Sample records for hand injuries caused



    We studied the long-term sequelae of hand injuries as a result of playing volleyball. In a retrospective study, 226 patients with injuries of the hand who were seen over a 5-year period at our Trauma Department, were investigated. Females accounted for 66 % of all injuries. The mean age was 26




    We studied the long-term sequelae of hand injuries as a result of playing volleyball. In a retrospective study, 226 patients with injuries of the hand who were seen over a 5-year period at our Trauma Department, were investigated. Females accounted for 66 % of all injuries. The mean age was 26 years




    The causes of occupational injuries (N = 2,365) were investigated. Accidents with machinery and hand tools were the two main causes (49.9%). 89% of the patients with occupational injuries were male. The highest risk group were in the age category of 19 years or less (51.9%). This age group also show

  4. Hand injuries as an indicator of other associated severe injuries.

    Vossoughi, Faranak; Krantz, Brent; Fann, Stephen


    The purpose of this study was to investigate the incidence of disabling or life-threatening injuries in patients with hand injuries. Retrospective data were collected from a level 1 trauma center registry. A total of 472 patients with hand injuries were admitted to the trauma unit between January 2000 and March 2004. Forty-four per cent of patients with hand injuries had life-threatening injuries. Fifty-one per cent of them had motor vehicle crash-related injuries. Motorcycle crashes were the next most common cause followed by explosions, falls, gunshots, machinery, stabs, bites, crushes, and so on. Frequency of associated injuries was as follows: head injuries, 31 per cent, including skull fractures, 22 per cent; spine injuries, 18 per cent, including spine fractures 18 per cent; chest injuries, 36 per cent, including rib fractures, 15 per cent; and abdominal injuries, 13 per cent. The authors focused on the incidence of disabling or life-threatening injuries in patients with hand injuries. Motor vehicle crashes were most common cause of hand injuries. The most common organs to be injured were chest and head. The most common head injury was skull fracture. Other injuries in decreasing order were spine and rib fractures. These data may be helpful in assessing ambulatory patients in the emergency room, in those hand injuries maybe indicative of other simultaneous life-threatening or disabling injuries.

  5. Pediatric hand treadmill injuries.

    Banever, Gregory T; Moriarty, Kevin P; Sachs, Barry F; Courtney, Richard A; Konefal, Stanley H; Barbeau, Lori


    The great popularity of physical fitness in modern society has brought many pieces of exercise equipment into our homes for convenience and privacy. This trend has come with an increasing rate of injuries to children who curiously touch moving parts, including treadmill belts. Experience with a recent series of treadmill contact burns to children's hands is described in this article. A retrospective chart review at a tertiary referral center from June 1998 until June 2001 found six children sustaining hand burns from treadmills. The patients' ages at presentation ranged from 15 to 45 months (average of 31 months, three boys and three girls). All injuries occurred in the home while a parent was using the treadmill. Burns involved the palmar aspect of the hand, mostly confined to the fingers, and the severity ranged from partialto full-thickness burns. All patients were initially managed with collagenase and bacitracin zinc/polymyxin B powder dressings to second- and third-degree burns, along with splinting and range-of-motion exercises. Two patients required skin grafting at 2 weeks and 2 months for full-thickness tissue loss and tight joint contracture, respectively. At an average follow-up of 12 months, all patients had full range of motion and no physical limitation. The rate of children injured by exercise equipment is expected to increase. Friction burns to the hands remain a concern, although early recognition and appropriate management are associated with excellent functional outcomes. Protective modification of exercise machines seems to be the best approach to eliminating these injuries.

  6. [A rare cause of compartment syndrome of the forearm and hand following snake bite injury].

    Schnecker, K


    With the intention to commit suicide a 25 year old patient was bitten by his own rattle snake. At the time of the admission the skin of the right forearm was dark, a hemorrhagic necrotizing colour, and the patient was in shock. He was immediately taken to the intensive care unit and the shock symptoms were treated there. Parasthesias in the area of the nervus medianus were also noticed. The treatment included an antiserum and the release of the tourniquet which caused a further increase of the swelling of the forearm. The lesion led to a hemorrhagic necrotizing inflammation. The surgical incision of the loge of Guyon, the carpal channel, the forearm and proximal of the lacertus fibrosus was persuaded. The circulation improved immediately and after three weeks the nerval function had recovered. The skin defect was covered 14 days after the first operation with meshgraft.

  7. Prediction of injuries caused by explosive events: A case study of a hand grenade incident in South Africa

    Whyte, TN


    Full Text Available , if one is close enough to the grenade primary blast injuries will occur in addition to penetration injuries caused by the fragments. Simulations were conducted to obtain pressure profiles that could be produced by the explosive charge contained...

