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Thoracic Injury

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https://www.readbyqxmd.com/read/28434767/extrarenal-rhabdoid-tumor-presented-with-an-immobile-arm-in-a-one-year-old-boy
#1
Chi-Ting Chung, Yen-Lin Liu, Chien-Jui Cheng, Kevin Li-Chun Hsieh, Min-Lan Tsai, Tai-Tong Wong
Infants with an immobile arm may be easily overlooked in primary care settings. Differential diagnoses include injuries, infections, neuropathies, ischemia and rarely, neoplasms. We report the case of a one-year-old boy with weakness in his left arm after minor trauma with a diagnosis of brachial plexus palsy initially. After rehabilitation for 2months, his weakness progressed to unsteady gait and quadriparesis. MRI revealed a huge solid tumor in the left supraclavicular fossa, which also involved the left brachial plexus, upper thoracic cavity, and left paravertebral space with invasion into the spinal canal...
April 20, 2017: Brain & Development
https://www.readbyqxmd.com/read/28434550/renal-failure-after-cardiac-operations-not-all-acute-kidney-injury-is-the-same
#2
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Shin-Rong Lee, Alejandro Suarez-Pierre, David Lehenbauer, Christopher M Sciortino, Robert S Higgins, Duke E Cameron, John V Conte, Glenn J Whitman
BACKGROUND: The Society of Thoracic Surgeons (STS) database does not distinguish between a decline in creatinine clearance vs new hemodialysis (HD) when qualifying acute renal failure (ARF) after a cardiac operation. We hypothesized that patients requiring HD experience significantly greater postoperative morbidity and death. METHODS: We included all patients who underwent STS index cardiac operations at our institution from 2008 to March 2015 and did not have preexisting renal failure (creatinine >4...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433355/the-no-touch-saphenous-vein-graft-in-elderly-coronary-bypass-patients-with-multiple-comorbidities-is-a-promising-conduit-to-substitute-the-left-internal-thoracic-artery
#3
Ninos Samano, Håkan Geijer, Lennart Bodin, Mikael Arbeus, John D Mannion, Michael Dashwood, Domingos Souza
OBJECTIVES: We investigated the patency rates of no-touch saphenous vein grafts anastomosed to the left anterior descending artery compared with the left internal thoracic artery. Further, we compared the patency of no-touch vein grafts to the left anterior descending artery with the patency of no-touch vein grafts to other coronary arteries. METHODS: Of 2635 consecutive patients undergoing coronary artery bypass grafting between 2003 and 2008, 168 (6.3%) were given at least a saphenous vein graft to the left anterior descending artery to avoid harvesting complications in high-risk patients or in response to a left internal thoracic artery injury...
March 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#4
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#5
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#6
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429535/a-cross-circulated-bicephalic-model-of-head-transplantation
#7
Peng-Wei Li, Xin Zhao, Yun-Long Zhao, Bing-Jian Wang, Yang Song, Zi-Long Shen, Hong-Jun Jiang, Hai Jin, Sergio Canavero, Xiao-Ping Ren
AIMS: A successful cephalosomatic anastomosis ("head transplant") requires, among others, the ability to control long-term immune rejection and avoidance of ischemic events during the head transference phase. We developed a bicephalic model of head transplantation to study these aspects. METHODS AND RESULTS: The thoracic aorta and superior vena cava of a donor rat were anastomosed with the carotid artery and extracorporeal veins of a recipient rat by vascular grafts...
April 21, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28429082/the-effect-of-a-combined-thoracic-and-soft-tissue-trauma-on-blood-flow-and-tissue-formation-in-fracture-healing-in-rats
#8
Lutz Claes, Florian Gebhard, Anita Ignatius, Raimund Lechner, Stefan Baumgärtel, Michael Kraus, Gert D Krischak
INTRODUCTION: Previously, it was found that fracture healing is impaired by blunt chest trauma and an additional soft-tissue trauma. The mechanisms leading to this disturbance are largely unknown. Here, we investigated the effect of thoracic and soft-tissue trauma on blood flow of the injured lower leg and on tissue differentiation and callus formation during fracture healing. MATERIALS AND METHODS: Male Wistar rats received either a mid-shaft fracture of the tibia alone (group A), an additional chest trauma (group B), or additional chest and soft-tissue traumas (group C)...
