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Blunt cardiac injury

Liming Yu, Chongxi Fan, Zhi Li, Jian Zhang, Xiaodong Xue, Yinli Xu, Guolong Zhao, Yang Yang, Huishan Wang
Stress hyperglycemia is commonly observed in patients suffering from ischemic heart disease. It not only worsens cardiovascular prognosis but also attenuates the efficacies of various cardioprotective agents. This study aimed to investigate the protective effect of melatonin against myocardial ischemia-reperfusion (MI/R) injury in acute hyperglycemic state with a focus on Notch1/Hes1/Akt signaling and intracellular thioredoxin (Trx) system. Sprague-Dawley rats were subjected to MI/R surgery and high glucose (HG, 500 g/L) infusion (4 ml/kg/h) to induce temporary hyperglycemia...
October 18, 2016: Journal of Pineal Research
Natalie Behrle, Peter Dyke, Abdallah Dalabih
Motor vehicle accident is the most common cause of blunt cardiac injury (BCI) in children (85.3%) due to the height of the child in relation to proper restraints and the compliant pediatric rib cage (J Trauma. 1996;40:200-202). Trauma to the chest wall may lead to injury of the myocardium, resulting in myocardial contusion, ventricular septal defect (VSD), ventricular free wall rupture, or valve compromise (J Trauma. 1996;40; 200-202; Heart Lung. 2012;41:200-202; J Inj Violence Res. 2012;4:98-100). There are several proposed mechanisms for the formation of VSD after blunt chest trauma including rupture of ischemic myocardium related to the initial trauma and reopening of a spontaneously closed congenital VSD...
September 23, 2016: Pediatric Emergency Care
Rachel M Stanley, Michael D Johnson, Cheryl Vance, Lalit Bajaj, Lynn Babcock, Shireen Atabaki, Danny Thomas, Harold K Simon, Daniel M Cohen, Daniel Rubacalva, P David Adelson, Blake Bulloch, Alexander J Rogers, Prashant Mahajan, Jill Baren, Lois Lee, John Hoyle, Kimberly Quayle, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVES: In preparation for a clinical trial of therapeutic agents for children with moderate-to-severe blunt traumatic brain injuries (TBIs) in emergency departments (EDs), we conducted this feasibility study to 1) determine the number and clinical characteristics of eligible children, 2) determine the timing of patient and guardian arrival to the ED, and 3) describe the heterogeneity of TBIs on computed tomography (CT) scans. METHODS: We conducted a prospective observational study at 16 EDs of children ≤ 18 years of age presenting with blunt head trauma and Glasgow Coma Scale (GCS) scores of 3-12...
September 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Abdelaaty A Shahat, Mansour S Alsaid, Syed Rafatullah, Mohammed O Al-Sohaibani, Mohammad K Parvez, Mohammed S Al-Dosari, Vassiliki Exarchou, Luc Pieters
BACKGROUND: Consumption of plant-derived nutraceuticals and crude drugs in traditional medicine is widely believed to confer beneficial effects in thwarting the progression of cardiovascular diseases. Rhus tripartita (family Anacardiaceae) has been traditionally used to treat a wide range of ailments. METHODS: In the present study we investigated the protective effects of an alcoholic extract of the stem part of Rhus tripartita male genotype (RTSM) on experimentally induced myocardial injury in rats...
2016: BMC Complementary and Alternative Medicine
Maria S Altieri, Ibrahim Almasry, Tyler Jones, Christa McPhee, Jane E McCormack, Emily C Huang, Patricia Eckardt, Marc J Shapiro, Sarah Eckardt, James A Vosswinkel, Randeep S Jawa
BACKGROUND: The prevalence and outcomes of older trauma patients with implantable cardioverter defibrillators (ICDs) or permanent pacemakers (PPMs) is unknown. METHODS: The trauma registry at a regional trauma center was reviewed for blunt trauma patients, aged ≥ 60 years, admitted between 2007 and 2014. Medical records of cardiac devices patients were reviewed. RESULTS: Of 4,193 admissions, there were 146 ICD, 233 PPM, and 3,814 no device patients; median Injury Severity Score was 9...
