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https://www.readbyqxmd.com/read/29785655/early-results-after-operatively-versus-non-operatively-treated-flail-chest-a-retrospective-study-focusing-on-outcome-and-complications
#1
Mathieu M E Wijffels, Tjebbe Hagenaars, Diba Latifi, Esther M M Van Lieshout, Michael H J Verhofstad
PURPOSE: Flail chest was traditionally treated non-operatively using mechanical ventilation and pain control. In order to reduce the occurrence of ventilation-associated complications and long-term disability, operative rib fixation is becoming a proven standard therapy for these patients. However, the consequences of the surgical complications may influence success rates negatively. The aim of this study was to compare the outcome of flail chest treatment by surgical rib fixation with non-operative treatment, with special focus on the impact of surgical complications...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29783885/pneumomediastinum-revisited-we-should-reconsider-usual-classification
#2
Melanie Dechamps, Lieven De Smedt, Said Hachimi Idrissi
Pneumomediastinum work-up should focus on differentiating mediastinal organ injuries from alveolar rupture since these two causative mechanisms have a different management and prognosis. After an admission at our Emergency Department, we wanted to challenge the current classification into 'spontaneous' or 'secondary' pneumomediastinum, which reflects the clinical rather than the pathophysiological circumstances and is therefore confusing and inappropriate to our view. We propose a new work-up algorithm based on clinical risks factors and chest CT findings...
May 21, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#3
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29780712/advantages-of-wound-retractor-device-versus-rigid-trocar-at-camera-port-in-video-assisted-thoracic-surgery-a-single-institution-experience
#4
Federico Raveglia, Ugo Cioffi, Matilde De Simone, Alessandro Rizzi, Andrea Leporati, Carmine Tinelli, Marco Chiarelli, Alessandro Baisi
Background: rigid trocars are widely adopted in video-assisted thoracic surgery (VATS), despite some disadvantages: (I) cannula strong pressure on intercostal nerve stimulating postoperative pain; (II) limited movement of thoracoscopic devices on their fulcrum when extreme acute angles with the chest wall are needed. Wound retractor (WR) device, designed for laparoscopic surgery, it is also used in VATS, but to protect mini-thoracotomy. We compared the use of extra-small WR versus rigid trocar at camera port that is the most painful thoracostomy...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29779595/disorders-of-the-chest-wall-clinical-manifestations
#5
REVIEW
Mazen O Al-Qadi
Chest wall disorders represent deformities and/or injuries that alter the rib cage geometry and result in pulmonary restriction, increased work of breathing, exercise limitations, and cosmotic concerns. These disorders are congenital or acquired and affect all ages. Disorders affecting the spine (kyphoscoliosis, ankylosing spondylitis), ribs (flail chest), and sternum (pectus excavatum) are discussed in this article, with emphasis on clinical presentations, pulmonary function abnormalities, diagnosis, and treatment...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29778065/reliability-of-the-sub-components-of-the-instrumented-timed-up-and-go-test-in-ambulatory-children-with-traumatic-brain-injury-and-typically-developed-controls
#6
Mark A Newman, Mark A Hirsch, Richard D Peindl, Nahir A Habet, Tobias J Tsai, Michael S Runyon, Toan Huynh, Nigel Zheng
BACKGROUND: Studies have evaluated the test-re-test reliability of subcomponents of the timed up and-go test in adults by using body-worn inertial sensors. However, studies in children have not been reported in the literature. RESEARCH QUESTION: To evaluate the within-session reliability of subcomponents of a newly developed electronically augmented timed 'upand-go' test (EATUG) in ambulatory children with traumatic brain injury (TBI) and children with typical development (TD)...
