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https://www.readbyqxmd.com/read/28427001/emergency-room-thoracotomy-for-acute-traumatic-cardiac-tamponade-caused-by-a-blunt-cardiac-injury-a-case-report
#1
Kenichiro Ishida, Yoshihiro Kinoshita, Nobutaka Iwasa, Masaro Nakae, Masayuki Sakaki, Yohei Ieki, Kyosuke Takahashi, Yumiko Shimahara, Taku Sogabe, Keiichiro Shimono, Mitsuhiro Noborio, Daikai Sadamitsu
INTRODUCTION: Traumatic blunt cardiac injuries have a high mortality rate, and prompt diagnosis and treatment can be lifesaving in cardiac tamponade. PRESENTATION OF CASE: A 62-year-old man was transferred to the emergency department after a motor vehicle accident. He was hemodynamically unstable. A focused assessment with sonography in trauma (FAST) showed pericardial fluid with right ventricular collapse consistent with cardiac tamponade in the subxiphoid view...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#2
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28414681/what-can-erode-through-lungs-bone-and-skin
#3
J M Manalac, D Shankaranayanan, J Paul-Olivier, L Guidry, N R Sells
CASE: A 51 year old African American Man without significant past history presented with three weeks of persistent cough productive of copious yellow sputum. He denied fevers, chills, hemoptysis, dyspnea, weight or appetite changes, sick contacts, recent travel. On physical examination, the patient was afebrile and appeared comfortable. He had decreased air entry of the left lower lobe with dullness to percussion. A 5x3 cm fluctuant mass was incidentally found on the left anterior chest wall at the level of the 11th rib with yellow expressible exudate at which time the patient reported a minor trauma sustained 3 weeks prior...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28401399/intelligent-viewpoint-selection-for-efficient-ct-to-video-registration-in-laparoscopic-liver-surgery
#4
Maria R Robu, Philip Edwards, João Ramalhinho, Stephen Thompson, Brian Davidson, David Hawkes, Danail Stoyanov, Matthew J Clarkson
PURPOSE: Minimally invasive surgery offers advantages over open surgery due to a shorter recovery time, less pain and trauma for the patient. However, inherent challenges such as lack of tactile feedback and difficulty in controlling bleeding lower the percentage of suitable cases. Augmented reality can show a better visualisation of sub-surface structures and tumour locations by fusing pre-operative CT data with real-time laparoscopic video. Such augmented reality visualisation requires a fast and robust video to CT registration that minimises interruption to the surgical procedure...
April 11, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28400940/early-diagnosis-of-penetrating-cardiac-and-pleural-injury-by-extended-focused-assessment-with-sonography-for-trauma
#5
K P Singaravelu, Rama Prakasha Saya, Vinay R Pandit
In India, stab injury is not uncommon, but identifying potential life threatening conditions in the emergency room (ER) and initiating prompt treatment are challenging. This is a case report of a young patient who presented to the ER with assault injury to the chest and shock; timely extended focused assessment with sonography for trauma helped to fast-track the patient to the operating room. A brief review of diagnosis and management of penetrating cardiac injury is presented herewith.
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28396930/initial-management-of-complex-hand-injuries-in-military-or-austere-environments-how-to-defer-and-prepare-for-definitive-repair
#6
Camille Choufani, Olivier Barbier, Antoine Grosset, James Charles Murison, Didier Ollat, Sylvain Rigal, Laurent Mathieu
INTRODUCTION: The damage control orthopedics (DCO) concept is a sequential surgical management strategy indicated when ideal primary treatment is not possible or suitable. DCO principles are routinely applied to hand traumas in wartime practice, but could also be useful in a civilian setting when immediate specialized management cannot be carried out. METHODS: The authors report three typical observations of soldiers treated for a complex hand trauma on the field by orthopedic surgeons from the French Military Health Service (FMHS)...
April 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28355371/characteristics-of-training-and-motivation-of-physicians-working-in-emergency-medicine
#7
Gilson Soares Feitosa-Filho, Marcelo Kirschbaum, Yuri Costa Sarno Neves, Bruna Melo Coelho Loureiro, Victor Augusto Camarinha de Castro Lima, Rafael Marques Calazans, Camila Kruschewsky Falcão, Renata Trindade El Fahl, Bianca Recarey Barreto
Introduction: Emergency medicine is an area in which correct decisions often need to be made fast, thus requiring a well-prepared medical team. There is little information regarding the profile of physicians working at emergency departments in Brazil. Objective: To describe general characteristics of training and motivation of physicians working in the emergency departments of medium and large hospitals in Salvador, Brazil. Method: A cross-sectional study with standardized interviews applied to physicians who work in emergency units in 25 medium and large hospitals in Salvador...
