10,008 results match your criteria Dysbarism


Systematic review and meta-analysis of clinical trials examining the effect of hyperbaric oxygen therapy in people with diabetes-related lower limb ulcers.

Diabet Med 2019 Apr 19. Epub 2019 Apr 19.

Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Aim: To examine the efficacy of hyperbaric oxygen therapy in healing diabetes-related lower limb ulcers through a meta-analysis of randomized clinical trials.

Methods: A literature search was conducted to identify appropriate clinical trials. Inclusion required randomized study design and reporting of the proportion of diabetes-related lower limb ulcers that healed. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.13975
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http://dx.doi.org/10.1111/dme.13975DOI Listing
April 2019
2 Reads

[The Critically Ill Obese Patient: Too Big to Fail?]

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Apr 12;54(4):256-266. Epub 2019 Apr 12.

Worldwide, currently more than 1.9 billion adults are overweight, 650 million of them are obese. Hereby they pose a significant burden on the budget of the health system and on the workload of intensive care units. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/a-0636-2735
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http://dx.doi.org/10.1055/a-0636-2735DOI Listing
April 2019
2 Reads

Pneumomediastinum in marijuana users: a retrospective review of 14 cases.

BMJ Open Respir Res 2019 12;6(1):e000391. Epub 2019 Feb 12.

Division of Pulmonary and Critical Care and Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Introduction: Inhaled marijuana has been infrequently identified as a potential risk factor for the development of spontaneous pneumomediastinum (SPM), a rare finding of free air in the mediastinum likely caused by barotrauma during breathing manoeuvres. The mechanism of inhalation drug use is often not ascertained by physicians, thus little is known about how different smoking techniques precipitate pulmonary injury. We aimed to evaluate the frequency of marijuana use in patients with non-traumatic pneumomediastinum over a 12-month period, identifying additional relevant clinical features or risk factors, and determining the extent to which clinicians record smoking techniques. Read More

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http://dx.doi.org/10.1136/bmjresp-2018-000391DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424304PMC
February 2019
1 Read

Airway pressure release ventilation during acute hypoxemic respiratory failure: a systematic review and meta-analysis of randomized controlled trials.

Ann Intensive Care 2019 Apr 4;9(1):44. Epub 2019 Apr 4.

Anesthesia and Intensive Care Unit, Università Politecnica delle Marche, Ancona, Italy.

Background: Airway pressure release ventilation (APRV) has been considered a tempting mode of ventilation during acute respiratory failure within the concept of open lung ventilation. We performed a systematic review and meta-analysis to verify whether adult patients with hypoxemic respiratory failure have a higher number of ventilator-free days at day 28 when ventilated in APRV compared to conventional ventilation strategy. Secondary outcomes were difference in PaO/FiO at day 3, ICU length of stay (LOS), ICU and hospital mortality, mean arterial pressure (MAP), risk of barotrauma and level of sedation. Read More

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http://dx.doi.org/10.1186/s13613-019-0518-7DOI Listing
April 2019
5 Reads

PO oscillations induce lung injury and inflammation.

Crit Care 2019 Mar 27;23(1):102. Epub 2019 Mar 27.

Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Background: Mechanical ventilation can lead to ventilator-induced lung injury (VILI). In addition to the well-known mechanical forces of volutrauma, barotrauma, and atelectrauma, non-mechanical mechanisms have recently been discussed as contributing to the pathogenesis of VILI. One such mechanism is oscillations in partial pressure of oxygen (PO) which originate in lung tissue in the presence of within-breath recruitment and derecruitment of alveoli. Read More

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http://dx.doi.org/10.1186/s13054-019-2401-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438034PMC
March 2019
1 Read

A Case of Pneumomediastinum and Pneumoperitoneum with Concurrent Massive Subcutaneous Emphysema due to Repositioning of a Tracheostomy Tube.

Cureus 2019 Jan 14;11(1):e3881. Epub 2019 Jan 14.

Internal Medicine, Brookdale University Hospital Medical Center, New York, USA.

Tracheostomy is a common procedure seen in critically ill patients that require long term ventilatory support. As with all airway access procedures, tracheotomy with prolonged tracheal tube placement comes with possible risks such as tracheal scarring, tracheal rupture, pneumothorax, tracheoesophageal fistula among others. Another possible complication, though rare, is escape of free air into the surrounding tissue, as well as pneumomediastinum (PM). Read More

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http://dx.doi.org/10.7759/cureus.3881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420328PMC
January 2019
1 Read

Cecum perforation secondary to plunger-induced barotrauma.