May 16, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29774196/common-carotid-artery-dissection-in-multiple-extracranial-injury-a-case-report
#7
Jin Sang Kil, Mi Kyung Lee, Ki Seong Eom
Traumatic common carotid artery dissection (CCAD) is rare. To our knowledge, only 14 case reports have described traumatic CCAD previously. Here, we report a case of CCAD in a patient with severe trauma. A 50-year-old man was lying on the road after drinking alcohol when a car drove over him. Computed tomography (CT) revealed multiple rib fractures with hemopneumothorax, lung contusion, flail chest, large amount of hematoma with bladder rupture, and fractures on the C6 spinous process, sacral ala, iliac bone, and pubic ramus...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773279/-non-tuberculous-mycobacterial-cervical-adenitis-in-children-2-cases
#8
N Sigg, S Bailleul, J-M Turmel, G Legrand, S Kettani, L Martin
BACKGROUND: Cervical lymphadenitis is the most common manifestation of infection with nontuberculous mycobacteria (NTM) in immunocompetent children. Nevertheless, it is poorly known by dermatologists. Its incidence, which is currently increasing since the cessation of BCG vaccination in 2007, raises several issues regarding its pathophysiology, diagnosis and management. PATIENTS AND METHODS: We report two cases of NTM adenitis: one in a 2-year-old girl vaccinated with BCG and one in an unvaccinated 22-month-old boy, in whom a misleading presentation led to delayed diagnosis...
May 14, 2018: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29771705/the-causality-nexus-between-the-tako-tsubo-syndrome-and-an-assault-a-forensic-case-report
#9
Malek Zribi, Syrine Azza Manoubi, Narjes Karray, Salma Charfeddine, Wiem Benamar, Zouhir Hammami, Samir Kammoun, Samir Maatoug
"Tako-tsubo" cardiomyopathy, also known as "broken heart syndrome," is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor...
May 4, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29768378/cerebral-infarction-as-initial-presentation-in-stress-cardiomyopathy-case-report-and-literature-review
#10
Qiongying Wang, Heng Yu, Cheng Jiang, Runmin Sun, Miaomiao Qi, Shougang Sun, Guangli Xu, Hongbin Cai, Zhenchang Zhang, Feng Zhao, Xiaoqing Kou, Jing Yu, Feng Bai
RATIONALE: The typical symptoms of stress cardiomyopathy include sudden-onset chest pain and breathlessness or collapse as well as classical symptoms of cardiovascular disease; however, rare reports have described nervous system symptoms as the initial manifestation. Here, we report the case of a young man who presented with a large cerebral infarction as the main clinical symptom of stress cardiomyopathy to increase recognition of the disease. PATIENT CONCERNS: A 28-year-old man was admitted to our hospital for sudden-onset weakness of the right limbs and unconsciousness for 1 day...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766123/orthopaedic-traumatology-fundamental-principles-and-current-controversies-for-the-acute-care-surgeon
#11
REVIEW
Shad K Pharaon, Shawn Schoch, Lucas Marchand, Amer Mirza, John Mayberry
Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29761277/treatment-of-differentiated-thyroid-cancer-can-endoscopic-thyroidectomy-via-a-chest-breast-approach-achieve-similar-therapeutic-effects-as-open-surgery
#12
Rui Qu, Jinyi Li, Jingge Yang, Peng Sun, Jian Gong, Cunchuan Wang
BACKGROUND: An analysis of some special factors was performed to further evaluate and discuss whether endoscopic surgery and traditional open surgery have similar therapeutic outcomes for differentiated thyroid cancer (DTC). METHODS: A retrospective study was performed on 76 patients undergoing surgery to treat DTC. Forty patients were treated by endoscopic thyroidectomy via the chest-breast approach (endoscopic group) and thirty-six patients were treated by open surgery (open group)...
May 14, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29761112/takotsubo-cardiomyopathy-mimicking-stent-thrombosis-after-percutaneous-coronary-intervention
#13
Furqan Khattak, Muhammad Khalid, Ghulam Murtaza, Timir K Paul
Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a transient left ventricular dysfunction associated with stress (usually emotional) induced myocardial injury and stunning. It often presents as myocardial infarction on surface electrocardiogram (EKG). Diagnosis is made by coronary angiography, which rules out coronary artery disease and shows pathognomonic apical ballooning. In this article, we present a case of a 72-year-old woman who initially presented with an ST segment elevation myocardial infarction on EKG...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29759424/lung-ultrasound-findings-undetectable-by-chest-radiography-in-children-with-community-acquired-pneumonia
#14
Giulio Iorio, Maria Capasso, Salvatore Prisco, Giuseppe De Luca, Carlo Mancusi, Bruno Laganà, Maria Antonietta Piscopo, Vincenzo Comune
The purpose of our study was to evaluate any differences between lung ultrasonography and chest radiography (CR) images in children with a diagnosis of community-acquired pneumonia (CAP) and, if there are any, to analyze the reasons and possible clinical implications. We reviewed the medical records of patients admitted to the pediatric ward from January 2014 to December 2016 and selected only cases discharged with a diagnosis of CAP who had undergone performed lung ultrasound (LUS) and CR within 24 h of each other...