August 4, 2016: American Journal of Surgery
Neha Garg, Kapil Dev Soni, Richa Aggarwal
BACKGROUND: Road traffic accident accounts for 70 % to 80 % of the blunt cardiac injury. The true incidence varies in the literature due to non-uniform criteria for diagnosis. CASE PRESENTATION: Here, we describe the case of a young male presenting after blunt chest injury and hemodynamic instability. Initially, the patient had frequent episodes of arrhythmias and hypotension due to cardiac injury per se. However, he was stabilized by day 2. Subsequently, patient developed cellulitis followed by septic shock and succumbed to cellulitis on day 5 of injury...
2016: Burns and trauma
Tobias Haltmeier, Elizabeth Benjamin, Stefano Siboni, Evren Dilektasli, Kenji Inaba, Demetrios Demetriades
PURPOSE: Prehospital endotracheal intubation (ETI) for traumatic brain injury (TBI) is a controversial issue. The aim of this study was to investigate the effect of prehospital ETI in patients with TBI. METHODS: Cohort-matched study using the US National Trauma Data Bank (NTDB) 2008-2012. Patients with isolated severe blunt TBI (AIS head ≥3, AIS chest/abdomen <3) and a field GCS ≤8 were extracted from NTDB. A 1:1 matching of patients with and without prehospital ETI was performed...
August 27, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Judith Bellapart, Catherine Abi-Fares, Kylie Cuthbertson, Kimble Dunster, Sara Diab, David G Platts, Christopher Raffel, Levon Gabrielian, Adrian Barnett, Jennifer Paratz, Rob Boots, John F Fraser
BACKGROUND: Cerebral microcirculation after head injury is heterogeneous and temporally variable. Regions at risk of infarction such as peri-contusional areas are vulnerable to anaemia. However, direct quantification of the cerebral microcirculation is clinically not feasible. This study describes a novel experimental head injury model correlating cerebral microcirculation with histopathology analysis. OBJECTIVE: To test the hypothesis that cerebral microcirculation at the ischaemic penumbrae is reduced over time when compared with non-injured regions...
August 26, 2016: Brain Injury: [BI]
Miriam Kalbitz, Jochen Pressmar, Johanna Stecher, Birte Weber, Manfred Weiss, Stephan Schwarz, Erich Miltner, Florian Gebhard, Markus Huber-Lang
BACKGROUND: The incidence of cardiac injury in immediate fatalities after blunt trauma remains underestimated, and reliable diagnostic strategies are still missing. Furthermore, clinical data concerning heart-specific troponin serum levels, injury severity score (ISS), catecholamine treatment and survival of patients on admission to the hospital have rarely been interrelated so far. Therefore, the object of the present study was to identify predictive parameters for mortality in the context of blunt cardiac injury...
August 8, 2016: World Journal of Surgery
Marco Chiarelli, Martino Gerosa, Angelo Guttadauro, Francesco Gabrielli, Giuseppe Vertemati, Massimo Cazzaniga, Luca Fumagalli, Matilde De Simone, Ugo Cioffi
BACKGROUND: The majority of patients with severe blunt chest trauma is successfully treated with supportive measures and thoracostomy tube; only few cases need urgent thoracotomy. Lung-sparing techniques are treatments of choice but major pulmonary resections are necessary in case of injuries involving hilar vessels or bronchi. Currently the mortality associated with pulmonary lobectomy performed for chest trauma is 40%. METHODS: Over a 2-year period [2013-2014], 210 patients with chest trauma were hospitalized at our Institution...
