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https://www.readbyqxmd.com/read/28337922/acquired-pulmonary-artery-pseudoaneurysms-a-pictorial-review
#1
Benedicte Guillaume, Anne Vendrell, Xavier Stefanovic, Frederic Thony, Gilbert R Ferretti
Pulmonary artery pseudoaneurysms (PAPs) are uncommon but potentially lethal. They may be incidentally discovered on imaging, or following massive hemoptysis if they rupture, with high risk of mortality. The most frequent causes of PAP are trauma and infectious disease. Vasculitis, in particular Behçet's disease, neoplasm, congenital disease and pulmonary hypertension are rarer causes of PAP. A PAP can be suspected from chest X-Ray and contrast CT, but requires confirmation by CT angiography. Arteriography is no longer performed for diagnostic purposes, but can be useful to prepare endovascular occlusion of the PAP...
March 24, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28334590/a-prospective-emergency-department-quality-improvement-project-to-improve-the-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease-lessons-learned
#2
Paula Tanabe, Caroline E Freiermuth, David M Cline, Susan Silva
BACKGROUND: Guidelines recommend rapid, aggressive management of vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD). A large prospective research and quality improvement (QI) project was conducted to measure changes in clinical outcomes in two EDs-academic medical centers with emergency medicine residency programs and Level 1 trauma centers-during a 2.5-year time period (October 2011-March 2014). METHODS: A QI team used a Plan-Do-Study-Act approach to modify and implement changes to opioid analgesic protocols for the emergency department (ED) treatment of VOC...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328730/partial-occlusion-conversion-from-thoracotomy-undelayed-but-shorter-occlusion-resuscitative-endovascular-balloon-occlusion-of-the-aorta-strategy-in-japan
#3
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tomohiro Funabiki
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a viable alternative to resuscitative thoracotomy (RT) in refractory hemorrhagic patients. We evaluated REBOA strategies using Japanese multi-institutional data. PATIENTS AND METHODS: The DIRECT-IABO investigators registered trauma patients requiring REBOA from 18 hospitals. Patients' characteristics, outcomes, and time in initial treatment were collected and analyzed. RESULTS: From August 2011 to December 2015, 106 trauma patients were analyzed...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28327940/the-nationwide-burden-of-neurological-conditions-requiring-emergency-neurosurgery
#4
Rafael De la Garza Ramos, C Rory Goodwin, Jonathan Nakhla, Rani Nasser, Reza Yassari, Eugene S Flamm, Ali Bydon, Geoffrey Colby, Daniel M Sciubba
BACKGROUND: Neurosurgical emergencies are an important cause of disability and mortality. OBJECTIVE: To examine the nationwide burden of neurological conditions requiring emergency neurosurgery. METHODS: The Nationwide Inpatient Sample database (2002-2011) was queried to identify adult patients with a primary discharge diagnosis of a neurosurgical condition who were admitted urgently/emergently or through a trauma center and underwent surgical intervention within 2 days of admission...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28296745/comparative-study-of-the-transcatheter-and-transthoracic-device-closure-treatments-for-atrial-septal-defect-a-chinese-single-institution-experience
#5
Qiang Chen, Hua Cao, Zhao-Yang Chen, Gui-Can Zhang, Liang-Wan Chen, Fan Xu, Jia-Jun He
The purpose of this study was to compare patient populations, safety, feasibility, complications, and total costs of the transcatheter and transthoracic device closure treatments for secundum atrial septal defect.From January 2014 to December 2014, we enrolled 155 patients with secundum atrial septal defects in our hospital. The patients were divided into 2 groups: the 70 patients in group A underwent transcatheter device closure, and the 85 patients in group B underwent transthoracic intraoperative device closure with a right lateral mini-thoracotomy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28291491/an-augmented-reality-based-approach-for-surgical-telementoring-in-austere-environments
#6
Dan Andersen, Voicu Popescu, Maria Eugenia Cabrera, Aditya Shanghavi, Brian Mullis, Sherri Marley, Gerardo Gomez, Juan P Wachs
Telementoring can improve treatment of combat trauma injuries by connecting remote experienced surgeons with local less-experienced surgeons in an austere environment. Current surgical telementoring systems force the local surgeon to regularly shift focus away from the operating field to receive expert guidance, which can lead to surgery delays or even errors. The System for Telementoring with Augmented Reality (STAR) integrates expert-created annotations directly into the local surgeon's field of view. The local surgeon views the operating field by looking at a tablet display suspended between the patient and the surgeon that captures video of the surgical field...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285483/a-perspective-on-the-potential-for-battlefield-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#7
Ryan M Knight