  8. Hand Injuries and Disorders

    ... the wrist, often making your fingers feel numb Injuries that result in fractures, ruptured ligaments and dislocations ... deformity Tendinitis - irritation of the tendons Disorders and injuries of your fingers and thumb

  9. Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

    Ana B. Sanchez


    Full Text Available Multiple mechanisms appear to contribute to neuronal stress and injury underlying HIV-associated neurocognitive disorders (HAND, which occur despite the successful introduction of combination antiretroviral therapy (cART. Evidence is accumulating that components of cART can itself be neurotoxic upon long-term exposure. In addition, abuse of psychostimulants, such as methamphetamine (METH, seems to compromise antiretroviral therapy and aggravate HAND. However, the combined effect of virus and recreational and therapeutic drugs on the brain is still incompletely understood. However, several lines of evidence suggest a shared critical role of oxidative stress, compromised neuronal energy homeostasis and autophagy in promotion and prevention of neuronal dysfunction associated with HIV-1 infection, cART and psychostimulant use. In this review, we present a synopsis of recent work related to neuronal stress and injury induced by HIV infection, antiretrovirals (ARVs and the highly addictive psychostimulant METH.

  10. Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND.

    Sanchez, Ana B; Kaul, Marcus


    Multiple mechanisms appear to contribute to neuronal stress and injury underlying HIV-associated neurocognitive disorders (HAND), which occur despite the successful introduction of combination antiretroviral therapy (cART). Evidence is accumulating that components of cART can itself be neurotoxic upon long-term exposure. In addition, abuse of psychostimulants, such as methamphetamine (METH), seems to compromise antiretroviral therapy and aggravate HAND. However, the combined effect of virus and recreational and therapeutic drugs on the brain is still incompletely understood. However, several lines of evidence suggest a shared critical role of oxidative stress, compromised neuronal energy homeostasis and autophagy in promotion and prevention of neuronal dysfunction associated with HIV-1 infection, cART and psychostimulant use. In this review, we present a synopsis of recent work related to neuronal stress and injury induced by HIV infection, antiretrovirals (ARVs) and the highly addictive psychostimulant METH.

  11. Hand and Wrist Injuries in Boxing and the Martial Arts.

    Drury, Benjamin Todd; Lehman, Thomas P; Rayan, Ghazi


    Hand and wrist injuries in martial arts are typically a reflection of the combat nature of this discipline. In striking sports, the axial load mechanism of injury is common and causes fractures and dislocations; in grappling sports, sprain injuries and degenerative changes predominate. There is clear evidence to support that hand protection reduces the risk of hand injury. Traditional training in martial arts on proper technique and target selection in striking sports reduces the risk of hand injury, and is an important component of hand and wrist injury prevention.

  12. [Hand injuries management of care and hand prevention networks].

    Couturier, Christian


    Injuries of the hand are common and sometimes more serious than it appears on a non-specialist initial examination. They are a public health issue with some major impact on the continued activity of patients who have been victims of those injuries. The European Federation of Hand Emergency Services (FESUM) accredits SOS Hand centers, dedicated hand trauma organizations in which the specialized medical cares is optima, avoiding the loss of chance to inadequate primary orientation. If nevertheless a serious injury leaves a debilitating sequela Hand Prevention networks, organized by practitioners of SOS Hand centers, help patients establish a process of socio-professional rehabilitation as soon as possible. These networks organize primary, secondary and tertiary prevention of hand trauma and disabilities that can accompany them. Innovative organizations, they resemble a national association that supports the development of new structures. They are open to all professionals of health and their patients, members or not of the network.

  13. Illness representations in patients with hand injury.

    Chan, Jeffrey C Y


    Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting.

  14. 20 Years of Research on Socioeconomic Inequality and Children's—Unintentional Injuries Understanding the Cause-Specific Evidence at Hand

    Lucie Laflamme


    Studies have been conducted at both area and individual levels, the bulk of which deal with road traffic, burn, and fall injuries. As a whole and for each injury cause separately, their results support the notion that low socioeconomic status is greatly detrimental to child safety but not in all instances and settings. In light of variations between causes and, within causes, between settings and countries, it is emphasized that the prevention of inequities in child safety requires not only that proximal risk factors of injuries be tackled but also remote and fundamental ones inherent to poverty.

  15. Fungal infections in corn picker hand injury

    Obradović-Tomašev Milana


    Full Text Available Introduction. Hand injuries caused by corn pickers are relatively rare but in most cases extensive, with massive tissue destruction. Severe wounds sustained during agricultural work are contaminated, with high incidence of infection. Objective. The aim of the study was to determine the frequency and type of fungal infection in corn picker injuries and their impact on the course and outcome of treatment. Methods. Corn picker hand injuries for the period 2006-2012 were analyzed. After setting up clinical suspicion, direct examination of repeated swabs and histopathological analysis of biopsy material were done in order to detect fungi. Results. From the total number of 60 patients, there was a fungal infection in nine of them (which makes 15% of the total number of patients. Aspergillus spp. was isolated in seven patients, Candida spp. in three, and Mucor spp. in one patient. None of the patients had increased risk factors for developing a fungal infection. In most cases, there was loss of graft and tissue necrosis in previously normally looking wound, after seven or more days. All patients were treated with repeated surgical debridement and concomitant parenteral and topical application of appropriate antifungal agents. There was no need for reamputation in any patient. Conclusion. A high degree of suspicion and a multidisciplinary approach are needed for early diagnosis of fungal infection. Confirmation of diagnosis and the initiation of surgical and appropriate antifungal therapy are essential for a successful outcome.