July 2016: Journal of Thoracic Disease
Jareer Heider Abu-Hmeidan, Arief Ismael Arrowaili, Raid Said Yousef, Sami Alasmari, Yasser M Kassim, Hamad Hamad Aldakhil Allah, Abdullah Mohammed Aljenaidel, Abdullah Abdulmohsen Alabdulqader, Muath Hamad Alrashed, Mulfi Ibrahim Alkhinjar, Nawwaf Rahi Al-Shammari
BACKGROUND: Blunt thoracic trauma can rarely result in coronary artery injury. Blunt trauma can result in occlusion of any of the coronary arteries or can lead to its rupture and bleeding. Traumatic coronary artery occlusion can lead to myocardial infarction, while its rupture and bleeding can result in hemopericardium and cardiac tamponade, and can be rapidly fatal. Survival after coronary artery rupture in blunt thoracic trauma is exceedingly rare. CASE PRESENTATION: We present a case of a young male who sustained a blunt thoracic trauma in a motor vehicle collision, that resulted in rupture of the left anterior descending (LAD) coronary artery and subsequent cardiac tamponade...
2016: Journal of Cardiothoracic Surgery
L Ressel, U Hetzel, E Ricci
Veterinary pathologists commonly encounter lesions of blunt trauma. The development of lesions is affected by the object's mass, velocity, size, shape, and angle of impact and by the plasticity and mobility of the impacted organ. Scrape, impact, and pattern abrasions cause localized epidermal loss and sometimes broken hairs and implanted foreign material. Contusions are best identified after reflecting the skin, and must be differentiated from coagulopathies and livor mortis. Lacerations-traumatic tissue tears-may have irregular margins, bridging by more resilient tissue, deviation of the wound tail, crushed hairs, and unilateral abrasion...
September 2016: Veterinary Pathology
Oğuz Karaca, Günhan Demir, Arda Özyüksel, Atıf Akçevin
Cardiac valve injury, a condition that can follow blunt thoracic trauma, has a wide range of clinical presentations, depending on the structures involved. Post-traumatic tricuspid regurgitation is relatively rare, caused by increase in intrathoracic pressure when the tricuspid valve leaflets close, leading to rupture of the chordae tendineae. A case of severe tricuspid regurgitation due to chordal rupture presenting with atrial flutter following a motorbike accident is described in the present report.
June 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Ling Gao, Yi-Chao Zhao, Yan Liang, Xian-Hua Lin, Ya-Jing Tan, Dan-Dan Wu, Xin-Zhu Li, Bo-Zhi Ye, Fan-Qi Kong, Jian-Zhong Sheng, He-Feng Huang
Diabetic pregnancy, with ever increasing prevalence, adversely affects embryogenesis and increases vasculometabolic disorder risks in adult offspring. However, it remains poorly understood whether maternal diabetes increases the offspring's susceptibility to heart injuries in adulthood. In this study, we observed that cardiac function and structure were comparable between adult offspring born to diabetic mice and their counterparts born to nondiabetic mice at baseline. However, in response to myocardial ischemia/reperfusion (MIR), diabetic mother offspring exhibited augmented infarct size, cardiac dysfunction, and myocardial apoptosis compared with control, in association with exaggerated activation of mitochondria- and endoplasmic reticulum (ER) stress-mediated apoptosis pathways and oxidative stress...
October 2016: Journal of Pineal Research
Ronnie N Mubang, W T Hillman Terzian, James Cipolla, Scott Keeney, John J Lukaszczyk, Stanislaw P Stawicki
Despite the frequent occurrence of blunt chest trauma, associated cardiac injuries are relatively rare. The most common presentation of blunt cardiac injury is benign arrhythmia (e.g., sinus tachycardia), followed in decreasing frequency by increasingly severe arrhythmias and finally physically evident injuries to the heart muscle, the conducting system, cardiac valves, and/or coronary vessels. Here we present an unusual case of a patient who sustained a right coronary artery dissection and associated acute myocardial infarction following a motor vehicle crash...
