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https://www.readbyqxmd.com/read/28102701/the-effect-of-pre-crash-velocity-reduction-on-occupant-response-using-a-human-body-finite-element-model
#1
B Guleyupoglu, J Schap, K D Kusano, F S Gayzik
OBJECTIVE: The objective of this study is to use a validated finite element model of the human body and a certified model of an ATD to evaluate the effect of simulated pre-crash braking on driver kinematics, restraint loads, body loads and computed injury criteria in four commonly-injured body regions. METHODS: The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant (M50-O) and the Humanetics Hybrid-III 50(th) percentile models were gravity settled in the driver position of a generic interior equipped with an advanced three point belt and driver airbag...
January 19, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28099387/use-of-an-evidence-based-algorithm-for-patients-with-traumatic-hemothorax-reduces-need-for-additional-interventions
#2
Bradley M Dennis, Stephen P Gondek, Richard A Guyer, Susan E Hamblin, Oliver L Gunter, Oscar D Guillamondegui
BACKGROUND: Concerted management of the traumatic hemothorax is ill-defined. Surgical management of specific hemothoraces may be beneficial. A comprehensive strategy to delineate appropriate patients for additional procedures does not exist. We developed an evidence-based algorithm for hemothorax management. We hypothesize the use of this algorithm will decrease additional interventions. METHODS: A pre/post study was performed on all patients admitted to our trauma service with traumatic hemothorax from August 2010 to September 2013...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28097236/lung-vaso-occlusion-in-sickle-cell-disease-mediated-by-arteriolar-neutrophil-platelet-microemboli
#3
Margaret F Bennewitz, Maritza A Jimenez, Ravi Vats, Egemen Tutuncuoglu, Jude Jonassaint, Gregory J Kato, Mark T Gladwin, Prithu Sundd
In patients with sickle cell disease (SCD), the polymerization of intraerythrocytic hemoglobin S promotes downstream vaso-occlusive events in the microvasculature. While vaso-occlusion is known to occur in the lung, often in the context of systemic vaso-occlusive crisis and the acute chest syndrome, the pathophysiological mechanisms that incite lung injury are unknown. We used intravital microscopy of the lung in transgenic humanized SCD mice to monitor acute vaso-occlusive events following an acute dose of systemic lipopolysaccharide sufficient to trigger events in SCD but not control mice...
January 12, 2017: JCI Insight
https://www.readbyqxmd.com/read/28090817/coronary-or-ventricular-rupture-after-blunt-chest-trauma-a-clinical-dilemma
#4
Anton Sabashnikov, Guido Michels, Javid Fatullayev, Kaveh Eghbalzadeh, Mohamed Zeriouh, Stephan Baldus, Jens Wippermann, Thorsten Wahlers, Navid Madershahian
Cardiac rupture (CR) is one of the most serious and life-threatening complications of blunt chest trauma (BCT) usually associated with high mortality. Moreover, its diagnosis and treatment strategies may be extremely challenging for clinicians due to various anatomical localisations of the tear. Whereas most injuries fall under the category of right atrial ruptures, left ventricular lesions represent a rare type of this injury, with greater mortality, particularly in cases of multi-chamber injuries. However, not only cardiac chamber or great vessel ruptures may occur as a result of BCT; a growing number of reports also describe BCT-induced isolated coronary artery injuries, including ruptures...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28087110/systematic-review-and-meta-analysis-of-randomized-controlled-trials-assessing-safety-and-efficacy-of-posterior-pericardial-drainage-in-patients-undergoing-heart-surgery
#5
Mirosław Gozdek, Wojciech Pawliszak, Wojciech Hagner, Paweł Zalewski, Janusz Kowalewski, Domenico Paparella, Thierry Carrel, Lech Anisimowicz, Mariusz Kowalewski
OBJECTIVES: To investigate the potential beneficial effects of posterior pericardial drainage in patients undergoing heart surgery. METHODS: Multiple online databases and relevant congress proceedings were screened for randomized controlled trials assessing the efficacy and safety of posterior pericardial drainage, defined as posterior pericardiotomy incision, chest tube to posterior pericardium, or both. Primary endpoint was in-hospital/30 days' cardiac tamponade...
December 19, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28079832/usefulness-of-low-dose-chest-ct-for-initial-evaluation-of-blunt-chest-trauma
#6
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/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#7
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#8
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28066906/causes-and-mechanisms-of-death-in-fatal-water-buffalo-attacks
#9
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/28062098/midshaft-clavicle-fractures-with-associated-ipsilateral-acromioclavicular-joint-dislocations-incidence-and-risk-factors
#10
Christina Ottomeyer, Benjamin C Taylor, Mark Isaacson, Lara Martinez, Pierce Ebaugh, Bruce G French
INTRODUCTION: Simultaneous ipsilateral clavicle and acromioclavicular (AC) joint injury have been infrequently reported in the literature at this time. The purpose of this study was to assess incidence as well as assess risk factors for this dual injury pattern. METHODS: We performed a retrospective review of a prospectively collected database (Level III evidence), evaluating 383 adult patients without previous shoulder girdle injury or trauma with a minimum 1-year follow-up who sustained a displaced diaphyseal clavicle fracture...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28060255/a-model-of-cardiac-remodeling-through-constriction-of-the-abdominal-aorta-in-rats
#11
Hui-Chun Ku, Shih-Yi Lee, Yuan-Kun Aden Wu, Kai-Chien Yang, Ming-Jai Su
Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and fluid retention. Changes in myocardial structure, electrical conduction, and energy metabolism develop with heart failure, leading to contractile dysfunction, increased risk of arrhythmias, and sudden death. Hypertensive heart disease is one of the key contributing factors of cardiac remodeling associated with heart failure. The most commonly-used animal model mimicking hypertensive heart disease is created via surgical interventions, such as by narrowing the aorta...
