RESEARCH
ABDOMINAL AORTIC ANEURYSMS Abstract*: Nussbaumer Aneurysm Dilation Ratio Excerpt* - "A concern regarding treatment of abdominal aortic aneurysms (AAAs) is whether to surgically repair the aneurysm or to monitor the rate of aneurismal growth periodically. Currently, when evaluating the risk of AAA rupture, a measurement of the maximal diameter of the aneurysm is taken into consideration." *This is a reprint of an earlier presentation given by Karen Nussbaumer, RDMS, RVT. The medical facilities’ logotypes therein does not imply any association with CURE, and none are implied – and the patent pending technology is held by Karen Nussbaumer, RDMS, RVT.
ACUTE TRAUMA PATIENTS Abstract*: Fat Embolism Clinical Scoring Excerpt* - "Acute trauma patients are likely to develop symptoms of Acute Respiratory Distress Syndrome (ARDS) . It has been considered that the cause of this pulmonary stress is from either embolus of deep venous thrombosis (DVT) or from fat embolus." *This is a reprint of an earlier presentation given by Karen Nussbaumer, RDMS, RVT. The medical facilities’ logotypes therein does not imply any association with CURE, and none are implied – and the patent pending technology is held by Karen Nussbaumer, RDMS, RVT.
THE TRAUMATIC RELATIONSHIP OF BLOOD, FAT AND CALCIUM; DEFENSE MECHANISMS OR DISEASE MECHANISMS? Coming Soon
ULTRASOUND: BREAST CANCER SCREENING ALTERNATIVE TO MAMMOGRAMS Coming Soon
RELATED PUBLICATIONS Am Surg. 2008 Feb;74 (2):124-8 18306861 (P,S,E,B) Konstantinos Spaniolas, George C. Velmahos, Stephan Wicky, Karen Nussbaumer, Laurie Petrovick, Alice Gervasini, Marc De Moya, Hasan B Alam, Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. It has been suggested that upper extremity deep venous thrombosis (UEDVT) is as common and dangerous as lower extremity deep venous thrombosis. Pulmonary embolism (PE) is often found with no evidence of associated lower extremity deep venous thrombosis and could have originated from UEDVT. Routine screening is well accepted for lower extremity deep venous thrombosis but not for UEDVT. We hypothesized that UEDVT in trauma is frequent but undetected; therefore, routine screening of trauma patients at risk will increase the UEDVT rate and decrease the PE rate due to early diagnosis and treatment. We evaluated the incidence of UEDVT and PE over 6 months before (Group BEFORE) and 6 months after (Group AFTER) implementing a policy of screening patients at high risk for deep venous thrombosis with Duplex ultrasonography. Group BEFORE was evaluated retrospectively and group AFTER prospectively. There were 1110 BEFORE and 911 AFTER patients. The two groups were similar. Of the AFTER patients, 86 met predetermined screening criteria and were evaluated routinely by a total of 130 Duplex exams. One patient in each group developed UEDVT (0.09% vs. 0.11%, P = 1.00). The brachial vein was involved in both patients. Six BEFORE (0.54%) and 1 AFTER (0.11%) patients developed PE (P = 0.137). The single AFTER patient with PE was not screened for UEDVT because he had no high-risk criteria. UEDVT is an uncommon event with unclear significance in trauma. Aggressive screening did not result in a higher rate of UEDVT diagnosis, nor an opportunity to prevent PE. |
