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1
Bradic, Nikola, Drazen Cuculic, and Ervin Jancic. "Terrorism in Croatia." Prehospital and Disaster Medicine 18, no. 2 (June 2003): 88–91. http://dx.doi.org/10.1017/s1049023x00000819.
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AbstractIntroduction:This report illustrates Croatia's experience with the terrorist attack in the city of Rijeka in October 1995. Also, the intention of this report is to outline how emergency services were functioning in this sudden-onset situation.Methods:The medical documentation of 27 wounded citizens in the attack was analyzed and the appearance of bodily wounds, severity of wounds, and the mechanisms of injury are described. From the forensic medical report, the wounds and damages sustained by the terrorist also were analyzed. All findings were compared with similar cases from around the world.Results:In the 27 wounded citizens, three (11%) had head injuries, and injuries of the abdomen in only two cases (7%) were found. The most common injuries sustained involved one or more extremities: 16 (59%) persons had wounds of an upper or lower extremity or a combination of multiple wounds. The main cause of death of the terrorist was explosive wounds to the chest and abdomen with destruction of multiple inner organs (primarily kidneys, liver, abdomen, and lung). Furthermore, the terrorist had a fracture of the skull base and multiple injuries to the brain.Conclusion:Comparing the findings with other data from the literature, the distribution in the percentages of wounded is almost the same as reported in many bomb attacks. In this case, the walls of the building protected many citizens, which is why so few were seriously injured. Forensic examination of the terrorist's body showed all of the characteristics of blast injuries.
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Yildirim, Çaglar, Özgür Haki Yüksel, Serkan Akan, Ahmet Ürkmez, and Ayhan Verit. "Lower pole renal cut injury due to the iliac wing fracture: A rare case report." Archivio Italiano di Urologia e Andrologia 87, no. 2 (July 7, 2015): 179. http://dx.doi.org/10.4081/aiua.2015.2.179.
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The most frequent causes of blunt genitourinary injuries are falls from heights, motor vehicle accidents and sports injuries. Firearm injuries and penetrating stab wounds are also frequently encountered. Skeletal system traumas in the vicinity of the urogenital system can cause urological organ injuries. Though rarely, renal traumas can be dependent on the kinetic energy of the trauma and the retroperitoneal movement capacity of the kidneys and cannot be explained with the proximity of the kidney to the skeletal system. In cases with high-energy decelerations, renal pedicle and ureteropelvic junction traumas are more frequently observed. Herein, we presented a grade 3 left kidney lower pole injury developed secondary to A2 type pelvic fracture following a high energy deceleration trauma. It should not be forgotten that especially in this type of fractures, injuries of the lower renal pole can occur.
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Kong, VY, GV Oosthuizen, and DL Clarke. "The spectrum of injuries resulting from posterior abdominal stab wounds: a South African experience." Annals of The Royal College of Surgeons of England 97, no. 4 (May 2015): 269–73. http://dx.doi.org/10.1308/003588415x14181254789204.
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IntroductionThe spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature on the spectrum of organ injury associated with SWs to the posterior abdomen, however, is limited.MethodsWe reviewed our experience of 105 consecutive patients who had established indications for laparotomy managed over a 4-year period in a high volume trauma service in South Africa.ResultsOf the 105 patients, 97 (92%) were male and the overall mean age was 24 years. Fifty-seven patients (54%) had immediate indications for laparotomy. The remaining 48 patients (46%) initially underwent active clinical observation and the indications for laparotomy became apparent during the observation period. Of the 105 laparotomies performed, 94 (90%) were positive and 11 (10%) were negative. Of the 94 positive laparotomies, 92 were therapeutic and 2 were non-therapeutic. A total of 176 organ injuries were identified: 50 (53%) of the 94 patients sustained a single organ injury while the remaining 44 (47%) sustained multiple organ injuries. The most commonly injured organs were the colon (n=63), spleen (n=21) and kidney (n=19).ConclusionsThe pattern of intra-abdominal injuries secondary to SWs to the posterior abdomen is different to that seen with the anterior abdomen. Colonic injury is most commonly encountered, followed by injuries to the spleen and kidney. Clinicians must remain vigilant because of the potential for occult injuries.
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Chauhan, D. C., P. S. Chari, G. K. Khuller, and Dalbir Singh. "Correlation of renal complications with extent and progression of tissue damage in electrical burns." Indian Journal of Plastic Surgery 37, no. 02 (July 2004): 099–104. http://dx.doi.org/10.1055/s-0039-1697236.
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ABSTRACTElectrical injuries due to high-tension voltage (>1000 volts) cause destruction at the point of contact with massive necrosis of deeper structures such as muscles, vessels and nerves. Rhabdomyolysis due to massive breakdown of skeletal muscles may lead to acute renal failure secondary to myoglobinuria. The study was undertaken to observe the correlation of renal complications with extent and progression of tissue damage in high-tension voltage electrical burns. Renal biochemical parameters as predictors of acute renal failure were also studied. Thirty two patients of high tension voltage electrical burn injuries presenting during one year period 1-1-2001 to 31-12-2001 were studied. Low-tension voltage electrical injuries (< 1000 volts) mimic thermal burns were excluded from the study. The electrical wound assessment and the renal biochemical parameters were done daily for the first seven days and then on alternate days for another seven days. Assessment of progression of wounds and correlation with the renal biochemical parameters was done. Patients who died following electrical burns were subjected to autopsy and histopathological examination of both kidneys. Out of the thirty-two patients, six (18.75%) went into acute renal failure. Five out of these six patients died because of renal failure (mortality rate 83.33%). There was definite progression of electric burn wounds. There was no correlation between progression of electrical burn wounds and acute renal failure. Serum creatinine was found to be the most important biochemical parameter as a prognostic indicator of acute renal failure.
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Sachdev, Namrita, Yashvant Singh, Sana ., and Dipshi Mehta. "Multi detector computed tomography imaging in penetrating injuries." International Journal of Research in Medical Sciences 8, no. 6 (May 26, 2020): 2259. http://dx.doi.org/10.18203/2320-6012.ijrms20202278.
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Background: Penetrating injuries forms an important component of surgical emergencies. Penetrating trauma typically involves the violation of the body by a gunshot wound (GSW) or stab wound. Emergency laparotomy is the accepted management in patients with a penetrating injury who are not hemodynamically stable. However, selective non-operative management has been shown to decrease the rate of unnecessary surgery. Plain radiographs and FAST are useful for initial assessment of these patients. Multi detector CT is an indispensable tool in the evaluation of patients who are stable and are candidates for conservative treatment.Methods: A cross sectional observational study was carried out on 40 patients admitted with penetrating injury to the trauma centre of PGIMER and Dr RML hospital. Of the 40 patients, 14 were taken for emergency laparotomy. In 26 cases, MDCT was done to evaluate for solid organ, hollow organ and vascular injuries.Results: The mean age of patients was 38 years, with male to female ratio of 5:1. Stab injury was the commonest type of injury, followed by gunshot wounds. Liver was the commonest solid organ involved, followed by kidneys and spleen. Other organs involved were diaphragm, small bowel and colon.Conclusions: Penetrating injuries can be life-threatening, making prompt diagnosis essential. Recognizing key abnormalities on MDCT ensures patients are triaged appropriately. Multi-detector CT is thus widely used to evaluate penetrating injuries in stable patients.
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Ksonz, I. V., Ie M. Grytsenko, M. I. Grystenko, O. V. Ovchar, and V. G. Fomin. "Penetrating Abdominal Trauma in Children." Paediatric Surgery. Ukraine, no. 1(70) (March 29, 2021): 102–6. http://dx.doi.org/10.15574/ps.2021.70.102.
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Injury is the leading cause of death among children and adolescents, with about 10% of injuries being penetrating. Penetrating injuries that occur if a child falls or sits down on a long, sharp object are rare by their mechanism. So far we have experience in treating 5 children with penetrating injuries to the abdominal organs involving long sharp objects. 3 children were injured by falling on a metal fence, and the other 2 by sitting down on a metal pin and a scythe. The consequences of the injuries were damage to the small intestine (1), colon (4), stomach (1), kidney (1), urinary bladder (2). Clinical cases. Two brothers, aged 11 and 12, who fell out of a tree on a metal fence from a height of about 3 meters, were brought Pediatric Municipal Clinical Hospital of Poltava Municipal Council with metal rods in their bodies. After preoperative preparation, the children were operated on. Removal of the foreign objects was performed in the operating room. One of the boys was found to have damage to the stomach, transverse colon, kidney crushing. Suturing of wounds of hollow organs, and nephrectomy were performed. The second boy was found to have damage to the rectum, a colostomy was performed with its subsequent closure. A 16-year-old girl was injured when she sat down on a vertical scythe blade. During the operation, wounds of the ileum and mesentery of the hungry intestine were revealed, the wounds were sutured. All children were discharged after they recovered. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: penetrating abdominal trauma, children.