J Surg Case Rep 2019 Mar 13;2019(3):rjz077. Epub 2019 Mar 13.

Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA.

Barotrauma to the colon and rectum is well documented, most commonly due to endoscopic complications. Here, we describe the unique case of a 56-year-old male presenting with peritonitis after self induced barotrauma to his colon following an attempt to alleviate 4-day obstipation with a toilet plunger. Exploratory laparotomy revealed a perforated and gangrenous right colon, which was promptly treated with an open right hemicolectomy and end-loop Prasad ileocolostomy. Read More

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https://academic.oup.com/jscr/article/doi/10.1093/jscr/rjz07
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http://dx.doi.org/10.1093/jscr/rjz077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415624PMC
March 2019
6 Reads

The effects of pressure in vitro on three methods of root canal obturation.

Diving Hyperb Med 2019 Mar;49(1):16-20

Department of Periodontology, Dental Faculty - Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran.

Introduction: The seal of root canal fillings depends on the anatomy of the root canal system and on the properties of filling materials and their bond to the walls of the root canal. Alterations in pressure may influence these properties. The current study investigated and compared microleakage in a tapered single-cone method versus lateral and vertical condensation after diving simulation. Read More

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http://www.dhmjournal.com/index.php/journals?id=53
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http://dx.doi.org/10.28920/dhm49.1.16-20DOI Listing
March 2019
2 Reads
0.607 Impact Factor

Eustachian tube balloon dilation in treatment of equalization problems of freediving spearfishermen.

Diving Hyperb Med 2019 Mar;49(1):9-15

ENT Department of Santa Maria Hospital of Terni, Viale Tristano di Joannuccio, Terni, Italy.

Background: Eustachian tube balloon dilation is a minimally invasive surgical procedure used to treat Eustachian tube dysfunction which is not responsive to conventional therapies.

Methods: In this cohort intervention series we report the results of balloon dilation in treating refractory equalization problems in 20 freediving spearfishermen; in 19 cases the problem was unilateral and in one case bilateral. All the patients had already received medical and insufflation therapy and four patients had also had nasal surgery. Read More

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http://dx.doi.org/10.28920/dhm49.1.9-15DOI Listing
March 2019
2 Reads

Spontaneous pneumomediastinum (Hamman's syndrome): presenting as acute severe asthma.

J R Coll Physicians Edinb 2019 Mar;49(1):31-33

Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield WF1 4DG, UK,

Spontaneous pneumomediastinum (SPM) is an uncommon finding and clinicians must consider this during their clinical evaluation. High degree of suspicion and appropriate investigations play key roles in early diagnosis and avoiding potential life-threatening complications. SPM usually presents without any comorbidities (primary) or due to an underlying pathology (secondary), such as underlying asthma, barotrauma, valsalva manoeuvre or an oesophageal rupture. Read More

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http://dx.doi.org/10.4997/JRCPE.2019.106DOI Listing
March 2019
6 Reads

Prevalence and Risk Factors for Hearing Loss in Chilean Shellfish Divers.

Ann Glob Health 2018 Aug 31;84(3):442-449. Epub 2018 Aug 31.

Center for International Health at the Institute for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, DE.

Background: Diving within artisanal fishing is a profession carried out by many men in coastal communities of southern Chile. These shellfish divers use surface supplied air for breathing. Among potential health threats are occupational accidents, decompression sickness and barotrauma. Read More

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http://dx.doi.org/10.29024/aogh.2310DOI Listing
August 2018
3 Reads

The impact of repetitive hyperbaric exposure during SCUBA diving on cochlear implants.

Laryngoscope 2019 Feb 27. Epub 2019 Feb 27.

National Hearing Implant and Research Centre, Beaumont Hospital, Dublin, Ireland.

Objectives/hypothesis: Complications during or after cochlear implantation are relatively rare. They occur more frequently in patients who partake in activities that can potentially lead to local trauma. No formal recommendations exist for participation in self-contained underwater breathing apparatus (SCUBA) activities. Read More

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http://dx.doi.org/10.1002/lary.27880DOI Listing
February 2019
1 Read

Barotrauma and Arterial Gas Embolism: A Diving Emergencies Simulation Case for Emergency Medicine Residents.