January 2016: Heart Views: the Official Journal of the Gulf Heart Association
Mehreen T Kisat, Asad Latif, Cheryl K Zogg, Elliott R Haut, Syed Nabeel Zafar, Zain G Hashmi, Tolulope A Oyetunji, Edward E Cornwell, Hasnain Zafar, Adil H Haider
BACKGROUND: Prolonged intensive care unit length of stay (ICU-LOS) is associated with high mortality for medical and surgical patients. Existing literature suggests that this may not be true for trauma patients. The objective of this study was to determine mortality associated with varying ICU-LOS among trauma patients and to assess for independent predictors of mortality. METHODS: Adult ICU patients (16-64 years) in the National Trauma Data Bank (2007-2012) were categorized by ICU-LOS: 1, 2-9, 10-40, and >40 days (determined based on inflection points)...
September 2016: Surgery
Alfonso Eirin, Behzad Ebrahimi, Soon Hyo Kwon, Justin A Fiala, Barbara J Williams, John R Woollard, Quan He, Ramech C Gupta, Hani N Sabbah, Y S Prakash, Stephen C Textor, Amir Lerman, Lilach O Lerman
BACKGROUND: Renovascular hypertension (RVH) impairs cardiac structure and left ventricular (LV) function, but whether mitochondrial injury is implicated in RVH-induced myocardial damage and dysfunction has not been defined. We hypothesized that cardiac remodeling in swine RVH is partly attributable to cardiac mitochondrial injury. METHODS AND RESULTS: After 12 weeks of hypercholesterolemic (HC)-RVH or control (n=14 each), pigs were treated for another 4 weeks with vehicle or with the mitochondrial-targeted peptide (MTP), Bendavia (0...
June 2016: Journal of the American Heart Association
Andrew S Williams, Mathieu Castonguay, Shawn K Murray
Blunt thoracic aortic injury (BTAI) resulting from cardiopulmonary resuscitation (CPR) is rarely reported and most reports are of aortic rupture. Clinical reports have also documented aortic dissection and intramural hematomas with sequential imaging showing the development of these aortic injuries after the administration of CPR, suggesting that non-transmural aortic injury may also result from CPR. We report partial separation of an aortic intimal atheromatous plaque as a component injury in a case with multiple complications of manual CPR...
May 30, 2016: International Journal of Legal Medicine
Jonathan M Powell, Emanuel Ebin, Steven Borzak, Anastasios Lymperopoulos, Charles H Hennekens
The hypothesis that paroxetine decreases morbidity and mortality in patients with heart failure (HF) is plausible but unproven. Basic research demonstrates that inhibition of G protein-coupled receptor kinase 2 (GRK2) both in vitro and in vivo in the myocardium may be beneficial. G protein-coupled receptor kinase 2 antagonism is purported to exert cardioprotective effects immediately following myocardial injury by blunting toxic overstimulation on a recently injured heart. In addition, chronic overexpression of GRK2 inhibits catecholamine induction of vital positive chronotropic and ionotropic effects required to preserve cardiac output leading to worsening of congestive HF...
May 24, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
Bellal Joseph, Kareem Ibraheem, Ansab A Haider, Narong Kulvatunyou, Andrew Tang, Terence O'Keeffe, Zachary M Bauman, Donald J Green, Rifat Latifi, Peter Rhee
BACKGROUND: Resuscitative thoracotomy (RT) has been the standard therapy in patients with acute arrest due to hemorrhagic shock. However; with the development of resuscitative endovascular balloon occlusion of the aorta (REBOA), its role as a potential adjunct to a highly morbid intervention like RT is being discussed. The aim of this study was to identify patients that most likely would have potentially benefitted from REBOA use based on autopsy findings. METHODS: We performed a four-year retrospective review of all RT performed at our Level I trauma center...
May 18, 2016: Journal of Trauma and Acute Care Surgery
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