February 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28341000/arterial-spin-labeling-perfusion-imaging-of-children-with-subdural-hemorrhage-perfusion-abnormalities-in-abusive-head-trauma
#8
Alex Mun-Ching Wong, Chih-Hua Yeh, Ho-Ling Liu, Tai-Wei Wu, Kuang-Lin Lin, Huei-Shyong Wang, Cheng-Hong Toh
BACKGROUND AND PURPOSE: Perfusion abnormalities have not been well described in children with subdural hemorrhage (SDH). We investigated whether patients with abusive head trauma (AHT+) had more perfusion abnormalities than those without (AHT-). MATERIALS AND METHODS: We reviewed the perfusion MR studies of 12 infants with SDH and 21 controls. The perfusion images were obtained using a pseudo-continuous arterial spin-labeling sequence with volumetric fast spin-echo readout...
March 21, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28324353/the-fast-d-protocol-a-simple-method-to-rule-out-traumatic-vascular-injuries-of-the-lower-extremities
#9
Miguel Angel Montorfano, Lisandro Miguel Montorfano, Federico Perez Quirante, Federico Rodríguez, Leonardo Vera, Luca Neri
BACKGROUND: The aim of this study is to assess the accuracy of a Fast Doppler protocol for the examination of an injured lower limb, namely 2-Point Fast Doppler (2PFD), in order to rapidly triage arterial lesions after penetrating trauma. METHODS: The presence of flow and the aspects of the Doppler waveform of the dorsalis pedis artery (DPA) and posterior tibial artery (PTA) of the injured lower limb (2PFD) were evaluated immediately before the execution of a standardized Color Duplex Doppler (SD) evaluation in 149 limbs of 140 patients with gunshot penetrating injuries...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28318439/focused-assessment-with-sonography-in-trauma-fast-in-2017-what-radiologists-can-learn
#10
John R Richards, John P McGahan
Focused assessment with sonography in trauma (FAST) has been extensively utilized and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly utilized to diagnose intraabdominal injury. Today the FAST examination has evolved into a more comprehensive study of the abdomen, heart, chest, and inferior vena cava, and many variations in technique, protocols, and interpretation exist. Trauma management strategies such as laparotomy, laparoscopy, endoscopy, computed tomographic angiography, angiographic intervention, serial imaging, and clinical observation have also changed over the years...
April 2017: Radiology
https://www.readbyqxmd.com/read/28294580/effect-of-cerebrospinal-fluid-modelling-on-spherically-convergent-shear-waves-during-blunt-head-trauma
#11
Amit Madhukar, Ying Chen, Martin Ostoja-Starzewski
The MRI-based computational model, previously validated by tagged MRI and HARP imaging analysis technique on in vivo human brain deformation, is employed to study transient wave dynamics during blunt head trauma. Three different constitutive models are used for the cerebrospinal fluid (CSF): incompressible solid elastic, viscoelastic and fluid-like elastic using an equation of state model. Three impact cases are simulated which indicate that the blunt impacts give rise not only to a fast pressure wave but also to a slow, and potentially much more damaging, shear (distortional) wave that converges spherically towards the brain center...
March 14, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28291703/fdp-fibrinogen-ratio-reflects-the-requirement-of-packed-red-blood-cell-transfusion-in-patients-with-blunt-trauma
#12
Shuichi Hagiwara, Makoto Aoki, Masato Murata, Minoru Kaneko, Yumi Ichikawa, Jun Nakajima, Yuta Isshiki, Yusuke Sawada, Jun'ichi Tamura, Kiyohiro Oshima
PURPOSE: To find factors that predict the requirement of packed red blood cells (pRBC) transfusion in patients with blunt trauma on arrival at the hospital. METHODS: We conducted blood tests in trauma patients whose trauma severity was suspected as being 3 and over in the Abbreviated Injury Scale. Patients were divided into the blood transfusion (BT) and control groups according to the requirement of pRBC transfusion within 24h after arrival. RESULTS: We analyzed 347 patients (BT group, n=14; control group, n=333)...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#13
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28262308/periosteal-fasciitis-in-a-7-year-old-girl-a-diagnostic-dilemma
#14
M Lääveri, K Heikinheimo, D Baumhoer, P J Slootweg, R-P Happonen
Periosteal fasciitis, considered a subtype of nodular fasciitis, is a rare benign soft tissue mass often misdiagnosed as a malignant lesion due to its fast and infiltrative growth pattern and histological features. Nodular fasciitis is usually found in the upper extremities in adults and in the head and neck region in children. Incorrect diagnosis may lead to overtreatment, potentially causing disturbed orofacial development in growing children. A rapidly growing asymptomatic mass, initially suspected to be a malignant bone tumour, was found in the left angle area of the mandible in a healthy 7-year-old girl...