  16. Improving hand hygiene after neurological injury.

    Duke, Lynsay; Gibbison, Lucy; McMahon, Victoria

    Caring for hands tightened by spasticity after stroke, brain injury or other neurological conditions can be challenging for care staff. Opening and cleaning the hand, managing pressure areas, cutting nails and reducing pain becomes more complex if muscles are tight and short. Hand hygiene is key for staff but literature on patients' hand and nail care is lacking, so specialist education and care planning may be needed to help staff ensure these activities are done well. This article outlines the importance of maintaining patients' hand hygiene, explores the barriers to providing effective care and discusses how they might be overcome.

  17. Therapy after injury to the hand.

    Dorf, Erik; Blue, Carla; Smith, Beth P; Koman, L Andrew


    Surgical and nonsurgical management of upper extremity disorders benefits from the collaboration of a therapist, the treating physician, and the patient. Hand therapy plays a role in many aspects of treatment, and patients with upper extremity injuries may spend considerably more time with a therapist than with a surgeon. Hand therapists coordinate edema control; pain management; minimization of joint contractures; maximization of tendon gliding, strengthening, and work hardening; counseling; and ongoing diagnostic evaluation. Modalities used to manage hand injuries include ultrasound, splinting, Fluidotherapy (Chattanooga Group, Chattanooga, TN), cryotherapy, various electrical modalities, phonophoresis, and iontophoresis.

  18. Hand Injury in Rock Climbing: Literature Review.

    Pozzi, A; Pivato, G; Pegoli, L


    With the amazing increasing in number of participants, rock climbing has become a popular sport in the last decade. A growing number of participants, with different skill level, inevitably leads to an increased number of injuries related to this practice. The kind of lesions that can be observed in rock-climbers is very specific and often involves the hand. For this reason is very important for any hand surgeon that is exposed to sport injuries to know which and the most common injuries related to this sport and which are the basic principles for the treatment of those. The aim of this article is to review the literature that has been published in the last ten year in this topic. On the NCBI database 22 articles where found that where related to rock climbing lesion affecting the hand or the whole body. Differences where found according to kind of rock climbing activity that was analyzed, alpine climb leads to more serious injuries, often affecting the lower limb, while in sport and recreational rock climbing the upper limb and the hand are definitely the most affected parts. Flexor pulley lesions, followed by fractures and strains are the most common lesions affecting the hand that are related to this practice.

  19. Time off work after occupational hand injuries

    Skov, O; Jeune, B; Lauritsen, Jens;


    This study analysed the impact of several factors on the start and duration of time off work among 802 patients with occupational hand injuries, in order to identify prognostic indicators. The study showed that external factors such as work and social condition seemed to have less influence on time...

  20. Hand injuries from tools in domestic and leisure settings: relative incidence and patterns of initial management.

    Williams, S T B; Power, D


    A search of the UK Department of Trade and Industry's Home and Leisure Accident database found 16,003 emergency hospital attendances in 2000-2002 following accidents with tools. The hand was the site of injury in 9535 cases (60%). The tool most commonly involved was a Stanley knife, causing as many hand injuries (21%) as all power tools combined. The power tools most frequently causing hand injury were circular saws (28% of power tool injuries), hedge trimmers (21%) and electric drills (17%). Compared to injuries from manual tools, power tool hand injuries were more than twice as likely to be referred to specialists and three times more likely to be admitted to hospital. Specialist referral/admission most commonly occurred following hand injury from mowers (51% admitted/referred), routers (50%) and circular saws (48%). The rate for manual blade injuries was 14%. Missed diagnoses following manual blade injuries may stem from comparatively low rates of specialist assessment.

  1. Analysis of Facial Injuries Caused by Power Tools.

    Kim, Jiye; Choi, Jin-Hee; Hyun Kim, Oh; Won Kim, Sug


    The number of injuries caused by power tools is steadily increasing as more domestic woodwork is undertaken and more power tools are used recreationally. The injuries caused by the different power tools as a consequence of accidents are an issue, because they can lead to substantial costs for patients and the national insurance system. The increase in hand surgery as a consequence of the use of power tools and its economic impact, and the characteristics of the hand injuries caused by power saws have been described. In recent years, the authors have noticed that, in addition to hand injuries, facial injuries caused by power tools commonly present to the emergency room. This study aimed to review the data in relation to facial injuries caused by power saws that were gathered from patients who visited the trauma center at our hospital over the last 4 years, and to analyze the incidence and epidemiology of the facial injuries caused by power saws. The authors found that facial injuries caused by power tools have risen continually. Facial injuries caused by power tools are accidental, and they cause permanent facial disfigurements and functional disabilities. Accidents are almost inevitable in particular workplaces; however, most facial injuries could be avoided by providing sufficient operator training and by tool operators wearing suitable protective devices. The evaluation of the epidemiology and patterns of facial injuries caused by power tools in this study should provide the information required to reduce the number of accidental injuries.

