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1
Hocking, DP, FG Marx, WMG Parker, JP Rule, SGC Cleuren, AD Mitchell, M. Hunter, JD Bell, EMG Fitzgerald, and AR Evans. "Inferring diet, feeding behaviour and causes of mortality from prey-induced injuries in a New Zealand fur seal." Diseases of Aquatic Organisms 139 (April 30, 2020): 81–86. http://dx.doi.org/10.3354/dao03473.
Повний текст джерелаАнотація:
New Zealand fur seals Arctocephalus forsteri are the most abundant of the 4 otariid (eared seal) species distributed across Australasia. Analyses of stomach contents, scats and regurgitates suggest a diet dominated by bony fish and squid, with cartilaginous species (e.g. sharks and rays) either absent or underrepresented because of a lack of preservable hard parts. Here we report on a subadult specimen from south-eastern Australia, which was found ashore emaciated and with numerous puncture wounds across its lips, cheeks, throat and the inside of its oral cavity. Fish spines embedded in the carcass revealed that these injuries were inflicted by chimaeras and myliobatiform rays (stingrays and relatives), which matches reports on the diet of A. forsteri from New Zealand, but not South Australia. Shaking and tearing of prey at the surface may help to avoid ingestion of the venomous spines, perhaps contributing to their absence from scats and regurgitates. Nevertheless, the number and severity of the facial stab wounds, some of which led to local necrosis, likely affected the animal’s ability to feed, and may account for its death. Despite their detrimental effects, fish spine-related injuries are difficult to spot, and may be a common, albeit cryptic, type of trauma. We therefore recommend that stranded seals be systematically examined for this potentially life-threatening pathology.
2
Singh, Niten, Eric Bluman, Benjamin Starnes, and Charles Andersen. "Dynamic Wound Closure for Decompressive Leg Fasciotomy Wounds." American Surgeon 74, no. 3 (March 2008): 217–20. http://dx.doi.org/10.1177/000313480807400307.
Повний текст джерелаАнотація:
Decompressive fasciotomy for preservation of lower extremity function and salvage is an essential technique in trauma. The wounds that result from the standard two incision four-compartment leg fasciotomy are often accompanied by a wide soft tissue opening that in the face of true compartment syndrome are often impossible to close in a delayed primary fashion. We describe a technique using a device that allows for dissipation of the workload across the wound margin allowing for successful delayed primary closure. Consecutive patients who presented to the 28th Combat Support Hospital in Baghdad, Iraq with a diagnosis of compartment syndrome of the leg, impending compartment syndrome of the leg, or compartment syndrome of the leg recently treated with fasciotomies were followed. All patients underwent placement of the Canica dynamic wound closure device (Canica, Almonte, ON, Canada). Eleven consecutive patients treated at a combat support hospital in support of Operation Iraqi Freedom underwent four-compartment fasciotomies for penetrating injuries. There were five patients that underwent a vascular repair [three superficial femoral artery (SFA) injuries and two below knee popliteal artery injuries] and six patients that had orthopedic injuries (three comminuted tibial fractures, two fibula fractures, and one closed pilon fracture). Patients returned to the operating room within 24 hours for washout and wound inspection. Mean initial wound size was 8.1 cm; mean postplacement size was 2.7 cm; average time to closure was 2.6 days. All patients were able to undergo primary wound closure of the medial incision and placement of the Canica device over the lateral incision. Ten of the 11 patients (91%) could be closed in delayed primary fashion after application of the device. In our series of patients with penetrating wartime injuries and compartment syndrome of the leg we have found the use of this dynamic wound closure device to be extremely successful and expedient.
3
Hamrahi, Victoria, Michael R. Hamblin, Walter Jung, John B. Benjamin, Kasie W. Paul, Alan J. Fischman, Ronald G. Tompkins, and Edward A. Carter. "Gram-Negative Bacterial Infection in Thigh Abscess Can Migrate to Distant Burn Depending on Burn Depth." Interdisciplinary Perspectives on Infectious Diseases 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/567140.
Повний текст джерелаАнотація:
Sepsis remains the major cause of death in patients with major burn injuries. In the present investigation we evaluated the interaction between burn injuries of varying severity and preexisting distant infection. We used Gram-negative bacteria (Pseudomonas aeruginosaandProteus mirabilis) that were genetically engineered to be bioluminescent, which allowed for noninvasive, sequential optical imaging of the extent and severity of the infection. The bioluminescent bacteria migrated from subcutaneous abscesses in the leg to distant burn wounds on the back depending on the severity of the burn injury, and this migration led to increased mortality of the mice. Treatment with ciprofloxacin, injected either in the leg with the bacterial infection or into the burn eschar, prevented this colonization of the wound and decreased mortality. The present data suggest that burn wounds can readily become colonized by infections distant from the wound itself.
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Fleming, Peter J. S., Lee R. Allen, Mani J. Berghout, Paul D. Meek, Peter M. Pavlov, Peter Stevens, Kevin Strong, Jim A. Thompson, and Peter C. Thomson. "The performance of wild-canid traps in Australia: efficiency, selectivity and trap-related injuries." Wildlife Research 25, no. 3 (1998): 327. http://dx.doi.org/10.1071/wr95066.
Повний текст джерелаАнотація:
Wild dogs and European red foxes are considered pest animals in Australia. Restraining devices to capture these wild canids are sometimes required by wildlife managers. However, the use of traps is controversial. This paper discusses the efficiency, selectivity and injuries inflicted by some leg-hold traps that are available in Australia for capturing wild canids. The trapping of feral cats with wild-canid traps is also briefly discussed. The most commonly used leg-hold trap in Australia is the toothed, steel-jawed, leg-hold trap. Alternative traps, including offset- and padded-jawed traps (similar to the Victor Soft Catch®), and steel-jawed traps that have been modified to incorporate padding and off-setting of jaws, were shown to be preferable. The alternative traps were as efficient and selective as toothed, steel-jawed traps, but were less injurious. The Treadle snare, although more likely to miss target animals, was also shown to be less injurious than unmodified, steel-jawed leg-hold traps. It is difficult to justify the continued use of unmodified, steel-jawed leg-hold traps for the capture of wild canids in Australia.
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Petkovic, Aleksandar, Srbobran Trenkic, Goran Stevanovic, Zoran Rancic, Zoran Golubovic, Miodrag Dinic, and Dragan Krasic. "Fasciocutaneous flaps in the management of soft-tissue defects of the lower leg caused by explosive weapons." Vojnosanitetski pregled 61, no. 1 (2004): 77–81. http://dx.doi.org/10.2298/vsp0401077p.
Повний текст джерелаАнотація:
The use of fasciocutaneous flaps for the reconstruction of lower leg soft-tissue defects inflicted during the bombing of our country is presented in this case report. The experience with 9 patients with soft-tissue defects of the lower leg is presented with the aim of examining the possibilities of war-wound reconstruction. The results of the earlier use of fasciocutaneous flaps in the lower leg reconstruction as well as the those obtained during the reconstruction of the lower leg soft-tissue defects in war wounds was proven to be safe and reliable method of the reconstructions of severe lower leg injuries, particularly of its distal segment and the malleolus region.
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Golubović, Ivan, Predrag Stojiljković, Mihailo Ille, Milan Radojković, Nemanja Jovanović, Milan Lazarević, Ivana Golubović, et al. "Disconnection of arterial collateral as the cause of lower leg amputation after conquassation caused by petrol tiller: A case report." Timocki medicinski glasnik 47, no. 2-3 (2022): 119–25. http://dx.doi.org/10.5937/tmg2202119g.
Повний текст джерелаАнотація:
Introduction. Leg conquassation caused by petrol tiller is one of the most severe injuries in bone and joint traumatology. Firm strokes by sharp tiller blades produce strong force that easily damages both soft tissues and bones. Since tillers are used in soil processing, the wounds are highly contaminated with dirt and fertilizers, hence the anaerobic spore-forming bacilli, such as tetanus and gas gangrene pathogens. Case report. This paper presents the treatment of a 69 years old man with chronic arterial insufficiency of the lower extremities who suffered severe injury of the lower leg (IIIB open tibial fracture according to Gustillo) by petrol tiller while performing agricultural work. Due to the absence of pulsations, Multislice CT angiography and arteriography were performed. Arteriography of the injured leg confirmed chronic occlusion of the anterior tibial artery and numerous stenotic lesions of the peroneal and posterior tibial arteries. Posterior tibial artery was chronically occluded in its distal part and connected to the foot with moderately developed collateral arteries which provided the viability of the injured leg. Despite undertaken basic principles of treatment of this serious injury (primary surgical treatment of wounds, external fixation, reconstruction of soft tissue, antibiotic and anti-tetanus prophylaxis) due to infection and gangrene the treatment ended with lower leg amputation. Conclusion. Leg amputation can be expected in this type of injuries in cases of extensive destruction of tissue in the field of existing chronic arterial insufficiency in elderly patients, even in the absence of injury of main blood vessels due to traumatic disconnection of collateral in such patients.
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Weiss, Janet M. "Treatment of Leg Edema and Wounds in a Patient With Severe Musculoskeletal Injuries." Physical Therapy 78, no. 10 (October 1, 1998): 1104–13. http://dx.doi.org/10.1093/ptj/78.10.1104.
Повний текст джерела
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Golubovic, Zoran, Vojkan Stanic, Srbobran Trenkic, Predrag Stojiljkovic, Goran Stevanovic, Aleksandar Lesic, Ivan Golubovic, Dragan Milic, Aleksandar Visnjic, and Stevo Najman. "Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters." Vojnosanitetski pregled 67, no. 8 (2010): 688–93. http://dx.doi.org/10.2298/vsp1008688g.
Повний текст джерелаАнотація:
Introduction. Injuries caused by aircraft bombs cause severe damages to the human body. They are characterized by massive destruction of injured tissues and organs, primary contamination by polymorph bacterial flora and modified reactivity of the body. Upon being wounded by aircraft bombs projectiles a victim simultaneously sustains severe damages of many organs and organ systems due to the fact that a large number of projectiles at the same time injure the chest, stomach, head and extremities. Case report. We presented a patient, 41 years of age, injured by aircraft bomb with hemo-pneumothorax and destruction of the bone and soft tissue structures of the foot, as well as the treatment result of such heavy injuries. After receiving thoracocentesis and short reanimation, the patient underwent surgical procedure. The team performed thoracotomy, primary treatment of the wound and atypical resection of the left lung. Thoracic drains were placed. The wounds on the lower leg and feet were treated primarily. Due to massive destruction of bone tissue of the right foot by cluster bomb splinters, and impossibility of reconstruction of the foot, guillotine amputation of the right lower leg was performed. Twelve days after the wounding caused by cluster bomb splinters, soft tissue of the left lower leg was covered by Tirsch free transplantant and the defect in the area of the left foot was covered by dorsalis pedis flap. The transplant and flap were accepted and the donor sites were epithelized. Twenty-six days following the wounding reamputation was performed and amputation stump of the right lower leg was closed. The patient was given a lower leg prosthesis with which he could move. Conclusion. Upon being wounded by aircraft bomb splinters, the injured person sustains severe wounds of multiple organs and organ systems due to simultaneous injuries caused by a large number of projectiles. It is necessary to take care of the vital organs first because they directly threaten the life of the wounded patient. Despite adequate surgical treatment of war wounds of the feet, because of massive defect of bone and soft tissue, amputation may be the only rational solution of the treatment. The resection of the lung may be successful method for the severe destruction of the lung.