MedEdPORTAL 2018 Dec 21;14:10788. Epub 2018 Dec 21.

Clinical Instructor of Medicine, Department of Emergency Medicine, NewYork-Presbyterian Hospital/Columbia University Medical Center.

Introduction: Arterial gas embolism (AGE) is a rare but severe complication of scuba diving. While AGE is most commonly encountered in coastal areas with high volumes of recreational divers, at-risk populations exist throughout the United States, making basic knowledge of the disease important for all emergency medicine (EM) physicians.

Methods: We used a hypothetical simulation case to train EM residents on diagnosis and management of AGE. Read More

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http://dx.doi.org/10.15766/mep_2374-8265.10788DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354796PMC
December 2018

Effects of Breath-Hold Deep Diving on the Pulmonary System.

Respiration 2019 Feb 15:1-8. Epub 2019 Feb 15.

Department of Sports Medicine, Medical Clinic, Eberhard Karls University of Tübingen, Tübingen, Germany.

This short review focuses on pulmonary injury in breath-hold (BH) divers. When practicing their extreme leisure sport, they are exposed to increased pressure on pulmonary gas volumes, hypoxia, and increased partial gas pressures. Increasing ambient pressures do present a serious problem to BH deep divers, because the semi-rigid thorax prevents the deformation required by the Boyle-Mariotte law. Read More

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http://dx.doi.org/10.1159/000495757DOI Listing
February 2019
1 Read

Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure-Guided Strategy vs an Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.

JAMA 2019 02 18. Epub 2019 Feb 18.

Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Importance: Adjusting positive end-expiratory pressure (PEEP) to offset pleural pressure might attenuate lung injury and improve patient outcomes in acute respiratory distress syndrome (ARDS).

Objective: To determine whether PEEP titration guided by esophageal pressure (PES), an estimate of pleural pressure, was more effective than empirical high PEEP-fraction of inspired oxygen (Fio2) in moderate to severe ARDS.

Design, Setting, And Participants: Phase 2 randomized clinical trial conducted at 14 hospitals in North America. Read More

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http://dx.doi.org/10.1001/jama.2019.0555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439595PMC
February 2019
3 Reads

SCUBA Medicine for otolaryngologists: Part I. Diving into SCUBA physiology and injury prevention.

Laryngoscope 2019 Feb 18. Epub 2019 Feb 18.

Department of Surgery, Division of Otolaryngology, University of Connecticut Health, Farmington, Connecticut, U.S.A.

Objectives: Introduce pertinent self-contained underwater breathing apparatus (SCUBA) physiology and corresponding terminology. Appreciate the scope of diving and related otolaryngological injury. Illustrate pathophysiologic mechanisms for diving injuries. Read More

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http://dx.doi.org/10.1002/lary.27867DOI Listing
February 2019
2 Reads

SCUBA Medicine for Otolaryngologists: Part II. Diagnostic, Treatment, and Dive Fitness Recommendations.

Laryngoscope 2019 Feb 18. Epub 2019 Feb 18.

Department of Surgery, Division of Otolaryngology, University of Connecticut Health, Farmington, Connecticut, U.S.A.

Objectives: Challenge current practices and misconceptions in treating recreational SCUBA (Self-contained underwater breathing apparatus) divers. Differentiate patients who are fit to dive and those with relative and absolute contraindications. Redefine the standard of care for fitness to dive parameters based on the most up-to-date evidence. Read More

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http://dx.doi.org/10.1002/lary.27874DOI Listing
February 2019
1 Read

Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges.

Eur J Case Rep Intern Med 2018 25;5(5):000823. Epub 2018 May 25.

Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia.

Introduction: Pulmonary interstitial emphysema is a rare finding defined as abnormal air collection inside the lung interstitial tissues. Described more frequently in ventilated new-borns, pulmonary interstitial emphysema is an uncommon barotrauma-related complication in adults. Management and clinical sequelae are poorly described. Read More

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https://www.ejcrim.com/index.php/EJCRIM/article/view/823
Publisher Site
http://dx.doi.org/10.12890/2018_000823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346923PMC
May 2018
6 Reads

Effects of Stepwise Lung Recruitment Maneuvers in Patients with Early Acute Respiratory Distress Syndrome: A Prospective, Randomized, Controlled Trial.

J Clin Med 2019 Feb 10;8(2). Epub 2019 Feb 10.