  2. Rehabilitation of the wrist and hand following sports injury.

    Jaworski, Carrie A; Krause, Michelle; Brown, Jennifer


    In sports, wrist and hand injuries are commonplace. Too often, injuries to these areas can be under-treated and left for further complications to arise. While some injuries to the wrist and hand can be treated conservatively with immediate return to play, others require a more in-depth assessment prior to return to play. This article describes the most common wrist and hand injuries in sport, and provides information related to current treatment approaches.

  3. Ten Leading Causes of Death and Injury

    ... Drug Overdose Traumatic Brain Injury Violence Prevention Ten Leading Causes of Death and Injury Recommend on Facebook ... Treated in Hospital Emergency Departments, United States – 2014 Leading Causes of Death Charts Causes of Death by ...

  4. Occupational hand injury patterns at Avicenna University Hospital

    Abdelmoughit Echchaoui


    Conclusion: Hand injuries are common in the workplace and affect mostly active and working-age people. Preventive measures are required and should receive appropriate attention and resources. [Hand Microsurg 2017; 6(2.000: 75-80

  5. A serious injury underlying an underestimated small laceration of the hand

    Burak Kaya


    Full Text Available In patients suffering from hand injuries, the most important diagnostic tools include patient history and physical examinations. Injuries of the hand caused by knives or drilling tools require careful attention because serious injuries can occur in the form of small skin incisions, depending on the distance and depth of the advance of the tool. Because stab wounds can appear minor superficially, whereas serious injuries can appear as small-access lacerations, the examining physician should be careful when evaluating wound severity. Here, we present a patient with an injury from a knife attack who was treated with an initial intervention that was insufficient to completely repair the injury. Upon initial examination, the only obvious sign of injury was a small laceration; however, the injury turned out to be much more serious in nature. [Hand Microsurg 2015; 4(3.000: 63-66

  6. Hand injuries from snow blowers: a report of an epidemic.

    Tetz, D J; Aghababian, R


    During a record snowfall in Worcester, Massachusetts, 11-13 December 1992, 37 male patients with hand injuries suffered during snow blower operation were seen at three area hospitals. Two previous reports describe 13 patients seen over a 3-year period and 28 patients over a 12-year period. This report describes the largest number of hand injuries from snow blowers that have occurred over a 48-hour period. The snow was unusual because of the high water density in the initial 9 inches (23 cm) that fell at an average temperature of 33 degrees F (0.6 degree C) with the final depth of 30 inches (76 cm), causing the machines to become clogged. Patients admitted to reaching into a running machine in 35/37 (95%) cases, 11/37 (30%) claimed the auger and impeller blades were disengaged, and 2/37 (5%) patients claimed their injuries occurred with the engines turned off. All injuries occurred when the patients placed their hands down the chute, contacting the impeller blades. Injuries involved 32 long, 15 ring, 13 index, and five small fingers and ranged from simple lacerations to partial phalangeal amputations. The majority, 27/37 (73%), were managed in emergency departments without interventions in the operating suites. Infection occurred in one patient who had the lesion repaired in the operating suite. As in previous studies, no differences were found for the variables of snow-blower age, type, or horsepower, or on experience level or age of the operators.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. [Safety handles for ski sticks to prevent eye, hand and stomach injuries (author's transl)].

    Payer, H


    Eye injuries caused by ski stick handles are rare but serious. The material and shape of the handle can be designed to prevent serious injury without adversely affecting function. Even at winter temperatures polyurethane remains moderately malleable and shock-absorbent; it is light, and is a poor heat conductor, so that the hands do not get cold quickly. The end of the handle is 8 cm in diameter; attached to this is an adjustable loop which fits around the hand. The loop opens on impact. It is thus impossible for the orbit to sustain injury and there is less danger to other injury-prone regions of the body such as the neck and stomach. The anatomically designed handles, with wide thumb supports, help prevent hand injuries, and in particular thumb injuries, to a large extent. Such injuries have occurred frequently in the past.

  8. Aeromonas hydrophila Septicemia in Acute Hand Injury: A Case Report

    Chin-Chiang Yang


    Full Text Available Aeromonas hydrophila is an uncommon and frequently overlooked cause of skin and soft-tissue infection. Rapid onset of cellulitis and bullae formation in the setting of soft-tissue trauma in connection with exposure to fresh water should alert the clinician to the possibility of infection by this organism. We report a case of severe necrotizing fasciitis due to A. hydrophila infection involving the hand and arm, complicated by septicemia within 30 hours of injury. In addition to appropriate antibiotic therapy and general supportive care, treatment involves early surgical exploration for compartment decompression and aggressive debridement of all necrotic tissue followed by skin grafting for delayed wound closure. There was good functional outcome after more than 1 year of follow-up. Early awareness of A. hydrophila infection, as well as of infection by Vibrio, is necessary in preventing crippling deformities of the hand in post-traumatic wound infection with a history of exposure to fresh water.

  9. A review of three cases of mobile blast: The new culprit of hand injury

    Nikunj B Mody


    Full Text Available Although blast injuries are common with war; cooking gas; firecracker, mobile phone blast cases are increasing in number in last couple of years. We present 3 cases of mobile blast in 3 children causing injury to dominant hand in them.

  10. [Surgical treatment of stiff metacarpophalangeal joint after hand injury].