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Bansal, Vishal, Chris M. Reid, Dale Fortlage, Jeanne Lee, Leslie Kobayashi, Jay Doucet, and Raul Coimbra. "Determining Injuries from Posterior and Flank Stab Wounds Using Computed Tomography Tractography." American Surgeon 80, no. 4 (April 2014): 403–7. http://dx.doi.org/10.1177/000313481408000425.
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Unlike anterior stab wounds (SW), in which local exploration may direct management, posterior SW can be challenging to evaluate. Traditional triple contrast computed tomography (CT) imaging is cumbersome and technician-dependent. The present study examines the role of CT tractography as a strategy to manage select patients with back and flank SW. Hemodynamically stable patients with back and flank SW were studied. After resuscitation, Betadine- or Visipaque®-soaked sterile sponges were inserted into each SW for the estimated depth of the wound. Patients underwent abdominal helical CT scanning, including intravenous contrast, as the sole abdominal imaging study. Images were reviewed by an attending radiologist and trauma surgeon. The tractogram was evaluated to determine SW trajectory and injury to intra- or retroperitoneal organs, vascular structures, the diaphragm, and the urinary tract. Complete patient demographics including operative management and injuries were collected. Forty-one patients underwent CT tractography. In 11 patients, tractography detected violation of the intra- or retroperitoneal cavity leading to operative exploration. Injuries detected included: the spleen (two), colon (one), colonic mesentery (one), kidney (kidney), diaphragm (kidney), pneumothorax (seven), hemothorax (two), iliac artery (one), and traumatic abdominal wall hernia (two). In all patients, none had negative CT findings that failed observation. In this series, CT tractography is a safe and effective imaging strategy to evaluate posterior torso SW. It is unknown whether CT tractography is superior to traditional imaging modalities. Other uses for CT tractography may include determining trajectory from missile wounds and tangential penetrating injuries.
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Babar, Khan Muhammad, Humera Sadaf Bugti, Fida Ahmed Baloch, Shakeel Akbar, Abdullah Makki, and Bilal Elahi. "PATTERNS AND OUTCOME OF PENETRATING ABDOMINAL TRAUMA." Professional Medical Journal 26, no. 07 (July 10, 2019): 1067–73. http://dx.doi.org/10.29309/tpmj/2019.26.07.3768.
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Objectives: To determine the mode of penetrating injuries to abdomen and to determine the effect of these injuries on outcome and to formulate recommendations for management of patients sustaining penetrating abdominal trauma. Study Design: Descriptive, cross sectional. Setting: Surgical Department Sandeman Provincial hospital, Quetta. Period: 1 year 2012-2013. Methodology: 147 consecutive cases of abdominal trauma presenting to emergency were studied for pattern of injury and management outcome. Data was recorded and analyzed using SPSS v10. Frequency tables were generated for various variables. Results: The commonest mode of injury was stabbing occurring in 76 cases (51.7%) followed by gunshot injuries in 60 cases (40.8%), 11 patients (7.4%) sustained blast pellet injuries. Patients were either managed conservatively or underwent laparotomy depending on mechanism of injury and clinical presentation. Stab and blast pallet wounds which were superficial were managed by local wound exploration those with peritoneal breach, hemodynamic instability and visceral evisceration were managed by Laprotomy. All gunshot injuries underwent mandatory Laprotomy. Gut was most commonly injured viscus followed by liver and kidney. Types of procedure performed were primary repair, bowel resection, protective ileostomy, splenectomy, nephrectomy, 2 patients were managed by damage control i.e. liver packing. Overall mortality was 5%. Conclusion: Mandatory laprotomy for all gunshots, and stabs and pellets that penetrate the peritoneal cavity proves to be safe and a prudent policy.
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Hassan, Khaled M., Abdullah A. Hamdi, Suhail A. Alhamad, Reem Q. Alanzi, Yousef A. Aleid, Abdullah S. Aldarwish, Abdullah H. Almuntashiri, et al. "Healing the chronic wounds in diabetes using old drugs." International Journal Of Community Medicine And Public Health 7, no. 10 (September 25, 2020): 4185. http://dx.doi.org/10.18203/2394-6040.ijcmph20203981.
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People with uncontrolled diabetes may develop poor circulation. As circulation slows down, blood moves more slowly, which makes it more difficult for the body to deliver nutrients to wounds. As a result, the injuries heal slowly, or may not heal at all. Due to the effects of diabetes on the nerves and blood vessels, diabetic patients might also experience other complications. These include heart disease, kidney disease, and eye problems. Hence, the need for therapeutic drugs is a must. In this review we analyze some drugs that have been used in diabetes wound healing including antiglycemic agents like dipeptidylpeptidase-4 (DPP4) inhibitors and metformin, statins and phenytoin. These drugs showed satisfying results giving the diabetes patients a glimmer of hop regarding their wound healing.
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Veeratterapillay, Rajan, Oliver Fuge, Philip Haslam, Chris Harding, and Andrew Thorpe. "Renal trauma." Journal of Clinical Urology 10, no. 4 (February 13, 2017): 379–90. http://dx.doi.org/10.1177/2051415817691642.
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The kidney is the most commonly injured genitourinary organ, and renal involvement has been reported in 1–5% of all trauma cases. Two mechanisms of renal injury are described, namely blunt (direct blow to the kidney, rapid acceleration/deceleration or a combination) and penetrating (from stab or gunshot wounds), with blunt injuries being most common in the UK. It is important to keep an index of suspicion for renal trauma as given by the mechanism of the injury or in poly-trauma. Accurate assessment and resuscitation are vital in the initial management. Imaging with computed tomography is critical to the accurate grading of the injury and helps guide subsequent treatment. The approach to management of renal injuries has changed over time. During the past two decades, advances in cross-sectional imaging coupled with minimally invasive intervention strategies (like angiography, embolisation and ureteric stenting) for managing traumatic renal injuries have allowed increased renal preservation by reducing the need for major surgical intervention. Nowadays, the vast majority of blunt injuries (up to 95%) are managed conservatively with accumulated experience suggesting this is safe. However, there is still a role for open surgical exploration in patients with haemodynamic instability or those who fail initial conservative/minimally invasive management.
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Kerforne, Thomas, Sébastien Giraud, Jérôme Danion, Raphael Thuillier, Pierre Couturier, William Hebrard, Olivier Mimoz, and Thierry Hauet. "Rapid or Slow Time to Brain Death? Impact on Kidney Graft Injuries in an Allotransplantation Porcine Model." International Journal of Molecular Sciences 20, no. 15 (July 26, 2019): 3671. http://dx.doi.org/10.3390/ijms20153671.
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The use of donors deceased after brain death (DBD) with extended criteria in response to the shortage of grafts leads to the removal of more fragile kidneys. These grafts are at greater risk of not being grafted or delayed function. A better knowledge of the pathophysiology of DBDs would improve this situation. There is a difference between the results from animal models of DBD and the clinical data potentially explained by the kinetics of brain death induction. We compared the effect of the induction rate of brain death on the recovery of post-transplant renal function in a pig model of DBD followed by allografts in nephrectomized pigs. Resumption of early function post-transplant was better in the rapidly generated brain death group (RgBD) and graft fibrosis at three months less important. Two groups had identical oxidative stress intensity but a greater response to this oxidative stress by SIRT1, PGC1-α and NRF2 in the RgBD group. Modulation of mechanistic target of rapamycin (mTOR) stimulation by NRF2 would also regulate the survival/apoptosis balance of renal cells. For the first time we have shown that an allostatic response to oxidative stress can explain the impact of the rapidity of brain death induction on the quality of kidney transplants.
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Shurygina, I. A., and M. G. Shurygin. "EFFECT OF JNK MAPK ON THE REPAIR OF DAMAGED SKELETAL MUSCLE." Acta Biomedica Scientifica 3, no. 5 (October 29, 2018): 137–40. http://dx.doi.org/10.29413/abs.2018-3.5.20.
