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Thoracic Injury

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https://www.readbyqxmd.com/read/29447771/topographical-distribution-of-perioperative-cerebral-infarction-associated-with-transcatheter-aortic-valve-implantation
#1
Jonathon P Fanning, Allan J Wesley, Darren L Walters, Andrew A Wong, Adrian G Barnett, Wendy E Strugnell, David G Platts, John F Fraser
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is associated with a high incidence of cerebrovascular injury. As these injuries are thought to be primarily embolic, neuroprotection strategies have focused on embolic protection devices. However, the topographical distribution of cerebral emboli and how this impacts on the effectiveness of these devices have not been thoroughly assessed. Here, we evaluated the anatomical characteristics of magnetic resonance imaging (MRI)-defined cerebral ischemic lesions occurring secondary to TAVI to enhance our understanding of the distribution of cardioembolic phenomena...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447489/compulsory-use-of-the-backboard-is-associated-with-increased-frequency-of-thoracolumbar-imaging
#2
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29445946/paravertebral-tumours-of-the-cervicothoracic-junction-extending-into-the-mediastinum-surgical-strategies-in-a-no-man-s-land
#3
Georgios K Prezerakos, Parag Sayal, Antonios Kourliouros, Periclis Pericleous, George Ladas, Adrian Casey
PURPOSE: Cervicothoracic paravertebral neoplasms extending into the mediastinum pose a surgical challenge due the complex regional anatomy, their biological nature, rarity and surgeon's unfamiliarity with the region. We aim to define a surgical access framework addressing the aforementioned complexities whilst achieving oncological clearance. METHODS: We carried out a retrospective review of 28 consecutive patients operated in two tertiary referral centres between 1998 and 2015...
February 14, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29445598/small-incisions-major-complications-video-assisted-thoracoscopic-surgery-management-of-intraoperative-complications
#4
William Grossi, Gianluca Masullo, Francesco Londero, Angelo Morelli
The object of our study is to show the causes leading to conversion, in order to observe the responsible variables and analyses if conversion influences the patient's outcome. Between January 2013 and December 2016, Udine Thoracic Department performed 180 video-assisted thoracoscopic surgery (VATS) lobectomies, and 24 cases were converted to thoracotomy due to an intra-operative complication such as arterial or venous bleeding, airway and other injuries. The VATS lobectomies' number increased over the three years: from 27 in 2013 to 55 in 2015 and 48 in 2016...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29445509/a-case-of-paraplegia-that-developed-6-years-after-thoracic-endovascular-aortic-repair-for-blunt-traumatic-aortic-injury
#5
Hiroyuki Takahashi, Tomohisa Shoko, Fumino Taketazu, Keiichi Kuriyama, Kazuhide Yoshikawa, Yoshizumi Deguchi
Case: Thoracic endovascular aortic repair (TEVAR) is becoming the standard therapy for blunt thoracic aortic injury (BTAI). However, the long-term outcomes of TEVAR for BTAI remain unclear. A 36-year-old man was admitted to our emergency department with dyspnea. He had been involved in a serious traffic accident 6 years earlier, requiring TEVAR for BTAI. Outcome: Acute heart failure and pneumonia were diagnosed on this admission. His respiratory condition improved, but paraplegia developed 10 h after hospitalization...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29445240/high-fat-diet-induced-metabolically-obese-and-normal-weight-rabbit-model-shows-early-vascular-dysfunction-mechanisms-involved
#6
Gabriela Alarcon, Julieta Roco, Mirta Medina, Analia Medina, Maria Peral, Susana Jerez
BACKGROUND: Obesity contributes significantly to the development and evolution of cardiovascular disease (CVD) which is believed to be mediated by oxidative stress, inflammation and endothelial dysfunction. However, the vascular health of metabolically obese and normal weight (MONW) individuals is not completely comprehended. OBJECTIVES: The purpose of our study was to evaluate vascular function on the basis of a high fat diet (HFD)-MONW rabbit model. SUBJECTS: Twenty four male rabbits were randomly assigned to receive either a regular diet (CD, n = 12) or a high-fat diet (18% extra fat on the regular diet, HFD, n = 12) for 6 weeks...
January 30, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29441442/internal-patterned-injuries-in-trauma
#7
Lucia Tattoli, Michael Tsokos, Claas Buschmann
Patterned bruising of the internal organs is unusual. In these cases a cutaneous pattern of bruising is not observed but the underlying tissue may show unusual injuries that may even be recognizable as a tramline pattern. We report the suicide of a 23-year-old man by jumping off a bridge. At autopsy, an unusual finding was "tramline" bruising of the right liver lobe. The "blunt objects" that inflicted the bruising were determined to be the right ribs which were pushed against the liver capsule as a consequence of the extensive thoracic and vertebral trauma after a fall from a height with intermediate impact...