    Rui, Yongjun; Shi, Haifeng; Mi, Jingyi; Chen, Guang; Wang, Jun; Qian, Jun


    To discuss the surgical procedures and curative effect of stiff 2-5 metacarpophalangeal (MP) joints after crash injury in hand. Between January 2006 and June 2009, 7 cases of stiff 2-5 MP joints were treated by releasing the stiff MP joints and reconstructing the function of lumbrical muscle in one stage. There were 6 males and 1 female with an average age of 32 years (range, 18-56 years). All injuries were caused by crash. Six cases suffered from multiple metacarpal fracture or complex dislocation of MP joint and 1 case suffered from complete amputation at level of middle palm of hand. The interval from initial wound healing to hospitalization was 3 to 15 months. Before operation, the X-ray films showed fracture healed and the results of nipping paper test were positive. All hands were treated with physical therapy for 1 month. After the plaster external fixation for 6 weeks, the physical therapy and function training were given. All wounds healed by first intention. The patients had no joint instability and extensor tendon side-slipping with normal finger function. Six patients were followed up from 6 months to 3 years. The extension and flexion of MP joint were 0 degree and 67-90 degrees, respectively. The average grip strength of injured dominant hand reached 86.70% of normal side and non-dominant hand reached 66.70% of normal side. The average injured dominant tip pinch strength reached 83.52% of normal side and non-dominant tip pinch strength reached 61.30% of normal side. Based on total active motion (TAM) system of Chinese Medical Association for Hand Surgery, the results were excellent in 4 cases, good in 1 case, and fair in 1 case; the excellent and good rate was 83.33%. In patients with stiff MP joint and lumbrical muscle defect, releasing stiff MP joint and reconstructing lumbrical function in one stage can recover the function of MP joint and achieve good outcome. Physical therapy plays an important role before operation.

  11. The incidence of hospital-treated occupational hand injuries

    Skov, O


    Previous studies have shown that young men have the highest frequency of occupational hand injuries. This study investigated their incidence and severity in relation to age and sex. For occupational hand injuries in general the estimated incidence rate was 17.1 per 1,000 person years. The inciden...... be partly due to selection bias, if older patients with minor injuries consult the hospital for treatment less frequently.......Previous studies have shown that young men have the highest frequency of occupational hand injuries. This study investigated their incidence and severity in relation to age and sex. For occupational hand injuries in general the estimated incidence rate was 17.1 per 1,000 person years. The incidence...... was found to be higher among men than women in all age groups below 60 years. The incidence for minor injuries declines with increasing age, but the rates for significant injuries are independent of age. The higher incidence rate for minor injuries among young patients could be real, but it could also...

  12. A periodical increase in hand injuries: The sacrifice feast

    Gokce Yildiran


    Conclusion: Although festivals are celebrated with much enthusiasm, carelessness or neglect may lead to undesirable results. Keeping children away from danger should be made a top priority during Sacrifice Feasts. In addition, not only should precautions be more intensively emphasized by the written and visual media, but special regulations should be implemented involving the transporting of amputated limbs. Furthermore, in some regions, many people, who are inexperienced butchers, sacrifice animals themselves, leading to numerous hand injuries. Consequently, in order to reduce the number of these hand injuries, animals should only be sacrificed by professionals. [Hand Microsurg 2015; 4(2.000: 28-31

  13. Determinants of return to work in patients with hand disorders and hand Injuries

    Opsteegh, L.; Reinders-Messelink, H.A.; Schollier, D.; Groothoff, J.W.; Postema, K.; Dijkstra, P.U.; van der Sluis, C.K.


    Introduction Return to work (RTW) in patients with hand disorders and hand injuries is determined by several determinants not directly related to the physical situation. Besides biomedical determinants, work-related and psychosocial determinants may influence RTW as well. This study is conducted to

  14. Injuries caused by pigs in Papua New Guinea.

    Barss, P; Ennis, S

    Pigs are intelligent animals that can be formidable adversaries to humans because of their sharp tusks and their ability to attack swiftly. Domestic and feral pigs have an important role in the ecology of village life in Melanesia. A six-year review of all injuries that were caused by pigs that were referred from the villages in Milne Bay Province, Papua New Guinea, to the Provincial Hospital was completed. Some of the injuries that were seen among the 20 patients who were studied included: three penetrating abdominal injuries with prolapse and strangulation of the intestine; a "sucking" chest wound; bilateral pneumothoraces; two infected open fractures of the radius and the ulna; a perforating injury of the knee with septic arthritis; a hand injury with laceration of multiple tendons; an arterial injury of the wrist; injury of a tibial nerve with foot drop; and a severe scrotal injury with exposure of the testicles. Most injuries resulted from the hunting of feral pigs. Adult male hunters who used dogs and carried only one spear were injured most frequently. Wounds from injuries by pigs are deep, often involve multiple critical structures, and are grossly contaminated. Resuscitation requires the administration of fluid and often blood. Treatment includes irrigation, debridement and closure of the wound. The principles of managing such injuries, the prevention of injuries, the ecology of pigs and humans, human infections originating from pigs, and safer methods of hunting pigs are discussed.

