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Internal Medicine (Tokyo, Japan) Jan 2022
Topics: Bone Diseases; Chest Pain; Humans; Musculoskeletal Pain; Xiphoid Bone
PubMed: 34219108
DOI: 10.2169/internalmedicine.7395-21 -
Frontiers in Oncology 2022Sternectomy is a procedure mainly used for removing tumor masses infiltrating the sternum or treating infections. Moreover, the removal of the sternum involves the... (Review)
Review
Sternectomy is a procedure mainly used for removing tumor masses infiltrating the sternum or treating infections. Moreover, the removal of the sternum involves the additional challenge of performing a functional reconstruction. Fortunately, various approaches have been proposed for improving the operation and outcome of reconstruction, including allograft transplantation, using novel materials, and developing innovative surgical approaches, which promise to enhance the quality of life for the patient. This review will highlight the surgical approaches to sternum reconstruction and the new perspectives in the current literature.
PubMed: 36387077
DOI: 10.3389/fonc.2022.975603 -
Journal of Cardiothoracic Surgery Nov 2017Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be... (Review)
Review
BACKGROUND
Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text.
METHODOLOGY AND REVIEW
This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and management of deep sternal wound infections and mediastinitis after cardiac surgery. The role of negative pressure wound therapy and initial and delayed surgical management is discussed with special emphasis on plastic techniques with muscle and omental flaps. Recent advances in reconstructive surgery are presented.
CONCLUSIONS
Deep sternal wound complications no longer spell debilitating morbidity and high mortality. Better understanding of risk factors that predispose to deep sternal wound complications and general improvement in theatre protocols for asepsis have dramatically reduced the incidence of deep sternal wound complications. Negative pressure wound therapy and appropriately timed and staged muscle or omental flap reconstruction have transformed the outcomes once these complications occur.
Topics: Cardiac Surgical Procedures; Humans; Mediastinitis; Sternotomy; Sternum; Surgical Flaps; Surgical Wound Infection; Thoracoplasty
PubMed: 29096673
DOI: 10.1186/s13019-017-0656-7 -
The American Journal of Tropical... Sep 2019
Topics: Abscess; Aged; Diagnosis, Differential; Humans; Male; Mycobacterium; Sternum; Tomography, X-Ray Computed; Tuberculosis
PubMed: 31971133
DOI: 10.4269/ajtmh.19-0200 -
Developmental Dynamics : An Official... Jan 2021In vertebrates, the trunk consists of the musculoskeletal structures of the back and the ventrolateral body wall, which together enclose the internal organs of the... (Review)
Review
In vertebrates, the trunk consists of the musculoskeletal structures of the back and the ventrolateral body wall, which together enclose the internal organs of the circulatory, digestive, respiratory and urogenital systems. This review gives an overview on the development of the thoracic and abdominal wall during amniote embryogenesis. Specifically, I briefly summarize relevant historical concepts and the present knowledge on the early embryonic development of ribs, sternum, intercostal muscles and abdominal muscles with respect to anatomical bauplan, origin and specification of precursor cells, initial steps of pattern formation, and cellular and molecular regulation of morphogenesis.
Topics: Abdominal Muscles; Abdominal Wall; Animals; Humans; Intercostal Muscles; Ribs; Sternum; Thoracic Wall; Vertebrates
PubMed: 32406962
DOI: 10.1002/dvdy.193 -
Medicine Aug 2021Early diagnosis as well as treatment is important in management of congenital muscular torticollis (CMT). The purpose of this study was to find an effective physical...
Effect of physical therapy intervention on thickness and ratio of the sternocleidomastoid muscle and head rotation angle in infants with congenital muscular torticollis: A randomized clinical trial (CONSORT).
BACKGROUND
Early diagnosis as well as treatment is important in management of congenital muscular torticollis (CMT). The purpose of this study was to find an effective physical therapy modality to improve the sternocleidomastoid (SCM) muscle thickness, the ratio of the SCM muscle thickness on the affected side to that on the non-affected side (A/N ratio), and head rotation in infant under 3 months of age diagnosed with CMT.
METHODS AND ANALYSIS
A single-blind, randomized clinical trial was conducted. Participants were assigned in one of the 3 study groups through randomization. The treatment was performed 3 times a week for 30 minutes until the head tilt was ≤5 degrees. Group 1 was treated by handling for active or active-assist movement, group 2 was treated with passive stretching, and group 3 was treated with thermotherapy. For general characteristics, a χ2 test and 1-way analysis of variance were used. Intragroup differences were analyzed using a paired t test, and intergroup differences were analyzed using an age-adjusted analysis of covariance.