March 2, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28262145/predictors-of-metabolic-syndrome-in-first-manic-episode
#15
Sermin Kesebir, Boray Erdinç, Nevzat Tarhan
OBJECTIVE: In the present study we aimed to investigate, whether an association between metabolic syndrome (MetS) and clinical features and affective temperaments exists or not in first manic episode of bipolar disorder (BD) and to clarify the prevalence and predictors of MetS. METHOD: A total of 150 patients who were received a diagnosis of bipolar disorder type I according to DSM-IV criteria and who were experiencing their first manic episode (FME) were screened consecutively for inclusion...
February 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28252424/the-peculiarities-of-treatment-of-uncomplicated-and-complicated-dental-injuries-caused-by-trauma
#16
M Mamaladze, N Nizharadze, O Vadachkoria
Trauma related injuries of permanent teeth occur frequently and are the most pressing issue the dentists are facing today. In different age groups the same type of trauma affects the teeth with different frequencies. For instance, accident related dental trauma in children and adults affected permanent teeth in 30% and deciduous teeth in 20%, respectively. It should also be noted that front teeth are more susceptible to traumatic injuries compared to the incisors. Upper front teeth were injured in 72% of cases, while lower central, upper lateral incisors, canines and premolars only in 6-8%...
January 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28240501/role-of-focused-assessment-with-sonography-for-trauma-as-a-screening-tool-for-blunt-abdominal-trauma-in-young-children-after-high-energy-trauma
#17
W Tummers, J van Schuppen, H Langeveld, J Wilde, E Banderker, A van As
BACKGROUND: The objective of the study was to review the utility of focused assessement with sonography for trauma (FAST) as a screening tool for blunt abdominal trauma (BAT) in children involved in high energy trauma (HET), and to determine whether a FAST could replace computed tomography (CT) in clinical decision-making regarding paediatric BAT. METHOD: Children presented at the Trauma Unit of the Red Cross War Memorial Children's Hospital, Cape Town, after HET, and underwent both a physical examination and a FAST...
June 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28214722/when-high-pressure-system-constraints-and-a-social-justice-mission-collide-a-socio-structural-analysis-of-emergency-department-social-work-services
#18
Megan Moore, Margaret Cristofalo, Danae Dotolo, Nicole Torres, Alexandra Lahdya, Leyna Ho, Mia Vogel, Mollie Forrester, Bonnie Conley, Susan Fouts
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10)...
April 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28210364/caudal-edge-of-the-liver-in-the-right-upper-quadrant-ruq-view-is-the-most-sensitive-area-for-free-fluid-on-the-fast-exam
#19
Viveta Lobo, Michelle Hunter-Behrend, Erin Cullnan, Rebecca Higbee, Caleb Phillips, Sarah Williams, Philips Perera, Laleh Gharahbaghian
INTRODUCTION: The focused assessment with sonography in trauma (FAST) exam is a critical diagnostic test for intraperitoneal free fluid (FF). Current teaching is that fluid accumulates first in Morison's pouch. The goal of this study was to evaluate the "sub-quadrants" of traditional FAST views to determine the most sensitive areas for FF accumulation. METHODS: We analyzed a retrospective cohort of all adult trauma patients who had a recorded FAST exam by emergency physicians at a Level I trauma center from January 2012 - June 2013...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28202056/normal-gastric-emptying-time-of-a-carbohydrate-rich-drink-in-elderly-patients-with-acute-hip-fracture-a-pilot-study
#20
Per M Hellström, Bodil Samuelsson, Amer N Al-Ani, Margareta Hedström
BACKGROUND: Guidelines for fasting in elderly patients with acute hip fracture are the same as for other trauma patients, and longer than for elective patients. The reason is assumed stress-induced delayed gastric emptying with possible risk of pulmonary aspiration. Prolonged fasting in elderly patients may have serious negative metabolic consequences. The aim of our study was to investigate whether the preoperative gastric emptying was delayed in elderly women scheduled for surgery due to acute hip fracture...
February 15, 2017: BMC Anesthesiology
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