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trauma thorax

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https://www.readbyqxmd.com/read/29146418/diagnostic-accuracy-of-the-extended-focused-abdominal-sonography-for-trauma-e-fast-performed-by-emergency-physicians-compared-to-computed-tomography
#1
Haldun Akoglu, Omer Faruk Celik, Ali Celik, Rabia Ergelen, Ozge Onur, Arzu Denizbasi
INTRODUCTION: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#2
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29120878/investigating-the-effects-of-under-triage-by-existing-major-incident-triage-tools
#3
James M Vassallo, Jason E Smith, Lee A Wallis
OBJECTIVES: Triage is a key principle in the effective management of a major incident. Its effectiveness is a balance between identifying those in need of life-saving intervention, and those triaged incorrectly as either needing/not needing life-saving intervention. The primary aim of this study was to report mortality in those under-triaged by existing major incident triage tools. Secondary aims were to report the ability of triage tools at identifying serious injury by body region (defined as the Abbreviated Injury Scale≥3)...
November 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29049240/the-thorax-trauma-severity-score-and-the-trauma-and-injury-severity-score-do-they-predict-in-hospital-mortality-in-patients-with-severe-thoracic-trauma-a-retrospective-cohort-study
#4
Seong Ho Moon, Jong Woo Kim, Joung Hun Byun, Sung Hwan Kim, Jun Young Choi, In Seok Jang, Chung Eun Lee, Jun Ho Yang, Dong Hun Kang, Ki Nyun Kim, Hyun Oh Park
Several scoring systems are commonly used to evaluate severity in patients with traumatic injuries. However, there is no generally accepted standard scoring system to assess the severity of thoracic trauma, specifically in patients who have sustained severe injuries. The present study aimed to evaluate the validity of the trauma and injury severity score (TRISS) and the thorax trauma severity score (TTSS) as predictors of in-hospital mortality in patients with severe thoracic trauma.We conducted a retrospective, consecutive review of the medical records of patients with severe thoracic trauma who were managed at our institution between January 2005 and December 2015...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019536/trauma-mechanism-predicts-the-frequency-and-the-severity-of-injuries-in-blunt-trauma-patients
#5
José Gustavo Parreira, Giovanna Zucchini Rondini, Cristiano Below, Giuliana Olivi Tanaka, Julia Nunes Pelluchi, Jacqueline Arantes-Perlingeiro, Silvia Cristine Soldá, José César Assef
OBJECTIVE: to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients. METHODS: retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL)...
July 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28988190/the-outcome-of-patients-in-traumatic-cardiac-arrest-presenting-to-deployed-military-medical-treatment-facilities-data-from-the-uk-joint-theatre-trauma-registry
#6
Ed B G Barnard, P A F Hunt, P E H Lewis, J E Smith
BACKGROUND: The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns. METHODS: A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken...
October 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28930098/bioimpedance-technology-for-detection-of-thoracic-injury
#7
Ruben Buendia, Stefan Candefjord, Benjamin Sanchez, Hans Granhed, Bengt-Arne Sjöqvist, Per Örtenwall, Eva-Corina Caragounis
OBJECTIVE: Thoracic trauma is one of the most common and lethal types of injury, causing over a quarter of traumatic deaths. Severe thoracic injuries are often occult and difficult to diagnose in the field. There is a need for a point-of-care diagnostic device for severe thoracic injuries in the prehospital setting. Electrical bioimpedance (EBI) is non-invasive, portable, rapid and easy to use technology that can provide objective and quantitative diagnostic information for the prehospital environment...
October 31, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28924833/rho-inhibiting-c2in-c3-fusion-toxin-inhibits-chemotactic-recruitment-of-human-monocytes-ex-vivo-and-in-mice-in-vivo
#8
Tobias Martin, Amelie Möglich, Ina Felix, Christina Förtsch, Anne Rittlinger, Annette Palmer, Stephanie Denk, Julian Schneider, Lena Notbohm, Mona Vogel, Hartmut Geiger, Stephan Paschke, Markus Huber-Lang, Holger Barth
Bacterial protein toxins became valuable molecular tools for the targeted modulation of cell functions in experimental pharmacology and attractive therapeutics because of their potent and specific mode of action in human cells. C2IN-C3lim, a recombinant fusion toxin (~50 kDa) of the Rho-inhibiting C3lim from Clostridium (C.) limosum and a non-toxic portion of the C. botulinum C2 toxin (C2IN), is selectively internalized into the cytosol of monocytic cells where C3lim specifically ADP-ribosylates Rho A and -B, thereby inhibiting Rho-mediated signaling...