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Regeneration of muscles after injuries, as well as the development of methods that stimulate this process, is an important problem in medicine and biology. The objective of the study was to evaluate the effect of local blocking of mitogen-activated protein kinase (MAPK) activity of the JNK group (c-Jun N-terminal kinase) on the repair of muscle tissue. Materials and methods. The effect of the JNK MAPK SP600125 blocker on the repair of muscle tissue was studied on a model of a skin and muscle wound in Wistar rats. The main group (n = 30) was injected with a drug plate containing SP600125 with a slow release of the active substance, the control group (n = 30) – the plate without the active substance. The number of dividing myosatellites and muscle kidneys in the damage zone was estimated. Results. Experimental studies have shown that when using a drug plate containing a JNK SP600125 blocker with a slow release of the active substance, the number of dividing myosatellites and forming muscle kidneys in the injury zone of the muscle in the main group on the 7th, 14th and 30th days was significantly higher (p < 0.05) than in the control. Conclusion. Local blockade of JNK MAPK in the zone of muscle damage provides the ability to stimulate the repair of damaged skeletal muscle.
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Namias, Nicholas, Antonio C. Marttos, Fernanda M. Kuchkarian, Daniel F. Rojas, Francisco S. Collet-Silva, Cleinaldo de Almeida Costa, George D. Garcia, and Carl I. Schulman. "Global Connections: Telemedicine as a Tool to extend Trauma Education." Panamerican Journal of Trauma, Critical Care & Emergency Surgery 2, no. 1 (2013): 62–66. http://dx.doi.org/10.5005/jp-journals-10030-1060.
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ABSTRACT Introduction Telemedicine is revolutionizing the delivery of trauma care and education. The International Trauma Tele- Grand Rounds is a series that unites institutions worldwide to discuss complex clinical cases and advanced trauma and critical care topics. Materials and methods Multiple remote institutions connect simultaneously to discuss the management of a trauma patient from the prehospital phase to discharge. Weekly, a case is presented in English by one institution on a rotating basis. Key points include mechanism of injury, resuscitation, laboratory and imaging diagnostics, surgical interventions, postoperative patient care, evaluation of treatment decisions and review of the literature. The highly interactive format allows participants to evaluate differences in trauma care across international health systems. Results During 2010 to 2011, 68 sessions were documented. Cases include blunt (42.6%), penetrating (48.5%), blast (7.4%) and crushing (1.5%) traumas. Gunshot wounds were the most frequent (25%). A holistic range of injuries were represented including injuries to major arteries, veins, lungs, heart, pericardium, esophagus, diaphragm, abdominal wall, stomach, intestines, liver, kidneys, pelvis, and the extremities. A variety of surgical and nonsurgical interventions were explored. To date, there have been 42 participating institutions from the United States, Brazil, Colombia, Bahamas, Canada, Mexico, Venezuela, Argentina, Panama, Puerto Rico, Dominican Republic, British Virgin Islands, Spain, Thailand, Turkey and Iraq; ranging from academic medical centers military hospitals, community hospitals, and rural hospitals. In 2011, the series received accreditation by the Accreditation Council for Continuing Medical Education. Conclusion Telemedicine offers a solution to address the disparities in access to trauma care and education. The diversity of institutional settings allows participants to learn from others on how to best treat trauma patients, despite differences in resources and expertise. In addition to serving as an educational tool, the series provides a mechanism for physicians to network and collaborate on future endeavors. How to cite this article Marttos AC, Kuchkarian FM, Rojas DF, Fraga GP, Collet-Silva FS, de Almeida Costa C, Garcia GD, Ginzburg E, Schulman CI, Namias N. Global Connections: Telemedicine as a Tool to extend Trauma Education. Panam J Trauma Critical Care Emerg Surg 2013;2(1):62-66.
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Vercammen, Yasmine, Dieter Dauwe, Greet De Vlieger, Sabrina Houthoofd, Lars Desmet, and Michael P. Casaer. "Povidone Iodine Disinfection Associated with Hypothyroidism and Potentially Contributing to Prolonged Kidney Failure." Case Reports in Critical Care 2021 (June 24, 2021): 1–8. http://dx.doi.org/10.1155/2021/5528210.
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Objectives. To report a case of povidone-iodine (PVP-I, Iso-Betadine®) disinfection of lower leg fasciotomy wounds resulting in iodide absorption and possibly contributing to hypothyroidism and prolonged kidney injury. Design. Case report. Setting. Pediatric intensive care unit (PICU), university hospital. Patients. A 13-year-old patient presenting with prolonged oligoanuric kidney failure and unexplained primary hypothyroidism three weeks after severe abdominal sepsis with multiple organ dysfunction and major rhabdomyolysis due to bilateral lower leg compartment syndrome, necessitating moderate size fasciotomies, disinfected daily with PVP-I. Interventions. Interruption of PVP-I exposure and initiation of thyroid hormone substitution. Measurements and Main Results. Hypothyroidism was revealed during diagnostic work-up for persistent hypertriglyceridemia. Thyroxine (T4) (4.0 mg/L) and tri-iodothyronine (T3) (64 ng/L) were moderately low, yet thyroid stimulating hormone (TSH) (16.8 mIU/L) was fourfold the maximal normal range value. This pattern, atypical for prolonged critical illness-related hypothyroidism, prompted interruption of PVP-I exposure and initiation of thyroid hormone substitution. Urinary production and creatinine clearance recovered during the following days, and one week later, intermittent renal replacement therapy could be terminated, suggesting that PVP-I toxicity and/or hypothyroidism may have contributed to the persistent renal failure three weeks after resolved septic shock and rhabdomyolysis. Elevated serum and urinary anion gap normalized simultaneously, but this evolution of rather nonspecific indices could be multifactorial. Conclusion. PVP-I is a commonly used broad-spectrum antimicrobial agent for prevention and treatment of wound infections. Toxic complications due to PVP-I absorption, after disinfection of extended thermal injuries larger than 20% of the body surface, have been described. In critically ill children, however, toxic effects of PVP-I may occur due to repeated disinfection of less extended wounds. Proposed screening strategies include: monitoring of the volumes of PVP-I applied daily; of the thyroid function, the serum, and/or urinary anion gap and the urinary iodide concentrations. These strategies, however, remain to be validated. This case report should be a wake-up call for daily integration of wound management in the clinical evaluation of critically ill patients.
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Piper, Ann-Katrin, Reece A. Sophocleous, Samuel E. Ross, Frances J. Evesson, Omar Saleh, Adam Bournazos, Joe Yasa, et al. "Loss of calpains-1 and -2 prevents repair of plasma membrane scrape injuries, but not small pores, and induces a severe muscular dystrophy." American Journal of Physiology-Cell Physiology 318, no. 6 (June 1, 2020): C1226—C1237. http://dx.doi.org/10.1152/ajpcell.00408.2019.
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The ubiquitous calpains, calpain-1 and -2, play important roles in Ca2+-dependent membrane repair. Mechanically active tissues like skeletal muscle are particularly reliant on mechanisms to repair and remodel membrane injury, such as those caused by eccentric damage. We demonstrate that calpain-1 and -2 are master effectors of Ca2+-dependent repair of mechanical plasma membrane scrape injuries, although they are dispensable for repair/removal of small wounds caused by pore-forming agents. Using CRISPR gene-edited human embryonic kidney 293 (HEK293) cell lines, we established that loss of both calpains-1 and -2 ( CAPNS1−/−) virtually ablates Ca2+-dependent repair of mechanical scrape injuries but does not affect injury or recovery from perforation by streptolysin-O or saponin. In contrast, cells with targeted knockout of either calpain-1 ( CAPN1−/−) or -2 ( CAPN2−/−) show near-normal repair of mechanical injuries, inferring that both calpain-1 and calpain-2 are equally capable of conducting the cascade of proteolytic cleavage events to reseal a membrane injury, including that of the known membrane repair agent dysferlin. A severe muscular dystrophy in a murine model with skeletal muscle knockout of Capns1 highlights vital roles for calpain-1 and/or -2 for health and viability of skeletal muscles not compensated for by calpain-3 ( CAPN3). We propose that the dystrophic phenotype relates to loss of maintenance of plasma membrane/cytoskeletal networks by calpains-1 and -2 in response to directed and dysfunctional Ca2+-signaling, pathways hyperstimulated in the context of membrane injury. With CAPN1 variants associated with spastic paraplegia, a severe dystrophy observed with muscle-specific loss of calpain-1 and -2 activity identifies CAPN2 and CAPNS1 as plausible candidate neuromuscular disease genes.
