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vascular AND trauma

Marco Stella, Emmanuele Santolini, Francesca Sanguineti, Lamberto Felli, Giovanni Vicenti, Davide Bizzoca, Federico Santolini
BACKGROUND: Acute compartment syndrome (ACS) is characterised by abnormal pressure inside a compartment, resulting in ischemia of muscles and nerves. Most orthopaedic surgeons, especially those who work in major trauma centres, have been or will be facing a case of ACS in their clinical activity. Fortunately, complications related to untreated compartment syndrome have become less frequent thanks to a better understanding of pathogenesis and to early recognition and prompt surgical treatment...
February 2, 2019: Injury
Byron Miyazawa, Alpa Trivedi, Padma Priya Togarrati, Daniel Potter, Gyulnar Baimukanova, Lindsay Vivona, Maximillian Lin, Ernesto Lopez, Rachael Callcut, Amit K Srivastava, Lucy Z Kornblith, Alexander T Fields, Martin A Schreiber, Charles E Wade, John B Holcomb, Shibani Pati
BACKGROUND: Platelet (Plt) derived-extracellular vesicles (Plt-EVs) have hemostatic properties similar to Plts. In addition to hemostasis, Plts also function to stabilize the vasculature and maintain endothelial cell (EC) barrier integrity. We hypothesized that Plt-EVs would inhibit vascular endothelial cell permeability, similar to fresh Plts. To investigate this hypothesis we utilized in vitro and in vivo models of vascular endothelial compromise and bleeding. METHODS: In vitro: Plt-EVs were isolated by ultracentrifugation and characterized for Plt markers and particle size distribution...
February 13, 2019: Journal of Trauma and Acute Care Surgery
Mariya M Mikhailova, Andrey A Panteleyev, Mikhail A Paltsev, Andrey A Panteleyev
It is a well-known fact, that there is a close interconnection between vascular and neural structures in both embryonic development and postnatal life. Different models have been employed to dissect the mechanisms of these interactions, ranging from in vitro systems (e.g., co-culture of neural and endothelial cells) to in vivo imaging of central neural system recovery in laboratory animals after artificially induced trauma. Nevertheless, most of these models have serious limitations. Here, we describe an ex vivo model, representing an organotypic co-culture of aortic fragments (AF) with longitudinal slices of mouse neonatal spinal cord (SC) or dorsal root ganglia (DRG)...
February 13, 2019: Cell Biology International
Renate Sørgjerd, Geir Arne Sunde, Jon-Kenneth Heltne
BACKGROUND: Intravenous access in critically ill and injured patients can be difficult or impossible in the field. Intraosseous access is a well-established alternative to achieve access to a noncollapsible vascular network. We wanted to compare the use of a sternal and tibial/humeral intraosseous device in a physician-staffed helicopter emergency medical service. METHODS: The helicopter emergency medical service in Bergen, Norway, is equipped with two different intraosseous devices, the EZ-IO and FAST-Responder...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Dian He, YunLi Yu, Shan Wu, ShuFen Tian, Hui Yu, Shu Xu, Lan Chu
BACKGROUND: Mixed cerebrovascular disease is a diagnostic entity that presents with hemorrhagic and ischemic stroke clinically and/or subclinically. Here, we report a patient with mixed vascular risk factors, who presented with multiple intracerebral hemorrhages and a simultaneously occurring cerebral infarction with hemorrhagic transformation. CASE PRESENTATION: A 63-year-old male with no history of trauma or prior neurological disease presented with a sudden onset of weakness in his right limbs, followed by an episode of focal seizure without impaired awareness...
February 12, 2019: BMC Neurology
Avraam Ploumis, Andreas Liampas, Michail Angelidis, Areti Theodorou, Vasilios Xydis, Ioannis Gelalis, Peter Zampakis, Vasilios Panagiotopoulos
Background: Hereditary multiple exostoses (HME) is an inherited genetic condition, characterized by the formation of multiple osteochondromas, developing throughout childhood and into puberty. Vascular complications associated with HME are uncommon. Methods: A case of a patient with HME who was admitted to hospital with subarachnoid hemorrhage (SAH), as a result of acute rupture of a basilar tip aneurysm (BTA), will be presented. Relevant literature on this topic will be systematically reviewed...
