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https://www.readbyqxmd.com/read/29913936/a-systematic-review-of-comparative-studies-indicates-that-paravertebral-block-is-neither-superior-nor-safer-than-epidural-analgesia-for-pain-after-thoracotomy
#1
Hilde M Norum, Harald Breivik
Background The "gold standard" for pain relief after thoracotomy has been thoracic epidural analgesia (TEA). The studies comparing TEA with paravertebral block (PVB) and recent reviews recommend PVB as a novel, safer method than TEA. Methods A systematic search of the Cochrane and PubMed databases for prospective, randomized trials (RCTs) comparing TEA and PVB for post-thoracotomy analgesia was done. We assessed how TEA and PVB were performed, methods of randomization, assessment of pain relief, and complications...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29886624/-establishment-and-evaluation-of-a-new-method-for-determining-hemodynamics-of-pulmonary-hypertension-rats
#2
Q Y Zheng, M D Kuang, Y Li, X T Wu, J Y Huang, C T Zhang, H W Liu, W J Lu, J Wang, Y Q Chen
Objective: By evaluating the hemodynamic parameters such as cardiac output (CO), right ventricular pressure (RVP), pulmonary artery pressure (PAP) and total pulmonary resistance index (TPRI) in pulmonary hypertension rat model, we established a more comprehensive hemodynamic evaluation system, which objectively evaluated the severity of disease and exercise tolerance in rats with pulmonary hypertension. Methods: SD rats were randomly divided into a control group and a model group with 5 rats in each group. The model group was intraperitoneally injected with SU5416 (20 mg/kg) and placed in an oxygen chamber at a 10% oxygen concentration for 21 days and then placed in a normoxic environment for 14 days...
June 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29885914/successful-treatment-of-massive-hemothorax-with-class-iv-shock-using-aortography-with-transcatheter-embolization-of-actively-bleeding-posterior-left-intercostal-arteries-after-penetrating-left-chest-trauma-a-case-for-the-hybrid-or
#3
Carolyn Moore, Golda Kwayisi, Prince Esiobu, Keren A Bashan-Gilzenrat, Leslie R Matthews, Jonathan Nguyen, Nathaniel Moriarty, Michael Liggon, Kahdi Udobi, Assad Taha, Ed Childs, Omar Danner
Hemothorax is a common occurrence after blunt or penetrating injury to the chest. Posterior intercostal vessel hemorrhage as a cause of major intrathoracic bleeding is an infrequent source of massive bleeding. Selective angiography with trans-catheter embolization may provide a minimally invasive and efficient method of controlling bleeding refractory to surgical treatment. PRESENTATION OF CASE: A 19 year-old male sustained a gunshot wound to his left chest with massive hemothorax and refractory hemorrhage...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29851837/hepatocellular-carcinoma-with-thoracic-metastases-presenting-as-hemothorax-a-case-report-and-literature-review
#4
Chih-Wei Yen, Li-Sheng Hsu, Chien-Wei Chen, Wei-Hsiu Lin
RATIONALE: Hemothorax caused by metastasis or direct invasion of hepatocellular carcinoma (HCC) in the chest is rare. We report a case of hemothorax caused by metastasis in the mediastinum and treated with transcatheter arterial embolization (TAE). PATIENT CONCERNS: A 60-year-old woman with HCC was admitted to receive chemotherapy. Two days after admission, she complained of dyspnea, and a chest X-ray revealed right pleural effusion. Thoracentesis confirmed the diagnosis of hemothorax...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29791072/massive-hemothorax-after-computed-tomography-guided-lung-tumor-biopsy-an-unusual-but-disastrous-complication
#5
Wei-Ming Huang, Hui-Chen Lin, Chia-Hung Chen, Chien-Wen Chen, Chih-Hsin Wang, Chung-Yao Huang, Ching-Che Wang, Chun-Chao Huang
Intercostal artery injury during transthoracic puncture is rare but is accompanied by high rates of morbidity and mortality. We report a case with metachronous double primary esophageal cancers and development of multiple lung nodules. Tissue proof for the lung nodules is required to guide the following treatment protocol. Our patient died soon after computed tomography-guided lung tumor biopsy was performed, as a result of procedure-related massive and uncontrolled hemothorax. The cause is likely intercostal artery injury related to the transthoracic puncture...