RESULTS
After the intervention, there was no significant difference between groups in terms of SCM thickness on the affected side and A/N ratio (P > .05). Degree of head rotation on the affected side showed significant differences between groups (P < .05), with Group 2 showing significantly better results than group 1 and group 3 (P < .05, both).
CONCLUSION
Passive stretching treatment was more effective than other treatments of this study for improvement in degree of head rotation in CMT infants under 3 months of age.
TRIAL REGISTRATION
The trial is registered at the Institutional Review Board of Sahmyook University (IRB number, 2-7001793-AB-N-012019103HR) and the Clinical Research Information Service (CRiS; registry number, KCT0004862).
Topics: Humans; Infant; Muscles; Physical Therapy Modalities; Single-Blind Method; Sternum; Torticollis; Weights and Measures
PubMed: 34414985
DOI: 10.1097/MD.0000000000026998 -
The Journal of Thoracic and... Dec 2018
Topics: Aortic Valve; Heart Valve Prosthesis; Sternotomy; Sternum
PubMed: 30107920
DOI: 10.1016/j.jtcvs.2018.06.076 -
Pediatrics and Neonatology Apr 2017There have been several reports of congenital malformations in the offspring of mothers who took valproic acid (VPA) during pregnancy as a treatment for epilepsy.
BACKGROUND
There have been several reports of congenital malformations in the offspring of mothers who took valproic acid (VPA) during pregnancy as a treatment for epilepsy.
METHODS
Herein, we describe four cases with typically similar facial features of fetal valproate syndrome accompanied to minor skeletal abnormalities.
RESULTS
The first case was a 16-month-old girl, presenting with facial dysmorphism, and finger abnormalities. Her mother took VPA (1500 mg/d) up to the 10 gestational week and at a dosage of 1000 mg/d through the pregnancy. The second patient was 5-year-old boy with speech disability, bilateral cryptorchidism, facial dysmorphism, and finger abnormalities whose mother took VPA (1000 mg/d) through pregnancy. The third 19-month-old patient was the brother of the second patient who had facial dysmorphism, bilateral cryptorchidism, and finger abnormalities. His mother also took VPA (1000 mg/d) through pregnancy. The fourth 3-year and 6 month-old boy with minor facial dysmorphism and sternum deformity was exposed to VPA (500 mg/d) in utero.
CONCLUSION
In conclusion, there is a recognizable spectrum of abnormalities in some infants exposed to VPA without dose-depence and the common facial dysmorphic features and minor skeletal abnormalities that may occur within the both low and high dose VPA use.
Topics: Abnormalities, Drug-Induced; Anticonvulsants; Child, Preschool; Craniofacial Abnormalities; Cryptorchidism; Epilepsy; Female; Fingers; Humans; Infant; Male; Pregnancy; Pregnancy Complications; Sternum; Valproic Acid
PubMed: 27422007
DOI: 10.1016/j.pedneo.2016.01.009 -
The Western Journal of Emergency... Mar 2021The intraosseous (IO) route is one of the primary means of vascular access in critically ill and injured patients. The most common sites used are the proximal humerus,... (Review)
Review
INTRODUCTION
The intraosseous (IO) route is one of the primary means of vascular access in critically ill and injured patients. The most common sites used are the proximal humerus, proximal tibia, and sternum. Sternal IO placement remains an often-overlooked option in emergency and prehospital medicine. Due to the conflicts in Afghanistan and Iraq the use of sternal IOs have increased.
METHODS
The authors conducted a limited review, searching PubMed and Google Scholar databases for "sternal IO," "sternal intraosseous," and "intraosseous" without specific date limitations. A total of 47 articles were included in this review.
RESULTS
Sternal IOs are currently FDA approved for ages 12 and older. Sternal IO access offers several anatomical, pharmacokinetic, hemodynamic, and logistical advantages over peripheral intravenous and other IO points of access. Sternal IO use carries many of the same risks and limitations as the humeral and tibial sites. Sternal IO gravity flow rates are sufficient for transfusing blood and resuscitation. In addition, studies demonstrated they are safe during active CPR.
CONCLUSION
The sternal IO route remains underutilized in civilian settings. When considering IO vascular access in adults or older children, medical providers should consider the sternum as the recommended IO access, particularly if the user is a novice with IO devices, increased flow rates are required, the patient has extremity trauma, or administration of a lipid soluble drug is anticipated.
Topics: Critical Illness; Emergency Medical Services; Humans; Infusions, Intraosseous; Risk Assessment; Sternum
PubMed: 34125048
DOI: 10.5811/westjem.2020.12.48939