May 11, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29757356/developing-a-diagnostic-understanding-of-gerd-phenotypes-through-the-analysis-of-levels-of-mucosal-injury-immune-activation-and-psychological-comorbidity
#15
C Zhong, K Liu, K Wang, H Liu, H Su, J Wu, L Duan
Patients with gastroesophageal reflux disease (GERD) can present with typical or atypical symptoms. The aim of this study is to explore the underlying physiological and psychological mechanisms that lead to different symptomatic manifestations of GERD. A total of 238 patients diagnosed with GERD underwent gastroscopy, 24 h multichannel intraluminal impedance-pH (MII-pH) monitoring, and psychological assessment with questionnaires. Patient symptoms were used to classify GERD into phenotypes of typical reflux syndrome (TRS, n = 87), reflux chest pain syndrome (RCS, n = 98), and extraesophageal syndromes (EES, n = 53)...
May 10, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29755709/perioperative-management-of-sickle-cell-disease
#16
REVIEW
Kwame Ofori Adjepong, Folashade Otegbeye, Yaw Amoateng Adjepong
Over 30 million people worldwide have sickle cell disease (SCD). Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlusive (painful) crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include a careful review of the patient's known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and opioid use...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29753793/short-term-prognosis-of-myocardial-injury-type-1-and-type-2-myocardial-infarction-in-the-emergency-unit
#17
Alain Putot, Sophie Buet Derrida, Marianne Zeller, Aurélie Avondo, Patrick Ray, Patrick Manckoundia, Yves Cottin
BACKGROUND: Type 2 myocardial infarction and non-ischemic myocardial injury, corresponding to troponin elevation without atherothrombosis, are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles and short-term prognoses remain to be investigated. METHODS: Among all the patients admitted from January 2014 to December 2016 in a university hospital ED (n=33,669), those with elevated conventional troponin Ic (≥0...
May 10, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29750698/peri-operative-copeptin-concentrations-and-their-association-with-myocardial-injury-after-vascular-surgery-a-prospective-observational-cohort-study
#18
Firmin Kamber, Eckhard Mauermann, Esther Seeberger, Lorenz Guerke, Christian Mueller, Daniel Bolliger, Giovanna A L Lurati Buse
BACKGROUND: Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES: In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to pre-operative levels...
May 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29744222/chest-wall-stabilization-in-trauma-patients-why-when-and-how
#19
REVIEW
Jose Ribas Milanez de Campos, Thomas W White
Blunt trauma to the chest wall and rib fractures are remarkably frequent and are the basis of considerable morbidity and possible mortality. Surgical remedies for highly displaced rib fractures, especially in cases of flail chest, have been undertaken intermittently for more than 50 years. Rib-specific plating systems have started to be used in the last 10 years. These have ushered in the modern era of rib repair with chest wall stabilization (CWS) techniques that are safer, easier to perform, and more efficient...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29739656/hip-dislocations-and-concurrent-injuries-in-motor-vehicle-collisions
#20
Joseph Cooper, Justin Tilan, Alexis D Rounds, Santano Rosario, Kenji Inaba, Geoffrey S Marecek
INTRODUCTION: Motor Vehicle Collisions (MVC) can cause high energy hip dislocations associated with serious injury profiles impacting triage. Changes in safety and regulation of restraint devices have likely lowered serious injuries from what was previously reported in the 1990s. This study aims to describe modern-day injury profile of patients with traumatic hip dislocations, with special attention to aortic injury. METHODS: Retrospective review of a prospectively maintained trauma database at an urban level 1 trauma center was conducted...
April 27, 2018: Injury
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