September 18, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28910469/prehospital-administration-of-tranexamic-acid-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#9
Steven G Schauer, Michael D April, Jason F Naylor, Jonathan Wiese, Kathy L Ryan, Andrew D Fisher, Cord W Cunningham, Noah Mitchell, Mark A Antonacci
BACKGROUND: Tranexamic acid (TXA) was shown to reduce overall mortality and death secondary to hemorrhage in a large prospective study. This intervention is time sensitive. As such, the Tactical Combat Casualty Care (TCCC) guidelines recommend use of this low-cost, safe intervention among patients with possible hemorrhagic shock, penetrating trauma to the thorax or trunk, or extremity amputation. OBJECTIVE: Prehospital administration of TXA by ground forces in the Afghanistan combat theater is described...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28876665/spectrum-of-intentional-injuries-in-the-juvenile-population-treated-at-a-level-one-trauma-centre-a-south-african-perspective
#10
V M Meijering, S Edu, P Navsaria, A J Nicol, S Sobnach
BACKGROUND: South Africa has one of the most violent societies worldwide. The national homicide rate is 34 per 100 000; young males form the majority of this cohort. Comprehensive injury surveillance in low and middle-income countries is limited and there is paucity of data describing the epidemiology and outcomes of intentional injuries within the juvenile population. METHOD: Ethical approval was obtained for this study. The Electronic Trauma Health Registry (eTHR) Application of the Trauma Centre at Groote Schuur Hospital in Cape Town was interrogated over an 18-month period (April 2014 - December 2016) for all patients (aged 12-19 years) treated for non-accidental trauma...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28852456/a-rare-diaphragmatic-hernia-with-a-delayed-presentation-of-intestinal-symptoms-following-spleno-distal-pancreatectomy-a-case-report
#11
Giancarlo Pansini, Giovanni Pascale, Ilaria Pigato, Enzo Malvicini, Dario Andreotti, Annalisa Caruso, Rocco Stano, Savino Occhionorelli
Acquired diaphragmatic hernia, non-related to trauma, is a very rare condition. It can constitute a therapeutic problem and the surgical solution is not always immediately clear. We report the case of a 73-year-old woman with a history of spleno-distal pancreatectomy for a neuroendocrine tumour performed in 2009, who came back to Emergency Room 2 years later, complaining of abdominal pain. Chest radiography and computed tomography were performed; they showed a diaphragmatic hernia with visceral migration into the thorax...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28846569/effects-of-prior-psychosocial-trauma-on-subsequent-immune-response-after-experimental-thorax-trauma
#12
Dominik Langgartner, Annette Palmer, Anne Rittlinger, Stefan O Reber, Markus Huber-Lang
Overshooting inflammation during the early phase after blunt thorax trauma promotes the development of acute respiratory distress syndrome, multiple organ failure and subsequent mortality. Given that individuals diagnosed with stress-related disorders are characterized by chronic low-grade inflammation, we hypothesize that "psychosocial traumatic preload" poses a risk factor for the above mentioned complications following thorax trauma.Here, we employed the chronic subordinate colony housing (CSC) paradigm to induce "psychosocial traumatic preload" and systemic low-grade immune activation in male mice, indicated by elevated plasma concentrations of different inflammatory mediators...
August 25, 2017: Shock
https://www.readbyqxmd.com/read/28838022/-characteristics-and-treatment-strategies-for-penetrating-injuries-on-the-example-of-gunshot-and-blast-victims-without-ballistic-body-armour-in-afghanistan-2009%C3%A2-%C3%A2-2013
#13
Christoph Güsgen, Arnulf Willms, Ines Richardsen, Dan Bieler, Erwin Kollig, Robert Schwab
Much like other countries, Germany has recently seen terrorist attacks being planned, executed or prevented at the last minute. This highlights the need for expertise in the treatment of penetrating torso traumas by bullets or explosions. Data on the treatment of firearm injuries and, even more so, blast injuries often stems from crises or war regions. However, it is difficult to compare injuries from such regions with injuries from civilian terrorist attacks due to the ballistic body protection (protective vests, body armour) worn by soldiers...