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Jacobs, Margaret D. "Seeing Like a Settler Colonial State." Modern American History 1, no. 2 (March 16, 2018): 257–70. http://dx.doi.org/10.1017/mah.2018.5.
Повний текст джерелаАнотація:
In 1998, the Canadian historian and politician Michael Ignatieff wrote: “All nations depend on forgetting: on forging myths of unity and identity that allow a society to forget its founding crimes, its hidden injuries and divisions, its unhealed wounds.” Ironically, Ignatieff's home country has belied his assertion. Canada has engaged in collective remembering of one of its hidden injuries—the Indian residential schools—through a Truth and Reconciliation Commission (TRC) from 2009 to 2015. Australia, too, has reckoned since the 1990s with its own unhealed wounds—the separation of Aboriginal and Torres Strait Islander children from their families, or, in common parlance, the “Stolen Generations.”
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Mori, Alfredo. "Misericord Injuries: Ancient and Modern." Prehospital and Disaster Medicine 34, s1 (May 2019): s150. http://dx.doi.org/10.1017/s1049023x19003364.
Повний текст джерелаАнотація:
Introduction:The Misericord, or stabbing pike, was a frequently used battlefield implement in medieval times. The misericord was used by battlefield clerics to relieve the suffering of irreparably wounded soldiers. Its cultural parallels include the Roman gladius, the Japanese wakazashi, and the eponymous Liston knife used in pre-Victorian era surgery in England.Methods:This demonstration will analyze modern misericord injuries in the light of the current epidemic of long knife (or zombie knife) attacks in London and the domestic terrorist threat in Australia.Discussion:A review of this weapon is pertinent to the projected low-technology, low-impact, and deep-penetrating wounds expected in urban terrorism in Australia and other cities globally. The talk will emphasize field discussion, demonstration, and disarming techniques against modern misericord-type weapons.
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Meek, PD, DJ Jenkins, B. Morris, AJ Ardler, and RJ Hawksby. "Use of Two Humane Leg-Hold Traps for Catching Pest Species." Wildlife Research 22, no. 6 (1995): 733. http://dx.doi.org/10.1071/wr9950733.
Повний текст джерелаАнотація:
This technical note comments on the use of Victor 'Soft Catch' No. 3 traps and Treadle snare throwers, two leg-hold devices that have been developed to minimise injuries to captured animals. Both types of traps were evaluated during more than 1000 nights of use. The numbers of animals caught in each trap type, and the degree of injury sustained by the trapped animals were recorded. Both these traps were found to be humane alternatives to the steel-jawed trap currently in common use in Australia. However, the 'Victor' traps were the more convenient to use. They gave fewer technical problems, minimised injuries, caught more animals and allowed fewer escapes.
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Adaiyi, Obene Tonye, Abhulimen Victor , and Echem Richard . "Evaluation of Gunshot Wounds to the Extremities: Correlation of Red Cross Wound Score and Initial Response to Management." American Journal of Health, Medicine and Nursing Practice 7, no. 11 (September 14, 2022): 9–21. http://dx.doi.org/10.47672/ajhmn.1191.
Повний текст джерелаАнотація:
Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cross Wound Score (RCWS) is a simple classification system that is thought to fairly assess severity of injury, influence surgical management and a good predictor of outcome in gunshot wounds. This study aims to evaluate the correlation between the Red Cross Wound Score RCWS and initial response to management.
Methodology: This was a prospective study recruiting all consenting patients who suffered gunshot wounds to any extremity and presented at the University of Port Harcourt Teaching Hospital (UPTH). The study was conducted over a 12-month period between October 2018 and September 2019. Data on demographics, anatomical region of the body involved, type of gun time between injury and hospital presentation were obtained using a proforma. Analysis of extracted data was done by the aid of SPSS for Windows version 20.
Findings: A total of 106 wounds from 82 patients were analyzed; seventy males (85.4%) and 12 females. AK 47 rifles and locally fabricated pistols were the wounding weapons in 32.9% and the left leg (28.3%) was the most injured extremity. Fifty-two wounds (49%) were grade 3, 44 (41.5%) wounds grade 2 and 10 wounds (9.4%) grade 1. There was a positive association between RCWS grade 3 wounds and limb length discrepancy and joint stiffness. Vascular injuries were seen in 6 patients (0.07%). Wound infection (46.2%), joint stiffness (41.5%) and shortening (34%) were the common complications in the study. The study showed that young adult males suffered more gunshot wounds than females. Most of the wounds were RCWS grade 3 and there was a positive association between RCWS grade 3 wounds and limb length discrepancy and joint stiffness. Patients with longer mean presentation time had a higher infection rate.
Recommendations: The Red Cross wound classification should be adopted as a useful scoring system. Also, patients with gunshot injuries should present earlier to the hospital to reduce complications.
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MIRZA, TAHIR IQBAL, and FAKHAR ILYAS MALIK. "BICYCLE PASSENGER INJURIES IN CHILDREN." Professional Medical Journal 16, no. 01 (March 10, 2009): 34–37. http://dx.doi.org/10.29309/tpmj/2009.16.01.2969.
Повний текст джерелаАнотація:
O b j e c t i v e ; To find out types of traumatic injuries in bicycle passenger children. S e t t i n g : At PAC hospital Kamra. P e r i o d :From October 2005 to October 2007. Patients & M e t h o d s : The children between the ages of 03 to 10 years were included in this study.They were divided into two groups. First group(Gp-l) sustained injuries due to ankle or foot entrapment in rear running wheel while thesecond group(Gp-ll) sustained injuries due to fall of bicycle, while child sitting alone either at front bar or rear luggage carrier unattended.R e s u l t s : Gp-I sustained mostly frictional injuries ranging from simple abrasion to deep lacerated wounds of lower leg, ankle and foot. Whilein Gp-ll severe injuries like fractures of upper and lower limbs, visceral abdominal injuries and head injuries were observed. C o n c l u s i o n :Bicycle passenger injuries are common injuries of the children in less developed countries. These injuries range from simple "road rash' toserious head injuries.
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Herawati, Leli. "TINGKAT PENGETAHUAN PASIEN TENTANG PERAWATAN LUKA DIABETES MELITUS DI RUMAH SAKIT PTPN II BANGKATAN BINJAI TAHUN 2016." Jurnal Riset Hesti Medan Akper Kesdam I/BB Medan 1, no. 2 (December 1, 2016): 110. http://dx.doi.org/10.34008/jurhesti.v1i2.71.
Повний текст джерелаАнотація:
Diabetic wounds are injuries that occur in patients with diabetics involving disorders of the peripheral and autonomic nerves. Every year more than one million people with diabetes lose one of their legs as one of the complications of diabetes, this means that every 30 seconds one leg is lost due to diabetes somewhere in the world. The purpose of this study was to determine the level of knowledge of patients in the treatment of diabetes mellitus wounds in PTPN II Hospital Binjai Departure in 2016. The method of this study was descriptive observational. The population in this study were all patients treated at the Women's Room at PTPN II Bangkat Binjai Hospital, totaling 20 people. The sample in this study amounted to 10 people with accidental sampling techniques. The results of this study indicate that the Knowledge Level of Patients About Diabetes Wound Care in the Women's Room of PTPN II Hospital Binjai Departure in 2016 which is interpreted is good knowledge as many as 6 people (60%), enough as many as 2 people (20%) and less than 2 people (20%). 3. It is expected that patients will be able to prevent Diabetes Injuries by controlling blood glucose, using footwear, treating toenails, foot care and foot exercises. If Complications with Diabetes Injuries have occurred, the patient is expected to be able to treat diabetic wounds properly.Keywords: Patient Knowledge, Diabetes Melitus Wound Care
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Kapp, Suzanne, and Nick Santamaria. "The effect of self-treatment of wounds on quality of life: a qualitative study." Journal of Wound Care 29, no. 5 (May 2, 2020): 260–68. http://dx.doi.org/10.12968/jowc.2020.29.5.260.
Повний текст джерелаАнотація:
Objective: Skin wounds, such as leg ulcers and pressure ulcers (PUs), can have a negative effect on quality of life (QoL). This effect has been confirmed among self-treaters of wounds, specifically. The aim of the study was to investigate the effect of self-treatment of wounds on the physical, emotional, lifestyle and financial domains of QoL. The findings of the study may be used to optimise the wellbeing of people who have wounds. Method: A qualitative study was conducted with people who were 18 years of age or older; lived in Victoria, Australia; spoke English; and had a wound that they had self-treated. Participants were interviewed and the data thematically analysed to identify themes that represented the effect of self-treatment on the physical, emotional, lifestyle and financial domains of QoL. Results: The participants (n=25) averaged 71 years of age and the majority (n=20) had leg wounds. Participants described mostly positive effects on QoL that were attributable to self-treatment. Self-treatment improved physical wellbeing because it resulted in better pain management and wound healing; however, it was a physical challenge for some. Self-treatment enhanced emotional wellbeing because it helped to manage worry about infection and resolve dissatisfaction with professional care. Self-treatment lessened the social consequences of the wound by enabling participants to create an acceptable appearance, maintain their lifestyle and minimise time receiving professional care. Self-treatment reduced the financial cost of wound dressings and the expense associated with receiving professional care. Conclusion: As an approach to care, self-treatment of wounds may offer QoL gains that might otherwise be unachievable. The importance of engaging patients in their own management, and the increasing accountability of healthcare providers to report consumer-focused outcomes, are further reasons to consider self-treatment of wounds as an approach to care in the community setting.
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Langford, Jane H., Phillip Artemi, and Shalom I. Benrimoj. "Topical Antimicrobial Prophylaxis in Minor Wounds." Annals of Pharmacotherapy 31, no. 5 (May 1997): 559–63. http://dx.doi.org/10.1177/106002809703100506.
Повний текст джерелаАнотація:
OBJECTIVE: To evaluate the ability of a novel topical antimicrobial gel containing cetrimide, bacitracin, and polymyxin B sulfate to prevent infections of minor wounds. DESIGN: A clinical trial compared the test preparation with placebo and a povidone iodine antiseptic cream. SETTING: Five primary schools in Sydney, Australia, participated in the study over a 6-week spring/summer school term. SUBJECTS: Children aged 5–12 years with parental consent were eligible for study participation. Accidental injuries occurring at school were treated in a standardized manner by nurses at each site. OUTCOME MEASURES: Wounds were evaluated by the medical practitioner after 3 days of topical treatment. The clinical outcome was classified as resolution or suspected infection. If a clinical infection was suspected, the injury was swabbed for microbiologic evaluation. Growth of a dominant microorganism was classified as a microbiologic infection. RESULTS: Of the 177 injuries treated, there were nine clinical infections. A comparison of these showed a significant difference among treatment groups (p < 0.05). This difference was associated with the test preparation and placebo; the test preparation reduced the incidence of clinical infection from 12.5% to 1.6% (p < 0.05; 95% CI, 0.011 to 0.207). A comparison of microbiologic infections showed no significant differences among treatment groups (p > 0.05). CONCLUSIONS: The novel gel preparation containing cetrimide, bacitracin, and polymyxin B sulfate showed therapeutic action and reduced the incidence of clinical infections in minor accidental wounds. It may be a suitable product for first aid prophylaxis.
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Lychagin, A. V., A. A. Gritsyuk, and V. S. Korytin. "Long-term complications of tibial injury." Grekov's Bulletin of Surgery 181, no. 1 (December 28, 2021): 80–87. http://dx.doi.org/10.24884/0042-4625-2022-181-1-80-87.