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Oguji, Emeka Cyprian, Chibueze Joseph Obigeorge, Johnson Obiechina Omeh, Amechi Jnr Odeku, Tachia Jaclyn Wanger, Chukwuebuka Abel Udeh, Chidubem John Ochi, et al. "Protection of histomorphology of vital organs by methanolic seed extract of Nigella sativa against cadmium-induced tissue injuries in rats." Journal of Drug Delivery and Therapeutics 11, no. 3-S (June 15, 2021): 19–26. http://dx.doi.org/10.22270/jddt.v11i3-s.4822.
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Background: Chemical-induced organ injuries have been on a fast rise for decades and these injuries have become common causes of mortality and morbidity in the society. Edible plant materials with medicinal properties have been used for treating various diseases for many centuries in folk medicine. Recently, the role of food or medicinal plants in human health has received considerable attention. Traditional uses of N. sativa seed range from soothing wounds to remedying cough, eczema, diabetes, inflammation of the bronchi and tooth aches; and these point to substantial tissue effects.
Objective: We investigated the protective effects of methanolic seed extract of Nigella sativa (MENS) against cadmium-induced histomorphological alterations in heart, kidney and liver tissues of albino rats.
Methods: Twenty five (25) male albino rats, weighing (200±20g), were randomly grouped into five groups: A, B, C, D, and E. Group B (Negative Control) received intraperitoneal administration of cadmium chloride (CdCl2, 5mg/kg) only, group C received CdCl2 and low dose MENS (300mg/kg, oral), group D received CdCl2 and high dose MENS (600mg/kg, oral), and group E (Positive control) received CdCl2 and Vitamin C (200mg/kg, oral), for 14 days. Group A (Normal control) received no administration. Heart, kidney and liver were harvested for histopathological analyses.
Results: Cadmium (CdCl2) induced significant histomorphological changes in the studied organs, and the heart was the most damaged of all the organs studied; however a significantly ameliorative effect by methanolic seed extracts was observed.
Conclusion: Nigella sativa seed extract is potentially tissue-protective against harmful chemical toxins like cadmium.
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Ahmed, Syed Faraz, Muhammad Uzair, Anas Bin Saif, Ahmed Mushtaq Khan, and Saima Faraz. "SIGNIFICANCE OF RENAL FUNCTION IN TRAUMA: AN OBSERVATIONAL STUDY TO ASCERTAIN CORRELATION TO EGFR." Pakistan Armed Forces Medical Journal 70, no. 6 (December 15, 2020): 1771–75. http://dx.doi.org/10.51253/pafmj.v70i6.2670.
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Objective: To assess renal function in combat patients at the time of arrival from Balochistan in Accident & Emergency (A&E) of an ‘A’ Class Military Hospital.
Study Design: Retrospective observational study with analysis to find correlation between measurable variables and glomerular filtration rate.
Place and Duration Of Study: Combined Military Hospital Malir Cantonment, Karachi, from October 2015 to October 2018.
Material and Methods: All patients with major injuries (New Injury Severity Score NISS ≥16) were included in the study to assess kidney function by calculating their estimated glomerular filtration rate (eGFR) using serum creatinine. Correlation was calculated between eGFR and other variables which were pulse, mean arterial pressure, temperature and haemoglobin.
Results: 75 patients were brought to A&E. 14 (18.66%) were brought in dead. There were 44 (58.6%) gunshot wounds, 14 (18.6%) blast injuries and 17 (22.6%) accidents post ambush attack. 26 (34.66%) were included in the study, with NISS ≥16. All patients were male with mean age 29.73 ± 5.08. 20 (77%) patients were fluid resuscitated in pre-hospital setting whereas 6 (23%) were not. Statistically significant correlations were found among eGFR and pulse rate, body temperature, mean arterial pressure, hemoglobin and NISS. 6 out of 26 patients not resuscitated in pre-hospital setting had a median eGFR of 53.5, as compared to median eGFR of 70 in 20 patients who were resuscitated before evacuation to CMH Malir, in the field medical units.
Conclusion: Fluid resuscitation in the field lowers the possibility of renal dysfunction.
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Клетикова, Людмила Владимировна, Всеволод Алексеевич Пономарев, and Любовь Васильевна Маловичко. "Internal organs and pathologies in birds in the urban environment." Herald of Tver State University. Series: Biology and Ecology, no. 1(61) (April 13, 2021): 61–69. http://dx.doi.org/10.26456/vtbio186.
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Врановые птицы являются наиболее многочисленными в орнитофауне городов Ивановской области. В связи с этим возрос интерес к изучению эколого-физиологических особенностей врановых птиц. Данная работа просвещена изучению относительной массы внутренних органов и заболеваний у врановых. Анализ данных показал, что наибольшая относительная масса сердца была у ворона; печени - у сойки и галки; желудка - у сойки и серой вороны; кишечника - у серой вороны и сороки; легких - у ворона; почек - у галки и серой вороны; селезенки - у серой вороны; поджелудочной железы - у ворона. Наиболее часто встречаются травмы: ампутация фаланг пальцев, колотые и рваные раны, переломы трубчатых костей ног и крыльев, гемартрозы, трещины грудной кости. Вороны часто страдают пододерматитом и панкреатитом, серые вороны - спленитом, сороки и галки - ожирением, галки и сойки - гепатозом, серые вороны - гистомонозом печени. Corvids are the most numerous birds in the avifauna of the cities of the Ivanovo Region. In this regard, interest in the study of the ecological and physiological characteristics of corvids has increased. This work is enlightened by the study of the relative mass of internal organs and diseases in corvids. Analysis of the data showed that the raven had the highest relative heart mass; jays and jackdaws have the highest relative liver mass; while the highest relative mass of stomach is recorded in jays and hooded crows. The highest relative mass of the intestines is shown in hooded crows and magpies; heaviest lungs are reported for ravens. Kidneys are heaviest at jackdaws and hooded crows; spleen has the highest relative mass in hooded crows; pancreas is heaviest in crows. The most common injuries are loss of the phalanges of toes, stab and laceration wounds, and fractures of the tubular bones of the legs and wings, hemarthrosis, cracks in the chest bone. Ravens often suffer from pododermatitis and pancreatitis, hooded crows suffer from splenitis, magpies and jackdaws shows signs of obesity, jackdaws, and jays often demonstrate hepatosis, while hooded crows are susceptible to liver histomonosis.
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Adhikari, Ranjith, Lalith Suriyagoda, Amal Premarathna, Niranjala De Silva, Ashoka Dangolla, Chandima Mallawa, Indira Silva, and Indika Gawarammana. "Development of a Treatment Protocol for Cobra (Naja naja) Bite Envenoming in Dogs." Toxins 12, no. 11 (November 2, 2020): 694. http://dx.doi.org/10.3390/toxins12110694.
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There is limited information on clinical profiles, treatment, and management aspects of Indian cobra (Naja naja) bite envenoming in dogs in Sri Lanka. Dogs with cobra bites presented to the Veterinary Teaching Hospital (VTH), University of Peradeniya, were prospectively studied over a period of 72 months; local and systemic clinical manifestations and hematological abnormalities were recorded. We studied 116 cobra bite envenomings in dogs. A grading system was established using a combination of anatomical site of fang marks, as well as local and systemic clinical manifestations. Accordingly, treatment strategies were established using Indian polyvalent antivenom (AVS). Pain and swelling at the bite site were major clinical signs observed, while neurotoxic manifestations (mydriasis, wheezing, and crackles) were detected in most dogs. Leukocytosis was observed in 78% of them. Statistical analysis revealed that the grading scores obtained were compatible to initiate AVS administration according to the severity. The minimum number required was 2 AVS vials (range 2–12). Almost 20% of the dogs developed wheezing, crackles, hypersalivation, restlessness, and dyspnea as adverse reactions to AVS treatment. Necrotic wounds on bitten anatomical sites developed in 19% of the dogs and 2.5% developed acute kidney injuries as a consequence of envenoming crisis. Despite treatment, 3% of dogs died. No dry bites were recorded.
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Chen, Amy Y., Michael G. Stewart, and Glenn Raup. "Penetrating Injuries of the Face." Otolaryngology–Head and Neck Surgery 115, no. 5 (November 1996): 464–70. http://dx.doi.org/10.1177/019459989611500519.