February 13, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29440235/do-patients-with-blunt-thoracic-aortic-injury-present-to-hospital-with-unstable-vital-signs-a-systematic-review-and-meta-analysis
#8
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
February 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29438587/managing-penetrating-renal-trauma-experience-from-two-uk-major-trauma-centres
#9
Marios Hadjipavlou, Edmund Grouse, Robert Gray, Denosshan Sri, Dean Huang, Christian Brown, Davendra Sharma
OBJECTIVES: To present our series of patients with penetrating renal trauma from two urban major trauma centres and discuss contemporary management of these injuries. METHODS: We reviewed prospective urological trauma databases for all patients presenting with penetrating renal trauma between January 2005 and October 2016. Patient demographics, clinical characteristics, imaging, management and follow-up data were analysed. RESULTS: Over the 11 year period, 63 patients presented with penetrating renal injuries...
February 13, 2018: BJU International
https://www.readbyqxmd.com/read/29438332/diaphragmatic-palsy
#10
REVIEW
Laxmi Kokatnur, Mohan Rudrappa
The diaphragm is the primary muscle of respiration, and its weakness can lead to respiratory failure. Diaphragmatic palsy can be caused by various causes. Injury to the phrenic nerve during thoracic surgeries is the most common cause for diaphragmatic palsy. Depending on the cause, the symptoms of diaphragmatic palsies vary from completely asymptomatic to disabling dyspnea requiring mechanical ventilation. On pulmonary function tests, there will be a decrease in the maximum respiratory muscle power. Spirometry shows reduced lung functions and a significant drop of lung function in supine position is typical of diaphragmatic palsy...
February 13, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29434464/arm-cycling-combined-with-passive-leg-cycling-enhances-vo2peak-in-persons-with-spinal-cord-injury-above-the-sixth-thoracic-vertebra
#11
Tom Tørhaug, Berit Brurok, Jan Hoff, Jan Helgerud, Gunnar Leivseth
Objective: To test whether passive leg cycling (PLC) during arm cycling ergometry (ACE) affects peak oxygen uptake (VO2peak) differently in individuals with spinal cord injury (SCI) at/above the 6th thoracic vertebra (T6) and below T6. Methods: We conducted a cross-sectional study, analyzed by univariate and multivariate regression models. Between- and within-group differences were examined during (a) ACE only, (b) ACE combined with PLC (ACE-PLC), and (c) ACE combined with functional electrical stimulation cycling (FES hybrid)...
2018: Topics in Spinal Cord Injury Rehabilitation
https://www.readbyqxmd.com/read/29432301/adenovirus-delivered-gfp-ho-1c-increment-23-attenuates-blood-spinal-cord-barrier-permeability-after-rat-spinal-cord-contusion
#12
Sheng Chang, Yunlong Bi, Xiangwei Meng, Lin Qu, Yang Cao
The blood-spinal cord barrier (BSCB) plays a key role in maintaining the microenvironment and is primarily composed of tight junction proteins and nonfenestrated capillary endothelial cells. After injury, BSCB damage results in increasing capillary permeability and release of inflammatory factors. Recent studies have reported that haem oxygenase-1 (HO-1) fragments lacking 23 amino acids at the C-terminus (HO-1C[INCREMENT]23) exert novel anti-inflammatory and antioxidative effects in vitro. However, no study has identified the role of HO-1C[INCREMENT]23 in vivo...
February 9, 2018: Neuroreport
https://www.readbyqxmd.com/read/29431856/cerebral-embolization-silent-cerebral-infarction-and-neurocognitive-decline-after-thoracic-endovascular-aortic-repair
#13
A H Perera, N Rudarakanchana, L Monzon, C D Bicknell, B Modarai, O Kirmi, T Athanasiou, M Hamady, R G Gibbs
BACKGROUND: Silent cerebral infarction is brain injury detected incidentally on imaging; it can be associated with cognitive decline and future stroke. This study investigated cerebral embolization, silent cerebral infarction and neurocognitive decline following thoracic endovascular aortic repair (TEVAR). METHODS: Patients undergoing elective or emergency TEVAR at Imperial College Healthcare NHS Trust and Guy's and St Thomas' NHS Foundation Trust between January 2012 and April 2015 were recruited...
February 12, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29428293/impact-of-spine-alignment-on-the-rotator-cuff-in-long-term-wheelchair-users
#14
Yasser Kentar, Manuela Brunner, Thomas Bruckner, Andreas Hug, Patric Raiss, Felix Zeifang, Markus Loew, Haidara Almansour, Michael Akbar
BACKGROUND: We investigated the impact of poor seated posture on the prevalence of rotator cuff tears (RCTs) among wheelchair-dependent individuals with long-standing paraplegia. METHODS: The study included 319 patients. Lateral radiographs of the spine were collected from a database and analyzed to assess the global spinopelvic alignment (SPA). Magnetic resonance images of both shoulders were obtained to detect the presence of cuff tears. Patients were divided into 2 groups: Group RCT-I included all patients with cuff tears (right, left, or bilateral), whereas group RCT-II consisted exclusively of patients with bilateral cuff tears...