August 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#14
B Mühling
In most cases blunt chest trauma leads to fractures of the bony thorax, i. e. ribs. In the case of accompanying hemothorax or pneumothorax initial management consists of chest tube drainage by mini-thoracotomy. Subsequently patients with blunt chest trauma have to be transferred to the intensive care unit as these patients are at risk of pulmonary insufficiency or persistent blood loss via the chest tube. Injury to the great vessels or heart requires trauma care in specialized centers. Penetrating trauma is always surgically treated and the foreign body is removed in the operating room (OR)...
September 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28743338/-clinical-characteristics-and-prognosis-in-patients-with-high-plasma-level-of-procalcitonin-an-analysis-in-188-patients
#15
Chuli Pan, Wei Cui, Feifei Zhou, Junwei Tu, Xiuhui Lin, Libin Li, Gensheng Zhang
OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. METHODS: A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28717556/thorax-computed-tomography-findings-in-patients-with-erectile-dysfunction
#16
Mustafa Resorlu, Muhammet Arslan, Ozan Karatag, Gurhan Adam
OBJECTIVE: Diabetes mellitus, smoking, dyslipidemia, and obesity play an important role in the etiology of erectile dysfunction, particularly in cases with vascular insufficiency. These risk factors also target the lungs due to their systemic effects. MATERIALS AND METHODS: Patients with penile vascular insufficiency determined at Doppler ultrasonography and undergoing thoracic computerized tomography for various reasons were included in this study. A history of acute thoracic trauma, pneumonic consolidation, or pelvic surgery and trauma were regarded as exclusion criteria...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28693640/all-terrain-vehicle-related-injuries-and-deaths-in-newfoundland-and-labrador-between-2003-and-2013-a-retrospective-trauma-registry-review
#17
Holly Black, Desmond Whalen, Sabrina Alani, Peter Rogers, Cathy MacLean
BACKGROUND: Injury and death involving all-terrain vehicles (ATV) has been reported in a number of Canadian provinces. The objective of this study is to describe the frequency, nature, severity, population affected, immediate health costs, efficacy of related legislation, and helmet use in ATV related injuries and deaths in Newfoundland and Labrador (NL). METHODS: A retrospective review of injured or deceased ATV riders of all ages entered in the Newfoundland and Labrador Trauma Registry from 2003 to 2013 was conducted...
July 11, 2017: CJEM
https://www.readbyqxmd.com/read/28660136/sternal-metastasis-the-forgotten-column-and-its-effect-on-thoracic-spine-stability
#18
REVIEW
Robert Pearse Piggott, Mark Curtin, Sudarshan Munigangaiah, Mutaz Jadaan, John Patrick McCabe, Aiden Devitt
Sternal metastases are not studied extensively in the literature. There is a paucity of information on their role in metastatic disease. The concept of the fourth column was described by Berg in 1993, and has been proven in case report, clinically and biomechanical studies. The role of the sternum as a support to the thoracic spine is well documented in the trauma patients, but not much is known about its role in cancer patients. This review examines what is known on the role of the fourth column. Following this we have identified two likely scenarios that sternal metastases may impact management: (1) sternal pathological fracture increases the mobility of the semi-rigid thorax with the loss of the biomechanical support of the sternum-rib-thoracic spine complex; and (2) a sternal metastasis increases the risk of fracture, and while being medical treated the thoracic spine should be monitored for acute kyphosis and neurological injury secondarily to the insufficiency of the fourth column...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28659674/blunt-diaphragmatic-injuries-pericardial-ruptures
#19
Tevrat Özalp, Mustafa Küpeli, Yaşar Sönmezoğlu, Abdülkadir Çakmak, Siraç Akgül, Mithat Fazlioğlu, Cevdet Tokat
Blunt traumatic diaphragmatic injuries (BTDIs) can be misdiagnosed. Careful evaluation of associated injuries in BTDI is important. In this study, we evaluated treatment options and difficulties in the diagnosis of patients with BTDI. We evaluated ten patients retrospectively with BTDI admitted to our departments, between January 2004 and 2015. Age, gender, trauma type, symptoms, radiological findings, diagnosis time, location and grade of the diaphragmatic injury, surgical type of repair, associated injuries and pericardial rupture, and morbidity and mortality rates were recorded...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#20
COMPARATIVE STUDY
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
September 2017: Annals of Surgery
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