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We reviewed 78 consecutive cases of penetrating facial injuries treated at Ben Taub General Hospital in Houston, Texas, between 1992 and 1994, and we analyzed injury patterns on the basis of (1) the mechanism of injury, and (2) the entry zone of the wounds. We found that gunshot wounds were more likely to require emergent airway establishment than shotgun wounds or stab wounds ( p = 0.03). We noted a higher prevalence of globe injury among shotgun wounds than among gunshot wounds ( p = 0.02). Nine (12%) patients had intracranial penetration of a bullet or shotgun pellet. Patients with gunshot wounds required open reduction and internal fixation of facial bone fractures more frequently than patients with shotgun wounds ( p = 0.01). Thirty patients underwent arteriograms, and 10 demonstrated positive findings. Although there were only 3 deaths in our series, 29 (37%) patients overall had some complication caused by their penetrating facial trauma, including blindness in 12 patients. There was no significant difference in the prevalence of complications between gunshot, shotgun, and stab wounds ( p = 0.18). With these injury patterns in mind, we describe an algorithm for evaluation and management of penetrating injuries of the face.
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Maslyakov, VV, EV Krjukov, VG Barsukov, KG Kurkin, PA Dorzhiev, and VR Gorbelik. "Heart injuries: main clinical symptoms." Laboratory diagnostics, no. 1 (February 27, 2019): 53–56. http://dx.doi.org/10.24075/brsmu.2019.003.
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Injuries to the heart are uncommon in peacetime, yet they result in life-threatening conditions, which makes timely diagnostics a crucial factor in saving patients' lives. In this connection, it is important to define the main signs of heart injuries. This study aimed to analyze the basic clinical symptoms associated with various wounds to the heart. We have retrospectively analyzed such symptoms registered in 86 patients with varying chest injuries that affect the heart. All patients were treated in the emergency surgery unit of the Engels Town Hospital from 1991 to 2017. 41 (47.6%) patient had stab wounds, and there were 45 (52.3%) cases of gunshot wounds. 23 (26.7%) patients had chest injuries affecting heart exclusively, while for 63 (73.2%) the consequences were wounds to other organs. We found that the clinical picture depends on the kind of injury to the heart: stab and slash wounds translate into more pronounced symptoms, while gunshot wounds do not produce such an effect. Accepting patients, practitioners should take this fact into account. The misdiagnosis rate for stab and slash heart wounds is 9.7%, that for gunshot wounds — 17.7%, the latter being the result of vagueness of the clinical picture. The clinical signs are most pronounced in the cases of stab and slash wounds to the heart.
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Maurin, Olga, Stanislas de Régloix, Stéphane Dubourdieu, Hugues Lefort, Stéphane Boizat, Benoit Houze, Jennifer Culoma, Guillaume Burlaton, and Jean-Pierre Tourtier. "Maxillofacial Gunshot Wounds." Prehospital and Disaster Medicine 30, no. 3 (April 14, 2015): 316–19. http://dx.doi.org/10.1017/s1049023x1500463x.
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AbstractThe majority of maxillofacial gunshot wounds are caused by suicide attempts. Young men are affected most often. When the lower one-third of the face is involved, airway patency (1.6% of the cases) and hemorrhage control (1.9% of the cases) are the two most urgent complications to monitor and prevent. Spinal fractures are observed with 10% of maxillary injuries and in 20% of orbital injuries. Actions to treat the facial gunshot victim need to be performed, keeping in mind spine immobilization until radiographic imaging is complete and any required spinal stabilization accomplished. Patients should be transported to a trauma center equipped to deal with maxillofacial and neurosurgery because 40% require emergency surgery. The mortality rate of maxillofacial injuries shortly after arrival at a hospital varies from 2.8% to 11.0%. Complications such as hemiparesis or cranial nerve paralysis occur in 20% of survivors. This case has been reported on a victim of four gunshot injuries. One of the gunshots was to the left mandibular ramus and became lodged in the C4 vertebral bone.MaurinO, de RégloixS, DubourdieuS, LefortH, BoizatS, HouzeB, CulomaJ, BurlatonG, TourtierJP. Maxillofacial gunshot wounds. Prehosp Disaster Med. 2015;30(3):14.
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de Rooster, H., O. Taeymans, H. van Bree, and M. Risselada. "Penetrating injuries in dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 05 (2008): 434–39. http://dx.doi.org/10.3415/vcot-07-02-0019.
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SummaryThe objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds.
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Leppäniemi, Ari, and Reijo Haapiainen. "Occult Diaphragmatic Injuries Caused by Stab Wounds." Journal of Trauma: Injury, Infection, and Critical Care 55, no. 4 (October 2003): 646–50. http://dx.doi.org/10.1097/01.ta.0000092592.63261.7e.
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Bingol, Hakan. "Abdominal Vascular Injuries Due to Missile Wounds." Journal of Academic Research in Medicine 4, no. 1 (May 2, 2014): 25–27. http://dx.doi.org/10.5152/jarem.2013.03.
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Richards, John T., Archie Overmann, Jonathan A. Forsberg, and Benjamin K. Potter. "Complications of Combat Blast Injuries and Wounds." Current Trauma Reports 4, no. 4 (August 18, 2018): 348–58. http://dx.doi.org/10.1007/s40719-018-0143-1.
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Lloris-Carsí, José Miguel, David García-Cerdá, Beatriz Prieto-Moure, Carlos Barrios, Antonio B. Martín-Ballester, and Dolores Cejalvo-Lapeña. "Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing." European Surgical Research 56, no. 3-4 (2016): 164–79. http://dx.doi.org/10.1159/000444320.
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Background: Renal injuries are relatively frequent in abdominal trauma. In some cases, adhesives and sealants can be used to repair and preserve injured organs. This paper describes the behaviour of three biomaterials - TachoSil®, GelitaSpon®, and a new elastic cyanoacrylate (CyA), Adhflex® - in standardized experimental renal injuries. Methods: Ninety male Wistar rats (300-350 g) were used. A Stiefel Biopsy Punch (8 mm diameter, 3 mm depth) was used to create injuries to the anterior kidney to evaluate wound healing. The animals were divided into five groups: (1) sham (n = 3); (2) control (n = 6), untreated, standard punch injury created on the anterior left kidney; (3) TachoSil® (n = 27), punch injury treated with TachoSil®; (4) GelitaSpon® (n = 27), punch injury treated with GelitaSpon®, and (5) Adhflex® (n = 27), punch injury treated with the new elastic CyA adhesive. The parameters studied were bleeding time, peritoneal adhesions, and histopathological evaluation of wound healing on days 2, 6, and 18, including measurements of the gap between wound edges, inflammatory reaction (CD68), and vascular neoformation (CD31). Results: The bleeding time was significantly shorter (27.7 ± 12.9 s) in the Adhflex® group than in the control (135.8 ± 11.6 s; p < 0.01), TachoSil® (77.5 ± 7.4 s; p < 0.05), and GelitaSpon® (82.5 ± 14.4 s; p < 0.05) groups. The incidence of intraperitoneal adhesions in the animals treated with Adhflex® was 3.6 times higher than in the non-treated group. It was also higher (p < 0.04) than in the groups treated with TachoSil® and GelitaSpon®. The time point with the largest gap between the wound edges and most abundant granulation tissue was at day 6. The largest gap after 18 days was reported for the Adhflex® adhesive. With regard to the markers CD31 and CD68, Adhflex® showed the largest areas 2 days after surgery, but no differences were found after 6 and 18 days versus the other treatments. The expression of the immunomarkers on the renal samples treated with Adhflex® was consistent with a normal healing process. Conclusions: In this experimental model of renal injuries, the new elastic CyA (Adhflex®) resulted in the shortest bleeding time. It offers rapid sealing of the bleeding produced by renal injuries, fixation to adjacent tissues, and reduced occurrences of relapse. The evolution of the scarring is similar to other procedures. Given that traumatic renal injuries are always an emergency due to haemorrhage, Adhflex® might offer additional benefits over conventional treatment methods in human clinical practice.
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Noguchi, K., N. Yoshikawa, S. Ito-Kariya, Y. Inoue, Y. Hayashi, H. Ito, H. Nakamura, and K. Iijima. "Activated mesangial cells produce vascular permeability factor in early-stage mesangial proliferative glomerulonephritis." Journal of the American Society of Nephrology 9, no. 10 (October 1998): 1815–25. http://dx.doi.org/10.1681/asn.v9101815.