School of Medicine, College of Medicine, Fu Jen Catholic University, Xinzhuang Dist., New Taipei City 24205, Taiwan (R.O.C).

Since the clinical benefit of lung recruitment maneuvers (LRMs) is still conflicting, we performed this prospective, randomized, controlled study to investigate whether LRMs should be used in the routine management of acute respiratory distress syndrome (ARDS). This trial was conducted in four intensive care units (ICUs) to compare application of a modified stepwise LRMs with solely lung-protective ventilation in patients with moderate to severe ARDS within 72 h from the onset. The primary outcome was 28-day mortality, and the secondary outcomes were ventilator-free days and ICU-free days. Read More

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http://www.mdpi.com/2077-0383/8/2/231
Publisher Site
http://dx.doi.org/10.3390/jcm8020231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406466PMC
February 2019
9 Reads

Texas Cardiologist Recalls Boston Marathon Bombing.

Authors:
David Doolittle

Tex Med 2018 Apr 1;114(4):28-29. Epub 2018 Apr 1.

When two pressure-cooker bombs filled with nails, ball bearings, and black powder exploded at the finish line of the 2013 Boston Marathon, killing three people and wounding hundreds more, Jorge Alvarez, MD, did what he believes anybody would do: Run toward the danger. Read More

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A Free Diver with Hemoptysis and Chest Pain.

R I Med J (2013) 2019 Feb 1;102(1):33-36. Epub 2019 Feb 1.

Associate Professor of Emergency Medicine, Alpert Medical School of Brown University.

[Full article available at http://rimed.org/rimedicaljournal-2019-02.asp]. Read More

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February 2019

Feasibility of an alternative, physiologic, individualized open-lung approach to high-frequency oscillatory ventilation in children.

Ann Intensive Care 2019 Jan 18;9(1). Epub 2019 Jan 18.

Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Huispost CA 80, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

Background: High-frequency oscillatory ventilation (HFOV) is a common but unproven management strategy in paediatric critical care. Oscillator settings have been traditionally guided by patient age and/or weight rather than by lung mechanics, thereby potentially negating any beneficial effects. We have adopted an open-lung HFOV strategy based on a corner frequency approach using an initial incremental-decremental mean airway pressure titration manoeuvre, a high frequency (8-15 Hz), and high power to initially target a proximal pressure amplitude (∆P) of 70-90 cm HO, irrespective of age or weight. Read More

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https://annalsofintensivecare.springeropen.com/articles/10.1
Publisher Site
http://dx.doi.org/10.1186/s13613-019-0492-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338613PMC
January 2019
12 Reads

Abdominal CT Scan Findings of Decompression Sickness: A Case Report.

J Radiol Case Rep 2018 Oct 31;12(10):17-23. Epub 2018 Oct 31.

Department of Radiology, Hahnemann University Hospital, Philadelphia, PA, USA.

This case report depicts the radiologic findings of a 51-year-old male presenting with Decompression Sickness. Decompression Sickness is diagnosed clinically, therefore radiologic imaging of this disease entity is limited. Our patient's history includes a scuba dive to depth of 110 feet with a descending time of 24 minutes and an ascending time of 8 minutes. Read More

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http://dx.doi.org/10.3941/jrcr.v12i10.3425DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312119PMC
October 2018
2 Reads

The use of drug eluting stents in infrapopliteal arteries: an updated systematic review and meta-analysis of randomised trials.

Int Angiol 2019 Jan 16. Epub 2019 Jan 16.

Faculty of Medicine, University of New South Wales, Sydney, Australia.

Background: Endovascular treatment below-the-knee is safe and effective but limited by poor potency. Coronary DES may play a role in providing mechanical scaffolding and deliver anti-proliferative drug to the site of vascular barotrauma to reduce the incidence of restenosis. Our aim was to evaluate and compare the use of contemporary drug-eluting stents (DES) with standard endovascular-therapies for atherosclerotic disease of infrapopliteal arteries. Read More

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https://www.minervamedica.it/index2.php?show=R34Y9999N00A190
Publisher Site
http://dx.doi.org/10.23736/S0392-9590.19.04049-5DOI Listing
January 2019
32 Reads

Strain by the train: Patterns of toad fatalities on a Brazilian Amazonian railroad.

Sci Total Environ 2019 Apr 4;660:493-500. Epub 2019 Jan 4.

