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Thoracic Injury

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 such as RT is being discussed. The aim of this study was to identify patients who most likely would have potentially benefited from REBOA use based on autopsy findings. METHODS: We performed a 4-year retrospective review of all RTs performed at our Level I trauma center...
November 2016: Journal of Trauma and Acute Care Surgery
Alexandros Stamatopoulos, Davide Patrini, Efstratios Koletsis, Elaine Borg, Reena Khiroja, Martin Hayward, David Lawrence, Nikolaos Panagiotopoulos
IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect practically every organ. Although it was first identified in pancreas and salivary glands, major organs like liver, biliary tree, kidney, thyroid glands and lungs are commonly involved, sometimes resulting in organ failure. We describe a case of an 41-year-old man presented with back pain after a rotator cuff injury. A Computed Tomography (CT) revealed incidentally a right lower lobe paravertebral lesion extending across the T5 and T6 vertebral levels and invading into the adjacent pleural surface...
2016: Respiratory Medicine Case Reports
Chris Durkin, Travis Schisler, Jens Lohser
PURPOSE OF REVIEW: Despite marked improvements in perioperative outcomes, esophagectomy continues to be a high-risk operation associated with significant morbidity and mortality. Progress has been achieved through evidence-based changes in preoperative optimization, intraoperative ventilation strategies, fluid therapy, and analgesia, as well as expedited postoperative recovery pathways. This review will summarize the recent literature on the anesthetic management of patients undergoing esophageal resection...
October 18, 2016: Current Opinion in Anaesthesiology
Benjamin W Starnes, Amit Dwivedi, Joseph Giglia, Karen Woo, Chyon Yeh
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Özlem Taşoğlu, Engin Koyuncu, Rabia Daylak, Derya Yumuşak Karacif, Zerrin I Nce, Didem Yenigün, Neşe Özgirgin
OBJECTIVE: To define the demographic and clinical characteristics of persons with spinal cord injury, rehabilitated in a primary referral rehabilitation center in Turkey. DESIGN: Retrospective study. SETTING: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey Methods: Medical records of all patients with spinal cord injury (acute-subacute-chronic) at a single academic referral center over the course of one year were reviewed...
October 20, 2016: Journal of Spinal Cord Medicine
Roger Christopher Gill, K M Inam Pal, Fatima Mannan, Amber Bawa, Saulat H Fatimi
INTRODUCTION: Penetrating oesophageal injuries are extremely rare. Their timely recognition can be difficult and optimal treatment remains controversial. Early recognition of injury is possible with the help of a high index of suspicion and early radiological and endoscopic examinations. Prompt surgical intervention with primary repair of injury, should be the goal. PRESENTATION OF CASES: We describe two cases of penetrating oesophageal trauma where T-Tube placement through the oesophageal defect, was successfully employed...
January 4, 2016: International Journal of Surgery Case Reports
F Bonnaire, M Goepel, P Bula
The requirements of the German statutory accident insurance (DGUV) for the new treatment procedure were presented on 1 January 2013 in a new catalogue. The implementation of the certification of hospitals for the very severe injury procedure (SAV) by the DGUV should have been completed by 2014. These requirements placed high demands on trauma-oriented hospitals because of the high structural and personnel prerequisites. The background to the new organization was the wish of the DGUV for quality improvement in patient treatment in hospitals for patients with very severe occupational and occupation-related trauma by placement in qualified centers with high case numbers...
October 17, 2016: Der Unfallchirurg
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Élizabeth Lalande, Chantal Guimont, Marcel Émond, Marc Charles Parent, Claude Topping, Brice Lionel Batomen Kuimi, Valérie Boucher, Natalie Le Sage
OBJECTIVES: The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results. METHODS: Adult patients who presented with clinical suspicion of rib fractures after mTI were included...
October 17, 2016: CJEM
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Henri de Lesquen, Fabien Beranger, Julie Berbis, Guillaume Boddaert, Antoine Poichotte, Francois Pons, Jean-Philippe Avaro
No abstract text is available yet for this article.
October 12, 2016: Injury
Ang Deng, Hong-Qi Zhang, Ming-Xing Tang, Shao-Hua Liu, Yu-Xiang Wang, Qi-Le Gao
OBJECTIVE The objective of this study was to evaluate the clinical efficacy of posterior-only surgical correction of dystrophic scoliosis in patients with neurofibromatosis Type 1 (NF1) using a multiple anchor point method (MAPM). METHODS From 2005 to 2014, 31 patients (mean age 13.5 years old, range 10-22 years old) suffering from dystrophic scoliosis associated with NF1 underwent posterior-only surgical correction using a MAPM. The apex of the deformity was thoracic (n = 25), thoracolumbar (n = 4), and lumbar (n = 2)...
