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https://www.readbyqxmd.com/read/27911066/-conservative-management-of-liver-trauma-and-its-complications-current-gold-standard
#1
R Gander, J A Molino, S Santiago, A Laín, G Guillén, C Giné, G Royo, S López, M Pérez, I Díez, S Cañadas, J Lloret, J Bueno
INTRODUCTION: The liver is the second most frequently involved organ in abdominal trauma in children. The aim of this study was to review the characteristics of liver traumas (LT) in children, its treatment and complications. MATERIAL AND METHODS: Retrospective study of patients with LT treated between 2010-2014. We analyzed data regarding diagnosis, conservative management (CM), complications and treatment. RESULTS: Twenty-four patients of LT with a mean age of 9...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27904757/brain-hemorrhage-after-electrical-burn-injury-case-report-and-probable-mechanism
#2
Gutierrez Aceves Guillermo Axayacalt, Ceja Espinosa Alejandro, Rios Alanis Marcos, Ruiz Flores Milton Inocencio, Herrera Gonzalez Jose Alfredo
BACKGROUND: High-voltage electric injury may induce lesion in different organs. In addition to the local tissue damage, electrical injuries may lead to neurological deficits, musculoskeletal damage, and cardiovascular injury. Severe vascular damage may occur making the blood vessels involved prone to thrombosis and spontaneous rupture. CASE DESCRIPTION: Here, we present the case of a 39-year-old male who suffered an electrical burn with high tension wire causing intracranial bleeding...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27902596/portable-disposable-ultrathin-endoscopy-tested-through-percutaneous-endoscopic-gastrostomy
#3
Myong Ki Baeg, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Bo-In Lee, In-Seok Lee, Myung-Gyu Choi
BACKGROUND: A portable disposable ultrathin endoscope (DUE) with high visual quality and maneuverability would reduce the need for expensive facilities and emergency endoscopy could be available anywhere. It would increase patient satisfaction, prevent unnecessary sedation, and reduce infection. Our aim was to evaluate the usefulness of portable DUE in performing percutaneous endoscopic gastrostomy (PEG). METHODS: We prospectively enrolled patients who underwent PEG under DUE guidance and compared them with historical controls who underwent PEG under conventional ultrathin endoscopy (CUE) guidance...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27894886/utility-of-urgent-computed-tomography-angiography-in-the-setting-of-intraparenchymal-brain-hemorrhage
#4
Omran Kaskar, Larry B Goldstein
BACKGROUND AND PURPOSE: Patients presenting with an intracerebral hemorrhage (ICH) generally have an initial noncontrast computed tomography (NCCT) of the brain. Computed tomography angiography (CTA) can help identify secondary causes of ICH and detect a "spot sign." We hypothesized that performing an urgent CTA in the setting of a presumed primary ICH has only limited utility and did not alter urgent management. METHODS: This was a retrospective study of consecutive patients presenting with a primary ICH identified from the Duke University Stroke Registry from 2010 to 2013 who had an ICH detected on an initial NCCT...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27894359/can-morphological-mri-differentiate-between-primary-central-nervous-system-lymphoma-and-glioblastoma
#5
H Malikova, E Koubska, J Weichet, J Klener, A Rulseh, R Liscak, Z Vojtech
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare, aggressive brain neoplasm that accounts for roughly 2-6% of primary brain tumors. In contrast, glioblastoma (GBM) is the most frequent and severe glioma subtype, accounting for approximately 50% of diffuse gliomas. The aim of the present study was to evaluate morphological MRI characteristics in histologically-proven PCNSL and GBM at the time of their initial presentation. METHODS: We retrospectively evaluated standard diagnostic MRI examinations in 54 immunocompetent patients (26 female, 28 male; age 62...
November 29, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#6
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27890955/aspergillus-meningoencephalitis-in-a-patient-with-human-immunodeficiency-virus-infection-normal-cerebrospinal-fluid-does-not-mean-absence-of-meningitis
#7
Soaham Dilip Desai, Sanket Seth, Aniketh Shah, Bhalendu Vaishnav
A male with human immunodeficiency virus infection presented with febrile encephalopathy followed by seizures and left hemiparesis. Initial imaging with contrast computerized tomography (CT) scan brain and cerebrospinal fluid (CSF) examination were normal. Subsequent magnetic resonance imaging brain revealed bilateral parieto-occipital infarcts with bleed. He did not improve on treatment with broad-spectrum antibiotics, anti-tubercular drugs, and antifungals. He finally succumbed to the disease. His CSF culture grew Aspergillus after 2 weeks...
