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https://www.readbyqxmd.com/read/29201808/management-of-traumatic-liver-and-bile-duct-laceration
#1
Charu Tiwari, Hemanshi Shah, Mukta Waghmare, Kiran Khedkar, Pankaj Dwivedi
Posttraumatic major bile leak in children is uncommon, with few cases reported in the literature. These injuries are seen in high-grade liver trauma and are difficult to diagnose and manage. We describe a 7-year-old boy with grade IV hepatic trauma and bile leak following blunt abdominal trauma. The leak was successfully managed by percutaneous drainage and endoscopic retrograde cholangiopancreatography (ERCP) stenting of the injured hepatic duct. How to cite this article: Tiwari C, Shah H, Waghmare M, Khedkar K, Dwivedi P...
July 2017: Euroasian journal of hepato-gastroenterology
https://www.readbyqxmd.com/read/29156155/leukotriene-b4-indicates-lung-injury-and-on-going-inflammatory-changes-after-severe-trauma-in-a-porcine-long-term-model
#2
Philipp Störmann, Birgit Auner, Lukas Schimunek, Rafael Serve, Klemens Horst, Tim-P Simon, Roman Pfeifer, Kernt Köhler, Frank Hildebrand, Sebastian Wutzler, Hans-Christoph Pape, Ingo Marzi, Borna Relja
BACKGROUND: Recognizing patients at risk for pulmonary complications (PC) is of high clinical relevance. Migration of polymorphonuclear leukocytes (PMN) to inflammatory sites plays an important role in PC, and is tightly regulated by specific chemokines including interleukin (IL)-8 and other mediators such as leukotriene (LT)B4. Previously, we have reported that LTB4 indicated early patients at risk for PC after trauma. Here, the relevance of LTB4 to indicating lung integrity in a newly established long-term porcine severe trauma model (polytrauma, PT) was explored...
December 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#3
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29097198/liver-lacerations-as-a-complication-of-cpr-during-pregnancy
#4
Timothy R Cox, Sarah D Crimmins, Allison M Shannon, Kristin L Atkins, Ronald Tesoriero, Andrew M Malinow
AIM: Cardiac arrest in peripartum patients is a rare but devastating event; reported rates in the literature range from 0.019% to 0.0085%. In the general population, a well-described complication of cardiopulmonary resuscitation (CPR), liver laceration and injury, is reported at a rate of between 0.5-2.9% after CPR. Liver laceration rate among peripartum patients receiving CPR has not been well-studied. We sought to find the rate of liver lacerations in the peripartum population associated with CPR, with the hypothesis that the rate would be higher than in the general population...
October 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/29064302/study-of-chest-injuries-to-3yo-child-occupants-seated-in-impact-shield-and-5-point-harness-crss
#5
Yong Han, Di Pan, Jun Ouyang, Lei Qian, Koji Mizuno, Anguo Cang
OBJECTIVE: To investigate whether the 5-point harness or the impact shield CRS or both has the potential to cause chest injuries to children. This is determined by examining whether the loading to the chest reaches the internal organ injury threshold for children. METHOD: The chest injury risk to a child occupant in a child restraint system (CRS) was investigated using Q3 dummy tests, finite element (FE) simulations (Q3 dummy and human models) and animal tests. The investigation was done for two types of CRSs (i...
October 24, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29061963/%C3%AE-v-integrins-on-mesenchymal-cells-regulate-skeletal-and-cardiac-muscle-fibrosis
#6
I R Murray, Z N Gonzalez, J Baily, R Dobie, R J Wallace, A C Mackinnon, J R Smith, S N Greenhalgh, A I Thompson, K P Conroy, D W Griggs, P G Ruminski, G A Gray, M Singh, M A Campbell, T J Kendall, J Dai, Y Li, J P Iredale, H Simpson, J Huard, B Péault, N C Henderson
Mesenchymal cells expressing platelet-derived growth factor receptor beta (PDGFRβ) are known to be important in fibrosis of organs such as the liver and kidney. Here we show that PDGFRβ(+) cells contribute to skeletal muscle and cardiac fibrosis via a mechanism that depends on αv integrins. Mice in which αv integrin is depleted in PDGFRβ(+) cells are protected from cardiotoxin and laceration-induced skeletal muscle fibrosis and angiotensin II-induced cardiac fibrosis. In addition, a small-molecule inhibitor of αv integrins attenuates fibrosis, even when pre-established, in both skeletal and cardiac muscle, and improves skeletal muscle function...