Повний текст джерелаАнотація:
The OBJECTIVE of the study, based on our own experience, was to determine the frequency, structure and specificity of long-term complications after replacement of soft tissue and leg bones defects, and to develop treatment tactics.METHODS AND MATERIALS. A retrospective study of the case of 53 patients who underwent treatment in the trauma department of the hospital for the period 2000 to 2008 was carried out. These patients had soft tissue wounds and circular defects of the tibial diaphysis because of severe open injuries of 17 (32.1 %) and gunshot wounds to the lower leg (36 (67.9 %). Patients underwent replacement of soft tissue and lower leg bones using the Ilizarov method and microsurgical reconstruction free flaps. The analysis of treatment results was carried out.RESULTS. After the end of inpatient treatment, patients were dynamic observation carried out. 39 (73.6 %) of 53 patients sought medical help, as for various complications, the average long-term follow-up was (42.2±5.5) months. The most frequent complications were relapses of soft tissue inflammation in 13.7 % and osteomyelitis in 24.5 % of cases, non-inflammatory complications were tibia fractures (5.7 %) and pseudarthrosis (7.6 %). The analysis of treatment methods of these complications is presented.CONCLUSION. Simultaneous replacement of extensive leg defects with a free vascularized flap and Ilizarov's distraction osteogenesis creates favorable conditions for wound healing and tibial restoration, however, in the long-term period there are complications in the form of recurrent osteomyelitis, tibia fractures and pseudarthrosis, which require specialized treatment based on a detailed analysis of the pathology and the previous treatment method.
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Yakubu, Alkassim, and Oluwatope A. Mabogunje. "Skin Cancer in Zaria, Nigeria." Tropical Doctor 25, no. 1_suppl (January 1995): 63–67. http://dx.doi.org/10.1177/00494755950250s120.
Повний текст джерелаАнотація:
Skin cancer from 775 patients in the savannah showed a preponderance of squamous cell carcinoma (SCC) of the leg related to neglected, poorly managed and chronic ulcers or scars from burns or injuries. SCC of the head and neck had no predisposing factor. Malignant melanoma overwhelmingly affected the feet, dermatofibrosarcoma affected the trunk and Kaposi sarcoma affected the limbs. Basal cell carcinoma (BCC) comprised only 2% of all skin cancers. The 18 albino patients had a higher frequency of both SCC and BCC mostly on the head and neck. Excisional surgery was generally effective, the wounds being closed primarily or by means of flaps and skin grafts. However, 98 patients required amputation below the knee for tibial involvement by SCC. The prognosis and health care costs of skin cancer will only be improved if burns and injuries are adequately treated.
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Velinovic, Milos, Mile Vranes, Biljana Obrenovic-Kircanski, Svetozar Putnik, Aleksandar Mikic, Dragutin Savic, Radmila Karan, and Natasa Kovacevic-Kostic. "Penetrating wound of the heart manifested with periphery embolism: Case report." Vojnosanitetski pregled 69, no. 9 (2012): 803–5. http://dx.doi.org/10.2298/vsp111007025v.
Повний текст джерелаАнотація:
Introduction. Heart injuries can be classified as penetrating and non-penetrating (blunt). Penetrating wounds are usually caused by stabbing with a piercing object, weapon or projectiles - missiles. The right atrium is damaged in most cases, because of its anatomical position - making the most of the anterior side of the heart. Morbidity caused by stabbing injuries to the heart is 20%-30%, while piercing wounds cause 30%-60% of deaths. Case report. A 28-year-old patient was admitted to our clinic with acute ischemia of the extremities. Angiography revealed a bullet in the right common femoral artery, occluding it. The patient denied having any piercing or shooting wound to his leg, but he said that four years before he had been shot to his chest. Echocardiography revealed an atrial septal defect of secondary type. An event reconstruction revealed that, four years after shooting, the bullet was displaced from the heart to the right common femoral artery. Conclusion. This case report is unique because of the rare type of injury, time that passed from the injury, the way bullet entered the artery (via atrial septal defect) and especially the success of both surgical procedures (embolectomy and repair of atrial septal defect).
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Medhora, Meetha, Tracy Gasperetti, Ashley Schamerhorn, Feng Gao, Jayashree Narayanan, Zelmira Lazarova, Elizabeth R. Jacobs, Sergey Tarima, and Brian L. Fish. "Wound Trauma Exacerbates Acute, but not Delayed, Effects of Radiation in Rats: Mitigation by Lisinopril." International Journal of Molecular Sciences 21, no. 11 (May 30, 2020): 3908. http://dx.doi.org/10.3390/ijms21113908.
Повний текст джерелаАнотація:
The goal of this study is to understand and mitigate the effects of wounds on acute radiation syndrome (ARS) and delayed effects of acute radiation exposure (DEARE), for preparedness against a radiological attack or accident. Combined injuries from concomitant trauma and radiation are likely in these scenarios. Either exacerbation or mitigation of radiation damage by wound trauma has been previously reported in preclinical studies. Female WAG/RijCmcr rats received 13 Gy X-rays, with partial-body shielding of one leg. Within 2 h, irradiated rats and non-irradiated controls were given full-thickness skin wounds with or without lisinopril, started orally 7 days after irradiation. Morbidity, skin wound area, breathing interval and blood urea nitrogen were measured up to 160 days post-irradiation to independently evaluate wound trauma and DEARE. Wounding exacerbated morbidity in irradiated rats between 5 and 14 days post-irradiation (during the ARS phase), and irradiation delayed wound healing. Wounding did not alter delayed morbidities from radiation pneumonitis or nephropathy after 30 days post-irradiation. Lisinopril did not mitigate wound healing, but markedly decreased morbidity during DEARE from 31 through 160 days. The results derived from this unique model of combined injuries suggest different molecular mechanisms of injury and healing of ARS and DEARE after radiation exposure.
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du Toit, Verona, and Richard Smith. "Survey of the Effects of Aerobic Dance on the Lower Extremity in Aerobic Instructors." Journal of the American Podiatric Medical Association 91, no. 10 (November 1, 2001): 528–32. http://dx.doi.org/10.7547/87507315-91-10-528.
Повний текст джерелаАнотація:
The rate of aerobic dance injuries has been high for two decades. To determine the types of lower-extremity injuries to aerobic instructors, a questionnaire was sent to 18 fitness centers in the Sydney, Australia, metropolitan area requesting information on the number and types of injuries, frequency of activity levels, footwear worn, and treatments sought. The reported rate of injury was 77%. The leg was the most common site of injury, reported by 52.9% of respondents, followed by the foot and ankle (32.8%), and the knee (20%). These figures are comparable to previous studies. Further investigation is warranted into causes and preventive measures, and information on the kinetics and kinematics of the lower extremity may increase understanding of the incidence of lower-extremity injuries to aerobic instructors and participants. (J Am Podiatr Med Assoc 91(10): 528-532, 2001)
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Obene, Tonye Adiyi, and Victor Abhulimen. "Presentations of gunshot injuries to the extremities in a tertiary hospital in Port Harcourt." International Surgery Journal 9, no. 10 (September 28, 2022): 1689. http://dx.doi.org/10.18203/2349-2902.isj20222592.
Повний текст джерелаАнотація:
Background: There is an increasing incidence of gunshot injuries in most countries around the world. Causes of gunshot injuries include herdsmen assault on communities, religious and ethnic riots, student cultism, inter-tribal wars, accidental injuries at funeral ceremonies and politically motivated murder. This study aims to highlight the presentations of gunshot injuries to the extremities in Port Harcourt.Methods: This was a prospective carried out on all patients who presented with gunshot injuries to the extremities at the University of Port Harcourt Teaching Hospital during the period of the study. Data on age, gender, anatomical region of the body involved in the injury, nature of the gun used, time between injury and presentation at the hospital were obtained. The information gotten was analyzed and presented in form of tables and figures.Results: Eighty-two subjects with 106 injuries were evaluated. Mean age±SD=28.28±8.04 years. Seventy were males and 12 females (M:F=5.83). Most were unmarried and unemployed. Eighty nine percent presented to the hospital within 6 hours of injury. The AK 47 and locally made pistol were the most used weapons. The left extremity was more affected than the right.Conclusions: This study showed that young adult unemployed males suffered more gunshot wounds than females. Subjects presented early to the hospital. The AK 47 and the local pistol were the weapons mostly used in inflicting these injuries. Most injuries were sustained on the leg.
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Samoylenko, G. E., S. O. Zharikov, and R. P. Klimanskyi. "The «Propeller»–technique in plastic surgery of the extensive wounds of distal leg and the foot." Klinicheskaia khirurgiia 86, no. 3 (February 28, 2019): 27–31. http://dx.doi.org/10.26779/2522-1396.2019.03.27.
Повний текст джерелаАнотація:
Objective. To increase the efficacy of plastic surgery in treatment of the extensive soft tissue defects, applying “sparing” resection of the lower third of the shin and foot for consequences of mechanical and/or thermal trauma or infectious–necrotic processes.
Materials and methods. We conducted a retrospective evaluation of the “Propeller”–technique application for the elevation of the skin islet flaps on sural neurovascular pedicle in 11 patients, who underwent surgery between 2014 and 2017. The task for investigation was to eliminate the shin and foot defects, developed due to large–scale tissue damage. The Group 1 was organized for patients with the mine–blast trauma and the coal mine occupational injuries (2 patients followed in each category). Management of purulent–necrotic wounds (Group 2) was required in cases of amputation and resection of the foot due to either osteomyelitis (3 patients followed) or frostbites (4 patients followed).
Results. All the patients had an adequate vascular supply of the affected limbs, even in 3 patients from the Group II, who had only one artery preserved. In all cases a secondary surgical debridement, necrectomy and the soft tissue defect repair were performed during the same operation.
Conclusions. Using of the tegument tissues mobilization complex “Propeller”– technique is an effective instrument for sealing of deep complex defects of different etiology, localized in distal part of the lower extremity.
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Gonzalez, Gilberto A., Christopher Castagno, Jordan Carter, Brinda Chellappan, and Philippe Taupin. "Negative pressure wound therapy on complex extremity wounds requiring coverage with a meshed bilayer wound matrix: a retrospective analysis." Journal of Wound Care 31, Sup9 (September 1, 2022): S8—S15. http://dx.doi.org/10.12968/jowc.2022.31.sup9.s8.
Повний текст джерелаАнотація:
Objective: The treatment of complex extremity wounds is technically challenging. In this 5-year retrospective review, we compared the use of Integra Meshed Bilayer Wound Matrix (IMBWM; Integra LifeSciences, US) followed by a split-thickness skin graft (STSG) combined with negative pressure wound therapy (NPWT) versus IMBWM followed by STSG alone for the management of these wounds. Method: Data from patients undergoing management using IMBWM for a complex extremity wound coverage were collected. Results: Among the 109 patients studied, the wounds of 62 patients were managed using IMBWM and NPWT, and 47 were managed using IMBWM alone. The most common aetiology of these injuries was trauma. Wound size and location were similar for each group, ranging in size from 2–30cm2 and being primarily on the forearm, followed by the leg and arm. There was a significantly greater take of the IMBWM+STSG with NPWT (96.8%) compared to without NPWT (85.1%, p=0.03). There were significantly fewer reapplications of the dermal matrix required in the NPWT group (3.2%) versus the non-NPWT group (14.9%, p=0.03). There were significantly fewer postoperative complications, prior to STSG, in the NPWT group (3.2%) versus the non-NPWT group (14.9%, p=0.03). Conclusion: The combination of IMBWM with NPWT leads to a higher success rate, and can reduce the number of dermal matrix reapplications and postoperative complications, in the setting of complex extremity wounds. The use of IMBWM in combination with NPWT has the potential to improve both surgical procedures and patient outcomes in this setting.
