after blunt thoraco-abdominal trauma...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27866218/prevalence-of-negative-ct-scans-in-a-level-one-trauma-center
#16
C K Hansen, R J Strayer, B D Shy, S Kessler, S Givre, K H Shah
PURPOSE: The rise of computed tomography (CT) use in trauma has become the subject of concern given the harms of CT including radiation, cost, over diagnosis and identification of incidental lesions. We developed a novel metric, the Negative CT Score, (∑CT-) which quantifies how often CT imaging identifies important injuries. Our objective was to describe the pattern of CT utilization in trauma at an urban academic level one trauma center using this novel metric. METHODS: This was a retrospective study of intermediate level trauma patients who received CT imaging over a 1-year study period at an urban level one trauma center...
November 19, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27865475/soluble-receptor-for-advanced-glycation-end-products-quantifies-lung-injury-in-polytraumatized-patients
#17
Lukas L Negrin, Gabriel Halat, Helmut Prosch, Michael Hüpfl, Stefan Hajdu, Thomas Heinz
BACKGROUND: Biomarkers caused by blunt chest trauma might leak into the vascular compartment and therefore reflect the severity of parenchymal lung injury (PLI). Five promising proteins were preselected after a literature scan. The objective of our study was to identify a biomarker that is released abundantly into the serum shortly after trauma and reliably quantifies the loss of functional lung tissue. METHODS: Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27849321/evaluation-of-patients-diagnosed-with-acute-blunt-aortic-injury-and-their-bedside-plain-chest-radiography-in-the-emergency-department-a-retrospective-study
#18
Funda Karbek Akarca, Tanzer Korkmaz, Celal Çınar, Elif Dilek Çakal, Murat Ersel
BACKGROUND: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury. METHODS: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27843541/blunt-diaphragmatic-lesions-imaging-findings-and-pitfalls
#19
REVIEW
Matteo Bonatti, Fabio Lombardo, Norberto Vezzali, Giulia A Zamboni, Giampietro Bonatti
Blunt diaphragmatic lesions (BDL) are uncommon in trauma patients, but they should be promptly recognized as a delayed diagnosis increases morbidity and mortality. It is well known that BDL are often overlooked at initial imaging, mainly because of distracting injuries to other organs. Sonography may directly depict BDL only in a minor number of cases. Chest X-ray has low sensitivity in detecting BDL and lesions can be reliably suspected only in case of intra-thoracic herniation of abdominal viscera. Thanks to its wide availability, time-effectiveness and spatial resolution, multi-detector computed tomography (CT) is the imaging modality of choice for diagnosing BDL; several direct and indirect CT signs are associated with BDL...
October 28, 2016: World Journal of Radiology
https://www.readbyqxmd.com/read/27827332/a-preventative-respiratory-protocol-to-identify-trauma-subjects-at-risk-for-respiratory-compromise-on-a-general-in-patient-ward
#20
Bethany A Nyland, Sarah K Spilman, Meghan E Halub, Keith D Lamb, Julie A Jackson, Trevor W Oetting, Sheryl M Sahr
BACKGROUND: Patients are at risk for respiratory complications after sustaining blunt chest trauma, yet contradictory evidence exists about the utility of prophylactic respiratory therapy to reduce respiratory complications in this population. This study assessed the effectiveness of a proactive respiratory protocol on an in-patient ward to identify trauma patients at risk for pulmonary complications, administer appropriate therapies, and prevent deterioration requiring transfer to the ICU...
December 2016: Respiratory Care
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