Programa de Pós-Graduação em Análise e Modelagem de Sistemas Ambientais, Instituto de Geociências, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais CEP 31270-901, Brazil; Transportation Research and Environmental Modeling Lab (TREM Lab), Instituto de Geociências, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais CEP 31270-901, Brazil.

Transportation infrastructures are directly responsible for killing billions of animals worldwide. Although the understanding about road impacts have recently increased, the impact of railroads on wildlife has received less attention. The current knowledge concerning the impacts of railroads focuses mainly on large mammals although amphibians might be affected. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00489697183526
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http://dx.doi.org/10.1016/j.scitotenv.2018.12.371DOI Listing
April 2019
7 Reads

Headache Attributed to Aeroplane Travel: An Historical Outline.

Headache 2019 Feb 11;59(2):164-172. Epub 2019 Jan 11.

Headache Centre, Department of Neurosciences, Padua University, Padua, Italy.

Introduction: Headache attributed to aeroplane travel (AH) is one of the new nosological entries in the International Classification of Headache Disorders (ICHD) 3 beta.

Materials And Methods: This study retraces the history of headache related to flight, from the initial description to the modern reports, on the basis of original sources.

Results: Head pain related to flight has been reported since the beginning of flight era. Read More

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http://dx.doi.org/10.1111/head.13467DOI Listing
February 2019
1 Read

The anatomic substrate of irreversible airway obstruction and barotrauma in a case of hurricane-triggered fatal status asthmaticus during puerperium: Lessons from an autopsy.

Respir Med Case Rep 2019 21;26:136-141. Epub 2018 Dec 21.

Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA.

Non-fully reversible airway obstruction in fatal asthma is often seen in association with profound structural changes of the bronchial wall, termed airway remodeling. Evidence suggests that heavy precipitation events can trigger epidemics of severe asthma. We present a case of fatal asthma in a young woman with no prior near-fatal exacerbations and postulate that the patient's extensive airway remodeling and puerperal state (susceptibility factors), in combination with a massive allergen challenge during a hurricane landfall (triggering factor), played a central role in her death. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22130071183038
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http://dx.doi.org/10.1016/j.rmcr.2018.12.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306954PMC
December 2018
4 Reads

A Case of Pott's Puffy Tumor Associated With Barosinusitis From Scuba Diving.

Pediatr Emerg Care 2018 Dec 28. Epub 2018 Dec 28.

McGill University Faculty of Medicine, Montreal, Quebec, Canada.

Barosinusitis, or sinus barotrauma, is a well-described condition associated with changes in barometric pressure during flight and diving that can result in sinonasal mucosal injury. In this case report, we present an adolescent who experienced barosinusitis during scuba diving and subsequently developed Pott's puffy tumor (PPT), characterized by frontal sinusitis, frontal bone osteomyelitis, and overlying subperiosteal abscess. This unique case of PPT following scuba diving provides the opportunity to review the pathophysiology of both barotrauma-induced sinus disease and PPT, a rare and unreported serious complication of barosinusitis. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001657DOI Listing
December 2018
0.923 Impact Factor

[The features and treatment of Xixia "May 17th" explosion accident].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Dec;30(12):1196-1199

Department of Burns and Plastic Surgery, the Affiliated Nanshi Hospital of Henan University, Nanyang 473065, Henan, China. Corresponding author: Wang Shuo, Email:

Objective: To retrospectively analyze the injury characteristics of victims and treatment strategies in the explosion accident on the 17th May 2018 in Xixia county (Xixia "May 17th" explosion accident).

Methods: Completion the Level Three treatment on time, which was depended on the leading role played by the regional trauma centers was the main rescuing mode of the work in Xixia county, where the primary and secondary treatments were the key parts. The three-level treatment model includes: the local hospital acts as a level-one emergency medical institution, county hospitals function as secondary emergency medical institutions, and other higher medical institutions are the tertiary first aid medical institutions. Read More

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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2018.012.018DOI Listing
December 2018
13 Reads

Funding falling for mine victim assistance.

Authors:
John Zarocostas

Lancet 2018 12;392(10164):2537-2538

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http://dx.doi.org/10.1016/S0140-6736(18)33168-4DOI Listing
December 2018

Barotraumatic blowout fracture of the orbit after sneezing: Cone beam CT demonstration.