April 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#9
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28422918/reassessing-the-cardiac-box-a-comprehensive-evaluation-of-the-relationship-between-thoracic-gunshot-wounds-and-cardiac-injury
#10
Rashi Jhunjhunwala, Michael J Mina, Elizabeth I Roger, Christopher J Dente, Michael Heninger, Jacquelyn S Carr, Stacy D Dougherty, Rondi B Gelbard, Jeffrey M Nicholas, Amy D Wyrzykowski, David V Feliciano, Bryan C Morse
BACKGROUND: High energy missiles can cause cardiac injury regardless of entrance site. This study assesses the adequacy of the anatomic borders of the current "cardiac box" to predict cardiac injury. METHODS: Retrospective autopsy review was performed to identify patients with penetrating torso gunshot wounds 2011-2013. Using a circumferential grid system around the thorax, logistic regression analysis was performed to detect differences in rates of cardiac injury from entrance/exit wounds in the "cardiac box" vs...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28418689/an-official-american-thoracic-society-workshop-report-chemical-inhalational-disasters-biology-of-lung-injury-development-of-novel-therapeutics-and-medical-preparedness
#11
Eleanor M Summerhill, Gary W Hoyle, Sven-Eric Jordt, Bronwen J Jugg, James G Martin, Sadis Matalon, Steven E Patterson, David J Prezant, Alfred M Sciuto, Erik R Svendsen, Carl W White, Livia A Veress
This report is based upon the proceedings from the Inhalational Lung Injury Workshop jointly sponsored by the American Thoracic Society (ATS) and the National Institute of Health (NIH)/National Institute of Neurologic Disorders and Stroke (NINDS) Countermeasures Against Chemical Threats (CounterACT) program on May 21, 2013 in Philadelphia, PA. The CounterACT program facilitates research leading to the development of new and improved medical countermeasures for chemical threat agents. The workshop was initiated by the Terrorism and Inhalational Disasters (TID) Section of the Environmental, Occupational, and Population Health Assembly (EOPH) of the ATS...
April 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28418395/an-analysis-of-ideal-and-actual-time-to-surgery-after-traumatic-spinal-cord-injury-in-canada
#12
R A Glennie, C S Bailey, E C Tsai, V K Noonan, C S Rivers, D R Fourney, H Ahn, B K Kwon, J Paquet, B Drew, M G Fehlings, N Attabib, S D Christie, J Finkelstein, R J Hurlbert, S Parent, M F Dvorak
STUDY DESIGN: Retrospective analysis of a prospective registry and surgeon survey. OBJECTIVES: To identify surgeon opinion on ideal practice regarding the timing of decompression/stabilization for spinal cord injury and actual practice. Discrepancies in surgical timing and barriers to ideal timing of surgery were explored. SETTING: Canada. METHODS: Patients from the Rick Hansen Spinal Cord Registry (RHSCIR, 2004-2014) were reviewed to determine actual timing of surgical management...
April 18, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28417251/irreversible-electroporation-for-the-treatment-of-rabbit-vx2-breast-cancer
#13
Wenlong Zhang, Wei Chai, Jianying Zeng, Jibing Chen, Liqi Bi, Lizhi Niu
Irreversible electroporation (IRE) is considered predominantly as a non-thermal ablative technique that uses electrical fields to permeabilize cell membranes and lead to cell death. In this study, we evaluated the efficacy of IRE in the rabbit VX2 breast cancer model. Thirty-five female New Zealand white rabbits were inoculated against VX2 breast cancer cells. The rabbits were randomly divided into two groups: a control group of 15 rabbits and an IRE treatment group of 20 rabbits. Treatment and treatment outcome were evaluated by computerized tomography (CT) scan (plain or contrast enhanced), tumor growth curves and pathological examination including H&E, TUNEL, PCNA and CD31 staining...