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Bezerra, Marcos André Cavalcanti, Isabela Cristina Farias, Diego Arruda Falcão, Igor de Farias Domingos, Luana Laranjeira Prado, Mariana Rezende Bandeira Mello, Taciana Mendonça, et al. "Association of MBL2 polymorphism with Leg Ulcers Development in Sickle Cell Anemia Patients." Blood 124, no. 21 (December 6, 2014): 4912. http://dx.doi.org/10.1182/blood.v124.21.4912.4912.
Повний текст джерелаАнотація:
Abstract Leg ulcers are the most common clinical manifestations of sickle cell anemia (SCA), a monogenic disease with huge clinical diversity among patients. They affect 8% to 10% of SCA patients, reaching a percentage greater than 50% in patients residing in tropical areas. These ulcers occur due to vascular occlusion, tissue hypoxia, hemolysis and genetic factors, presenting a slow healing, high recurrence rate and huge susceptibility to infection. Recently, some studies have shown a positive relationship between the complement system and the development of some vascular diseases and injuries such as leg ulcers in non-SCA patients. Mannan-binding lectin (MBL) is an important component of the humoral innate immune system, and MBL possesses several characteristics indicating that it may play an essential role in wound healing; modulating inflammation and contributing to the clearance of microorganisms and apoptotic cells. In a recent study of chronic leg and foot ulcer patients, serum MBL levels were significantly different between wounds of different etiologies, with chronic venous leg ulcers patients having a higher frequency of MBL deficiency. Polymorphisms in the MBL2 are associated with a reduction in the MBL protein serum levels, increasing risk of developing leg ulcers and also the maintenance of these wounds, compromising the integrity of the immune defence and its response to potential invading pathogens. Here, we aimed to determine the frequency of polymorphisms in the promoter region -221 (Y / X) and -550 (H / L) and exon 1 of the MBL2 and assess the clinical impact of these variants in a northeastern Brazilian SCA population who presented leg ulcers. Two-hundred seventy-five unrelated SCA patients were included. According the leg ulcers presence, the total cohort was classified in patients presenting current or prior history of leg ulcers (n=100) and SCA patients above 18 years with no history of leg ulcers (n=175). Molecular analysis was performed by qPCR. Our population was in Hardy-Weinberg equilibrium. The allelic frequency of haplotypes associated with high MBL production (HYA, LYA) was 54.5% for cases and 62.9% in controls. The genotypes related to low MBL production (HYO, LYO) in cases and controls was 27.5% and 18.6%, respectively. The frequency of genotype related to intermediate MBL production (LXA) was 18% in cases and 18.5% in controls. We had no statistically significant results when we analyzed only the polymorphisms (P>0.05). However, the phenotypic analysis between high and low MBL production revealed that patients with leg ulcers have lower MBL protein levels (P=0.019). We focused specifically on a possible role of MBL deficiency on healing complications, based on the facts that MBL deficiency is the most common immune disorder, and that a common causality for prolonged healing of these ulcers is infection or colonization by bacteria. In our study, MBL deficiency appears to increase the risk of developing leg ulcers in SCA patients. Disclosures No relevant conflicts of interest to declare.
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Bandara, D. M. D. N., and A. W. Suraj Chandana. "IDENTIFYING ANKLE INJURY PATTERNS OF NETBALL PLAYERS FOR MAINTAIN THEIR HEALTH AND WELLBEING." Gladi : Jurnal Ilmu Keolahragaan 12, no. 02 (July 2, 2021): 207–15. http://dx.doi.org/10.21009/gjik.122.12.
Повний текст джерелаАнотація:
Netball is a ball game played by two groups of seven players. Its improvement, got from early forms of ball, started in England during the 1890s. By 1960, universal playing guidelines had been institutionalized for the game. The ankle joint is a pivot joint framed between the tibia and fibula and the bone and enables the foot to twist upwards and downwards. The joint likewise permits a modest quantity of pivot. The joint's dependability originates from the basic course of action of the bones and the encompassing tendons. Ankle injuries can transpire at any age. This article surveys epidemiological investigations on ankle injuries in netball, and what are the sorts of ankle injuries, how it's happen and also survey how counteractive action from ankle injuries and aversion strategies. Furthermore, talk about around a few activities that can use for prevent from ankle injuries in netball. The purpose of the study was to investigate the several Ankle injuries of netball players in different countries. The methodology used for this review was based on previously published guidelines. It included research articles, journals, research publications, reviews and books. Collect all the findings and add the references. Of 47 articles are found and 18 are included in this review essay. Results demonstrate that the ankle injury was the most widely recognized harmed body site in netball and an Ankle sprain was the real lower leg damage happen in Netball. Ankle sprains represent an enormous level of wounds supported in netball. This efficient survey gives a synopsis of the study of disease transmission of ankle damage in Netball.
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Zhang, Li, Simei Wang, Meihua Tan, Hongwei Zhou, Ying Tang, and Yan Zou. "Efficacy of Oxidized Regenerated Cellulose/Collagen Dressing for Management of Skin Wounds: A Systematic Review and Meta-Analysis." Evidence-Based Complementary and Alternative Medicine 2021 (August 4, 2021): 1–10. http://dx.doi.org/10.1155/2021/1058671.
Повний текст джерелаАнотація:
Objective. The purpose of this study was to evaluate the wound healing efficacy of oxidized regenerated cellulose (ORC)/collagen dressing and ORC/collagen/silver-ORC dressings compared to standard of care or control in treatment of chronic skin wounds such as diabetic foot ulcers (DFUs), venous leg ulcers (VLUs), and pressure injuries sore ulcers (PISUs). Methods. An electronic search was carried out in four popular databases PubMed, Scopus, Embase, and CENTRAL to identify thirteen included studies, comparing the clinical efficacy of ORC/collagen dressings when compared to control in management of chronic skin wounds, especially DFUs, VLUs, and PISUs, and skin graft donor site wounds. Results. Consolidated data from thirteen comparative clinical studies undertaken for management of DFUs, VLUs, and PISUs showed favorable outcomes towards use of ORC/collagen compared to other traditional and hydrocolloid foam dressings in terms of wound healing rate ( P = 0.02 ) and percentage wound relative reduction ( P = 0.003 ). The time taken to achieve complete wound healing in the included studies did not show any statistical significant difference ( P = 0.24 ). There was no significant difference in adverse events between ORC/collagen-treated group and comparative group ( P = 0.19 ). Conclusion. ORC/collagen wound dressings are beneficial in terms of improved wound healing rate and percentage wound relative reduction compared to already existing traditional standard of care with non-MMP, inhibiting biomaterials such as moistened gauze, autologous growth factors, hydrocolloid foam dressings, or ovine extracellular matrix.
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Aljuboori, Zaid. "Surgical removal of a spinal intrathecal projectile led to a significant improvement of cauda equina syndrome." Surgical Neurology International 11 (August 1, 2020): 227. http://dx.doi.org/10.25259/sni_434_2020.
Повний текст джерелаАнотація:
Background: Penetrating gunshot wounds of the spine are common and can cause severe neurological deficits. However, there are no guidelines as to their optimal treatment. Here, we present a penetrating injury to the lower thoracic spine at the T12 level that lodged within the canal at L1, resulting in a cauda equina syndrome. Notably, the patient’s deficit resolved following bullet removal. Case Description: A 29-year-old male sustained a gunshot injury. The bullet entered the right lower chest, went through the liver, entered the spinal canal at T12, fractured the right T12/L1 facet, and settled within the canal at the L1 level. The patient presented with severe burning pain in the right leg, and perineum. On exam, he had right-sided moderate weakness of the iliopsoas and quadriceps femoris muscles, a right-sided foot drop, decreased sensation throughout the right leg, and urinary retention. Computed tomography myelography showed the bullet located intrathecally at the L1 level causing compression of the cauda equina. The patient underwent an L1 laminectomy with durotomy for bullet removal. Immediately postoperatively, the patient improved; motor power returned to normal, the sensory exam significantly improved; and he was left with only mild residual numbness and burning pain in the right leg. Conclusion: With gunshot injuries, there is a direct correlation between the location/severity of the neurological injury and the potential for recovery. In patients with incomplete cauda equina syndromes, bullet extraction may prove beneficial to neurological outcomes.
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McMahon, Elise, Rod Pope, and Kate Freire. "Relationships Between Lateral Limb Bias, Turnout, and Lower Limb Injury in a Female Pre-Professional Ballet Dancer Population." Journal of Dance Medicine & Science 25, no. 2 (June 15, 2021): 139–46. http://dx.doi.org/10.12678/1089-313x.061521i.
Повний текст джерелаАнотація:
Dancers are known to have specific limb preferences when they dance and commonly experience lower limb injury, especially early in their training. The primary aim of this study was to determine and examine the relationships between lateral limb bias, perceived turnout profile, and lower limb injury history in female pre-professional ballet dancers using current definitions of lateral bias, leg dominance, and the concept of "working" and "supporting" legs in dance. A cross-sectional survey design with retrospective recall of 12-month injury history was employed. An online questionnaire was distributed to female dancers between the ages of 16 and 21 years who were training in classical ballet at the pre-professional level in Australia. The questionnaire gathered information regarding laterality, perceived turnout asymmetry, and self-reported 12-month injury profile. Descriptive and correlation analyses were employed to describe dancer profiles and determine relationships between the three variables. Thirty-two dancers participated. The majority of participants (67%) had right-side dominance and most indicated the right leg as their preferred supporting leg (86.7%) and working leg (60%). A total of 17 participants (53.1%) reported at least one injury in the preceding 12-month period and the side injured was significantly correlated with leg dominance (rS = 0.595, p = 0.012), with the majority of injuries also affecting the preferred supporting and working leg. Dancer perceptions regarding turnout range were correlated with their perceptions of leg dominance (rS = 0.556, p = 0.001), but no statistically significant associations were found between perceptions of turnout range and injury side. In pre-professional dancers, the dominant and the preferred supporting or working leg tend to be the same leg, and the results suggest that the dominant and preferred supporting and working leg of dancers are at greatest risk of injury.
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Sharwood, Lisa, Holger Mueller, Rebecca Ivers, Bharat Vaikuntam, Tim Driscoll, and James Middleton. "The Epidemiology, Cost, and Occupational Context of Spinal Injuries Sustained While ‘Working for Income’ in NSW: A Record-Linkage Study." International Journal of Environmental Research and Public Health 15, no. 10 (September 27, 2018): 2121. http://dx.doi.org/10.3390/ijerph15102121.
Повний текст джерелаАнотація:
This study aimed to describe the epidemiological characteristics, the occupational context, and the cost of hospitalised work-related traumatic spinal injuries, across New South Wales, Australia. A record-linkage study of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Study period 2013–2016. Eight hundred and twenty-four individuals sustained work-related spinal injuries; 86.2% of whom were males and had a mean age of 46.6 years. Falls led to 50% of the injuries; predominantly falls from building/structures, ladders or between levels. Falls occurred predominantly in the construction industry (78%). Transport crashes caused 31% of injuries and 24% in heavy vehicles. Half of all the transport injuries occurred ‘off road’. The external cause was coded as ‘non-specific work activity’ in 44.5% of cases; missing in 11.5%. Acute care bed days numbered at 13,302; total cost $19,500,000. High numbers of work-related spinal injuries occurred in the construction industry; particularly falling from a height. Off-road transport-related injuries were significant and likely unaddressed by ‘on-road’ prevention policies. Medical record documentation was insufficient in injury mechanism and context specificity. Workers in the construction industry or those using vehicles off-road were at high risk of spinal injury, suggesting inefficient systems approaches or ineffective prevention policies. Reducing the use of non-specific external cause codes in patients’ medical records would improve the measurement of policy effectiveness.