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Vascular permeability factor (VPF), also known as vascular endothelial growth factor (VEGF), is a multifunctional cytokine involved in angiogenesis, inflammation, and wound healing. Although VPF/VEGF has been reported to be produced only by glomerular podocytes in glomeruli, it was found that it is produced by human cultured mesangial cells (MC). Therefore, immunohistochemical analysis (using indirect immunofluorescence and in situ hybridization) of VPF/VEGF in normal kidneys (n = 7) and biopsy specimens taken from 83 patients with renal diseases, including mesangial proliferative glomerulonephritis (PGN) (n = 58), was performed to examine whether VPF/VEGF is produced by MC in human PGN. In all of the healthy subjects and all of the patients except those with PGN (disease control subjects), VPF/VEGF protein and mRNA were detected mainly in podocytes. However, in some PGN patients, VPF/VEGF protein was demonstrated clearly in MC as well as in podocytes, as some of the VPF/VEGF was colocalized with alpha-smooth muscle actin, a marker of activated MC, and VPF/VEGF mRNA was expressed by MC and podocytes. Mesangial VPF/VEGF expression level increased significantly in PGN patients with early lesions (P < 0.01 versus healthy subjects or disease control subjects, P < 0.05 versus PGN with later lesions). The time between biopsy and disease onset was significantly shorter in PGN patients with than in those without mesangial VPF/VEGF expression (P < 0.01). These findings provide the first evidence that activated MC are a source of VPF/VEGF in human PGN, and indicate that mesangial VPF/VEGF expression is characteristic of early lesions of PGN. Because VPF/ VEGF plays a pivotal role in tissue repair, MC-produced VPF/VEGF may play pathophysiologic roles, including promoting recovery from glomerular injuries, in early-stage PGN.
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Karademir, Kenan, Mustafa Gunhan, and Cevat Can. "Effects of blast injury on kidneys in abdominal gunshot wounds." Urology 68, no. 6 (December 2006): 1160–63. http://dx.doi.org/10.1016/j.urology.2006.08.1091.
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Madsen, AS, GL Laing, JL Bruce, and DL Clarke. "A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service." Annals of The Royal College of Surgeons of England 98, no. 7 (September 2016): 488–95. http://dx.doi.org/10.1308/rcsann.2016.0181.
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Introduction The aim of this comparative study of gunshot wounds (GSWs) and stab wounds (SWs) to the neck was to quantify the impact of the mechanism of injury on the outcome and management of penetrating neck injury (PNI). Methods A prospective trauma registry was interrogated retrospectively. Data were analysed pertaining to demographics and injury severity score (ISS), physiology on presentation, anatomical site of wounds and injuries sustained, investigations, management, outcome and complications. Results There were 452 SW and 58 GSW cases over the 46 months of the study. Patients with GSWs were more likely to have extracervical injuries than those with SWs (69% vs 63%). The incidence of a ‘significant cervical injury’ was almost twice as high in the GSW cohort (55% vs 31%). For patients with transcervical GSWs, this increased to 80%. The mean ISS was 17 for GSW and 11 for SW patients. Those in the GSW cohort presented with threatened airways and a requirement for an emergency airway three times as often as patients with SWs (24% vs 7% and 14% vs 5% respectively). The incidence among GSW and SW patients respectively was 5% and 6% for airway injuries, 12% and 8% for injuries to the digestive tract, 21% and 16% for vascular injuries, 59% and 10% for associated cervical injuries, 36% and 14% for maxillofacial injuries, 16% and 9% for injuries to the head, and 35% and 45% for injuries to the chest. In the GSW group, 91% underwent computed tomography angiography (CTA), with 23% of these being positive for a vascular injury. For SWs, 74% of patients underwent CTA, with 17% positive for a vascular injury. Slightly more patients with GSWs required operative intervention than those with SWs (29% vs 26%). Conclusions Patients with GSWs to the neck have a worse outcome than those with injuries secondary to SWs. However, the proportion of neck injuries actually requiring direct surgical intervention is not increased and most cases with PNI secondary to GSWs can be managed conservatively with a good outcome. Imaging should be performed for all GSWs to the neck.
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BUDI, Hendrik Setia, Wisnu Setyari JULIASTUTI, and Winda ARIANI. "MTT-BASED CYTOTOXIC EVALUATION OF AMBONESE BANANA STEM SAP (Musa paradisiaca var. sapientum (L.) Kuntze) ON FIBROBLAST CELLS." Periódico Tchê Química 17, no. 36 (December 20, 2020): 624–33. http://dx.doi.org/10.52571/ptq.v17.n36.2020.639_periodico36_pgs_624_633.pdf.
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Traditional herbal remedies are naturally occurring, plant-derived substances with limited to no chemical processing and have been used in local or national healing traditions to treat illness. In global health debates, traditional herbal medicines are gaining considerable attention. Many hope new research into herbal medicine will play a vital role in global health. Countries like China, India, Nigeria, USA, and also the World Health Organization (WHO) made large investments in ancient herbal medicines. Currently, the use of the Indonesian plant has dramatically improved the medical and dentistry field. The dental and oral care is often related to wounds, and the Ambonese banana stem has been proven as an effective treatment for these injuries. This study aimed to evaluate the effectiveness and safety of the Ambonese banana stem sap through cytotoxicity tests on the fibroblast cell culture of Baby Hamster Kidney-21 (BHK-21). This study was carried out on three BHK-21 fibroblast cell culture, namely, the media and cell control, and the Ambonese banana stem sap with a concentration of 10%, 20%, 30%, 40%, 50%, 60 %, 70%, 80%, 90%, and 100% incubated for 24 hours at 37ºC and 5% CO2. Then, MTT was evenly dispersed on the media to obtain accurate optical density value. All quantitative data were statistically analyzed using one-way ANOVA and Tukey's HSD Test. The result showed significant differences in optical density values between groups with p = 0.000 (p 0.05). There was no significant difference between the cell control and the Ambonese banana stem sap group with concentrations of 90%, 80%, 70%, 60%, 50%, 30%, 20%, and 10%. It was also observed that the Ambonese banana stem sap is nontoxic to fibroblast cells since its viability value was more than 60%.
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Siracuse, Jeffrey, Alik Farber, Thomas W. Cheng, Yi Zuo, Douglas W. Jones, Jeffrey Kalish, and Bindu Kalesan. "IP259. Analysis of Vascular Injuries After Gunshot Wounds." Journal of Vascular Surgery 67, no. 6 (June 2018): e155. http://dx.doi.org/10.1016/j.jvs.2018.03.214.
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Campion, T., and S. Cross. "The spectrum of injuries in buttock stab wounds." Clinical Radiology 72, no. 7 (July 2017): 543–51. http://dx.doi.org/10.1016/j.crad.2017.02.009.
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Khalil, Muhammad Abdul Mabood, Jackson Tan, Said Khamis, Muhammad AshhadUllah Khalil, Rabeea Azmat, and Arslan Rahat Ullah. "Cigarette Smoking and Its Hazards in Kidney Transplantation." Advances in Medicine 2017 (2017): 1–11. http://dx.doi.org/10.1155/2017/6213814.
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Cigarette smoking affects many organs. It causes vasoconstriction through activation of sympathetic nervous system which leads to elevation of blood pressure and reduction in glomerular filtration rate and filtration pressure. It also causes thickening of renal arterioles. Cigarette smoking increases the risk of microalbuminuria and accelerates progression of microalbuminuria to macroalbuminuria. Furthermore, it causes rapid loss of glomerular filtration rate in chronic kidney disease patients. After kidney donation, these factors may be injurious to the solitary kidney. Kidney donors with history of cigarette smoking are prone to develop perioperative complications, pneumonia, and wound infection. Postkidney transplantation various stressors including warm and cold ischemia time, delayed graft function, and exposure to calcineurin inhibitors may result in poor graft function. Continuation of cigarette smoking in kidney transplant recipients will add further risk. In this review, we will specifically discuss the effects of cigarette smoking on normal kidneys, live kidney donors, and kidney transplant recipients. This will include adverse effects of cigarette smoking on graft and patient survival, cardiovascular events, rejection, infections, and cancers in kidney transplant recipients. Lastly, the impact of kidney transplantation on behavior and smoking cessation will also be discussed.
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Ramasamy, A., SE Harrisson, MPM Stewart, and M. Midwinter. "Penetrating Missile Injuries During the Iraqi Insurgency." Annals of The Royal College of Surgeons of England 91, no. 7 (October 2009): 551–58. http://dx.doi.org/10.1308/003588409x464720.