July 2016: Indian Journal of Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/27881833/apixaban-for-treatment-of-embolic-stroke-of-undetermined-source-atticus-randomized-trial-rationale-and-study-design
#8
Tobias Geisler, Sven Poli, Christoph Meisner, Juergen Schreieck, Christine S Zuern, Thomas Nägele, Johannes Brachmann, Werner Jung, Georg Gahn, Elisabeth Schmid, Hansjörg Bäezner, Timea Keller, Gabor C Petzold, Jan-Wilko Schrickel, Jan Liman, Rolf Wachter, Frauke Schön, Martin Schabet, Alfred Lindner, Albert C Ludolph, Hubert Kimmig, Sebastian Jander, Uwe Schlegel, Meinrad Gawaz, Ulf Ziemann
RATIONALE: Optimal secondary prevention of embolic stroke of undetermined source is not established. The current standard in these patients is acetylsalicylic acid, despite high prevalence of yet undetected paroxysmal atrial fibrillation. AIM: The ATTICUS randomized trial is designed to determine whether the factor Xa inhibitor apixaban administered within 7 days after embolic stroke of undetermined source, is superior to acetylsalicylic acid for prevention of new ischemic lesions documented by brain magnetic resonance imaging within 12 months after index stroke...
November 23, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27881496/penetrating-intracranial-injury-caused-by-an-unusual-home-made-iron-pyrotechnic-device
#9
Slobodan Nikolić, Vladimir Živković
Herein, a potentially dangerous explosive home-made device used for fun and entertainment is described. It consists of two iron parts connected with a U-shaped thick wire: a wedge about 8 cm in length, which fits into a hollow cylinder, filled with a small amount of nitre (the mineral form of potassium nitrate). Striking the device onto a hard surface creates a spark inside it, which burns the nitre, producing a very loud bang. We are in possession of such device in our forensic museum collection. We present a case from 1937 related to the use of this explosive home-made device...
November 23, 2016: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/27867925/a-stable-secondary-gliosarcoma-with-extensive-systemic-metastases-a-case-report
#10
Tae-Min Choi, Young-Jun Cheon, Tae-Young Jung, Kyung-Hwa Lee
A 63-year-old man complained of intermittent motor weakness of his arm. The magnetic resonance image (MRI) of his brain displayed a high signal lesion in right cingulate gyrus on T2 weighted image. One year later, he showed a stuporous mental status with repeated seizures, and the follow-up brain MRI showed heterogeneously enhanced mass associated with bleeding. He was treated with surgery and radiotherapy for secondary glioblastomas in right cingulate gyrus. One year more later, a mass recurred on the left frontal base, and gliosarcoma was diagnosed...
October 2016: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/27857909/the-effect-of-preoperative-antiplatelet-therapy-on-hemorrhagic-complications-after-decompressive-craniectomy-in-patients-with-traumatic-brain-injury
#11
Hokyun Han, Eun Jung Koh, Hyunho Choi, Byong-Cheol Kim, Seung Yeob Yang, Keun-Tae Cho
OBJECTIVE: Traditionally, it is generally recommended that antiplatelet agent should be discontinued before surgery. However, decompressive craniectomy (DC) in patients with traumatic brain injury (TBI) is performed emergently in most cases. Therefore, DC cannot be delayed to the time when the effect of antiplatelet agent on bleeding tendency dissipates. In this study, we evaluated the effect of preinjury antiplatelet therapy on hemorrhagic complications after emergent DC in patients with TBI...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857787/a-study-of-neurosonogram-abnormalities-clinical-correlation-with-neurosonogram-findings-and-immediate-outcome-of-high-risk-neonates-in-neonatal-intensive-care-unit
#12
Niranjan Nagaraj, Pramod Kumar Berwal, Anusha Srinivas, Ramnarayan Sehra, Sarika Swami, Prathyusha Jeevaji, Gotam Swami, Lokesh Choudary, Ayush Berwal
BACKGROUND: Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27856955/microsurgery-for-aruba-trial-a-randomized-trial-of-unruptured-brain-arteriovenous-malformation-eligible-unruptured-brain-arteriovenous-malformations
#13
Johnny Wong, Alana Slomovic, George Ibrahim, Ivan Radovanovic, Michael Tymianski
BACKGROUND AND PURPOSE: The management of unruptured brain arteriovenous malformations (ubAVMs) remains controversial despite ARUBA trial (A Randomized Trial of Unruptured Brain Arteriovenous Malformation), a controlled trial that suggested superiority of conservative management over intervention. However, microsurgery occurred in only 14.9% of ARUBA intervention cases, raising concerns about the study's generalizability. Our purpose was to evaluate whether, in a larger ARUBA-eligible ubAVM population, microsurgery produces acceptable outcomes...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27856651/flat-detector-computed-tomography-pbv-map-in-the-evaluation-of-presurgical-embolization-for-hypervascular-brain-tumors
#14
Li-Li Wen, Xin Zhang, Qing-Rong Zhang, Qi Wu, Shu-Juan Chen, Jin-Long Deng, Kaiyi Huang, Han-Dong Wang
BACKGROUND: Preoperative embolization of hypervascular brain tumors is frequently used to minimize intraoperative bleeding. OBJECTIVE: To explore the efficacy of embolization using flat-detector CT (FDCT) parenchymal blood volume (PBV) maps before and after the intervention. MATERIALS AND METHODS: Twenty-five patients with hypervascular brain tumors prospectively received pre- and postprocedural FDCT PBV scans using a biplane system under a protocol approved by the institutional research ethics committee...