October 24, 2017: Nature Communications
https://www.readbyqxmd.com/read/29034490/hepatic-complications-of-umbilical-venous-catheters-in-the-neonatal-period-the-ultrasound-spectrum
#7
Betul Emine Derinkuyu, Oznur Leman Boyunaga, Cagri Damar, Sezin Unal, Ebru Ergenekon, Ayse Gul Alimli, Cigdem Oztunali, Canan Turkyilmaz
OBJECTIVES: Umbilical venous catheterization is commonly used in the neonatal period; however, it has some complications. In this study, we evaluated neonates who underwent umbilical venous catheterization and developed hepatic complications. Furthermore, we aimed to define all of the possible lesions and to clarify the imaging findings of umbilical venous catheter-induced hepatic injury. METHODS: Two hundred forty-four neonates who underwent umbilical venous catheterization between March 2013 and September 2015 in a single tertiary care referral center were included in this study...
October 16, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29033774/hemothorax-following-uncomplicated-endoscopic-variceal-sclerotherapy-and-ligation-for-esophageal-varices
#8
Tomoko Ochiai, Yukiomi Nakade, Rena Kitano, Shunsuke Kato, Kazumasa Sakamoto, Tadahisa Inoue, Yuji Kobayashi, Norimitsu Ishii, Tomohiko Ohashi, Yoshio Sumida, Kiyoaki Ito, Haruhisa Nakao, Chihiro Furuta, Motoki Yano, Masashi Yoneda
Endoscopic variceal sclerotherapy and ligation are standard treatment modalities used for the management of esophageal varices. Reportedly, sclerotherapy and ligation are associated with complications such as hematuria, pulmonary thrombus formation, pleural effusion, renal dysfunction, and esophageal stenosis. However, hemothorax following sclerotherapy and ligation has not yet been reported. We treated a patient who presented with liver cirrhosis and polycythemia vera and later developed hemothorax following the above-mentioned procedures...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28975653/analysis-of-skeletal-muscle-microcirculation-in-a-porcine-polytrauma-model-with-haemorrhagic-shock
#9
Zhi Qiao, Klemens Horst, Michel Teuben, Johannes Greven, Luxu Yin, Yannik Kalbas, René H Tolba, Hans-Christoph Pape, Frank Hildebrand, Roman Pfeifer
Polytraumatised patients with haemorrhagic shock are prone to develop systemic complications, such as SIRS (systemic inflammatory response syndrome), ARDS (acute respiratory distress syndrome) and MOF (multiple organ failure). The pathomechanism of severe complications following trauma is multifactorial, and it is believed that microcirculatory dysfunction plays an important role. The aim of this study was to determine the changes in the microcirculation in musculature over time during shock and subsequent resuscitation in a porcine model of haemorrhagic shock and polytrauma...
October 3, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28962752/chitosan-kaolin-composite-porous-microspheres-with-high-hemostatic-efficacy
#10
Xun Sun, Zonghao Tang, Meng Pan, Zhengchao Wang, Hongqin Yang, Haiqing Liu
The hemostatic performance of chitosan was greatly improved by blending it with kaolin to fabricate porous composite microspheres (CSMS-K) through inverse emulsion method combining with thermally induced phase separation. The CSMS-K had high amount of interior and surface pores. The synergetic hemostatic competence of chitosan and kaolin components made the hemostatic efficacy of CSMS-K superior to chitosan porous microspheres (CSMS). The hemostatic time of CSMS-K3 in the rat tail amputation and liver laceration models was down to respective 120 and 99s from 183 and 134s of CSMS, and the blood loss of CSMS-K3 was respectively 65% and 36% of that of CSMS in the rat tail amputation and liver laceration models...
December 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28932700/endovascular-management-of-arterial-injuries-after-blunt-or-iatrogenic-renal-trauma
#11
REVIEW
Romaric Loffroy, Olivier Chevallier, Sophie Gehin, Marco Midulla, Pierre-Emmanuel Berthod, Christophe Galland, Pascale Briche, Céline Duperron, Nabil Majbri, Christiane Mousson, Nicolas Falvo
The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28932393/icd-lead-extraction-not-a-benign-procedure-external-chest-compression-not-a-benign-manoeuvre
#12
Federico Sertic, Paolo Bosco, Antonella Ferrara, Patrick Heck, Yasir Abu-Omar
This is the case of a 45-year-old man who was electively admitted to our hospital for revision and extraction of his faulty implantable cardioverter-defibrillator lead and box. The procedure was complicated by cardiac tamponade requiring pericardiocentisis (unsuccessful) and cardiopulmonary resuscitation. The patient was then rushed to theatre for emergency sternotomy and institution of cardiopulmonary bypass. A tear in the superior vena cava was identified and repaired. Unfortunately, the patient suffered of a liver laceration, due to chest compression, which required emergency laparotomy...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28930966/bilateral-pulmonary-emboli-and-extensive-inferior-vena-cava-thrombosis-in-the-setting-of-large-subcapsular-hematoma-and-liver-laceration-after-blunt-trauma
#13
Alejandro Betancourt-Ramirez, Soraya SMolero, Patrizio Petrone, Corrado P Marini, Heidi L Frankel
No abstract text is available yet for this article.