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INTRODUCTION Since the invasion of Iraq in 2003, the conflict has evolved from asymmetric warfare to a counter-insurgency operation. This study investigates the pattern of wounding and types of injuries seen in casualties of hostile action presenting to a British military field hospital during the present conflict. PATIENTS AND METHODS Data were prospectively collected on 100 consecutive patients either injured or killed from hostile action from January 2006 who presented to the sole coalition field hospital in southern Iraq. RESULTS Eighty-two casualties presented with penetrating missile injuries from hostile action. Three subsequently died of wounds (3.7%). Forty-six (56.1%) casualties had their initial surgery performed by British military surgeons. Twenty casualties (24.4%) sustained gunshot wounds, 62 (75.6%) suffered injuries from fragmentation weapons. These 82 casualties were injured in 55 incidents (mean, 1.49 casualties; range 1–6 casualties) and sustained a total 236 wounds (mean, 2.88 wounds) affecting a mean 2.4 body regions per patient. Improvised explosive devices were responsible for a mean 2.31 casualties (range, 1–4 casualties) per incident. CONCLUSIONS The current insurgency in Iraq illustrates the likely evolution of modern, low-intensity, urban conflict. Improvised explosive devices employed against both military and civilian targets have become a major cause of injury. With the current global threat from terrorist bombings, both military and civilian surgeons should be aware of the spectrum and emergent management of the injuries caused by these weapons.
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Stekolnikov, A. A., and M. A. Ladanova. "TECHNOLOGICAL INJURIES IN INDUSTRIAL PIG FARMING." International bulletin of Veterinary Medicine 1 (2020): 135–39. http://dx.doi.org/10.17238/issn2072-2419.2020.1.135.
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Industrial injuries in pig farms of closed type are a very common pathology. Howev-er, nowadays, injury prevention and treat-ment of sick animals in the conditions of industrial pig breeding complex do not bring good results and require improvements. Ac-cording to the literature, there is no infor-mation about the results of the use of oint-ments and immuno- stimulators in the treat-ment of pigs with bitten wounds of the ears, tails and other parts of the body. In this re-gard, we have set a goal to develop therapeu-tic measures for injuries of piglets in a pig breeding complex of a closed type. We ana-lyzed the prevalence of industrial injuries in pigs. During the clinical examination, we studied the specific structures of injuries. The main cause of pigs injuries in industrial farming is cannibalism. In 28 days, 60% of pigs in the second experimental group, showed complete cicatrization of the wound, and 40% of animals showed this process regenerated on 85-95%, meanwhile 2 days they also had complete scarring of the wound. In 28 days, 50% of pigs of the third experimental group had a complete cicatriza-tion of the wound, and for 50% were ob-served scarring of the wound by 75-85%, and only after 4 days they demonstrated the complete scaring of the defect. For the treatment of bitten wounds as a result of developing cannibalism, it is recommended, to use local treatment of wounds with chlor-hexidine solution and argosulfan ointment daily 2 times a day and also to use the im-munostimulator “Ferrovir” in a dose of 1.0 ml/m2 per week. Such scheme of treatment of bitten wounds gives the best therapeutic effect.
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Yamamoto, Ryo, Mark Muir, and Alicia Logue. "Colon Trauma: Evidence-Based Practices." Clinics in Colon and Rectal Surgery 31, no. 01 (December 19, 2017): 011–16. http://dx.doi.org/10.1055/s-0037-1602175.
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AbstractColon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.
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Sizyi, M. Yu. "Septic complications in patients with neck wounds." Експериментальна і клінічна медицина 84, no. 3 (August 21, 2020): 64–66. http://dx.doi.org/10.35339/ekm.2019.84.03.10.
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Nowadays, we have been a steady increase in injuries as the social conditions of life and have changed. Statistically found that 54.0 % of people of car accidents have injuries to the head and neck. According to the literature, mortality in patients with neck injury which is complicating by pyoinflammatory persists up to 30.0-76.0 %. The management of neck trauma can be challenging and sometimes overwhelming, as this anatomical region contains many vital structures. These structures may pose a diagnostic and therapeutic dilemma. Our research based on the results of diagnosis and treatment of 124 patients with a purulent mediastinitis, complicating traumatic injuries of the neck organs. Among these men – 92 (74.2 %), women – 32 (25.8 %). The results of treatment depend on timely diagnosis, hospitalization in a specialized compartment and conducting active surgical tactics
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Kaufman, Howard H. "Treatment of head injuries in the American Civil War." Journal of Neurosurgery 78, no. 5 (May 1993): 838–45. http://dx.doi.org/10.3171/jns.1993.78.5.0838.
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✓ At the time of the American Civil War (1861–1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery.
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Oosthuizen, GV, VY Kong, T. Estherhuizen, JL Bruce, GL Laing, JJ Odendaal, and DL Clarke. "The impact of mechanism on the management and outcome of penetrating colonic trauma." Annals of The Royal College of Surgeons of England 100, no. 2 (February 2018): 152–56. http://dx.doi.org/10.1308/rcsann.2017.0147.
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Introduction In light of continuing controversy surrounding the management of penetrating colonic injuries, we set out to compare the outcome of penetrating colonic trauma according to whether the mechanism of injury was a stab wound or a gunshot wound. Methods Our trauma registry was interrogated for the 5-year period from January 2012 to December 2016. All patients over the age of 18 years with penetrating trauma (stab or gunshot) and with intraoperatively proven colonic injury were reviewed. Details of the colonic and concurrent abdominal injuries were recorded, together with the operative management strategy. In-hospital morbidities were divided into colon-related and non-colon related morbidities. The length of hospital stay and mortality were recorded. Direct comparison was made between patients with stab wounds and gunshot wounds to the colon. Results During the 5-year study period, 257 patients sustained a colonic injury secondary to penetrating trauma; 95% (244/257) were male and the mean age was 30 years. A total of 113 (44%) sustained a gunshot wound and the remaining 56% (144/257) sustained a stab wound. Some 88% (226/257) of all patients sustained a single colonic injury, while 12% (31/257) sustained more than one colonic injury. A total of 294 colonic injuries were found at laparotomy. Multiple colonic injuries were less commonly encountered in stab wounds (6%, 9/144 vs. 19%, 22/113, P < 0.001). Primary repair was more commonly performed for stab wounds compared with gunshot wounds (118/144 vs. 59/113, P < 0.001). Patients with gunshot wounds were more likely to need admission to intensive care, more likely to experience anastomotic failure, and had higher mortality. Conclusions It would appear that colonic stab wounds and colonic gunshot wounds are different in terms of severity of the injury and in terms of outcome. While primary repair is almost always applicable to the management of colonic stab wounds, the same cannot be said for colonic gunshot wounds. The management of colonic gunshot wounds should be examined separately from that of stab wounds.
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Bhandari, Prem Singh, Mrinal Kanti Mukherjee, and Sanjay Maurya. "Reconstructive challenges in war wounds." Indian Journal of Plastic Surgery 45, no. 02 (May 2012): 332–39. http://dx.doi.org/10.4103/0970-0358.101316.
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ABSTRACTWar wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds.
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HAIDER RIZVI, SYED IJLAL, Khurram Sohail, MUHAMMAD ASLAM, and Humaira Arshad. "FIREARM WOUNDS." Professional Medical Journal 17, no. 01 (March 10, 2010): 68–72. http://dx.doi.org/10.29309/tpmj/2010.17.01.1984.
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Objectives: To study the different changes occurring at cellular level in firearm injuries from near to distant shots. StudyDesign: A prospective Study. Place and Duration of Study: Khyber Teaching Hospital Peshawar and B.V Hospital Bahawalpur. Material &Methods: Bodies presenting for autopsy within 12 hours after firearm injury were included. Wounds expressing maximum details were selectedfor study. Tissue samples were taken from wounds and preserved in 10% formalin. Sections were taken and slides were stained with HarrisHaemotoxylin. Olympus P-6 was used for photography and Nikon ( FE-2 body) for gross and microscopic photography. Results: Themorphology at cellular level was variable according to the distance of fire. Marked distortion and streaming of nuclei was more pronounced andevident in close contact wounds. However changes were less pronounced with the increasing distance. Section of exit lesion reveled splittingbetween dermis and epithelium. Further in this study rifle fire fatalities were maximum (53.33%) and distant shot fatalities were predominant(73.33%.). Conclusion: Microscopy can also be used as an additional tool to differentiate between entry and exit wounds and for estimatingrange of fire.
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Jha, Shilpa, Wasim S. Khan, and Nashat A. Siddiqui. "Mammalian Bite Injuries to the Hand and Their Management." Open Orthopaedics Journal 8, no. 1 (June 27, 2014): 194–98. http://dx.doi.org/10.2174/1874325001408010194.
