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Acta Radiologica (Stockholm, Sweden :... Jul 2023A hemorrhagic aortopulmonary artery sheath (HAPS) is an infrequent and critical complication of aortic dissection (AD), which is caused by a hematoma extending through... (Review)
Review
A hemorrhagic aortopulmonary artery sheath (HAPS) is an infrequent and critical complication of aortic dissection (AD), which is caused by a hematoma extending through the ruptured aortic wall into the aortopulmonary artery sheath. The adventitial hematoma might narrow or even occlude the lumen of the pulmonary arteries and extend into the pulmonary interstitium and alveoli. The prompt and accurate recognition of HAPS on computed tomography (CT) is crucial and might assist in the diagnosis of unidentifiable AD. HAPS was manifested as high attenuation areas surrounded the pulmonary arteries without enhancement on CT; even thickened bronchovascular sheath and ground-glass consolidations surrounded bronchovascular distribution, which might be associated with the prognosis. Aggressive and effective surgical treatment is the primary determinant of short-term survival.
Topics: Humans; Aortic Dissection; Hemorrhage; Aorta; Pulmonary Artery; Hematoma
PubMed: 36683329
DOI: 10.1177/02841851221151148 -
Journal Francais de Medecine Et... 1961
Topics: Hematoma; Humans; Lung; Lung Injury; Medical Records; Vascular Diseases
PubMed: 13886026
DOI: No ID Found -
Commentary: External wrapping in proximal intramural hematoma of the aorta: What's behind the magic?The Journal of Thoracic and... Jul 2022
Topics: Aorta; Aortic Diseases; Hematoma; Humans
PubMed: 33023748
DOI: 10.1016/j.jtcvs.2020.09.023 -
Shock (Augusta, Ga.) Nov 2019Neutrophil recruitment into the lung airspaces plays an important role in the containment and clearance of bacteria. Hemorrhagic shock, a complication of traumatic...
Neutrophil recruitment into the lung airspaces plays an important role in the containment and clearance of bacteria. Hemorrhagic shock, a complication of traumatic injury, induces immune dysfunction that compromises host defense and frequently leads to secondary infection. The objective of the current study was to determine whether prior hemorrhage impacts neutrophil recruitment in response to secondary Pseudomonas aeruginosa. Experiments were performed using a mouse model (C57BL/6) of respiratory infection by P. aeruginosa (strain PA103, 3 × 10 colony-forming units [CFUs]) that is delivered by intratracheal inhalation 24 h after hypovolemic hemorrhagic shock (fixed mean arterial blood pressure at 35 mmHg for 90 min, Ringer's lactate infused as fluid resuscitation). By postmortem flow cytometry analyses of bronchoalveolar lavage fluid, we observe that prior hemorrhage attenuates the entry of neutrophils into the lung airspaces in response to P. aeruginosa. The reduction in neutrophil recruitment occurs in an amplified inflammatory environment, with elevated lung tissue levels of interleukin 6 and C-X-C motif ligand 1 in mice receiving hemorrhage prior to infection. As compared to either insult alone, outcome to sequential hemorrhage and respiratory infection includes enhanced mortality. The effect of prior hemorrhage on clearance of P. aeruginosa, as determined by quantifying bacterial CFUs in lung tissue, was not statistically significant at 24 h postinfection, but our data suggest that further inquiry may be needed to fully understand the potential impact of hemorrhagic shock on this process. These results suggest that changes in neutrophil recruitment may contribute to the immune dysfunction following hemorrhagic shock that renders the host susceptible to severe respiratory infection.
Topics: Animals; Chemokine CXCL1; Hemorrhage; Interleukin-6; Lung; Mice; Neutrophils; Pseudomonas Infections; Pseudomonas aeruginosa; Respiratory Tract Infections
PubMed: 30475329
DOI: 10.1097/SHK.0000000000001288 -
Thoracic Surgery Clinics Feb 2007Approximately one third of patients admitted to major trauma centers in the United States sustain serious injuries to the chest. The lungs, which occupy a large portion... (Review)
Review
Approximately one third of patients admitted to major trauma centers in the United States sustain serious injuries to the chest. The lungs, which occupy a large portion of the chest cavity and lie in close proximity to the bony thorax, are injured in the majority of these patients directly or indirectly. A significant number of lung injuries are also associated with trauma to other critical thoracic structures. This article discusses blunt trauma injuries of the lung, which include pulmonary contusions, hematomas, lacerations, and pulmonary vascular injuries.
Topics: Hematoma; Humans; Lacerations; Lung Diseases; Lung Injury; Thoracic Surgery, Video-Assisted; Wounds, Nonpenetrating
PubMed: 17650697
DOI: 10.1016/j.thorsurg.2007.03.017 -
European Journal of Cardio-thoracic... Nov 2022
Topics: Humans; Aged; Japan; Aortic Dissection; Hematoma
PubMed: 36355457
DOI: 10.1093/ejcts/ezac530 -
The Neurologist Jan 2024Patients with spontaneous intracerebral hemorrhage (sICH) are at high risk for venous thromboembolism (VTE). The administration of mechanical and pharmacological VTE... (Review)
Review
BACKGROUND
Patients with spontaneous intracerebral hemorrhage (sICH) are at high risk for venous thromboembolism (VTE). The administration of mechanical and pharmacological VTE prophylaxis after sICH is important but challenging. The safety and efficacy of the optimal anticoagulant dose, timing, and type of VTE chemoprophylaxis in cases of sICH are still unclear, and clinicians are concerned that it may lead to cerebral hematoma expansion, which is associated with poor prognosis. Through this literature review, we aim to summarize the latest guidelines, recommendations, and clinical research progress to support evidence-based treatment strategies.