Clin Ter 2018 Nov-Dec;169(6):e265-e268

Section of Diagnostic Imaging - DIBIMED, University of Palermo, Palermo, Italy.

A 40-year-old man with no history of trauma or previous sinus surgery complained sudden right diplopia after vigorous sneezing. The patient was submitted elsewhere to a MRI study for persisting diplopia, with inconclusive findings. One week later the patient was submitted to a maxillofacial cone beam CT (CBCT) in our Institution. Read More

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http://dx.doi.org/10.7417/CT.2018.2089DOI Listing
January 2019

An unusual case of pulmonary fat embolism following blunt trauma.

Forensic Sci Med Pathol 2018 Dec 7. Epub 2018 Dec 7.

Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska str, Belgrade, 11000, Serbia.

Fat embolism is markedly underdiagnosed, even though it is a well-known phenomenon following fractures of the long bones, injury to subcutaneous fat tissue, rupture of a fatty liver, surgical operations on fatty tissues, septicemia, burns and barotrauma. Forensic pathologists tend to "simplify" autopsy report conclusion in cases with multiple injuries where fat embolism and exsanguination could be considered to be the concomitant causes of death. Herein we present a case of 24-year-old male who was beaten with a metal rod by several persons. Read More

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http://link.springer.com/10.1007/s12024-018-0053-0
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http://dx.doi.org/10.1007/s12024-018-0053-0DOI Listing
December 2018
15 Reads

Bedside respiratory physiology to detect risk of lung injury in acute respiratory distress syndrome.

Authors:
Jeremy R Beitler

Curr Opin Crit Care 2019 Feb;25(1):3-11

Division of Pulmonary, Allergy, and Critical Care Medicine, Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons, New York, New York, USA.

Purpose Of Review: The most effective strategies for treating the patient with acute respiratory distress syndrome center on minimizing ventilation-induced lung injury (VILI). Yet, current standard-of-care does little to modify mechanical ventilation to patient-specific risk. This review focuses on evaluation of bedside respiratory mechanics, which when interpreted in patient-specific context, affords opportunity to individualize lung-protective ventilation in patients with acute respiratory distress syndrome. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000579DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402876PMC
February 2019
5 Reads

Mineralocorticoid receptor: A hidden culprit for hemodialysis vascular access dysfunction.

EBioMedicine 2019 Jan 5;39:621-627. Epub 2018 Dec 5.

Division of Kidney Disease and Hypertension, Department of Medicine, Brown University School of Medicine, Providence, RI, United States; Division of Nephrology, Department of Medicine, University of Toledo College of Medicine, Toledo, OH, United States. Electronic address:

Hemodialysis vascular access dysfunction is a common and intractable problem in clinical practice with no definitive therapy yet available. As a key mediator of vascular and cardiac maladaptive remodeling, mineralocorticoid receptor (MR) plays a pivotal role in vascular fibrosis and intimal hyperplasia (IH) and is potentiated locally in hemodialysis vascular access following diverse injuries, like barotrauma, cannulation and shear stress. MR-related genomic and non-genomic pathways are responsible for triggering vascular smooth muscle cell activation, proliferation, migration and extracellular matrix overproduction. Read More

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http://dx.doi.org/10.1016/j.ebiom.2018.11.054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354623PMC
January 2019
3 Reads

A diver with immersion pulmonary oedema and prolonged respiratory symptoms.

Diving Hyperb Med 2018 Dec;48(4):259-261

Department of Pulmonary Medicine, Kameda Medical Centre, Kamogawa, Chiba, Japan.

Immersion pulmonary oedema (IPE) is particularly associated with an excessive reaction to exercise and/or cold stress. IPE usually resolves without recompression therapy within a day or two. Herein we report a diver diagnosed with IPE, in whom symptoms persisted for five days. Read More

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http://dx.doi.org/10.28920/dhm48.4.259-261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355313PMC
December 2018
20 Reads

Lobectomy with ECMO Support in an Infant Who Developed Pulmonary Interstitial Emphysema Following Repair of Hypoplastic Aortic Arch.

Braz J Cardiovasc Surg 2018 Sep-Oct;33(5):528-530

Department of Surgery; Division of Cardiothoracic Surgery; Pediatric and Congenital Cardiac Surgery Section Jackson Memorial Hospital - University of Miami Miller School of Medicine, Miami, USA.