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Bangun, Seri Rayani, Mestiana Br Karo, Barce Inel Crevis Gulo, Anna Pefrianti Siburian, Fransiskanes Manurung, and Lisbeth L. Sihotang. "Perawatan Luka Penderita Kusta Dengan Daun Tetanus (Leea Aequata L) Pengobatan Tradisonal Suku Karo." JURNAL KREATIVITAS PENGABDIAN KEPADA MASYARAKAT (PKM) 4, no. 5 (October 1, 2021): 1103–8. http://dx.doi.org/10.33024/jkpm.v4i5.4212.
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ABSTRAK Kusta merupakan penyakit yang disebabkan oleh mycobacterium leprae. Penyakit kusta pada stadium lanjut sering disertai luka akibat terjadinya kerusakan saraf pada daerah kaki yang menimbulkan gangguan sensibilitas kelumpuhan otot dan luka penderita kusta sering infeksi dan sulit untuk disembuhkan karena pasien sering terlambat datang untuk berobat. Perawatan luka kusta dengan menggunakan agen topikal yang tepat merupakan faktor terpenting dalam penyembuhan Luka penderita Kusta . Tujuan dilakukannya penelitian ini diharapkan dapat meningkatkan pengetahuan masyarakat terhadap pentingnya perawatan luka pada penderita kusta di pusat Rehabilitasi kusta Desa Galang. Adapun kegiatan yang dilakukan yaitu berupa pemeriksaan kesehatan dan juga perawatan luka penderita kusta dengan menggunakan obat tradisional tambar tetanus (LEEA AEQUATA L). Penderita kusta yang mengikuti perawatan luka sebanyak 34 orang. Masyarakat sangat antusias dalam mengikuti perawatan luka yang dilaksanakan serta akan berupaya melaksanakannya secara mandiri dirumah untuk meningkatkan status kesehatan penderita kusta. Kata Kunci : Penderita Kusta, Luka , LEEA AEQUATA L. ABSTRACT Leprosy is a disease caused by mycobacterium leprae. Leprosy at an advanced stage is often accompanied by injuries due to nerve damage in the leg area which causes impaired sensibility, muscle paralysis, and leprosy wounds are often infected and difficult to heal because patients often come late for treatment. The treatment of leprosy wounds by using the right topical agent is the most important factor in the healing of leprosy wounds. The purpose of this research is expected to increase public knowledge of the importance of wound care for people with leprosy at the Leprosy Rehabilitation Center in Galang Village. The activities carried out are in the form of health checks and also the treatment of leprosy wounds using the traditional tambar tetanus medicine(LEEA AEQUATA L). The community is very enthusiastic about participating in the counseling that is carried out and will try to implement it independently which can improve the health status of leprosy sufferers. Keywords: Leprosy Patients, Wounds, LEEA AEQUATA L.
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FELSMANN, MARIUSZ Z., and MACIEJ GOGULSKI. "Post-mortem diagnosis of gunshot injuries in an osprey: A case report." Medycyna Weterynaryjna 74, no. 1 (2018): 6014–2018. http://dx.doi.org/10.21521/mw.6014.
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The shooting of protected species, especially rare animals, is regarded as a priority issue by law enforcement authorities. In such cases, an expert veterinarian is required not only to confirm the death of the animal as a result of shooting, but also to provide a precise description of the shot. In cases of shootings with pellet bullets, such a description is particularly difficult. The evaluation of the gunshot wounds of an osprey (Pandion haliaetus) delivered to the Veterinary Medical Centre at the University of Poznań called for the use of a variety of diagnostic techniques. A preliminary assessment confirming the shot was based on an X-ray photo. Computed tomography (CT) was used for in-depth diagnostics, providing a spatial representation of bullet stopping points and fragments. The shot caused a lower leg bone fracture. This damage upset the anatomical structure of the animal's limb, which made it impossible to establish the wound channel by CT. Therefore, full shot characteristics could only be made only after a classical post-mortem examination. This examination facilitated the use of modern imaging diagnostic techniques. The use of mixed diagnostic techniques enabled us to determine the number of shots, the type of ammunition used and the direction from which the shot was fired. On the one hand, this case illustrates the possibilities offered by modern imaging diagnostic techniques and, on the other hand, it shows that the classic post-mortem examination remains a primary diagnostic tool for veterinary forensic experts. This is especially important when preparing forensic veterinary opinions in high-priority law enforcement cases. .
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Ignacio, Del Carmen-Ortega, Cahuana-Quispe Alberto Ignacio, Jaimes-Duran Edwing Michel, and Soulé-Martínez Christian Enrique. "Clinical application of the anterolateral thigh free flap in high energy injuries of the lower extremity." International Journal of Research in Medical Sciences 9, no. 4 (March 26, 2021): 1192. http://dx.doi.org/10.18203/2320-6012.ijrms20211374.
Повний текст джерелаАнотація:
One of the recurring problems in plastic and reconstructive surgery is the loss of tissues of the lower extremities as a result of high-energy injuries. The difficulty of this reconstruction lies in the need for a sufficiently suitable and resistant tissue to allow this restoration. The thigh-free anterolateral flap, since its description in 1984, has great versatility for complex or extensive lower extremity reconstructions. We presented the case of a 37-year-old male patient who had a high-energy road accident on a bicycle, impacting a moving vehicle causing a multi fragmented fracture of the right proximal tibia AO 41 C2.2/Schatzker V. He was treated surgically with material from osteosynthesis and iliac crest graft. It is complicated by infection of the surgical wound, exposure of osteosynthesis material and absence of skin covering. Reconstruction of the upper third of the right leg was performed with a thigh-free anterolateral free flap with 2 end-to-end venous anastomoses from the flap to anterior tibial veins, and 1 end-to-end anastomosis from perforating artery to anterior tibial artery, with no associated complications. The thigh-free anterolateral free flap is a versatile and reliable mechanism for the reconstructive surgeon, as it provides excellent coverage for complex lower extremity wounds as well as low donor site morbidity. Outpatient follow-up with adequate clinical evolution was done.
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Ellis, Lisa, Patricia Terrill, George Miller, Kin Seng Tong, and Miguel Cabalag. "Postoperative management of lower limb split-thickness skin grafts in Australia." Australasian Journal of Plastic Surgery 3, no. 2 (September 30, 2020): 11–21. http://dx.doi.org/10.34239/ajops.v3n2.232.
Повний текст джерелаАнотація:
Background: Evidence for postoperative management of split-thickness skin grafts (SSGs) to lower leg wounds has shown early mobilisation has no adverse effects on graft take, while improving patient outcomes and significantly reducing hospitalisation costs. The development of negative-pressure wound therapy (NPWT) for SSGs led to new options for bolster dressings. This study aimed to determine the current postoperative mobilisation and dressing choices of Australian plastic surgeons. Methods: Australian plastic surgeons were invited electronically to participate in a questionnaire regarding their postoperative regimens for lower limb SSG in 2013, and again in 2018. A literature review was performed to establish whether surgeon-reported practice was in line with current evidence for early mobilisation of lower limb SSGs and also for NPWT on SSGs. Results: In 2013, 119 responses were received and in 2018, 110 responses were received. Survey responses showed significant reductions in the numbers of patients kept immobilised for more than five days (30% to 9%, p = 0.001) between 2013 and 2018. Surgeons reported immobilising their patients longer with standard dressings than with NPWT dressings (p = 0.003 by multinomial logistic regression). More than two-thirds of surgeons reported NPWT use in both 2013 (66%) and 2018 (70%). Conclusion: Between 2013 and 2018, NPWT use increased slightly and the percentage of surgeons mobilising their patients early significantly increased, in accordance with evidence in the literature. A link was noted between NPWT use and an increased tendency to early mobilisation. However, a large proportion of surgeons continued to prescribe bed rest postoperatively.
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Swoboda, Laura. "A Retrospective Analysis of Clinical Use and Outcomes Using Viable Placental Membrane Allografts in Chronic Wounds." Wounds : a compendium of clinical research and practice 33, no. 12 (December 10, 2021): 329–33. http://dx.doi.org/10.25270/wnds/2021.329333.
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Introduction. Viable placental membrane (vPM) has been shown to decrease time to healing, adverse wound events, and wound-related infections. Wound research exclusion criteria commonly exclude wound types other than diabetic foot ulcers and venous leg ulcers (VLUs), comorbidities including peripheral arterial disease (PAD) and uncontrolled diabetes mellitus (DM), and wounds with exposed bone or tendon. Objective. This retrospective research study evaluated the clinical use and outcomes of the vPM with living mesenchymal stem cells used in chronic wound management in the community hospital outpatient department setting with the goal of comparing real-world use and outcomes of the product with use and outcomes described in the chronic wound literature. Materials and Methods. A retrospective analysis on vPM treatments at a Wisconsin academic health system’s community hospitals. Participants included all patients who received vPM therapy between July 1, 2016, and August 21, 2019. Results. A total of 89 patients received vPM treatment during the study period (mean age, 70 years; 69% male [n = 61], 31% female [n = 28]). Wound types were 54% diabetic or neuropathic foot ulcers (n = 48), 17% VLUs (n = 15), 7% pressure injuries (n = 6), and 22% atypical wounds (n = 20). The average wound duration prior to vPM initiation was 104 days. Average wound size at presentation was 6.9 cm2. Of study participants 54% had PAD (n = 48), 63% had DM (n = 56), 33.7% had DM and PAD (n = 30), and 17% had exposed bone or tendon (n = 15). Average adjusted time to healing after initiation of vPM was 81.2 days. The percentage of wounds healed 12 weeks after initiation of vPM treatment was 57%. Conclusions. Effectiveness of vPM observed in controlled trials also was observed in this real-world study on vPM for multiple wound types, patients with comorbidities including PAD and uncontrolled DM, and wounds with exposed bone or tendon. Results of this study were not statistically different from those reported in the literature. More randomized controlled trials are needed to explore the efficacy of vPM on patient presentations common to wound healing centers.
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MACEDO, JEFFERSON LESSA SOARES, SIMONE CORRÊA ROSA, DANIEL LOBO BOTELHO, CLENDES PEREIRA DOS SANTOS, MURILO NEVES DE QUEIROZ, and TABATHA GONÇALVES ANDRADE CASTELO BRANCO GOMES. "Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital." Revista do Colégio Brasileiro de Cirurgiões 44, no. 1 (February 2017): 9–16. http://dx.doi.org/10.1590/0100-69912017001003.