November 2018: Journal of Vascular and Interventional Neurology
Sorena Keihani, Douglas M Rogers, Bryn E Putbrese, Rachel A Moses, Chong Zhang, Angela P Presson, James M Hotaling, Raminder Nirula, Xian Luo-Owen, Kaushik Mukherjee, Bradley J Morris, Sarah Majercik, Joshua Piotrowski, Christopher M Dodgion, Ian Schwartz, Sean P Elliott, Erik S DeSoucy, Scott Zakaluzny, Brenton G Sherwood, Bradley A Erickson, Nima Baradaran, Benjamin N Breyer, Brian P Smith, Barbara U Okafor, Reza Askari, Brandi Miller, Richard A Santucci, Matthew M Carrick, Jurek F Kocik, Timothy Hewitt, Frank N Burks, Marta E Heilbrun, Jeremy B Myers
BACKGROUND: The management of high-grade renal trauma (HGRT) and the indications for intervention are not well-defined. The American Association for the Surgery of Trauma (AAST) renal grading does not incorporate some important clinical and radiologic variables associated with increased risk of interventions. We aimed to use data from a multi-institutional contemporary cohort to develop a nomogram predicting risk of interventions for bleeding after HGRT. METHODS: From 2014 to 2017, data on adult HGRT (AAST grades III-V) were collected from 14 Level-1 trauma centers...
February 7, 2019: Journal of Trauma and Acute Care Surgery
Xin Nee Ho, Ian Jy Wee, Nicholas Syn, Michael Harrison, Lauren Wilson, Andrew Mtl Choong
INTRODUCTION: Blunt traumatic thoracic aortic injury, the second leading cause of death from trauma, poses unique challenges in its management. However, there has not yet been a corresponding consolidated series of outcomes reported in Asia, which this systematic review aims to address. METHOD: This review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Searches were performed on MEDLINE, EMBASE, Google Scholar, and Cochrane Database for studies performed in Asia reporting the endovascular management of blunt traumatic thoracic aortic injury...
February 10, 2019: Vascular
Murat Ekşi, Emel Özcan-Ekşi, Ayça Arslanhan, Hakan Şirinoğlu, Sertaç Erbil, Abuzer Güngör, Oktay Algin, Deniz Konya
AIM: Trauma and diabetes with concomitant vascular pathologies are leading causes of limb amputations. Functionality following amputation procedures is very important for social re-integration of the patients. In this study, we aimed to learn how rat primary somatosensory cortex (pSSC) responses to the loss of inputs from hind-paw, using fMRI of an inferior magnetic power (1.5 Tesla) with special designed high-powered rat coil. MATERIAL AND METHODS: Ten adult male Sprague-Dawley rats were enrolled in this study...
January 24, 2019: Turkish Neurosurgery
Dominic Pang, Diane Hildebrand, Paul Bachoo
BACKGROUND: Blunt traumatic thoracic aortic injury (BTAI) is a life-threatening surgical emergency associated with mortality up to 8000 per year, most commonly caused by rapid acceleration/deceleration injury sustained through motor vehicle accident and/or blunt thoracic trauma. BTAI has high pre-hospital mortality following the primary injury, with only 10% to 15% of patients surviving long enough to reach the hospital. Open surgical repair had remained the standard treatment option for BTAI since successfully introduced in 1959...
February 6, 2019: Cochrane Database of Systematic Reviews
Antonio Brillantino, Francesca Iacobellis, Patrizio Festa, Arianna Mottola, Ciro Acampora, Fabio Corvino, Santolo Del Giudice, Michele Lanza, Mariano Armellino, Raffaella Niola, Luigia Romano, Maurizio Castriconi, Maurizio De Palma, Giuseppe Noschese
Objective: To evaluate the safety and effectiveness of NOM (non-operative management) in the treatment of blunt liver trauma, following a standardized treatment protocol. Methods: All the hemodynamically stable patients with computed tomography (CT) diagnosis of blunt liver trauma underwent NOM. It included strict clinical and laboratory observation, 48-72h contrast enhanced ultrasonography (CEUS) or CT follow-up, a primary angioembolization in case of admission CT evidence of vascular injuries and a secondary angioembolization in presence of vascular injuries signs at follow-up CEUS...
January 2019: Bulletin of Emergency and Trauma
Luigi Branca Vergano, Mauro Monesi
Background and aim of the work The term "floating shoulder" was used in a previous paper to describe lesions of at least two components of the SSSC (superior shoulder suspensory complex), a bony-ligamentous structure of the shoulder girdle. Following this article other types of floating shoulder were described, including scapulothoracic dissociation (STD), a rare lesion with potentially devastating consequences, with detachment of the scapular body from the thoracic wall, with following lateralization of the scapula,  fracture of the clavicle or injury of the adiacent sterno-clavear or acromion-clavicular joints...
November 15, 2018: Acta Bio-medica: Atenei Parmensis
Shimpei Tsuboki, Takayuki Kawano, Yuki Ohmori, Toshihiro Amadatsu, Akitake Mukasa
BACKGROUND: Sixth-nerve palsy often develops as a result of trauma, neoplasm, or vascular disease affecting the pons. Less commonly, this palsy can be caused by pathology of the internal carotid artery in the cavernous sinus region. Here, we describe a rare case of spontaneous dissection of the internal carotid artery in the cavernous sinus accompanied by acute sixth nerve palsy that was successfully treated with surgery. CASE DESCRIPTION: An 18-year-old man presented suddenly and spontaneously with isolated abducent nerve palsy...