  15. A Five-Year Review of Tag Rugby Hand Injuries.

    Joyce, C W; Woods, J F C; Murphy, S; Bollard, S; Kelly, J L; Carroll, S M; O'Shaughnessy, M


    Tag rugby is one of the fastest growing sports in Ireland. It is a soft-contact team game that is loosely based on the rugby league format except players try to remove Velcro tags from their opponents' shorts rather than engage in a typical rugby tackle. The purpose of this study was to examine all tag rugby associated hand injuries over a five-year period in three large tertiary referral hospitals in Ireland. Using the patient corresponding system, 228 patients with hand injury related tag rugby injuries were observed from 2010 to 2015. There were 138 males and 90 females in the study and over 40% of patients required surgery. Most of the patients were young professionals with an average age of 30. Twenty-five patients worked in the financial services whilst there were 23 teachers. Fractures accounted for 124 of the 228 injuries and mallet injuries accounted for 53. Eighty percent of all injuries occurred during the tackle. The mean number of days missed from work was 9.1±13.8 days. These injuries resulted in an average of seven hospital appointments per patient. Considering it is a soft-contact sport, it is surprising the number of hand injuries that we have observed. Although safety measures have been introduced to decrease the number of hand injuries in recent years, there is a need for further improvements. Better player education about seeking prompt medical attention once an injury occurs, coupled with longer shorts worn by players may improve measures for the sport. Copyright © 2016. Published by Elsevier Ltd.

  16. Injury incidence and cause in elite gymnasts.

    Felländer-Tsai, L; Wredmark, T


    This report describes the incidence, localization, and cause of injuries in Swedish male and female elite gymnasts during 18 active months (three seasons). Thirty-one elite gymnast clubs with all together 437 gymnasts were included in the study, which consisted of a written questionnaire reporting morphometric facts as well as data concerning the injury. There were in total 82 injury reports. The injury incidence was 6.25 per 100 elite gymnasts and season. A majority of the injuries occurred in the lower extremities. The right leg was injured more often than the left. Most of the severe injuries occurred during mounting and dismounting which advocates the need for preventive measures in association with these particular events. Male gymnasts were more prone to sustain severer injuries such as dislocations and fractures. Severe injuries affected the upper extremity in 83%, and the right side was injured more often than the left.

  17. Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries.

    Frank, Matthias; Hecht, Juliane; Napp, Matthias; Lange, Joern; Grossjohann, Rico; Stengel, Dirk; Schmucker, Uli; Ekkernkamp, Axel; Hinz, Peter


    Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is immense and determined by the casualties' disability and impairment, it is the objective of this study to present data on the functional outcome, disability, and impairment of hand injuries due to electric circular saws. Patients treated from 1999 through 2007 for circular saw-related hand injuries were contacted and asked for clinical follow-up assessment. The clinical follow-up protocol consisted of a physical examination and an assessment of static muscle power (grip and pinch strength). For assessment of the subjective experience of the patients regarding their injury-related disability and impairment, the DASH follow-up questionnaire was used. The occupational impact of these injuries was measured by number of lost working days. Finally, safety-related behaviour of the patients was investigated. 114 Patients were followed-up on average 52 months after the injury. Average in-house treatment was 8.8 days. Average time lost from work was 14.8 weeks. A significant reduction of static muscle testing parameters compared with the uninjured hand was revealed for grip strength, tip pinch, key pinch, and palmar pinch. Average DASH score was 17.4 (DASH work 15.8, DASH sports/music 17.7). Most patients had more than ten years experience in using these power tools. The everyday occurrence of circular saw-related hand injuries followed by relatively short periods of in-house treatment might distort the real dimension of the patients' remaining disability and impairment. While the trauma surgeon's view is generally confined to the patients' clinical course, the outcome parameters in this follow-up investigation, with loss of working time as the key factor, confirm that the whole socioeconomic burden is much greater than the direct cost of treatment.

  18. High-Pressure Injection Injuries to the Hand

    Davod Jafari


    Full Text Available Background High-pressure injections into the hand, burden devastating and permanent functional impairments. Many materials including paint, paint thinner, gasoline, oil and grease are reported as the causative agents. These injuries need multiple procedures and reconstructions most of the time and 40% of the injuries may end with amputation of the injured part. Objectives The aim of this study was to report the treatment outcomes and methods of treatments of patients with high-pressure injection injuries of the hand. Methods We retrospectively reviewed the medical records, imaging files and demographic data of patients, who were treated at our center due to the high-pressure injuries to their hands. We recorded the kind of the injected materials, time to the first treatment procedure, times of operation, and methods of their treatments. The outcomes of the injuries as well as the deficiency of the digital joints motion were also reported. Results Nine cases with high-pressure injury of the hand were enrolled in this study. All patients were male with mean age of 26.88 ± 7.52. Mean follow-up time was 28.55 ± 12.49 months. The dominant hand was the right side in seven patients and left in two patients. Injury was in the left hand of seven patients and right hand of two patients. Index finger was the most common involved part (five cases followed by the thumb (two cases. Injected material was grease in seven cases, water-base paint and water, each in one case.Mean time delay to the first treatment procedure was 29.16 ± 25.66 hours for seven patients. This was exceptionally long for two patients (seven days and 24 months. Type of treatment was debridement and skin graft for three cases, debridement and cross finger flap for two cases, debridement for two cases and nerve graft for one case. Amputation of the necrotic digit was performed for one case. Mean hospitalization time was 8.33 ± 3.64 days for all patients.Mean total active range of motion

