scholarly journals Uneventful survival of a rural child after penetrating cardiac injury by a thorn: a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Rik De Decker ◽  
Yifan Joshua Li ◽  
Dirk von Delft ◽  
Heidi Meyer ◽  
Alfred Mureko
Keyword(s):  
Cardiac Injury ◽  
Median Sternotomy ◽  
Management Guidelines ◽  
Pulsatile Mass ◽  
Cardiac Apex ◽  
Definition Of ◽  
The Right ◽  
Penetrating Cardiac Injury ◽  
Learning Points

Abstract Background Paediatric penetrating cardiac injury is extremely rare, precluding published management guidelines, therefore warranting a case-by-case approach with learning points gleaned from each case. Case summary A 7-year-old boy presented to a rural hospital with a stab wound to the chest by a Withaak (Vachellia tortilis) thorn. The patient was haemodynamically stable on presentation, but a 2 cm subcutaneous, pulsatile mass was present at the cardiac apex. Echocardiography revealed a foreign body penetrating from the apex into the heart, with evidence for a fistula between a cardiac chamber and the pulsatile mass. Angiography confirmed the existence of the fistula between the right ventricle (RV) and the pulsatile mass. A controlled extraction under general anaesthaesia via median sternotomy was performed in-theatre, with blood products and cardiac bypass on standby. The patient recovered without complications and was discharged after 4 days. Discussion Our case illustrates the limitations of echocardiography in identifying the precise anatomical definition of penetrating cardiac injuries. Angiography is therefore indicated in such cases. The injury to the RV and the haemostatic effects of the in situ thorn were favourable prognostic factors. We believe that the mortality risk reduction of extraction under full control warrants the minor morbidity of a median sternotomy.

Operative Management Considerations in a Patient With Multiple Occult Penetrating Cardiac Injuries

2022 ◽  
pp. 000313482110540
Author(s):  
Jaclyn N Portelli Tremont ◽  
Andrea Ward ◽  
Amirreza Motameni
Keyword(s):  
Cardiac Injury ◽  
Median Sternotomy ◽  
Exploratory Laparotomy ◽  
Operative Management ◽  
Traumatic Injuries ◽  
Left Chest ◽  
Urban Level ◽  
The Right ◽  
High Index Of Suspicion ◽  
Penetrating Cardiac Injury

Penetrating cardiac injury remains one of the deadliest traumatic injuries. Early identification and definitive operative management are critical tenets for patient survival; however, variable clinical presentations can obscure the diagnosis. Here, we present the case of a 58-year-old obese man who presented to an urban level 1 trauma center with multiple stab wounds to the epigastrium and lateral left chest in the axillary line with an unknown weapon. The patient was taken emergently to the operating room for exploratory laparotomy, median sternotomy, and attempted repair of multiple full-thickness lacerations of the right ventricle and left and right atrium. This case demonstrates several instructive points. First, a high index of suspicion for penetrating cardiac injury is needed, especially during triage of multiple injuries. Second, careful release of cardiac tamponade is critical. Finally, there are several indications for cardiopulmonary bypass, which include multichambered injuries, uncontrollable hemorrhage, and concern for intracardiac injury.

The Diagnosis and Surgical Management of Intracardiac Quill Foreign Body in a Dog

2016 ◽  
Vol 52 (1) ◽  
pp. 73-76 ◽  
Author(s):  
Daniel Joseph Santiago Nucci ◽  
Julius Liptak
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Right Ventricle ◽  
Surgical Management ◽  
Foreign Bodies ◽  
Cardiac Injury ◽  
Median Sternotomy ◽  
Good Prognosis ◽  
Bilateral Pneumothorax ◽  
The Right