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28852464/missed-diagnosis-of-a-large-right-sided-diaphragmatic-rupture-with-herniated-liver-and-concomitant-liver-laceration-after-blunt-trauma-consequences-for-delayed-surgical-repair
#14
Kjetil Søreide, Andreas Reite, Rune Haaverstad
Diaphragmatic injuries are relatively rare and as such frequently missed, particularly if they occur as a rare event on the right-sided dome. Even if detected in the early phase, the concomitant injury of other organs may delay the time to repair. The delay in surgical correction may aggravate additional adherences between thoracic and abdominal organs and cause the diaphragmatic muscle to retract, causing a larger tissue defect that may prevent primary suture repair. This should be taken into consideration when choosing access to repair (thoracic, abdominal or both cavities), mode (open or laparoscopic) and type of repair (primary suture or use of mesh material to close the defect)...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28682477/preclinical-safety-and-efficacy-of-andexanet-alfa-in-animal-models
#15
G Lu, S J Hollenbach, D C Baker, S Tan, A Hutchaleelaha, J T Curnutte, P B Conley
Essentials There is currently no approved reversal agent for factor Xa (FXa) inhibitors Andexanet alfa has been developed to reverse the anticoagulant effects of FXa inhibitors Andexanet reduced blood loss and anticoagulation markers in rivaroxaban-anticoagulated rabbits Andexanet was well tolerated in monkeys and rats, with no evidence of prothrombotic activity SUMMARY: Background Andexanet alfa is a recombinant modified form of factor Xa (FXa), designed to bind to and reverse the anticoagulant activity of FXa inhibitors...
July 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28644516/hemostatic-efficiency-of-modern-topical-sealants-comparative-evaluation-after-liver-resection-and-splenic-laceration-in-a-swine-model
#16
Hamidreza Fonouni, Arash Kashfi, Ali Majlesara, Oliver Stahlheber, Lukas Konstantinidis, Negin Gharabaghi, Thomas W Kraus, Arianeb Mehrabi, Hani Oweira
Parenchymal transection during hepatobiliary surgery can disrupt small vasculature or bile ducts, which could be managed difficultly. Sealants are helpful tools to achieve better hemostasis. The aim of this study is to analyze the hemostatic efficiency of four modern sealants in a porcine model. In this study, 40 landrace pigs were assigned equally to the control (without sealant) and four sealant groups. Standardized liver resection and splenic lesions were performed and left without using sealant (control) or treated with one of the following sealants: TachoSil(®) , Tissucol Duo(®) , Coseal(®) , and FloSeal(®) ...
June 23, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#17
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28597665/-injuries-associated-with-cardiopulmonary-resuscitation-in-non-survivors-after-out-of-hospital-cardiac-arrest-autopsy-study
#18
Lucia Ihnát Rudinská, Petr Hejna, Margita Smatanová, Peter Ihnát, Igor Dvořáček
The aim of the present study is to investigate incidence and seriousness of CPR-associated injuries on a cohort of CPR non-survivors after out-of-hospital cardiac arrest in the Moravian-Silesian region. In total, 80 persons were included in the study within the study period (2012 - 2015). CPR-associated injuries were identified in 75 (93.7 %) persons, multiple injuries were found in 73 persons. Spectrum of identified injuries covered skin injuries of the upper half of the body, head and neck injuries, rare abdominal injuries and very frequent thorax injuries...
2017: Soudní Lékarství
https://www.readbyqxmd.com/read/28570538/uncontrolled-hemorrhagic-shock-modeled-via-liver-laceration-in-mice-with-real-time-hemodynamic-monitoring
#19
Mitchell Dyer, Shannon Haldeman, Andres Gutierrez, Lauryn Kohut, Anirban Sen Gupta, Matthew D Neal
Uncontrolled hemorrhage is an important cause of preventable deaths among trauma patients. We have developed a murine model of uncontrolled hemorrhage via a liver laceration that results in consistent blood loss, hemodynamic alterations, and survival. Mice undergo a standardized resection of the left-middle lobe of the liver. They are allowed to bleed without mechanical intervention. Hemostatic agents can be administered as pre-treatment or rescue therapy depending on the interest of the investigator. During the time of hemorrhage, real-time hemodynamic monitoring via a left femoral arterial line is performed...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28538647/bilateral-pulmonary-emboli-and-extensive-inferior-vena-cava-thrombosis-in-the-setting-of-large-subcapsularhematoma-and-liver-laceration-after-blunt-trauma
#20
Alejandro Betancourt-Ramirez, Soraya SMolero, Patrizio Petrone, Corrado P Marini, Heidi L Frankel
No abstract text is available yet for this article.
May 22, 2017: Journal of Trauma and Acute Care Surgery
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