October 14, 2016: Journal of Neurosurgery. Pediatrics
Norikazu Kawai, Takeshi Kawaguchi, Motoaki Yasukawa, Takashi Tojo
Anatomical variations of the pulmonary artery increase the risks for vessel injury and critical mistakes during pulmonary artery resection. The mediastinal basal pulmonary artery is a rare branch abnormality and is the first branch of the pulmonary artery to flow into the basal segment. We report a patient who underwent video-assisted thoracic surgery (VATS) right lower lobectomy for lung cancer with a mediastinal basal pulmonary artery. The mediastinal basal pulmonary artery was detected preoperatively by computed tomography...
October 13, 2016: General Thoracic and Cardiovascular Surgery
Aysel Kurt, Hasan Turut, Ahmet Acipayam, Aynur Kirbas, Suleyman Yuce, Medine Cumhur Cure, Erkan Cure
OBJECTIVE: Multiple rib fractures (RFs) and pulmonary contusions (PCs), with resulting systemic lung inflammation, are the most common injuries caused by blunt chest trauma (BCT) in motor vehicle accidents. This study examined levels of the inflammation marker interleukin (IL)-6 and those of the acute-phase reactant surfactant protein (SP)-D in patients with BCT. DESIGN: Prospective, cross-sectional, observational study. SETTING: Single-centre, tertiary care hospital in the Black Sea Region of Turkey...
October 12, 2016: BMJ Open
Eric Goudie, Mehdi Tahiri, Moishe Liberman
VATS lobectomy is a safe and effective treatment strategy for operable stage I and II lung cancer. It has a similar five-year survival compared to open lobectomy (thoracotomy). VATS lobectomy is associated with less postoperative complications and shorter hospital length of stay when compared to lobectomy by thoracotomy. VATS lobectomy has not been widely adopted by the thoracic surgical community, in part, due to technical reasons. Pulmonary artery branch manipulation in VATS lobectomy is one of the most critical parts of the procedure, especially when endostaplers are used for ligation and division of the vessel...
October 6, 2016: Surgical Technology International
Kestutis Skucas, Vaida Pokvytyte
BACKGROUND: Of the research was to examine the effects of twelve weeks of combined dry land strength and resistance swimming training for increasing upper body strength, swimming performance and stroking parameters in swimmers with paraplegia and to determine correlation between these parameters. METHODS: The preliminary, the second (after 4 weeks), the third (after 8 weeks) and the last (after 12 weeks) testing were performed. The measurements consisted of the following assessments: the assessment of isometric strength in dry land (tension force), the assessment of swimming performance and stroke parameters during 50m backstroke, the assessment of strength during tethered swimming (tension force)...
October 11, 2016: Journal of Sports Medicine and Physical Fitness
Mona Sarfaty, Jennifer Kreslake, Gary Ewart, Tee L Guidotti, George D Thurston, John R Balmes, Edward W Maibach
The American Thoracic Society (ATS), in collaboration with George Mason University, surveyed international members of the society to assess perceptions, clinical experiences, and preferred policy responses related to global climate change. A recruitment email was sent by the ATS President in October 2015 to 5,013 international members. Subsequently, four reminder emails were sent to nonrespondents. Responses were received from 489 members in 68 countries; the response rate was 9.8%. Half of respondents reported working in countries in Asia (25%) or Europe (25%), with the remainder in South America (18%), North America (Canada and Mexico) (18%), Australia or New Zealand (9%), and Africa (6%)...
October 2016: Annals of the American Thoracic Society
Fei Chang, Dasheng Cheng, Mingyuan Qian, Wei Lu, Huatao Li, Hongtai Tang, Zhaofan Xia
BACKGROUND As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. CASE REPORT A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area)...
October 11, 2016: American Journal of Case Reports
K M Kurbonov, F I Makhmadov, K R Nazirboev, A A Aminov
AIM: to prove the efficacy and safety of video-assisted techniques in diagnosis and treatment of victims with thoracic and abdominal trauma. MATERIAL AND METHODS: It was analyzed treatment of 249 patients with thoracic (n=82), abdominal (n=122) and thoracoabdominal injuries (n=35) who were divided into 2 groups depending on treatment. Control group of conventional diagnosis and treatment included 130 (52%) patients. Group 2 consisted of 119 (48%) patients in whom differentiated surgical approach combined with current technologies was applied...
2016: Khirurgiia
Zeynep Aslı Kartal, Nalan Kozacı, Bülent Çekiç, İnan Beydilli, Mehmet Akçimen, Dilek Soydam Güven, İclal Erdem Toslak
OBJECTIVE: In this study, emergency physicians and on-call radiologists were compared regarding identification of fatal injuries on computed tomographic (CT) scans in patients with trauma. MATERIALS AND METHODS: Multiply injured patients who were older than 18 years and underwent CT scanning were included in the study. The CT scans were interpreted by the responsible emergency physician. At the same time, these images were also evaluated by the on-call radiologist...
August 24, 2016: American Journal of Emergency Medicine
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