A dog was referred to Alta Vista Animal Hospital with a porcupine quill penetrating the right ventricle. The presenting complaint was tachypnea and dyspnea secondary to bilateral pneumothorax. Computed tomography revealed bilateral pneumothorax without evidence of quills. A median sternotomy was performed and the quill was removed. The dog recovered uneventfully. Quill injuries are common in dogs; however, intracardiac quill migration is rare. Dogs without evidence of severe cardiac injury secondary to intracardiac foreign bodies may have a good prognosis.

scholarly journals An unusual myocardial infarction

2014 ◽  
Vol 1 (2) ◽  
pp. K9-K12 ◽  
Author(s):  
Sara Di Michele ◽  
Francesca Mirabelli ◽  
Domenico Galzerano ◽  
Sunil Mankad
Keyword(s):  
Myocardial Infarction ◽  
Heart Diseases ◽  
Cardiac Tumors ◽  
List Type ◽  
Transthoracic Echocardiogram ◽  
Cardiac Apex ◽  
The Right ◽  
Electrocardiogram Ecg ◽  
Learning Points ◽  
Chest Ct Scan

Summary We present a 74-year-old male with a chondrosarcoma, who presented with chest pain. The history, electrocardiogram (ECG), and biomarkers established the diagnosis of myocardial infarction (MI); angiography did not show coronary atherosclerosis and, both initial transthoracic echocardiogram and chest computed tomography (CT), did not demonstrate any cardiac abnormalities. A second echocardiogram following a routine ECG showed presence of a mass involving the right ventricle and the cardiac apex that was confirmed by chest CT scan. We underline the importance of considering cardiac tumors in the clinical arena of MI management. Learning points Cardiac tumors cause ECG changes similar to ischemic heart diseases. Keep in mind cardiac tumors when performing transthoracic echocardiogram (TTE) in the setting of suspected MI. TTE is the technique of choice in detecting cardiac tumors.

scholarly journals Missed Traumatic Conoventricular Septal Defect: A Case Report

2021 ◽  
Vol 24 (4) ◽  
pp. E680-E683
Author(s):  
Mingjin Cheng ◽  
Niuliu Huang ◽  
Chengdong Ning ◽  
Qianlun Huo
Keyword(s):  
Septal Defect ◽  
Cardiac Injury ◽  
Penetrating Trauma ◽  
Emergency Operation ◽  
Ventricular Septum ◽  
Right Ventricular Free Wall ◽  
Left Chest ◽  
Septal Defects ◽  
The Right ◽  
Penetrating Cardiac Injury

Traumatic ventricular septal defects (VSDs) after penetrating trauma to the left chest are rare. Most of the traumatic VSDs are located in the muscular ventricular septum, and a few reports place them in the membranous ventricular septum. There has been no report of traumatic conoventricular VSD by penetrating trauma. We present a case of penetrating cardiac injury (PCI). The rupture of the right ventricular free wall was found and repaired in emergency operation. This is the first report of the use of auricular forceps to control cardiac rupture bleeding. After operation, we found traumatic conoventricular VSD, which was repaired under cardiopulmonary bypass.

Intracellular EDEMA does not adversely affect the ability to cryopreserve intact hearts

1993 ◽  
Vol 51 ◽  
pp. 278-279
Author(s):  
CL Hastings ◽  
RD Carlton ◽  
FG Lightfoot ◽  
AF Tryka
Keyword(s):  
Cell Injury ◽  
Median Sternotomy ◽  
Left Ventricular ◽  
Ventricular Free Wall ◽  
Hypoxic Cell ◽  
Free Wall ◽  
Sprague Dawley ◽  
Left Ventricular Free Wall ◽  
Sprague Dawley Rats

The earliest ultrastructural manifestation of hypoxic cell injury is the presence of intracellular edema. Does this intracellular edema affect the ability to cryopreserve intact myocardium? To answer this guestion, a model for anoxia induced intracellular edema (IE) was designed based on clinical intraoperative myocardial preservation protocol. The aortas of 250 gm male Sprague-Dawley rats were cannulated and a retrograde flush of Plegisol at 8°C was infused over 90 sec. The hearts were excised and placed in a 28°C bath of Lactated Ringers for 1 h. The left ventricular free wall was then sliced and the myocardium was slam frozen. Control rats (C) were anesthetized, the hearts approached by median sternotomy, and the left ventricular free wall frozen in situ immediately after slicing. The slam frozen samples were obtained utilizing the DDK PS1000, which was precooled to -185°C in liguid nitrogen. The tissue was in contact with the metal mirror for a dwell time of 20 sec, and stored in liguid nitrogen until freeze dry processing (Lightfoot, 1990).