  19. Ulnar nerve injuries of the hand producing intrinsic muscle denervation of magnetic resonance imaging

    Barberie, J.E.; Connell, D.G.; Munk, P.L.; Janzen, D.L. [Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, (Canada). Department of Radiology


    Muscle and nerve injuries in the hand may be difficult to detect and diagnose clinically. Two cases are reported in which magnetic resonance imaging showed ulnar nerve injury and intrinsic hand muscle denervation. The clinical, anatomical and radiological features of injury to the deep motor branch of the ulnar nerve and associated muscle denervation are discussed and illustrated. Compression of the deep motor branch of the ulnar nerve is a rare cause of hand dysfunction. This condition produces a clinical syndrome characterized by weakness of the muscles innervated by the deep branch of the ulnar nerve, with normal sensation in the hand. Denervation of the intrinsic hand muscles is variable, depending on the site and severity of the nerve injury. The anatomy of the ulnar nerve is complex and ulnar nerve compression syndrome is difficult to detect and localize clinically. Multiple causes exist, including ganglions; repeated trauma, typically occupationally related; calcification adjacent to the pisiform and the pisotriquetral joint; anomalous muscle bellies; fractures or dislocations affecting the ulnar side of the wrist; vascular anomalies of the ulnar artery; and oedema of the hand, requiring differing surgical treatments. We report two patients who presented with ulnar nerve compression syndrome secondary to post-traumatic neuromas as a result of blunt trauma to the palm. Copyright (1999) Blackwell Science Pty Ltd 12 refs., 2 figs.

  20. Hyperextended Knee: Cause of Serious Injury?

    ... tear one of the knee ligaments, particularly the anterior cruciate ligament (ACL). If the knee injury is severe enough to cause swelling, pain or instability, see a doctor immediately. Even if the injury doesn't need surgical repair, physical therapy may be needed to help restore leg strength ...

  1. [Hand injuries in workers on the eastern shore of Marcaibo Lake in the state of Zulia, Venezuela, 1986-1993].

    Sirit-Urbina, Yadira; Fernández-D'Pool, Janice; Lubo-Palma, Adonías


    In order to analyze the frequency, injury rate and cause of on site accidents to the hands of workers on the east coast of lake of Maracaibo in Zulia State, data was obtained from the accident reports registered with the Venezuelan Institute of Social Security. An occupational hand injury was defined as a traumatic injury to the hands, fingers or wrists that occurred while the employee was at work; that resulted from a single exposure to a hazardous agent. The following variables were analyzed: age, severity, economic activity, material agent, mechanic cause, type of injury, type of accident and unsafe action. The frequency rate was used to analyze the annual accident rate. During the period under study 2.456 injuries to the hand were registered, representing 36% of the total injuries reported; 95% were light injuries, 5% incapacitating and two cases resulted in the death of the worker. 72% of the injuries were located in the fingers, 22% in the hands and 6% in the wrists. The greatest frequency of injuries were found in the economic activity in mines and quarries with a rate of 123.1 per thousand. The age group most affected was of 20-29 years (42%), Wounds or contusions and crushings were the injuries most commonly reported, in 39% and 36% of the cases respectively. The main type of injuries were caused by run over, running into or blow from objects. The principal agents causing injuries were materials, substances and radiations in 45% of the cases. It is concluded that the hand injury rate is very high in the exploitation of mines and quarries and represents the main cause of worker's disability.


    M.S. Farahvash


    Full Text Available in ordere to determine the prognosis of perforating eye injuries caused hy BB guns in our patients, the"nvisual and anatomic results of 14 patients with gun injuries seen between September 1996 and February 1998 in Farafti Hospital and private office in Tehran were reviewed. Five patients liad nonn erf orating eye injuries. All perforated eyes underwent scleral buckling, tenseclomy, vitrectomy ami silicone injection. All injured iyes had a visual acuity of light perception or better at presentation. Among 9 cases of perforating injuries. 7 had doable and 2 had single perforation. All patients had a final.

  3. Causes of anterior cruciate ligament injuries

    Ristić Vladimir


    Full Text Available In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries - that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen, 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%, injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%, then in handball players (22%, basketball players (13%, volleyball players (8%, martial arts fighters (4%. However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players. Type of footwear, warming up before the activity, genetic predisposition and everyday therapy did not have a significant influence on getting injured. Anterior cruciate ligament injuries happened three times more often during matches, in the middle and at the end of a match and training session (79%, at landing after the jump or when changing direction of movement (75% without a contact with other competitors, on dry surfaces (79%, among not so well prepared sportsmen.