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has a place in civilian trauma centers in the United States, and British physicians performed the first prehospital REBOA, proving the concept viable for civilian emergency medical service. Can this translate into battlefield REBOA to stop junctional hemorrhage and extend "golden hour" rings in combat? If yes, at what level is this procedure best suited and what does it entail? This author's perspective, after treating patients on the battlefield and during rotary wing evacuation, is that REBOA may have a place in prehospital resuscitation but patient and provider selection are paramount...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285476/resuscitative-endovascular-balloon-occlusion-of-the-aorta-pushing-care-forward
#8
William Teeter, Anna Romagnoli, Jacob Glaser, Andrew D Fisher, Jason Pasley, Brian Scheele, Melanie Hoehn, Megan Brenner
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), used to temporize noncompressible and junctional hemorrhage, may be deployable to the forward environment. Our hypothesis was that nonsurgeon physicians and high-level military medical technicians would be able to learn the theory and insertion of REBOA. METHODS: US Army Special Operations Command medical personnel without prior endovascular experience were included. All participants received didactic instruction of the Basic Endovascular Skills for Trauma Course™ together, with individual evaluation of technical skills...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#9
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28280712/malocclusion-after-open-reduction-of-midfacial-fracture-a-case-report
#10
Seong-Un Lim, Ki-Su Jin, Yoon-Sic Han, Ho Lee
Malocclusion is a serious complication of open reduction surgery for facial fractures. It is often caused by the lack of adequate consideration for the occlusal relationship before the trauma and intermaxillary fixation during the operation. This is a case report of postoperative malocclusion that occurred in a patient with a midfacial complex fracture.
February 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28255447/high-flow-priapism-treated-with-superselective-transcatheter-embolization-using-polyvinyl-alcohol-particles
#11
Sebastián Sánchez-López, Silvia González-Gómez, Katyna Di Lizio-Miele, Joaquín González-Gómez
OBJECTIVES: Priapism is a persistent erection of the penis not associated with sexual stimulation. High-flow priapism is caused by unregulated arterial inflow, usually preceded by perineal or penile blunt trauma and formation of an arterial-lacunar fistula. We present a case of high-flow priapism in a 13-year-old patient managed with polyvinyl alcohol particles. METHODS: After obtaining informed consent of the parents of the minor, diagnosis was made with penile Color Doppler Ultrasound and confirmed with flush angiography...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28254602/evaluation-of-a-traumatic-vertebral-artery-occlusion
#12
Jaclyn J Renfrow, Mark B Frenkel, Matthew S Edwards, John A Wilson
BACKGROUND: Penetrating neck injury occurs in 5-10% of all trauma cases and carries a significant burden of morbidity and mortality (15%). We describe the evaluation and management of a 25 year-old man shot in the neck with occlusion of the left vertebral artery from its origin to C6. This is a case report where medical data was retrospectively analyzed with institutional IRB approval. CASE DESCRIPTION: Neurologic examination revealed paresthesias and dysesthesias in a left C8 dermatomal distribution...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28253183/anatomy-of-an-occlusal-splint
#13
Danny K Crout
Occlusal splints, also known as bite guards, oral orthotics, and oral appliances, are utilized frequently in dental practices. They are commonly used to relax jaw muscles, prevent temporomandibular jaw trauma, protect dentition, and control headaches. How well occlusal splints work is another matter. Numerous studies, when taken as a whole, suggest only a modest indication that they are useful. This review applies principles of neurophysiology to analyze the usefulness of several types of occlusal splint in relation to their design and function...
March 2017: General Dentistry
https://www.readbyqxmd.com/read/28246625/endovascular-management-of-a-combined-subclavian-and-vertebral-artery-injury-in-an-unstable-polytrauma-patient-case-report-and-literature-review
#14
Christian David Weber, Philipp Kobbe, Christian Herren, Andreas H Mahnken, Frank Hildebrand, Hans-Christoph Pape
While blunt trauma of the head and neck are a common pattern of injury, significant problems related to the prompt diagnosis and optimal management of traumatic artery injuries have been reported in the literature. While patients with major artery injuries might develop hemorrhagic shock very rapidly, patients with blunt cerebrovascular injuries (BCVI) can present asymptomatic, but complications like basilar territory infarction, cortical blindness and death may occur. We report the life- and limb-saving management in a 57-year-old hemodynamically unstable trauma patient...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28228434/sagittal-sinus-thrombosis-in-jak2-v617f-mutation-without-overt-myeloproliferative-disorder
#15
Prashant Ramesh Bhand, Supriya Ramesh Karde, Nagabathula Ramesh
We describe a case of a man aged 41 years who presented with a history of generalised headaches for 1 week and an acute episode of tonic-clonic seizures. He had no history of medical illness, was non-smoker, with an extensive family history of haematological disorders. Initial CT brain with contrast did not show any abnormalities in brain parenchyma. X-ray and CT right shoulder showed shoulder dislocation secondary to trauma associated with seizure prior to hospital admission. Subsequently, MRA and MRV brain was arranged, which revealed extensive expansible occlusive filling defect dominating the middle of superior sagittal sinus with left frontal cortical and subcortical acute oedema...