REVIEW SUMMARY
It has been proven that intermittent pneumatic compression can effectively reduce the risk of VTE and should be used at the time of hospital admission, whereas gradient compression stockings or lack of prophylaxis in sICH cases are not recommended by current guidelines. Studies regarding pharmacological VTE prophylaxis in patients with ICH were reviewed and summarized. Prophylactic anticoagulation for VTE in patients with ICH seems to be safe and was not associated with cerebral hematoma expansion. Meanwhile, the prophylactic efficacy of anticoagulation for pulmonary embolism seems to be more obvious than that of deep vein thrombosis in patients with ICH.
CONCLUSIONS
Clinicians should pay attention to the prevention and management of VTE after sICH. Intermittent pneumatic compression should be applied to patients with sICH on the day of hospital admission. After documentation of bleeding cessation, early initiation of pharmacological VTE prophylaxis (24 h to 48 h from sICH onset) seems to be safe and effective in pulmonary embolism prophylaxis.
Topics: Humans; Venous Thromboembolism; Anticoagulants; Cerebral Hemorrhage; Pulmonary Embolism; Hematoma; Risk Factors
PubMed: 37582632
DOI: 10.1097/NRL.0000000000000509 -
Forensic Science, Medicine, and... Sep 2015
Topics: Adventitia; Aged; Aorta; Aortography; Female; Hematoma; Hemorrhage; Humans; Pulmonary Artery; Rupture, Spontaneous; Tomography, X-Ray Computed
PubMed: 26105786
DOI: 10.1007/s12024-015-9686-4 -
American Family Physician Apr 2012Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities... (Review)
Review
Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities that should be treated, or may provide clues to an underlying systemic disease that requires further workup. Excessive keratinaceous material under the nail bed in a distal and lateral distribution should prompt an evaluation for onychomycosis. Onychomycosis may be diagnosed through potassium hydroxide examination of scrapings. If potassium hydroxide testing is negative for the condition, a nail culture or nail plate biopsy should be performed. A proliferating, erythematous, disruptive mass in the nail bed should be carefully evaluated for underlying squamous cell carcinoma. Longitudinal melanonychia (vertical nail bands) must be differentiated from subungual melanomas, which account for 50 percent of melanomas in persons with dark skin. Dystrophic longitudinal ridges and subungual hematomas are local conditions caused by trauma. Edema and erythema of the proximal and lateral nail folds are hallmark features of acute and chronic paronychia. Clubbing may suggest an underlying disease such as cirrhosis, chronic obstructive pulmonary disease, or celiac sprue. Koilonychia (spoon nail) is commonly associated with iron deficiency anemia. Splinter hemorrhages may herald endocarditis, although other causes should be considered. Beau lines can mark the onset of a severe underlying illness, whereas Muehrcke lines are associated with hypoalbuminemia. A pincer nail deformity is inherited or acquired and can be associated with beta-blocker use, psoriasis, onychomycosis, tumors of the nail apparatus, systemic lupus erythematosus, Kawasaki disease, and malignancy.
Topics: Carcinoma, Squamous Cell; Hematoma; Hemorrhage; Humans; Nail Diseases; Nails; Nails, Malformed; Skin Neoplasms
PubMed: 22534387
DOI: No ID Found -
World Neurosurgery Sep 2019Intraneural hematomas are an uncommon cause of a focal mononeuropathy. When they do occur, it is usually in the setting of inherited or iatrogenic coagulopathies or as a...
Intraneural hematomas are an uncommon cause of a focal mononeuropathy. When they do occur, it is usually in the setting of inherited or iatrogenic coagulopathies or as a consequence of injections targeting nerves. We report a man aged 68 years on warfarin therapy for a prior pulmonary embolism who presented with a 6-month history of progressive weakness of knee flexion and ankle movement, excruciating pain, and dense numbness in his posterior left thigh and below the knee, consistent with a severe high sciatic palsy. Imaging depicted a contiguous cystic mass of mixed T1 and T2 intensities involving the left sciatic nerve in the thigh, which was radiologically interpreted as a hip arthroplasty-associated pseudotumor. The patient underwent surgical exploration, which revealed a thick hemorrhagic pseudocompartment within the sciatic nerve. The histopathologic diagnosis was consistent with chronic hemorrhage. These impressive lesions should be included in the differential diagnosis of nerve masses.
Topics: Aged; Anticoagulants; Hematoma; Humans; Male; Pulmonary Embolism; Sciatic Neuropathy; Warfarin
PubMed: 31181364
DOI: 10.1016/j.wneu.2019.05.256