THE CONCEPT OF CONSTITUTIONAL AND LEGAL GUARANTEES OF ELECTORAL RIGHTS

2020 ◽  
Vol 10 (4) ◽  
pp. 85-90
Author(s):  
VLADIMIR TROYAN ◽  
Keyword(s):  
Scientific Research ◽  
Formal Aspect ◽  
Universal Approach ◽  
Right To Vote ◽  
Definition Of ◽  
The Right

The relevance of the interpretation of constitutional and legal guarantees of the right to vote is mediated by isolated scientific research in this area, as well as the lack of a universal approach to legal guarantees. In this regard, the purpose of the article is to argue and disclose the author’s definitive aspect of the claimed guarantees. In the work, the author named and characterized the normative (based exclusively on legal means) with the perspective of a branch of legal and technical; regulatory and institutional (combines the formal aspect with the activities of authorized entities) and associated legal (including a set of legal and other aspects) approaches to the definition of legal guarantees. Based on the second approach, as well as combining the guarantees of the right to vote directly guarantees of the subjective right itself and guarantees of its implementation, the author offers a definition of constitutional and legal guarantees of the right to vote.

Off-Pump Supraarterial Decompression Myotomy for Myocardial Bridging

2005 ◽  
Vol 8 (1) ◽  
pp. 49 ◽  
Author(s):  
Mersa M. Baryalei ◽  
Theodorus Tirilomis ◽  
Wolfgang Buhre ◽  
Stephan Kazmaier ◽  
Friedrich A. Schoendube ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Exercise Testing ◽  
Clinical Symptoms ◽  
Therapeutic Option ◽  
Median Sternotomy ◽  
Myocardial Bridging ◽  
Off Pump ◽  
Hemodynamic Compromise ◽  
Artery Disease ◽  
The Right

Background: Myocardial bridging of the left anterior descending (LAD) artery may result in clinical symptoms. Surgery with cardiopulmonary bypass (CPB) is a therapeutic option with considerable risk. We hypothesized that off-pump supraarterial myotomy could be an effective treatment modality. Methods: Between October 1998 and May 2000, 13 patients were referred for surgery. All were symptomatic despite medical therapy. Anteroseptal ischemia had been proven by thallium scintigraphy in all 13 patients, exercise testing was positive in 11. All patients were operated on with an off-pump approach after median sternotomy. Results: Mean patient age was 61 8 years (range, 43-71 years). Coronary artery disease mandating additional bypasses was present in 3 patients. The bypasses were done off pump in 2 patients. Conversion to on-pump surgery was necessary in 3 of 13 patients (23%) because of hemodynamic compromise (1 patient), opening of the right ventricle (1 patient), and injury to the LAD (1 patient). Supraarterial myotomy was performed in all patients. One patient who underwent surgery with CPB developed postoperative anteroseptal myocardial infarction. Postoperative exercise testing was performed in all patients and did not reveal any persistent ischemia. Mortality was 0%. All patients were free from symptoms and had not undergone repeat interventions after an average of 51 7 months of follow-up. Conclusions: Off-pump supraarterial myotomy effectively relieves coronary obstruction but has a certain periprocedural risk as evidenced by 1 myocardial infarction, 1 right ventricular injury, and 1 LAD injury. Long-term freedom from symptoms and from reintervention favor further investigation of this surgical therapy.