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Bite wounds are a common form of hand injury with the potential to lead to severe local and systemic sequelae and permanent functional impairment. Mammalian bite wounds may be caused by a variety of animal class and species; injuries resulting from dogs, cats and humans are the most widely discussed and reported in the literature. Bite wounds may be contaminated with aggressive pathogens and the anatomical vulnerability of structures within the hand means that without early recognition and treatment with irrigation and antibiotics, alongside a low index of suspicion for deep structural involvement requiring formal surgical exploration and washout, the consequences of such injuries can be disastrous. We review the literature and discuss the epidemiology, pathophysiology and microbiology relating to these injuries, as well as clinical aspects including signs, symptoms, and management.
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Trukhan, A. P., D. V. Alkhovik, I. G. Kosinsky, V. A. Koryachkin, V. A. Porkhanov, and I. Yu Zherkal. "REPUBLICAN CENTER FOR TREATMENT OF GUNSHOT WOUNDS AND MINE-EXPLOSIVE INJURIES: 3 YEARS OF EXPERIENCE AND TRENDS OF DEVELOPMENT." Novosti Khirurgii 29, no. 2 (April 21, 2021): 207–12. http://dx.doi.org/10.18484/2305-0047.2021.2.207.
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Objective. To evaluate the results of organizational measures for improving the efficiency of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries. Methods. The study is based on an analysis of the work of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries and includes patients (n=54) who were treated from November 1, 2016 to October 31, 2019. Gunshot wounds were detected in 42 patients (77.8%). Explosive trauma was detected in 12 patients (22.2%). The most common causes of injuries were personal carelessness (20 cases (37.0%)), carelessness of others (16 cases (29.6%)), suicidal attempts (9 cases (16.6%)). In accordance with the purpose of the survey, three equal time intervals (three periods) each being equal to one year were studied. The following indicators were analyzed: the number of patients, the time from the moment of injuring to hospitalization, the type of patient’s transportation, the quality of surgical care at the hospitalization stages. Results. Implementation of the proposed organizational measures allowed increasing the number of patients hospitalized into the Republican Center for the treatment of gunshot wounds and mine-explosive injuries during the third year of work by 66.7% and 78.6%, respectively, compared with the previous time intervals. The frequency of hospitalization of patients within 24 hours after receiving an injury increased from 66.7% to 72.7%, and among patients who are not military personnel - from 45.5% to 69.2%. The proportion of errors in the treatment of patients with gunshot wounds and explosive injuries decreased by 34.0%. Conclusion. The proposed organizational measures allowed increasing the efficiency of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries. In the future, it is advisable to continue close cooperation with healthcare organizations and to improve the regulatory framework for the treatment of gunshot wounds of various localization. What this paper adds The paper presents the results of the analysis of three-year work of the RepublicanCenter for the treatment of gunshot wounds and mine-explosive injuries.Realization of the proposed organizational measures allowed increasing the number of hospitalized patients, shortening the period from injury to hospitalization, and reducing the number of errors in patient care.
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Grimell, Jan. "Veterans, the hidden wounds of war, and soul repair." Spiritual Care 7, no. 4 (October 8, 2018): 353–63. http://dx.doi.org/10.1515/spircare-2018-0008.
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AbstractTo better understand how deployment in war zones and/or combat may inflict emotional wounds upon veterans, researchers, clinicians, and caregivers it was recently started to focus on the concepts of moral and spiritual injuries. Such injuries may remain undiscovered during psychiatric screening for posttraumatic stress disorder. What is often missing, however, is a conceptualization of the part of the self which is implicitly related to emotional wounds caused by moral and spiritual injuries. This article utilizes a number of historical and contemporary conceptualizations of what is called the soul, and their implications for pastoral and spiritual care of emotionally wounded veterans. Moreover, it explores the use of biblical stories in pastoral and spiritual care among veterans suffering from moral and spiritual injuries.
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Rouse, D. A. "Patterns of Stab Wounds: A Six Year Study." Medicine, Science and the Law 34, no. 1 (January 1994): 67–71. http://dx.doi.org/10.1177/002580249403400110.
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A series of 156 consecutive deaths from stabbing were analysed for age and sex of victim, number and size of wounds, the incidence and pattern of defence wounds, the association with other injuries and the pattern of self-inflicted wounds.
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Newlands, Shawn D., Sreedhar Samudrala, and W. Kevin Katzenmeyer. "Surgical Treatment of Gunshot Injuries to the Mandible." Otolaryngology–Head and Neck Surgery 129, no. 3 (September 2003): 239–44. http://dx.doi.org/10.1016/s0194-5998(03)00481-9.
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OBJECTIVES: Our goal was to review and identify risk factors for complications from treatment of mandible fractures due to gunshot wounds. STUDY DESIGN AND SETTING: We conducted a retrospective review of treatment outcomes in 90 patients with gunshot wounds to the mandible treated over a 10-year period at 2 tertiary care centers. RESULTS: Our series of 90 patients with mandibular injuries due to gunshot wounds included 68 patients who underwent surgical procedures on the mandible. There were 14 complications in this group. Complications were more common in patients whose mandibles were rigidly fixated; however, these patients' injuries were more severe. Complications were significantly increased in patients who lost a segment of mandible in the injury. CONCLUSIONS: Complications were related to severity of injury and independent of treatment modality. SIGNIFICANCE: The complication rate for patients with gunshot injuries can be very high, particularly if bone is missing. Stabilization of remaining mandibular segments with potentially multiple subsequent reconstructive procedures is often required to restore mandibular continuity in these patients.
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Cicák, A., and I. Mihál. "Can artificial wounding of beech stems induce necroses?" Journal of Forest Science 51, No. 12 (January 10, 2012): 559–63. http://dx.doi.org/10.17221/4588-jfs.
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The paper presents data on the induction of necroses after small injuries to beech stems caused by electrodes during measuring cambium electric resistance. Altogether 121 beech stems of tree class 1–3 (according to Kraft) were evaluated. Among 2,904 mechanical injuries in 121 stems evaluated (24 per stem), 155 injuries induced necroses, hence each 19<sup>th</sup> injury induced necrosis. Most stems (33.06%) showed one necrosis, few stems (4.96%) showed even four necroses. 28.93% of stems did not show any necrosis. In order to prevent the infection of wounds and subsequent induction of necroses the authors recommend to treat any wounds with a suitable fungicide after using an equipment causing even negligible wounds of stems.
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Verkoelen, Carl F., Burt G. Van Der Boom, Adriaan B. Houtsmuller, Fritz H. Schröder, and Johannes C. Romijn. "Increased calcium oxalate monohydrate crystal binding to injured renal tubular epithelial cells in culture." American Journal of Physiology-Renal Physiology 274, no. 5 (May 1, 1998): F958—F965. http://dx.doi.org/10.1152/ajprenal.1998.274.5.f958.
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The retention of crystals in the kidney is considered to be a crucial step in the development of a renal stone. This study demonstrates the time-dependent alterations in the extent of calcium oxalate (CaOx) monohydrate (COM) crystal binding to Madin-Darby canine kidney (MDCK) cells during their growth to confluence and during the healing of wounds made in confluent monolayers. As determined by radiolabeled COM crystal binding studies and confirmed by confocal-scanning laser microscopy, relatively large amounts of crystals (10.4 ± 0.4 μg/cm2) bound to subconfluent cultures that still exhibited a low transepithelial electrical resistance (TER < 400 Ω ⋅ cm2). The development of junctional integrity, indicated by a high resistance (TER > 1,500 Ω ⋅ cm2), was followed by a decrease of the crystal binding capacity to almost undetectable low levels (0.13 ± 0.03 μg/cm2). Epithelial injury resulted in increased crystal adherence. The highest level of crystal binding was observed 2 days postinjury when the wounds were already morphologically closed but TER was still low. Confocal images showed that during the repair process, crystals selectively adhered to migrating cells at the wound border and to stacked cells at sites were the wounds were closed. After the barrier integrity was restored, crystal binding decreased again to the same low levels as in undamaged controls. These results indicate that, whereas functional MDCK monolayers are largely protected against COM crystal adherence, epithelial injury and the subsequent process of wound healing lead to increased crystal binding.
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Guo, Ying, and Faye Y. Chiou-Tan. "Radial Nerve Injuries from Gunshot Wounds and Other Trauma." American Journal of Physical Medicine & Rehabilitation 81, no. 3 (March 2002): 207–11. http://dx.doi.org/10.1097/00002060-200203000-00009.
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