Pulmonary interstitial emphysema (PIE) is a common problem in premature neonates with respiratory distress syndrome. This condition is often related to barotrauma caused by mechanical ventilation or continuous positive airway pressure applied to low birth weight neonates. The clinical diagnosis can be challenging. Read More

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http://dx.doi.org/10.21470/1678-9741-2018-0135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257528PMC
March 2019
4 Reads

Distribution characteristics of combat-related shrapnel and relationship to weapon type and conflict location: Experience of an operational field hospital.

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):587-593

Department of Radiology, Dr. Aşkım Tüfekçi State Hospital, Adana-Turkey.

Background: The aim of this study was to investigate the characteristics of shrapnel distribution in the body and a possible relationship to the type of weapon and type of location of the conflict.

Methods: The records of 246 patients admitted to a level-III trauma center with any kind of firearm injury were examined retrospectively. Ninety patients who had at least 1 radiologically-proven piece of shrapnel in their body were included in the study. Read More

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http://dx.doi.org/10.5505/tjtes.2018.13402DOI Listing
November 2018
2 Reads

Amputation-Site Soft-Tissue Restoration Using Adipose Stem Cell Therapy.

Plast Reconstr Surg 2018 11;142(5):1349-1352

Pittsburgh, Pa.; Bethesda, Md.; and New York, N.Y. From the Departments of Plastic Surgery, Psychiatry, Radiology, Rehabilitation Science and Technology, and Bioengineering, University of Pittsburgh; the VA Pittsburgh Healthcare System; the University of Pittsburgh McGowan Institute of Regenerative Medicine; the Department of Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center; and New York University Langone Medical Center.

Soft-tissue deficits in amputation stumps can lead to significant pain and disability. An emerging treatment option is stem cell-enriched fat grafting. This is the first study assessing the potential for this treatment modality in lower extremity amputation sites. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004889DOI Listing
November 2018
12 Reads

Terrorist explosive belt attacks: specific patterns of bone traumas.

Int J Legal Med 2019 Mar 29;133(2):565-569. Epub 2018 Nov 29.

Institut Médico Légal, 2 place Mazas, 75012, Paris, France.

In cases of terrorist bomb attacks, the issue of victim identification is the principal aim. For investigators and justice, terrorists must also be identified in a timely manner. The fragmentation of bodies caused by explosive devices however makes this operation difficult. Read More

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http://link.springer.com/10.1007/s00414-018-1977-3
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http://dx.doi.org/10.1007/s00414-018-1977-3DOI Listing
March 2019
6 Reads

Triage and Treatment of Mass Casualty Decompression Sickness After Depressurization at 6400 m.

Aerosp Med Hum Perform 2018 12;89(12):1085-1088

Decompression sickness is a condition that results from an abrupt change from a higher to a lower pressure. It is described most commonly in divers; however, it can occur in aviation incidents, which this case report will discuss. Following an acute cabin depressurization incident, 36 patients presented to a small outpatient clinic with multiple symptoms, including fatigue, headache, nausea, vomiting, and dizziness. Read More

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http://dx.doi.org/10.3357/AMHP.5142.2018DOI Listing
December 2018
2 Reads

Apoptotic mechanisms in rabbits with blast-induced acute lung injury 1.

Acta Cir Bras 2018 Oct;33(10):896-903

Master degree candidate, Department of Cardiopulmonary Rehabilitation Center, 128th Hangzhou Hospital, Military Hangzhou Clinical College, Anhui Medical University, Hangzhou, Zhejiang Province, China. Sample extraction, analysis of data.

Purpose: To investigate the apoptotic mechanisms in rabbits with blast-induced acute lung injury (ALI).

Methods: A total of 40 rabbits were randomly divided into a blank control group (A, n=10) and an experimental group (EXP, n=30). Explosion-induced chest-ALI models were prepared and sampled at different time points (4, 12, and 24h after modeling, T1-T3) to test the lung dry weight/wet weight ratio (W/D) and arterial oxygen pressure (PaO2), apoptosis of lung tissue by the TUNEL assay, and Caspase-3, Bax, and Bcl-2 levels by immunohistochemical analysis. Read More

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http://dx.doi.org/10.1590/s0102-865020180100000004DOI Listing
October 2018
21 Reads

Bubble Formation in Children and Adolescents after Two Standardised Shallow Dives.

Int J Sports Med 2019 Jan 20;40(1):31-37. Epub 2018 Nov 20.