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ABSTRACT Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25.6 years, predominantly male (62.5%). The most frequent wounds were of the distal third of the lower limb (37.5%). Bone or tendon exposures occurred in 55% had and there was a 35% rate of exposed lower limb fractures. The treatments employed were skin grafting (57.5%), local fasciocutaneous flap (15%), muscle flap (12.5%), cross-leg fasciocutaneous flap, reverse sural flap (12.5%) and microsurgical flap (2.5%). Short-term evaluation showed that 35 patients had excellent or good results (87.5%), four had a regular result (10%), and one had an unsatisfactory result (2.5%). In the long term, of the 18 patients who answered the questionnaire, ten resumed walking, even with support, in the first three months after surgery (55.6%). Conclusion: young men involved in motorcycle accidents during leisure time represented the profile of patients with lower limb trauma requiring surgical reconstruction; the distal third of the leg was the most affected region. Grafting was the most used technique for reconstruction and postoperative functional evaluation showed that, despite complex lesions, most patients evolved with a favorable healing process and successful functional evolution.
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Golubovic, Zoran, Goran Vidic, Srbobran Trenkic, Zoran Vukasinovic, Aleksandar Lesic, Predrag Stojiljkovic, Goran Stevanovic, Ivan Golubovic, Aleksandar Visnjic, and Stevo Najman. "Treatment of open tibial shaft fracture with soft tissue and bone defect caused by aircraft bomb: Case report." Srpski arhiv za celokupno lekarstvo 138, no. 7-8 (2010): 510–14. http://dx.doi.org/10.2298/sarh1008510g.
Повний текст джерелаАнотація:
Introduction. Aircraft bombs can cause severe orthopaedic injuries. Tibia shaft fractures caused by aircraft bombs are mostly comminuted and followed by bone defects, which makes the healing process extremely difficult and prone to numerous complications. The goal of this paper is to present the method of treatment and the end results of treatment of a serious open tibial fracture with soft and bone tissue defects resulting from aircraft bomb shrapnel wounds. Case Outline. A 26-year-old patient presented with a tibial fracture as the result of a cluster bomb shrapnel wound. He was treated applying the method of external bone fixation done two days after wounding, as well as of early coverage of the lower leg soft tissue defects done on the tenth day after the external fixation of the fracture. The external fixator was removed after five months, whereas the treatment was continued by means of functional plaster cast for another two months. The final functional result was good. Conclusion. Radical wound debridement, external bone fixation of the fracture, and early reconstruction of any soft tissue and bone defects are the main elements of the treatment of serious fractures.
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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.
Повний текст джерелаАнотація:
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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Sonikpreet, Sonikpreet, Gulshan Oberoi, and Sarwan Kumar. "Case Report: Maggots' Infestation As a Predisposing Condition for Heparin-Induced Thrombocytopenia, a Newest Entity." Blood 124, no. 21 (December 6, 2014): 5021. http://dx.doi.org/10.1182/blood.v124.21.5021.5021.
Повний текст джерелаАнотація:
Abstract Introduction Thromobocytopenia is a well-recognized complication of heparin with risk of venous or arterial thrombosis. Heparin induced thrombocytopenia, Type I (HIT-I) is a self-limiting, nonautoimmune, and most common form of thrombocytopenia. Heparin induced thrombocytopenia, Type - II (HIT-II) is an immune mediated and serious adverse drug reaction caused by formation of heparin-platelet factor 4 (PF4) complex antibodies. Its incidence ranges from 0.2% – 5.0% in patients exposed to heparin for more than 4 days and 0.2% for those treated with unfractionated heparin (UFH) for less than 4 days. HIT-II is referred as HIT in this abstract. Maggots' therapy is used in clinical centers all over the world for the treatment of chronic wounds, such as leg ulcers, pressure sores, diabetic and necrotic ulcers, as well as infected surgical wounds, burns and trauma injuries. Maggots' therapy has core beneficial effects on a non-healing wound by mechanisms of debridement, disinfection and enhanced healing. In the last decade, maggots have been used to treat wounds of thousands of patients worldwide, so clinicans have recognized maggots' therapy as an important adjunct to conventional medicine. Despite its widespread usage, the relationship between maggots and heparin-induced thrombocytopenia is undiscovered and unexplored. We are reporting a first ever case of heparin-induced thrombocytopenia where maggots predisposed to this medical condition. Case Patient is a 50-year-old morbidly obese (body mass index 68) male with medical history significant for diabetes mellitus-2 and hypertension presented in the hospital with left lower leg pain, which was sharp, 6/10, non-radiating, with no aggravating, and relieving factors. On presentation, he was hemodynamically stable. Physical examination revealed bilateral lower extremity hyper-pigmentation, chronic stasis changes and a superficial posterior malodorous ulcer of the left leg infested with 5-6 maggots. Rest of the examination was unremarkable. Maggots were removed, started antibiotics and he received subcutaneous heparin as thromboprophylaxis. His platelets dropped from 108X109/L to 66X109/L after a single dose of subcutaneous unfractionated heparin. 4 T score revealed high pre-test probability. Laboratory results showed positive heparin-PF4 antibody. Imaging studies were negative for any venous or arterial thrombi/emboli. Heparin was discontinued immediately and argatroban was begun. There was noticeable rise in his platelet count. He was discharged upon symptomatic improvement of his leg pain along with normalization of his platelet counts. Discussion Heparin-induced thrombocytopenia is a clotting disorder where antibodies like IgG, IgM, and IgA are provoked by heparin, and highly immunogenic complex of heparin-PF4. Then, heparin-PF4-antibody complex binds to an activated platelet surface, binding of this immune complex to endothelial cell surfaces and tissue factor leads to thrombosis. Genetic and patient-specific interactions may also have an impact on HIT. Maggots have been extensively studied in the wound healing process and various mechanisms of actions have been described in the literature. Maggots combat clinical infection by exudate production, ingestion of wound bacteria and secreting potent bactericidal agents. Maggots form granulation tissue by complex interactive healing process. Upon maggots’ exposure, growth factors, such as platelet-derived growth factor (PDGF), epidermal growth factor (EGF), fibroblast growth factor (FGF) and transforming growth factor (TGF), are produced and released from the wound site to rapidly recruit inflammatory cells via cytokines and chemokines to an injured area. These factors increase the capillary permeability to the wound site. Also, these growth factors are formed, stored and released from platelets, as is platelet factor 4 complex. Hence, maggots activate platelets, release immunogenic PF-4 complex and initiate the whole cascade of heparin-induced thrombocytopenia. We need further studies to validate the interrelation of maggots’ therapy or infestation and heparin-induced thrombocytopenia. Disclosures No relevant conflicts of interest to declare.
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Agotegaray, Juan Ignacio, Ignacio Comba, Luciana Bisiach, and María Emilia Grignaffini. "Vascular Complications in Arthroscopic Repair Of Posterior Cruciate Ligament." Orthopaedic Journal of Sports Medicine 5, no. 1_suppl (January 1, 2017): 2325967117S0001. http://dx.doi.org/10.1177/2325967117s00019.
Повний текст джерелаАнотація:
Introduction: Posterior cruciate ligament is the primary stabilizer of the knee. Among the potential complications in arthroscopic repair of this ligament, there are vascular lesions, due to laceration, thrombosis and injury of the intima of the popliteal artery. We used one case to show the vascular complications that may arise in arthroscopic repair of the posterior cruciate ligament, how to handle it and the results. Methods: One patient, 33 years old, with a history of traffic accident. In a physical exam the patient shows pain and swelling of the knee, positive posterior drawer test and positive Godfrey test. X-rays on the knee show posterior tibial translation and MRI a complete fibers rupture at the middle third of the posterior cruciate ligament. An arthroscopic repair surgery was scheduled three weeks after trauma, with PCL reconstruction using simple band technique.After surgical intervention, hemostatic cuff was released, no peripheral pulse, paleness and coldness of the member was confirmed. An arteriography was carried out, which confirmed absences of distal vascular filling in the popliteal artery. An urgent referral was carried out with Vascular Surgery Services, who had been informed of the surgery previously (a notification that is part of our routine for this kind of interventions). Arteriorrhaphy and venorrhaphy of the popliteal arteries was fulfilled 12 hours later, with a leg fasciotomy. Daily monitoring was performed, and after 72 hours, muscle necrosis is seen with wound drainage, analysis shows presence of gram-negative bacilli, Proteus Mirabilis-Pseudomonas spp and the lab results showed leukocytes: 8.700/ml, ESR: 58, CRP: 48. A new surgery is performed with complete resection of the anterior external compartment of the leg, and a system of continuous cleansing is applied with physiological saline solution and boric acid for 14 days until drainage is eliminated. Vancomycin and ceftazidime EV was indicated for 14 days and, after a good evolution of the wounds, patient is discharged from hospital with Sulfamethoxazole/trimethoprim 160mg/800mg to be taken orally for 14 days. Results: After treatment with oral antibiotic is completed, wounds progress positively. Foot in equinus position, has positive distal pulses with distal sensibility. Use of a thermoforming brace is indicated for movement. Vascular Surgery Services are currently following patient’s evolution. An ankle arthrodesis surgery is evaluated for the future. Conclusion: Combined injuries that result in a posterior tibial translation over 15 mm and, those that come along with injuries in the anterior cruciate ligament or posterior lateral structures of the knee, should be repaired through surgery. Vascular lesion caused by laceration, thrombosis or injury of the intima of the popliteal artery, mainly during perforation and preparation of tibial tunnel, is a serious lesion. Although these vascular lesions during arthroscopy are complications relatively rare, a potential risk should be considered, with consequences that could be fatal for the extremity and for patient’s life when bleeding is involved. In those cases, urgent treatment is imperative, that is the reason we believe it is safe to coordinate with Vascular Surgery Services before the surgery is carried out.
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Эліна, Т. В., та Л. Є. Галавська. "РОЗРОБКА КОНСТРУКЦІЇ ТА ТЕХНОЛОГІЇ ВИГОТОВЛЕННЯ АДАПТИВНИХ ШКАРПЕТОК ДЛЯ ЛЮДЕЙ З ВАДАМИ ГОМІЛКОСТОПУ". Fashion Industry, № 1 (25 травня 2021): 43–50. http://dx.doi.org/10.30857/2706-5898.2021.1.2.
Повний текст джерелаАнотація:
Development of functional socks for people with special needs who have diseases associated with ankle defects, including patients with diabetes.Methodology. The analytical method of reviewing scientifi c, technical, and patent documentation in the fi eld of research is used in the work. An experimental method for determining the elongation on a tensile tester WDW-05M, unfolding method. Analysis of problems associated with the elimination of excess pressure of the sock on the foot in people with increased measurements of the feet and ankles due to gunshot wounds, injuries or chronic diseases, including varicose veins, diabetes, edema, tumors, etc. confi rms the need to deve lop a new range of functional sock products. In the course of the research, the properties of weft-knitted structures were analyzed and a scientifi cally substantiated design of adaptive socks for home use was proposed. The design includes at least two sections, the elastic properties of which diff er. The back side of the leg, heel, sole, and toe are made of 1x1 rib knit, the instep and the front part of the leg are made of 3x3 rib knit. The section with higher stretchability and elasticity, made of 3x3 rib knit, softly maintains the shape of the socks’ leg, practically without creating pressure on the ankle and allowing to signifi cantly increase the perimeter of the sock in the area of the foot, toes, and/or heel. A sam ple of adaptive socks made of PAN yarn 32x2 tex х4 by knitting according to the shape of the unfolding of its 3D surface was made on the fl at knitting machine PVRK of the 8-th gauge. The connection of the product's parts in order to give the product a three-dimensional shape is made on a linker machine Hague D280E.Practical value. The design and technology of manufacturing functional socks have been developed. It is proposed to use industrial and semi-industrial double-bed fl at-knitting machines as technologic al equipment for their production. The use of various rib knit patterns for diff erent functional zones o f a sock allows providing the set value of conditional tension of threads when using the sock on a foot of atypical measurements.