May 23, 2018: Thoracic Cancer
https://www.readbyqxmd.com/read/29788685/the-lateral-intercostal-artery-perforator-as-an-alternative-donor-vessel-for-free-vascularized-lymph-node-transplantation
#6
Min-Seok Daniel Kwak, Hans-Guenther Machens
Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29752921/reconstruction-of-small-chest-wall-defects-caused-by-tubercular-abscesses-using-two-different-flaps
#7
Woo Ju Kim, Woo Seob Kim, Han Koo Kim, Tae Hui Bae
Tubercular infection of the chest wall is rare and typically progresses to abscess formation. The treatment of these abscesses combines medical therapy with surgical debridement, which can cause defects of various sizes. We have reconstructed relatively small chest wall defects caused by tubercular abscesses using 2 different flaps: a lateral intercostal artery perforator flap and a split pectoralis major muscle flap. The use of these flap techniques may provide a novel approach to cover small chest wall defects caused by tubercular abscesses...
May 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29745038/intralobar-pulmonary-sequestration-originating-from-the-intercostal-arteries-treated-with-surgical-resection
#8
Xin Li, Hui Du, Mujeeb Ur Rehman, Ming Dong, Minghui Liu, Hongyu Liu, Jun Chen
Intralobar pulmonary sequestration originating from the intercostal arteries is rarely reported. Herein, we report an unusual case of a 56-year-old male patient with intralobar pulmonary sequestration supplied from the intercostal arteries on the left lower lobe who presented after a month of a repeated cough and massive hemoptysis. Although transcatheter arterial embolization was performed three times, the patient's symptoms were not relieved. A left lower lobectomy was performed with video-assisted thoracic surgery...
May 9, 2018: Thoracic Cancer
https://www.readbyqxmd.com/read/29736973/aberrant-right-subclavian-artery-causing-megaoesophagus-in-three-cats
#9
F Cinti, D Della Santa, S Borgonovo, R Bussadori, D Troiano, G Pisani
Three entire, domestic, shorthair male cats (age range: 3 months to 5 years) were referred because of regurgitation. Megaoesophagus attributable to aberrant right subclavian artery, originating from the aorta at the level of the fourth intercostal space, was diagnosed in all cats using thoracic radiography and CT angiography. One cat had concurrent patent ductus arteriosus with a normal aortic arch. Three-dimensional volume-rendered CT images were used to assess the malformations and to plan surgery for the treatment of the vascular anomalies...
May 7, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29725663/recovery-of-lost-motor-evoked-potentials-in-open-thoracoabdominal-aortic-aneurysm-repair-using-intercostal-artery-bypass
#10
Alexander Gombert, Jochen Grommes, Danny Hilkman, Drosos Kotelis, Werner H Mess, Michael J Jacobs
Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29718234/technical-points-for-aortic-valve-replacement-through-right-anterior-minithoracotomy
#11
Olivier Bouchot, Andranik Petrosyan, Marie Catherine Morgant, Ghislain Malapert
After 8 years of practice and over 400 operated patients, we present a technique of minimally invasive aortic valve replacement that can be used by all surgeons on many patients. The access to the aorta is via the 2nd or 3rd right anterior intercostal space. Cardiopulmonary bypass is provided using the femoral artery and vein. The aorta is clamped directly. One shot of Custodiol (EUSA Pharma, Limonest, France) is the most commonly used cardioplegia. Aortic valve replacement is performed in the regular way...
May 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29707377/transaxillary-uniportal-video-assisted-thoracoscopic-surgery-for-right-upper-lobectomy
#12
Yaxing Shen, Yong Zhang, Jianchao Sun, Jianying Gu, Yunfeng Yuan, Qun Wang
Uniportal video-assisted thoracic surgery (VATS) was growing popular since its first introduction. Based on the conventional uniportal VATS, we modified the technique and introduced transaxillary uniportal VATS lobectomy in this case report. In March 2017, transaxillary uniportal VATS was firstly attempted on a patient suffering from right upper lobe lesion at the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University. A 4-cm single incision was made at the fossa axillaris paralleled to the skin folds, to which a soft wound protector was applied to reach the third intercostal space along the anterior axillary line...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#13
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29700771/atraumatic-tension-hemothorax-associated-with-ruptured-aneurysm-of-intercostal-artery-azygous-fistula-a-case-report
#14
Takashi Nakayama, Hirofumi Uehara, Marie Osawa, Yukichi Tanahashi, Hiroshi Kondo, Masafumi Kawamura
Atraumatic tension hemothorax is extremely rare. We report a case of 62-year-old woman presented with obstructive and hypovolemic shock status by tension hemothorax due to ruptured aneurysm of congenital intercostal artery-azygous fistula. Contrast-enhanced computed tomography and aortography revealed an aberrant 12th intercostal artery flowing into the aneurysm with a fistula draining into the azygous vein and the rupture of aneurysm. Our experience indicates that the rupture of congenital arteriovenous fistulas (AVFs) of systemic circulation in the thoracic cavity might cause not only hypovolemic shock but also atraumatic tension hemothorax...