June 2017: Biomedical Microdevices
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#14
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28415830/triptolide-mitigates-radiation-induced-pneumonitis-via-inhibition-of-alveolar-macrophages-and-related-inflammatory-molecules
#15
Chun Chen, Shanmin Yang, Mei Zhang, Zhenhuan Zhang, Steven B Zhang, Bing Wu, Jinsheng Hong, Weijian Zhang, Jianhua Lin, Paul Okunieff, Lurong Zhang
Ionizing radiation-induced pulmonary injury is a major limitation of radiotherapy for thoracic tumors. We have demonstrated that triptolide (TPL) could alleviate IR-induced pneumonia and pulmonary fibrosis. In this study, we explored the underlying mechanism by which TPL mitigates the effects of radiotoxicity. The results showed that:(1) Alveolar macrophages (AMs) were the primary inflammatory cells infiltrating irradiated lung tissues and were maintained at a high level for at least 17 days, which TPL could reduce by inhibiting of the production of macrophage inflammatory protein-2 (MIP-2) and its receptor CXCR2...
March 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411737/neck-posture-during-lifting-and-its-effect-on-trunk-muscle-activation-and-lumbar-spine-posture
#16
Thomas M Hlavenka, Vanessa F K Christner, Diane E Gregory
Neck and head posture have been found to have a significant influence on the posture of the lower spine region during lifting and both an extended/upward gaze and a flexed/downward gaze have been hypothesized to lead to increased pain and/or overuse of the neck musculature. As a result, strength training recommendations have turned to the use of a retracted neck posture as being the safer posture to assume during lifting. This study examined trunk and neck muscle activity and lumbar spine posture in seven participants while performing moderate load lifts using a retracted neck posture (chin drawn in posteriorly; recently gaining popularity among coaches, trainers, and physical therapists to reduce neck pain during lifting, and freestyle neck posture (no instructions given)...
July 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28402091/thoracic-trauma-and-acute-respiratory-distress-syndrome-in-polytraumatized-patients-admitted-to-a-level-i-trauma-center-a-retrospective-analysis
#17
Thomas Haider, Gabriel Halat, Thomas Heinz, Stefan Hajdu, Lukas L Negrin
BACKGROUND: Although thoracic trauma has often been associated with the development of ARDS in general, its impact on ARDS in combination with severe concomitant injuries has still to be elucidated. Therefore, the objective of this study was to determine the frequency of thoracic trauma and ARDS in polytraumatized patients, and to evaluate the impact of thoracic trauma on the occurrence and the onset of ARDS. METHODS: Included in this retrospective cohort study were all polytraumatized patients over 18 years of age, with an injury severity score (ISS) of at least 16, who were admitted to our level I trauma center over a three-year time period...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28400726/review-of-epidural-spinal-cord-stimulation-for-augmenting-cough-after-spinal-cord-injury
#18
REVIEW
Jan T Hachmann, Jonathan S Calvert, Peter J Grahn, Dina I Drubach, Kendall H Lee, Igor A Lavrov
Spinal cord injury (SCI) remains a debilitating condition for which there is no cure. In addition to loss of somatic sensorimotor functions, SCI is also commonly associated with impairment of autonomic function. Importantly, cough dysfunction due to paralysis of expiratory muscles in combination with respiratory insufficiency can render affected individuals vulnerable to respiratory morbidity. Failure to clear sputum can aggravate both risk for and severity of respiratory infections, accounting for frequent hospitalizations and even mortality...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#19
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28399877/overground-vs-treadmill-based-robotic-gait-training-to-improve-seated-balance-in-people-with-motor-complete-spinal-cord-injury-a-case-report
#20
Amanda E Chisholm, Raed A Alamro, Alison M M Williams, Tania Lam
BACKGROUND: Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI)...
April 11, 2017: Journal of Neuroengineering and Rehabilitation
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