administrasi ketatausahaan sekolah

2020 ◽  
Author(s):  
Isra Revenia
Keyword(s):  
Information Needs ◽  
Control Functions ◽  
Definition Of ◽  
The Right ◽  
And Control

This article is made to know the destinantion and the administrasi functions of the school in order to assist the leader of an organazation in making decisions and doing the right thing, recording of such statements in addition to the information needs also pertains to the function of accountabilitty and control functions. Administrative administration is the activity of recording for everything that happens in the organization to be used as information for leaders. While the definition of administration is all processing activities that start from collecting (receiving), recording, processing, duplicating, minimizing and storing all the information of correspondence needed by the organization. Administration is as an activity to determine everything that happens in the organization, to be used as material for information by the leadership, which includes all activities ranging from manufacturing, managing, structuring to all the preparation of information needed by the organization.

SELF ASSESSMENT TO KNOW UNDERSTANDING MATHEMATIC CONCEPT

2018 ◽  
Vol 3 (1) ◽  
pp. 14-21
Author(s):  
Deni Iriyadi
Keyword(s):  
Qualitative Study ◽  
Qualitative Analysis ◽  
Resolution Limit ◽  
Self Assessment ◽  
Limit Concept ◽  
Research Instrument ◽  
Definition Of ◽  
The Right

This research is a qualitative study aimed to determine the students' understanding of the concept of matter limit. The subjects were students of class XI IPA 1 SMA Negeri 1 Watampone. The concept includes the definition of the limit. Data obtained using a research instrument in the form of self-assessment and then proceed with the interview subjects were selected based on the results of self-assessment has been done before. Analysis using qualitative analysis of students' understanding of the concept of the limit concept. The results of this study indicate that students' understanding of concepts some of which are not / do not understand especially regarding definitions limit. In addition students are also wrong about the resolution limit. Students who understand the concept of limit dinyakatakan them restate concepts, including examples and classify the sample to non-completion of function and limit the right results.

DIRECTIONS FOR PROVISION OF PUBLIC BODIES’ TRANSPARENCY AND ACCOUNTABILITY IN CONDITIONS OF PARTICIPATORY DEMOCRACY DEVELOPMENT

2018 ◽  
Vol 1 (11) ◽  
pp. 144-154
Author(s):  
Olga Mykhailоvna Ivanitskaya
Keyword(s):  
Public Administration ◽  
Participatory Democracy ◽  
Main Task ◽  
The Public ◽  
State Governance ◽  
Legislative Initiative ◽  
The Government ◽  
Definition Of ◽  
The Right ◽  
Transparency And Accountability

The article is devoted to issues of ensuring transparency and ac- countability of authorities in the conditions of participatory democracy (democ- racy of participation). It is argued that the public should be guaranteed not only the right for access to information but also the prerequisites for expanding its par- ticipation in state governance. These prerequisites include: the adoption of clearly measurable macroeconomic and social goals and the provision of control of the processes of their compliance with the government by citizens of the country; ex- tension of the circle of subjects of legislative initiative due to realization of such rights by citizens and their groups; legislative definition of the forms of citizens’ participation in making publicly significant decisions, design of relevant orders and procedures, in particular participation in local referendum; outlining methods and procedures for taking into account social thought when making socially im- portant decisions. The need to disclose information about resources that are used by authorities to realize the goals is proved as well as key performance indicators that can be monitored by every citizen; the efforts made by governments of coun- tries to achieve these goals. It was noted that transparency in the conditions of representative democracy in its worst forms in a society where ignorance of the thought of society and its individual members is ignored does not in fact fulfill its main task — to establish an effective dialogue between the authorities and so- ciety. There is a distortion of the essence of transparency: instead of being heard, society is being asked to be informed — and passively accept the facts presented as due. In fact, transparency and accountability in this case are not instruments for the achievement of democracy in public administration, but by the form of a tacit agreement between the subjects of power and people, where the latter passes the participation of an “informed observer”.

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