November 17, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27847192/trends-in-1029-trauma-deaths-at-a-level-1-trauma-center-impact-of-a-bleeding-control-bundle-of-care
#15
Blessing T Oyeniyi, Erin E Fox, Michelle Scerbo, Jeffrey S Tomasek, Charles E Wade, John B Holcomb
BACKGROUND: Over the last decade the age of trauma patients and injury mortality has increased. At the same time, many centers have implemented multiple interventions focused on improved hemorrhage control, effectively resulting in a bleeding control bundle of care. The objective of our study was to analyze the temporal distribution of trauma-related deaths, the factors that characterize that distribution and how those factors have changed over time at our urban level 1 trauma center...
November 3, 2016: Injury
https://www.readbyqxmd.com/read/27843362/isolated-oculomotor-nerve-palsy-resulting-from-acute-traumatic-tentorial-subdural-hematoma
#16
Victoria Cui, Timur Kouliev
Acute subdural hematoma (SDH) resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm) or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27837045/pharmacologic-stress-gastropathy-prophylaxis-may-not-be-necessary-in-at-risk-surgical-trauma-icu-patients-tolerating-enteral-nutrition
#17
Nicole M Palm, Brian McKinzie, Pamela L Ferguson, Emily Chapman, Margaret Dorlon, Evert A Eriksson, Brent Jewett, Stuart M Leon, Alicia R Privette, Samir M Fakhry
OBJECTIVE: Stress gastropathy is a rare complication of the intensive care unit stay with high morbidity and mortality. There are data that support the concept that patients tolerating enteral nutrition have sufficient gut blood flow to obviate the need for prophylaxis; however, no robust studies exist. This study assesses the incidence of clinically significant gastrointestinal bleeding in surgical trauma intensive care unit (STICU) patients at risk of stress gastropathy secondary to mechanical ventilation receiving enteral nutrition without pharmacologic prophylaxis...
November 10, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27822765/syringomyelia-caused-by-an-arachnoid-web-in-a-patient-with-shunted-dandy-walker-malformation
#18
Hee Chang Lee, Jung Won Choi, Ji Yeoun Lee, Ji Hoon Phi, Seung-Ki Kim, Byung-Kyu Cho, Kyu-Chang Wang
INTRODUCTION: Dandy-Walker malformation (DWM) is a congenital brain anomaly characterized by dysgenesis of the cerebellar vermis and the presence of a posterior fossa cyst. The association of syringomyelia with DWM is extremely rare. CASE REPORT: A 10-year-old patient who was diagnosed with DWM in infancy presented with progressive scoliosis and fecal incontinence. He had been treated with cystoventriculoperitoneal shunting with a Y-connection during infancy, which was followed by a revision 6 years later...
November 7, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27822079/intravenous-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke-a-feasibility-and-safety-study
#19
Elyar Sadeghi-Hokmabadi, Mehdi Farhoudi, Aliakbar Taheraghdam, Mazyar Hashemilar, Daryous Savadi-Osguei, Reza Rikhtegar, Kaveh Mehrvar, Ehsan Sharifipour, Parisa Youhanaee, Reshad Mirnour
BACKGROUND: In developing countries, intravenous thrombolysis (IVT) is available at a limited number of centers. This study aimed to assess the feasibility and safety of IVT at Tabriz Imam Reza Hospital. METHODS: In a prospective study, over a 55-month period, any patient at the hospital for whom stroke code had been activated was enrolled in the study. Data on demographic characteristics, stroke risk factors, admission blood pressure, blood tests, findings of brain computed tomography (CT) scans, time of symtom onset, time of arrival to the emergency department, time of stroke code activation, time of CT scan examination, and the time of recombinant tissue plasminogen activator administration were recorded...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27818606/modeling-4d-pathological-changes-by-leveraging-normative-models
#20
Bo Wang, Marcel Prastawa, Andrei Irimia, Avishek Saha, Wei Liu, S Y Matthew Goh, Paul M Vespa, John D Van Horn, Guido Gerig
With the increasing use of efficient multimodal 3D imaging, clinicians are able to access longitudinal imaging to stage pathological diseases, to monitor the efficacy of therapeutic interventions, or to assess and quantify rehabilitation efforts. Analysis of such four-dimensional (4D) image data presenting pathologies, including disappearing and newly appearing lesions, represents a significant challenge due to the presence of complex spatio-temporal changes. Image analysis methods for such 4D image data have to include not only a concept for joint segmentation of 3D datasets to account for inherent correlations of subject-specific repeated scans but also a mechanism to account for large deformations and the destruction and formation of lesions (e...
October 2016: Computer Vision and Image Understanding: CVIU
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