February 8, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29428212/computed-tomography-window-blending-feasibility-in-thoracic-trauma
#15
Jacob C Mandell, Jeremy R Wortman, Tatiana C Rocha, Les R Folio, Katherine P Andriole, Bharti Khurana
RATIONALE AND OBJECTIVES: This study aims to demonstrate the feasibility of processing computed tomography (CT) images with a custom window blending algorithm that combines soft-tissue, bone, and lung window settings into a single image; to compare the time for interpretation of chest CT for thoracic trauma with window blending and conventional window settings; and to assess diagnostic performance of both techniques. MATERIALS AND METHODS: Adobe Photoshop was scripted to process axial DICOM images from retrospective contrast-enhanced chest CTs performed for trauma with a window-blending algorithm...
February 7, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29428017/long-term-functional-outcomes-after-traumatic-thoracic-and-lumbar-spine-fractures
#16
Ashley P Marek, Jean Dominique Morancy, Jeffrey G Chipman, Rachel M Nygaard, Robert M Roach, Michele M Loor
The incidence of thoracolumbar spine fractures in blunt trauma is 4 to 5 per cent. These fractures may lead to neurologic injury, chronic back pain, and disability. Most studies from United States trauma centers focus on neurologic sequelae and/or compare treatment modalities. However, most patients with spine fractures do not have a neurologic deficit. Our primary objective was to determine the long-term outcome of traumatic thoracolumbar spine fractures, specifically addressing quality of life, chronic pain, and employment using a validated patient outcome survey...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29423312/epidemiological-profile-of-spinal-cord-injuries-at-a-tertiary-rehabilitation-center-in-kuwait
#17
L Prasad, S Al Kandari, U Ramachandran, D Shehab, S Alghunaim
Study design: Retrospective, descriptive study. Objective: To describe the epidemiological profile of patients with spinal cord injury (SCI) in Kuwait. Setting: Physical Medicine and Rehabilitation Hospital, Kuwait. Methods: Review of medical records of 241 adult patients with SCI admitted during the period 2010-2015. The data collected included gender, age, etiology, neurological and vertebral level of injury and American Spinal Injury Association impairment scale (AIS)...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29421694/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-resuscitative-thoracotomy-in-select-patients-with-hemorrhagic-shock-early-results-from-the-american-association-for-the-surgery-of-trauma-aortic-occlusion-in-resuscitation-for-trauma-and-acute-care
#18
Megan Brenner, Kenji Inaba, Alberto Aiolfi, Joseph DuBose, Timothy Fabian, Tiffany Bee, John B Holcomb, Laura Moore, David Skarupa, Thomas M Scalea
BACKGROUND: Aortic occlusion (AO) is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage. STUDY DESIGN: AAST AORTA registry identified trauma patients without penetrating thoracic injury undergoing AO at the level of the descending thoracic aorta (RT or Zone 1 REBOA) in the Emergency Department (ED). Survival outcomes relative to the timing of CPR need and admission hemodynamic status were examined...
February 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29420582/ethyl-pyruvate-ameliorates-hepatic-injury-following-blunt-chest-trauma-and-hemorrhagic-shock-by-reducing-local-inflammation-nf-kappab-activation-and-hmgb1-release
#19
Nils Wagner, Scott Dieteren, Niklas Franz, Kernt Köhler, Katharina Mörs, Luka Nicin, Julia Schmidt, Mario Perl, Ingo Marzi, Borna Relja
BACKGROUND: The treatment of patients with multiple trauma including blunt chest/thoracic trauma (TxT) and hemorrhagic shock (H) is still challenging. Numerous studies show detrimental consequences of TxT and HS resulting in strong inflammatory changes, organ injury and mortality. Additionally, the reperfusion (R) phase plays a key role in triggering inflammation and worsening outcome. Ethyl pyruvate (EP), a stable lipophilic ester, has anti-inflammatory properties. Here, the influence of EP on the inflammatory reaction and liver injury in a double hit model of TxT and H/R in rats was explored...
2018: PloS One
https://www.readbyqxmd.com/read/29419715/spine-trauma-from-personal-watercraft-usage
#20
Chester J Donnally, Gil Metser, Eric S Roth, Justin P Moo Young, Augustus J Rush, Motasem A Al Maaieh
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To identify patient characteristics and associated injuries in those sustaining a spine fracture from personal watercraft (PWC) usage. SUMMARY OF BACKGROUND DATA: There are few studies regarding PWC use and injuries, and even more scarce are studies evaluating PWC usage and spine injuries. Identifying high risk actions and individuals can help to effectively treat them, reduce mortality, and possibly avoid certain spine fractures...
February 6, 2018: Spine
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