April 26, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29697377/challenges-and-management-of-congenital-abdominal-wall-defects-review
#15
D G Chakhunashvili, N Lomidze, L Karalashvili, L Kikalishvili, K Chakhunashvili, Z Kakabadze
Management of congenital abdominal wall malformations is still a challenge in paediatric surgery due to visceroabdominal disproportion, large defects of abdominal wall and immature abdominal cavity. Most of the patients treated with primary closure need artificial substitutes like patches or biomaterials for non-permanent abdominal wall closure. Patches represent the source of constant infections and complications like separation of prosthesis from fascia. Removal of these patches and ventral hernia repair is essential afterwards...
March 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29694666/comparison-of-dorsal-intercostal-artery-perforator-propeller-flaps-and-bilateral-rotation-flaps-in-reconstruction-of-myelomeningocele-defects
#16
Goktekin Tenekeci, Yavuz Basterzi, Sakir Unal, Alper Sari, Yavuz Demir, Celal Bagdatoglu, Bahar Tasdelen
AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects...
April 9, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29687675/massive-spontaneous-hemothorax-in-patients-with-neurofibromatosis-type-1
#17
Pedro José Gil Vázquez, Andrés Del Amor Arroyo Tristán, Jesús Martínez Baños, Juan Torres Lanzas
Spontaneous hemothorax is an uncommon event that can occur in patients with a history of neurofibromatosis type 1 because of intrathoracic vascular malformations that predispose to aneurysms or bleeding from thoracic tumors. Only 53 cases of this rare association have been reported in the literature since 1975. We described 2 cases: one patient was a 73-year-old man with a right hemothorax secondary to an intercostal neurofibroma; the other was a 35-year-old woman with a left hemothorax secondary to a neurofibroma that compromised the internal mammary artery...
June 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29680304/spinal-dural-arteriovenous-fistula-assumed-to-be-symptomatic-after-placement-of-lumbar-cerebrospinal-fluid-drain
#18
Senshu Nonaka, Hidenori Oishi, Satoshi Tsutsumi, Koichiro Sakamoto, Hidehiro Okura, Takamoto Suzuki, Hisato Ishii, Yukimasa Yasumoto
A 69-year-old man presented with severe headache. Cranial computed tomography revealed diffuse subarachnoid hemorrhage. An anterior communicating artery aneurysm was identified and successfully obliterated by open microsurgery on the same day. Following placement of a continuous lumbar cerebrospinal fluid drain on hospitalization day 7, the patient developed a severe paraplegia and sensory loss below T6. Cerebral magnetic resonance imaging did not identify a responsible lesion. Spinal magnetic resonance imaging, however, showed extensive intramedullary hyperintensity on T2-weighted sequences...
April 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29652794/the-voice-of-the-heart-vowel-like-sound-in-pulmonary-artery-hypertension
#19
Mohamed Elgendi, Prashant Bobhate, Shreepal Jain, Long Guo, Jennifer Rutledge, Yashu Coe, Roger Zemp, Dale Schuurmans, Ian Adatia
Increased blood pressure in the pulmonary artery is referred to as pulmonary hypertension and often is linked to loud pulmonic valve closures. For the purpose of this paper, it was hypothesized that pulmonary circulation vibrations will create sounds similar to sounds created by vocal cords during speech and that subjects with pulmonary artery hypertension (PAH) could have unique sound signatures across four auscultatory sites. Using a digital stethoscope, heart sounds were recorded at the cardiac apex, 2nd left intercostal space (2LICS), 2nd right intercostal space (2RICS), and 4th left intercostal space (4LICS) undergoing simultaneous cardiac catheterization...
April 13, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29642694/integrated-quadruple-stress-echocardiography
#20
Eugenio Picano, Doralisa Morrone, Maria C Scali, Alda Huqi, Katia Coviello, Quirino Ciampi
Stress Echocardiography (SE) is an established diagnostic technique. For 40 years, the cornerstone of the technique has been the detection of regional wall motion abnormalities (RWMA), due to the underlying physiologically-relevant epicardial coronary artery stenosis. In the last decade, three new parameters (more objective than RWMA) have shown the potential to integrate and comple- ment RWMA: 1- B-lines, also known as ultrasound lung comets, as a marker of extra-vascular lung water, measured using lung ultrasound with the 4-site simplified scan symmetrically of the antero- lateral thorax on the third intercostal space, from mid-axillary to anterior axillary and mid- clavicular line; 2-left ventricular contractile reserve (LVCR), assessed as the peak stress/rest ratio of left ventricular force, also known as elastance (systolic arterial pressure by cuff sphygmomanome- ter/end-systolic volume from 2D echocardiography); 3- coronary flow velocity reserve (CFVR) on left anterior descending coronary artery, calculated as peak stress/rest ratio of diastolic peak flow velocity assessed using pulsed-wave Doppler...
April 11, 2018: Minerva Cardioangiologica
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