German Sport University, Institute of Physiology and Anatomy, Cologne, Germany.

Circulating venous bubbles after dives are associated with symptoms of decompression sickness in adults. Up to now it is not known to what extent children and adolescents are subjected to a bubble formation during their shallow dives and if there are possible indications for that. The aim of this pilot study is to investigate whether bubbles and/or symptoms occur after standardised repeated dives performed by young divers. Read More

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http://dx.doi.org/10.1055/a-0777-2279DOI Listing
January 2019
18 Reads

Additional Vitamin and Mineral Support for Patients with Severe Burns: A Nationwide Experience from a Catastrophic Color-Dust Explosion Event in Taiwan.

Nutrients 2018 Nov 16;10(11). Epub 2018 Nov 16.

Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei 970, Taiwan.

Major burn injuries, which encompass ≥20% of the total body surface area (TBSA), are the most severe form of trauma because of the stress response they provoke, which includes hypermetabolism, muscle wasting, and stress-induced diabetes. In 2015, a color-dust explosion disaster occurred in the Formosa Fun Coast of Taiwan and injured 499 people, who were transferred via a nationwide emergency delivery system. Some recommendations are currently available regarding vitamin and mineral support for wound healing and recovery in severe burns, but there is a lack of evidence to confirm the benefits. Read More

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http://dx.doi.org/10.3390/nu10111782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266218PMC
November 2018
17 Reads

Recruitment manoeuvres for adults with acute respiratory distress syndrome receiving mechanical ventilation: a systematic review and meta-analysis.

J Crit Care 2019 Apr 3;50:1-10. Epub 2018 Nov 3.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China. Electronic address:

Purpose: To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care.

Materials And Methods: Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary outcome was mortality. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08839441183096
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http://dx.doi.org/10.1016/j.jcrc.2018.10.033DOI Listing
April 2019
11 Reads

Modes of Neonatal Ventilation: Breathe Deeply!

Authors:
Shawn Hughes

Crit Care Nurs Clin North Am 2018 Dec;30(4):523-531

NICU Respiratory Care Services, Charlotte R. Bloomberg Children's Center, Neonatal Intensive Care Unit, Johns Hopkins Hospital, 8th Floor, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address:

The art and science of neonatal ventilation continue to evolve with advances in technology and as a result of evidenced based research. Although some historically administered therapies remain such as nasal continuous positive airway pressure, newer therapies have emerged in the neonatal intensive care unit such as pressure regulated volume control and neurally adjusted ventilatory assist. The challenge for clinicians continues to be which mode will support the patient's medical diagnosis with minimal barotrauma or lung injury. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08995885183097
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http://dx.doi.org/10.1016/j.cnc.2018.07.008DOI Listing
December 2018
11 Reads

Higher PEEP improves outcomes in ARDS patients with clinically objective positive oxygenation response to PEEP: a systematic review and meta-analysis.

BMC Anesthesiol 2018 11 17;18(1):172. Epub 2018 Nov 17.

Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.

Background: Mortality in patients with acute respiratory distress syndrome (ARDS) remains high. These patients require mechanical ventilation strategies that include high positive end-expiratory pressure (PEEP). It remains controversial whether high PEEP can improve outcomes for ARDS patients, especially patients who show improvement in oxygenation in response to PEEP. Read More

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https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s1
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http://dx.doi.org/10.1186/s12871-018-0631-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240288PMC
November 2018
15 Reads

Investigation of Brain Impairment Using Diffusion-Weighted and Diffusion Tensor Magnetic Resonance Imaging in Experienced Healthy Divers.

Med Sci Monit 2018 Nov 17;24:8279-8289. Epub 2018 Nov 17.

Department of Radiology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey.

BACKGROUND The aim of this study was to understand the changes of decompression illness in healthy divers by comparing diffusion-weighted (DWI) and diffusion tensor MRI findings among healthy professional divers and healthy non-divers with no history of diving. MATERIAL AND METHODS A total of 26 people were recruited in this prospective study: 11 experienced divers with no history of neurological decompression disease (cohort) and 15 healthy non-divers (control). In all study subjects, we evaluated apparent diffusion coefficient (ADC) and type of diffusion tensor metric fractional anisotropy (FA) values of different brain locations (e. Read More

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http://dx.doi.org/10.12659/MSM.911475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252049PMC
November 2018
3 Reads