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Sihotang, Martin Gabe Tua, Anak Agung Ngurah Ronny Kesuma, I. Komang Agus Krisna Saputra, and I. Komang Mahendra Laksana. "Osteomielitis kronis pada pasien anak laki-laki setelah cakaran kucing: laporan kasus." Intisari Sains Medis 13, no. 2 (August 30, 2022): 591–94. http://dx.doi.org/10.15562/ism.v13i2.1314.
Повний текст джерелаАнотація:
Background: Chronic osteomyelitis is still an important problem in the orthopedic field, especially in developing countries. Cat's claws contain many harmful microorganisms and can cause significant morbidity ranging from infection of skin tissue, muscle, and even deeper to bone tissue (osteomyelitis). The aim of this study was to report that injuries caused by cat-scratches and not receiving proper treatment can develop into chronic osteomyelitis. Case presentation: A 14-year-old boy came to the orthopedic polyclinic of Wangaya General Hospital with complaints of a left leg wound that had not healed since 2 years ago after got cat-scratches. The wound was oozing pus, tenderness, and the ankle area was found to be difficult to move because the patient's leg felt stiff. On physical, laboratory, and radiographic examination were found to be suggestive of chronic osteomyelitis. Conclusion: In general, cat scratch injuries are simple and harmless wounds, but if left untreated can lead to infection and morbidity in the future. Persistent symptoms and unrelieved wound conditions should be important indications for patients and practitioners of the possibility of infection that extends to soft tissue or bone tissue. A good understanding of acute wound management is very important in preventing serious infections. Latar belakang: Osteomielitis kronik masih merupakan masalah penting di bidang ortopedi terutama di negara berkembang. Pada cakaran kuku kucing mengandung banyak mikroorganisme berbahaya dan dapat menyebabkan morbiditas yang signifikan mulai dari infeksi jaringan kulit, otot, bahkan lebih dalam sampai mengenai jaringan tulang (osteomielitis). Tujuan dari penelitian ini adalah untuk melaporkan cidera yang disebabkan oleh cakaran kucing dan tidak mendapatkan pengobatan dengan baik dapat berkembang menjadi osteomielitis kronis. Laporan kasus: Seorang anak laki-laki berusia 14 tahun datang ke poliklinik ortopedi RSUD Wangaya dengan keluhan luka kaki kiri yang tidak kunjung sembuh sejak 2 tahun yang lalu, luka mengeluarkan nanah, nyeri tekan, serta pada daerah ankle ditemukan sulit untuk digerakkan yang dikarenakan kaki pasien terasa kaku. Pada pemeriksaan fisik dan laboratorium ditemukan mengarah pada osteomielitis kronis. Simpulan: Pada umumnya cidera cakaran kucing hanya luka sederhana dan tidak berbahaya, tetapi jika diabaikan dapat menyebabkan infeksi dan morbiditas dikemudian hari. Gejala yang menetap dan kondisi luka yang tidak membaik harus menjadi indikasi penting bagi penderita dan praktisi terhadap kemungkinan infeksi yang meluas ke jaringan lunak ataupun jaringan tulang. Pemahaman yang baik tentang penanganan luka akut menjadi sangat penting dalam mencegah terjadinya infeksi yang serius.
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Rwigema, Jean-Claude, Abhay Gokhale, Julie Glowacki, Tracy Dixon, Ken Patrene, G. David Roodman, Peter Wipf, and Joel Greenberger. "Impaired Osseous Wound Healing Following Ionizing Irradiation Is Ameliorated by Mitochondrial Targeted Nitroxide JP4-039." Blood 114, no. 22 (November 20, 2009): 4576. http://dx.doi.org/10.1182/blood.v114.22.4576.4576.
Повний текст джерелаАнотація:
Abstract Abstract 4576 In the case of a nuclear explosion, combined injuries may include ionizing irradiation and bone fracture. We evaluated the potential bone wound healing stimulation capacity of a new mitochondrial targeted nitroxide - JP4-039 - that was developed and demonstrated to protect against total body irradiation. JP4-039 was synthesized by coupling Tempol (4-hydroxy-2,2,6,6-tertamethylpiperidine-N-oxyl) and a novel alkene isotere analog of a gramicidin S (GS) fragment. JP4-039 is now being tested to determine whether it can also improve osseous wound healing. A model for osseous wound healing was used in the right hind leg of C57BL/6NHsd female mice and irradiated in doses ranging from 0 to 30 Gy, then holes drilled in both tibias 24 hr later. The mice were sacrificed at 7, 14, 21, 28 or 35 days. Tibial wounding and x-rays were used for determination of wound size. The bones were fixed, sectioned, and examined for osseous wound repair. A significant irradiation- induced delay in wound repair (hole diameter) was detected at 21 days in both the 20 Gy (0.93 ± 0.11 mm, p=0.008) and 30 Gy (1.1 ± 0.1 mm, p=0.0002) groups, compared with the 0 Gy group (0.67 ± 0.23 mm). At 28 days, there were statistically significant increased hole diameters between each irradiation groups (10 Gy, 0.76 ± 0.08 mm, p=0.003; 20 Gy, 0.87 ± 0.36 mm, p=0.04; 30 Gy, 0.76 ± 0.22 mm, p=0.02) and the 0 Gy group (0.32 ± 0.32 mm). By day 35, the wounds in the 0 Gy group were healed (0.08 ± 0.17 mm), while wounds in the 20 Gy group (0.22 ± 0.24 mm, p=0.02) and 30 Gy group (0.34 ± 0.23 mm, p=0.001) remained significantly larger. To determine whether JP4-039 improved the time of osseous wound healing, mice were injected intraperitoneally with JP4-039 (10 mg/kg) 10 min before drilling holes in both rear legs. Mice injected with JP4-039 before drilling showed significant improvement in osseous wound healing in 14 days and 21 days after drilling (0.55 ± 0.3 and 0.47 ± 0.04 mm, respectively), compared with 0.84 ± 0.05 and 0.64 ± 0.05 mm, respectively for control mice (p < 0.05 according to Tukey's multiple comparison statistical test). To test whether JP4-039 can improve osseous wound healing in irradiated limbs, mice were injected with JP4-039 (10 mg/kg) 10 min before 20 Gy to the right hind leg. Wounds were made in both tibae 24 hr after irradiation. At 21 and 28 days after wounding, bones from JP4-039 treated-irradiated mice displayed improved healing with holes of 0.51 ± 0.05 and 0.37 ± 0.04 mm, respectively, compared with 1.01 ± 0.10 and 0.76 ± 0.13 mm, respectively, for control irradiated bones. This is significant at < 0.05 as calculated using a Tukey's multiple comparison statistical test. Histopathological evaluation of specimens from mice pre-treated with JP4-039 prior to irradiation confirmed radiographic evidence of improved healing. Thus, JP4-039 enhances bone repair and is effective in a combined irradiation injury setting. Supported by NIAID/NIH grant U19AI068021 and BARDA Contract HHSO10200800062C. Disclosures: Roodman: Novartis: Consultancy, Research Funding, Speakers Bureau; Amgen: Consultancy; Celgene: Consultancy; Acceleron: Consultancy.
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Riginos, Alice Swift. "The wounding of Philip II of Macedon: fact and fabrication." Journal of Hellenic Studies 114 (November 1994): 103–19. http://dx.doi.org/10.2307/632736.
Повний текст джерелаАнотація:
This paper, concerning one element in the ancient biographical tradition of Philip II of Macedon, demonstrates the manner in which facts—that the Macedonian monarch was gravely wounded in the right eye, in the collar bone, and in the leg—become the basis of fictitious fabrications entered into the biographical tradition and accepted as elements of Philip's ‘life’. A diachronic analysis of the complete literary testimonia which convey information concerning these traumata attempts to determine when and how the biographical facts were altered and embellished over the centuries following Philip's death. Since the stunning discovery by Andronicos at Vergina in 1977 of the tomb designated Royal Tomb II, identified by the excavator as the tomb of Philip II, considerable interest has been focused on the wounds of Philip II in linking items recovered from the tomb and the physical remains of the male decedent with the great king of Macedon. A diachronic review of the literary traditions regarding Philip's injuries, useful to those arguing the identification of the occupant of Royal Tomb II, reveals a great deal about ancient biographical practices. Particularly in the case of the blinding wound to Philip's right eye, it is evident that the facts are very soon obscured by an overlay of fictitious embellishments, frequently amusing, which were created to heighten interest in an occurrence of lasting impact on Philip and became stock items in his βίος.
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Matthews, Marc R., Emily Helmick, Christopher Mellon, Danielle Thornburg, Areta Kowal-Vern, William H. Tettelbach, and Kevin N. Foster. "552 Limb Salvage: Amputations Prevented with Dehydrated Human Amnion/Chorion Membrane Allografts (dHACM) Used in Combination with Decellularized Human Collagen Matrix (dHCM)." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S124—S125. http://dx.doi.org/10.1093/jbcr/irab032.202.
Повний текст джерелаАнотація:
Abstract Introduction Burn and traumatic limb injuries with exposed bone/tendon typically require surgical flaps or amputations for healing. Some burn patients are not candidates for these invasive techniques. Placental amniotic membrane has been used as a wound dressing for more than 100 years and may offer an alternative to flaps and/or amputations. Processed dehydrated human amnion/chorion membrane (dHACM), from human placental tissue, contains type 1 human collagen as well as non-viable cells and 285 identified regulatory proteins including growth factors, chemokines, cytokines, metalloproteinases, and other tissue growth and inflammatory mediators. dHACM has been successfully used as a dressing for wound ulcers, burns, donor sites, & surgical debridement. This study reports the use of dHCAM as a limb salvage tool in four patients with severe injuries. Methods This is a retrospective case series of patients suffering severe lower extremity injury with bone/tendon exposure that had applied dHACM/dHCM over or packed (depending on wound depth), then covered with 3% bismuth tribromophenate petrolatum dressing & glycerol/ hydroxyethylcellulose lubricant. Negative pressure wound therapy (NPWT) was initiated; wound re-evaluation occurred in seven days. dHACM/dHCM was reapplied if required (bone still exposed). Results There were 3 males and 1 female with three burns and one NSTI. The mean±sd (median) age was 58±23 (61) years; % total burn surface area 3±3 (2); length of hospital stay 48±30 (40) days; number of tangential excisions & debridements 6.5±1 (6.5); days from admission to product application 49±47 (34) and discharge 24±19 (19) days; negative pressure wound therapy (NPWT) 53±6 (56) days. All four patients continued treatment upon discharge with clinic visits and home NPWT. All recovered with good results and no complications. Treatment may be continued with NPWT therapy at home or in a skilled nursing facility. Patients healed after two to three dHACM/dHCM applications and did not require leg or foot amputations. Conclusions In select limb salvage cases, dHACM/HCM may be a promising alternative to extremity amputations, tissue transfer flaps or other techniques for secondary intention healing of wounds with bone/tendon exposure.
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Doktor, Katherine L., Kelsey Heffernan, Danielle Drames, and Dana D. Byrne. "1419. A Rare Case of Clostridium beijerinckii Traumatic Osteomyelitis." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S517. http://dx.doi.org/10.1093/ofid/ofz360.1283.