December 2, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28057790/novel-risk-markers-and-risk-assessments-for-cardiovascular-disease
#12
REVIEW
Mark R Thomas, Gregory Y H Lip
The use of risk markers has transformed cardiovascular medicine, exemplified by the routine assessment of troponin, for both diagnosis and assessment of prognosis in patients with chest pain. Clinical risk factors form the basis for risk assessment of cardiovascular disease and the addition of biochemical, cellular, and imaging parameters offers further refinement. Identifying novel risk factors may allow greater risk stratification and a steady, but gradual progression toward precision medicine. Indeed, the generation of data in this area of research is explosive and when combined with new technologies and techniques provides the potential for more refined, targeted approaches to cardiovascular medicine...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28054289/procalcitonin-is-a-poor-predictor-of-non-infectious-fever-in-the-neurocritical-care-unit
#13
Karin Halvorson, Sameer Shah, Corey Fehnel, Bradford Thompson, N Stevenson Potter, Mitchell Levy, Linda Wendell
BACKGROUND: Fever is a common occurrence in the Neurocritical Care Unit (NCCU). It is reported that up to 50 % of these fevers are associated with a non-infectious source. As this is a diagnosis of exclusion, a complete fever evaluation must be done to rule out infection. Procalcitonin (PCT) has been identified as a possible biomarker to distinguish infectious from non-infectious etiologies of fever. We hypothesized that PCT could be used as a predictor of infectious fever in febrile patients with intracranial hemorrhage admitted to the NCCU...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28052158/factors-associated-with-nontransfer-in-trauma-patients-meeting-american-college-of-surgeons-criteria-for-transfer-at-nontertiary-centers
#14
Quanhong Zhou, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
Importance: Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. Objective: To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. Design, Setting, and Participants: A retrospective cohort study was performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28049509/hyperbaric-oxygen-therapy-for-a-refractory-skin-ulcer-after-radical-mastectomy-and-radiation-therapy-a-case-report
#15
Mitsuhiro Enomoto, Kazuyoshi Yagishita, Kae Okuma, Takuya Oyaizu, Yasushi Kojima, Atsushi Okubo, Takuma Maeda, Satoko Miyamoto, Atsushi Okawa
BACKGROUND: Radiation therapy is performed as an adjuvant therapy when indicated following surgical resection of malignant tumors. However, radiation exposure induces acute or chronic dermatitis, depending on the radiation dose, interval, tissue volume, or irradiated area of the body. Radiation-induced skin ulcers and osteomyelitis of the underlying bone are intractable late-stage complications of radiation therapy, and often require reconstructive surgery to cover exposed tissue. Hyperbaric oxygen therapy has been suggested as a treatment for delayed radiation injury with soft tissue and bony necrosis...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28048337/we-fg-202-03-quantitative-ct-based-analysis-to-assess-lung-injury-following-proton-radiotherapy
#16
T Underwood, C Grassberger, H Willers, S MacDonald, R Jimenez, H Paganetti
PURPOSE: Relative to photon alternatives, the increased dose-conformity associated with proton therapy is expected to reduce the extent of radiation-induced lung toxicity. However, analysis of follow-up data is yet to be published in this area. In this study we retrospectively analyzed late-phase HU changes for proton therapy cohorts of chest wall and lung patients. METHODS: From our institution's register of patients treated using double-scattered protons, all chest wall and stereotactic lung cases (treated 2011-2012 and 2008-2014 respectively) were initially considered...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043994/long-term-results-following-emergency-stent-graft-repair-for-traumatic-rupture-of-the-aortic-isthmus%C3%A2
#17
Cecile Martin, Frederic Thony, Mathieu Rodiere, Pierre Bouzat, Pierre Lavagne, Michel Durand, Olivier Chavanon
OBJECTIVES: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. METHOD: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28035466/a-rare-postoperative-complication-of-anterior-lower-thoracic-instrumentation-diaphragmatic-laceration-with-hemothorax
#18
Yat Wa Wong, Jason Pui Yin Cheung, Keith Dip Kei Luk, Kenneth Man Chee Cheung
PURPOSE: To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column. METHODS: A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness. However, after a bout of coughing, there was sudden increase in chest drain output, hemodynamic instability and massive fluid collection in the right chest cavity...
December 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28031828/three-simultaneous-cases-of-hypersensitivity-pneumonitis-and-acute-lung-injury-caused-by-dichloromethane
#19
Kei Takamura, Takahiro Ogi, Makoto Yamamoto, Keisuke Kikuchi
Three middle-aged male patients were admitted to our hospital complaining of dry cough, dyspnoea, and fever. All three of them had cleaned a refrigerator at a Chinese noodle mill using paint remover containing dichloromethane (90%) the previous day. Chest X-rays revealed bilateral diffuse infiltrative shadows on the lungs. We performed transbronchial lung biopsies and bronchoalveolar lavage (BAL) via bronchoscopy for each patient. Bronchoalveolar lavage showed increased total cell count as well as lymphocyte and neutrophil fraction...
November 2016: Respirology Case Reports
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#20
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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