February 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28222758/erratum-to-resuscitative-endovascular-balloon-occlusion-of-the-aorta-versus-aortic-cross-clamping-among-patients-with-critical-trauma-a-nationwide-cohort-study-in-japan
#16
Toshikazu Abe, Masatoshi Uchida, Isao Nagata, Daizoh Saitoh, Nanako Tamiya
No abstract text is available yet for this article.
February 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28216142/astrocytic-calcium-waves-signal-brain-injury-to-neural-stem-and%C3%A2-progenitor%C3%A2-cells
#17
Anna Kraft, Eduardo Rosales Jubal, Ruth von Laer, Claudia Döring, Adriana Rocha, Moyo Grebbin, Martin Zenke, Helmut Kettenmann, Albrecht Stroh, Stefan Momma
Brain injuries, such as stroke or trauma, induce neural stem cells in the subventricular zone (SVZ) to a neurogenic response. Very little is known about the molecular cues that signal tissue damage, even over large distances, to the SVZ. Based on our analysis of gene expression patterns in the SVZ, 48 hr after an ischemic lesion caused by middle cerebral artery occlusion, we hypothesized that the presence of an injury might be transmitted by an astrocytic traveling calcium wave rather than by diffusible factors or hypoxia...
March 14, 2017: Stem Cell Reports
https://www.readbyqxmd.com/read/28215930/ultrasound-guided-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-resuscitation-area
#18
Takayuki Ogura, Alan Kawarai Lefor, Mitsunobu Nakamura, Kenji Fujizuka, Kousuke Shiroto, Minoru Nakano
BACKGROUND: In trauma resuscitation with resuscitative endovascular balloon occlusion of the aorta (REBOA), urgent and accurate placement of the catheter in the resuscitation area without fluoroscopy can shorten the time from admission to REBOA, allowing rapid, temporary control of bleeding. DISCUSSION: The experience-based protocol in our center for ultrasound-guided REBOA in the resuscitation area without fluoroscopy is as follows: the femoral artery is punctured and a guidewire inserted; sonography is used to verify that the guidewire is in the abdominal aorta; the position of the balloon is confirmed with ultrasound after estimating the distance to the clavicle, and the pressure in the radial artery and sheath is used to monitor correct positioning; connect the pressure transducer to the catheter sheath for continuous monitoring of the blood pressure in the sheath, and inflate the balloon until the blood pressure tracing at the sheath has disappeared; check the pulse in the left radial artery, and withdraw the catheter slightly if the pulse in the radial artery is not palpable or is decreased (if this pulse is not palpable or decreased, the balloon is in the aortic arch)...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28203028/-unerupted-first-deciduous-molar-located-higher-to-the-first-premolar-a-case-report
#19
Y Zhan, H Liu
Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar process to its functional position in the oral cavity. The process of tooth eruption can be divided into different phases: pre-eruptive bone stage, alveolar bone stage, mucosal stage, preocclusal stage, occlusal stage and maturation stage. Any disturbance in these phases can lead to eruptive anomalies. The incidence of unerupted teeth is usually higher among permanent teeth than among deciduous ones. Of the primary teeth reported as unerupted, second deciduous molars are the teeth most frequently involved, followed by primary central incisors...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28183285/early-detection-of-myocardial-infarction-following-blunt-chest-trauma-by-computed-tomography-a-case-report
#20
Thung-Lip Lee, Chin-Feng Hsuan, Chen-Hsiang Shih, Huai-Wen Liang, Hsing-Shan Tsai, Wei-Kung Tseng, Kwan-Lih Hsu
BACKGROUND: Blunt cardiac trauma encompasses a wide range of clinical entities, including myocardial contusion, cardiac rupture, valve avulsion, pericardial injuries, arrhythmia, and even myocardial infarction. Acute myocardial infarction due to coronary artery dissection after blunt chest trauma is rare and may be life threatening. Differential diagnosis of acute myocardial infarction from cardiac contusion at this setting is not easy. CASE PRESENTATION: Here we demonstrated a case of blunt chest trauma, with computed tomography detected myocardium enhancement defect early at emergency department...
February 10, 2017: BMC Cardiovascular Disorders
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