Повний текст джерелаАнотація:
Abstract Background We present a case of Clostridium beijerinckii osteomyelitis in the presence of retained foreign bodies not seen on MRI. Methods A 45-year-old female with type 2 diabetes sustained multiple open right leg injuries, grossly contaminated with gravel, after a motor vehicle collision. She underwent external fixation (ex-fix) and 5 irrigations and debridements (I&D) initially. Polymicrobial intraoperative cultures (Cx) were treated with vancomycin and ertapenem for 6 weeks. One month post-antibiotic completion, pain, and swelling developed in ankle; contrast MRI revealed avascular necrosis and osteomyelitis (OM) of talus. Cx from repeat I&D grew same organisms; meropenem was recommended for 6 weeks. During meropenem week 6, pain was minimal and wound was closed. During attempt to implant hardware, pus was seen around peroneal tendon. Cx grew Clostridium species and Bacteroides from tibia, calcaneus, talus, and peroneal tendon sheath; meropenem was continued. Pain worsened 3 weeks later; I&D revealed pus in lateral ankle. To better access the medial ankle, a longitudinal incision was made along posterior tibial tendon, perpendicular to prior surgical incision. Immediate purulence, grass blades, and rocks were seen. Brucella agar had a rare gray colony at 48 hours and was subbed to blood and Brucella agar; it grew on Brucella agar with aero tolerance test. Gram stain showed Gram-positive rods with subterminal spores. Rapid ANA panel identified isolate as Clostridium beijerinckii (Cb) with > 99.9% probability and bioscore 1/24. Results Cb is a strict anaerobic gram-positive rod with oval subterminal spores. Found in soil and water, its main use is industrial solvent production. Infection by Cb is rare; only 2 cases of OM, 1 traumatic endophthalmitis, and 1 mitral valve endocarditis have been reported. While uncommon, Clostridial osteomyelitis is associated with contaminated open traumatic injuries. It can be difficult to eradicate, despite aggressive surgical intervention and appropriate antibiotics. Conclusion This is the third case of Cb OM described. Anaerobic cultures should be collected during I&D of open traumatic wounds. If infection persists, careful intraoperative evaluation of wound for residual foreign bodies, even if not seen radiologically, should be performed. Disclosures All authors: No reported disclosures.
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Pankevych, V. V., U. D. Matolych, S. V. Ushtan, Z. P. Putko, and Yu B. Dmytryshyn. "Characteristics of Muscle Recovery under Experimental Post-Traumatic Contracture." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 6, no. 5 (October 27, 2021): 110–15. http://dx.doi.org/10.26693/jmbs06.05.110.
Повний текст джерелаАнотація:
The frequency of traumatic injuries of the maxillofacial area and the degree of their severity, have been increasing in recent years. The introduction of modern methods of treatment made it possible to improve the results of treatment and shorten its duration. Myogenic contractures develop as a complication after facial injuries, soft tissue injuries, in particular, masticatory muscles. The gastrocnemius muscle of a rat has the same striated structure as the pterygoideus medialis muscle of a person. The purpose of the work is to study the regeneration of striatal muscles with post-traumatic contractures on the basis of combined treatment of laboratory rats. Materials and methods. The study was carried out on 45 sexually mature 12 months old outbred white male rats, which weighed 180-200 g. In animals, reflex post-traumatic muscle contractures (traumatic myositis) resulting from the slaughter of calf muscles (without violating the integrity of muscle tissue) were simulated on the posterior left leg. The rats were divided into two groups. Group 1 included 21 animals that did not receive treatment and whose wounds healed by secondary intention. Group 2 included 24 rats that received combined treatment: on the 2nd day after surgery – general (oral) administration of the drug with the active substance cyclobenzaprine hydrochloride – 0.15 mg, once a day with daily procedures of magnetic laser therapy on the affected hind limb. Results and discussion. Depending on the signs of pain behavior (changes in behavior, restriction of movement, increased sensitivity, pain), the intensity of myogenic pain syndrome was assessed (low, moderate, high, very high). It was found that the use of combined treatment (magnetic laser therapy and the use of cyclobenzaprine hydrochloride) led to the normalization of behavioral and motor reactions by the 28th day: 56% of rats didn’t feel any pain and 44% had a low level of pain. The animals with the same trauma, which weren’t treated, showed a high and moderate level of pain. On the 28th day these animals could lean on their hind limbs while they were moving. However, they could not fully move due to a sharp restriction of their left hind limb function. The obtained results are the basis for the development of new approaches to improving the methods of prevention and rehabilitation treatment of contractures using magnetic laser therapy and central muscle relaxants. Conclusion. It was found that the use of magnetic laser therapy and cyclobenzaprine hydrochloride inhibited the development of an acute inflammatory reaction in the damaged muscle tissue of the hind limb of animals, accelerated and optimized reparative processes, which prevented excessive, functionally significant growth of connective tissue
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Bari, Md Saiful, Yan C. S. M. Laurenson, Andrew M. Cohen-Barnhouse, Stephen W. Walkden-Brown, and Dana L. M. Campbell. "Effects of outdoor ranging on external and internal health parameters for hens from different rearing enrichments." PeerJ 8 (March 6, 2020): e8720. http://dx.doi.org/10.7717/peerj.8720.
Повний текст джерелаАнотація:
In Australia, free-range layer pullets are typically reared indoors, but adult layers go outdoors, and this mismatch might reduce adaptation in laying environments. Enrichments during rearing may optimise pullet development and subsequent welfare as adult free-range hens. In the outdoor environment, hens may have greater opportunities for exercise and natural behaviours which might contribute to improved health and welfare. However, the outdoor environment may also result in potential exposure to parasites and pathogens. Individual variation in range use may thus dictate individual health and welfare. This study was conducted to evaluate whether adult hens varied in their external and internal health due to rearing enrichments and following variation in range use. A total of 1386 Hy-Line Brown® chicks were reared indoors across 16 weeks with three enrichment treatments including a control group with standard housing conditions, a novelty group providing novel objects that changed weekly, and a structural group with custom-designed structures to increase spatial navigation and perching. At 16 weeks of age the pullets were moved to a free-range system and housed in nine identical pens within their rearing treatments. All hens were leg-banded with microchips and daily ranging was assessed from 25 to 64 weeks via radio-frequency identification technology. At 64–65 weeks of age, 307 hens were selected based on their range use patterns across 54 days up to 64 weeks: indoor (no ranging), low outdoor (1.4 h or less daily), and high outdoor (5.2–9 h daily). The external and internal health and welfare parameters were evaluated via external assessment of body weight, plumage, toenails, pecking wounds, illness, and post-mortem assessment of internal organs and keel bones including whole-body CT scanning for body composition. The control hens had the lowest feather coverage (p < 0.0001) and a higher number of comb wounds (P = 0.03) than the novelty hens. The high outdoor rangers had fewer comb wounds than the indoor hens (P = 0.04), the shortest toenails (p < 0.0001) and the most feather coverage (p < 0.0001), but lower body weight (p < 0.0001) than the indoor hens. High outdoor ranging decreased both body fat and muscle (both p < 0.0001). The novelty group had lower spleen weights than the control hens (P = 0.01) but neither group differed from the structural hens. The high outdoor hens showed the highest spleen (P = 0.01) and empty gizzard weights (P = 0.04). Both the rearing enrichments and ranging had no effect on keel bone damage (all P ≥ 0.19). There were no significant interactions between rearing treatments and ranging patterns for any of the health and welfare parameters measured in this study (P ≥ 0.07). Overall, rearing enrichments had some effects on hen health and welfare at the later stages of the production cycle but subsequent range use patterns had the greatest impact.
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Pallela, Someshwara Rao Narayana, and Padmavathi Narahari. "A study to find the causes of diabetic foot infections in a selected community." International Surgery Journal 4, no. 7 (June 22, 2017): 2153. http://dx.doi.org/10.18203/2349-2902.isj20172576.
Повний текст джерелаАнотація:
Background: Ulcerations associated with diabetes are the most common cause of foot infections. Most of these ulcers are a direct result of loss of sensation secondary to peripheral neuropathy. The prevalence of leg ulceration is approximately 1% to 2%, and is slightly higher in the older adult population. Venous ulcers are the most common form of leg ulcers, accounting for almost 80% of all lower extremity ulcerations. Peak prevalence is between 60 and 80 years. Approximately one third of patients with chronic venous insufficiency will develop venous ulceration before the age of 40 years. In addition, venous ulcers may have a prolonged duration and are associated with a high rate of recurrence, which contributes to their prevalence. Approximately 15% of persons with diabetes will develop foot ulceration during their lifetime. Most lower extremity amputations in India are preceded by a foot ulcer. This study is done to find the commonest causes of foot infection in the background of neuropathy among the selected population.Methods: Total of 153 patients were included in this study. Detailed history was taken and all the wounds were classified according to Wagner’s grades. Foot infections in the grade 3,4, 5 (which required debridement/amputations) were included in the study. Foot ulcerations without infections were excluded from the study.Results: 142 (92%) of the patients with infection had diabetic neuropathy. All patients with diabetic neuropathy presented with sensory neuropathy. 33 (21%) patients presented with infection due to previous callus. 52 (33%) patients presented with infection due to previous non-healing ulcer. 20 (13%) patients with deformities developed callus at bony pressure areas due to neuropathy or post-surgery sequel. One patient had hot water burns injury. Five (0.03%) patients had Ingrown nails. 14 (0.09%) patients related to barefoot walking/thorn prick injuries. 6 (0.03%) patients had fungal infection. Two (0.01%) patients had itching and scratching over legs. 15 (0.09%) patients had history of previous amputation. Vigorous massage was the cause in 1 patient (0.006%). Shoe bite injury resulted in foot ulcer in 2 (0.02%) patients. Two (0.02%) patients presented with infection due to deep cracks in heels.Conclusions: Neuropathic changes is the most common cause of diabetic foot infections among which callus, non-healing trophic ulcer and previous amputee are the predominant causes. Patient education has a crucial role in prevention of diabetic foot infections by foot care precautions.
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Fearn, S., L. Schwarzkopf, and R. Shine. "Giant snakes in tropical forests: a field study of the Australian scrub python, Morelia kinghorni." Wildlife Research 32, no. 2 (2005): 193. http://dx.doi.org/10.1071/wr04084.
Повний текст джерелаАнотація:
Studies on species that attain very large body sizes provide a powerful opportunity to clarify the ecological correlates and consequences of body size, but logistical obstacles mean that most ‘giant’ species have attracted little field-based research. The Australian scrub python, Morelia kinghorni (= M. amethistina in earlier literature), is the largest Australian snake. Our three-year field study in the Tully River Gorge of tropical north-eastern Australia provides the first detailed ecological data on this species. Snakes aggregate in the gorge during the dry season for reproductive activities (combat, courtship and mating), and these aggregations consist primarily of large adult males. Wet-season samples from a nearby road contained more females, and more juvenile animals. Body temperatures of diurnally active pythons averaged 25.2°C, and were highly correlated with air and substrate temperatures. Larger snakes were cooler than smaller conspecifics, perhaps reflecting their slower heating rates. Recapture of marked individuals suggests that pythons of both sexes and all body sizes maintain fixed home ranges, as the distance from initial capture did not increase through time; most animals were recaptured <100 m from their initial capture point, but some dispersed at least 1.5 km. Adult male pythons spanned a massive range in body sizes (1.3–3.76 m in snout–vent length, 0.30–11 kg in mass), and larger males were more likely to engage in combat, exhibit combat-related injuries (bite wounds) and obtain matings. Presumably reflecting the reproductive advantage of larger body size, males attained much larger maximum sizes than did females within our study population.