January 31, 2019: World Neurosurgery
Cevriye Mülkoğlu, Hakan Genç
BACKGROUND: Hypothenar Hammer Syndrome (HHS) is an uncommon vascular syndrome of upper extremity. HHS should be considered in patients who are presented with digital ischemia. Distal ulnar artery compression at the level of Guyon's canal with trauma result in thrombus or aneurysm. It may be observed following repetitive chronic trauma or acute blunt trauma to hypothenar eminence. Middle-aged male laborers, smokers and dominant hands are affected frequently. Hand pain, discoloration or ulceration of digits, cold intolerance, hypothenar pulsatile mass, hypothenar weakness, numbness are significant clinical findings...
January 31, 2019: Annals of Vascular Surgery
Davinder Ramsingh, Venkat Reddy Mangunta
Caring for the trauma patient requires an in-depth knowledge of the pathophysiology of trauma, the ability to rapidly diagnose and intervene to reverse the derangements caused by shock states, and an aptitude for the use of advanced monitoring techniques and perioperative point-of-care ultrasonography (P-POCUS) to assist in diagnosis and delivery of care. Historically, anesthesiology has lagged behind in wholly embracing this technology. P-POCUS has the potential to allow the trauma anesthesiologist to diagnose numerous injuries, quickly guide the placement of central vascular catheters and invasive monitors, and assess the efficacy of interventions...
March 2019: Anesthesiology Clinics
Alissara Vanichkulbodee, Suwara Issaragrisil, Pholaphat Charles Inboriboon
BACKGROUND: Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury. OBJECTIVE: We report the rare case of SEH associated with traditional massage initially presenting with delayed lower paraplegia. CASE REPORT: A 20-year-old man presented with bilateral lower extremity weakness and numbness 3 h prior to presentation. 3 days prior he was given a layperson Thai massage by a friend...
January 15, 2019: American Journal of Emergency Medicine
Marissa A Ruehle, Mon-Tzu Alice Li, Albert Cheng, Laxminarayanan Krishnan, Nick J Willett, Robert E Guldberg
Traumatic musculoskeletal injuries that result in bone defects or fractures often affect both bone and the surrounding soft tissue. Clinically, these types of multi-tissue injuries have increased rates of complications and long-term disability. Vascular integrity is a key clinical indicator of injury severity, and revascularization of the injury site is a critical early step of the bone healing process. Our lab has previously established a pre-clinical model of composite bone-muscle injury that exhibits impaired bone healing; however, the vascularization response in this model had not yet been investigated...
January 25, 2019: Acta Biomaterialia
Yunbin Xu, Yong Li, Weiguo Bao, Shi Qiu
OBJECTIVE: To investigate the clinical significance of minimally invasive direct coronary artery bypass (MIDCAB). METHODS: 300 patients admitted to the Second Hosptial of Shandong University Hospital from March 2006 to February 2010 were retrospectively analyzed and received off-pump operation under general anesthesia. According to surgical methods, patients were divided into the MIDCAB group (n=90) and the median sternotomy off-pump coronary artery bypass (OPCAB) group, namely the OPCAB group (n=210)...
January 24, 2019: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Samer Makki Mohamed Al-Hakkak, Firas Shaker Mahmoud Al-Faham, Ali Najeh Al-Awwady
INTRODUCTION: Acute limb ischemia is a sudden decrease in limb perfusion that threatens the viability of the limb. Complete or even partial occlusion of the arterial supply to a limb can lead to rapid ischemia and poor functional outcomes within hours. In human echinococcosis cardiac involvement is a rare presentation, it may lead to life-threatening complications including cyst rupture; anaphylactic shock; tamponade; pulmonary, cerebral or peripheral arterial embolism. Cardiac hydatid cyst (CHC) may have different presentation include acute lower limb ischemia secondary to embolization from a ruptured cyst...
January 14, 2019: International Journal of Surgery Case Reports
Parthiban Balasundaram, Leve Joseph Devarajan Sebastian, Nishchint Jain, Anuj Prabhakar, Ajay Garg, Shailesh Gaikwad
BACKGROUND: Arterial pseudoaneurysms of the neck are rarely reported in pediatric population with no dedicated large series available yet. Trauma and infection are the most common causes for these aneurysms, with congenital and collagen vascular disorders being the less common etiologies. These lesions can be life threatening, especially when they present with bleeding or airway compromise. METHODS: We searched our radiology information system for all cases of pediatric neck aneurysm presented between June 2015 and May 2018...
January 23, 2019: World Neurosurgery
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