  4. Suicide bomb attack causing penetrating craniocerebral injury

    Manzar Hussain; Muhammad Ehsan Bari


    Penetrating cerebral injuries caused by foreign bodies are rare in civilian neurosurgical trauma,although there are various reports of blast or gunshot injuries in warfare due to multiple foreign bodies like pellets and nails.In our case,a 30-year-old man presented to neurosurgery clinic with signs and symptoms of right-sided weakness after suicide bomb attack.The skull X-ray showed a single intracranial nail.Small craniotomy was done and the nail was removed with caution to avoid injury to surrounding normal brain tissue.At 6 months' follow-up his right-sided power improved to against gravity.

  5. Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries

    Frank Matthias


    Full Text Available Abstract Background Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is immense and determined by the casualties' disability and impairment, it is the objective of this study to present data on the functional outcome, disability, and impairment of hand injuries due to electric circular saws. Methods Patients treated from 1999 through 2007 for circular saw-related hand injuries were contacted and asked for clinical follow-up assessment. The clinical follow-up protocol consisted of a physical examination and an assessment of static muscle power (grip and pinch strength. For assessment of the subjective experience of the patients regarding their injury-related disability and impairment, the DASH follow-up questionnaire was used. The occupational impact of these injuries was measured by number of lost working days. Finally, safety-related behaviour of the patients was investigated. Results 114 Patients were followed-up on average 52 months after the injury. Average in-house treatment was 8.8 days. Average time lost from work was 14.8 weeks. A significant reduction of static muscle testing parameters compared with the uninjured hand was revealed for grip strength, tip pinch, key pinch, and palmar pinch. Average DASH score was 17.4 (DASH work 15.8, DASH sports/music 17.7. Most patients had more than ten years experience in using these power tools. Conclusion The everyday occurrence of circular saw-related hand injuries followed by relatively short periods of in-house treatment might distort the real dimension of the patients' remaining disability and impairment. While the trauma surgeon's view is generally confined to the patients' clinical course, the outcome parameters in this follow-up investigation, with loss of working time as the key factor, confirm that the whole socioeconomic burden is much

  6. Traumatic hand injuries: the emergency clinician's evidence-based approach.

    Andrade, Aaron; Hern, H Gene


    At the start of your Saturday afternoon shift, you are not surprised to see that several patients are waiting to be seen for physical injuries. The first patient is a 34-year-old woman who sustained injury to her hand while skiing, 2 hours prior to her arrival. She reports falling with her hand still tethered to the pole's grip, landing on her outstretched right hand. She felt a painful snap in her right thumb, which still hurts, but otherwise she did not sustain any other trauma. Her only complaint currently is pain at the base of the right thumb. The patient is otherwise completely healthy, has no past medical or surgical history, and takes no medications. Upon examination, the affected hand appears to be surprisingly normal except for mild tenderness and swelling over the ulnar aspect of her first metacarpophalangeal joint and mildly decreased strength in her pincher grasp. X-ray reveals no fracture. You wonder if there is additional testing that should be done to evaluate this injury. You move on to a second patient, a 24-year-old man who cut his ring finger knuckle when he punched a wall 2 days ago. Physical examination reveals a small puncture wound over the IV metacarpophalangeal joint with mild swelling, erythema, warmth, and decreased range of motion secondary to pain. X-ray reveals no fracture, but there's something suspicious about this case. A third patient is a 37-year-old industrial worker whose finger contacted the stream of a high-powered grease injector. Physical examination reveals a small puncture wound over the volar proximal interphalangeal joint of his left long finger, mild tenderness to palpation over the area, and slight decreased range of motion secondary to pain. You wonder if the injury is as benign as it looks.

  7. [Modern pneumatic weapons and injuries they cause].

    Kozachenko, I N


    The data on the history of development and further improvement of pneumatic weapons are presented with special reference to specific features of different types and varieties of these weapons, cartridges for them, and the sphere of their application. Investigations into peculiarities of damages caused by high-capacity pneumatic weapons to the objects of forensic medical expertise affected from different distances are reviewed. Results of forensic medical expertise and clinical studies on the structure of body injuries inflicted by gunshots from pneumatic weapons to the human body are discussed. The author emphasizes the necessity of developing up-to-date terminology and classification of gunshot injuries caused by shooting from pneumatic weapons.

  8. Reverse on-top plasty in mutilating hand injuries.

    Sohn, Won-Il; Han, Soo-Hyung; Jung, Sung-No


    For crushing injury of the hand that involves 4-digit amputations sparing the thumb, lengthening of amputated stump and covering the defect are important for hand function. From March 2007 to September 2011, the authors performed "reverse on-top plasty" in 5 patients. The fifth metacarpal bone was disarticulated, turned over 180 degrees, and embedded in reverse direction so that the metacarpal base becomes the tip of new finger. Soft tissue defects were covered using anterolateral thigh free flap or reverse radial forearm flap. The mean follow-up period was 21.2 months, and major complications such as bony resorption did not occur. Static 2-point discrimination showed fair recovery of fingertip sense. Key pinch power was 76.4% of the uninjured hand. In conclusion, reverse on-top plasty is good in gaining more sufficient finger length and durability using cartilaginous portion of the fifth metacarpal bone than the previously used on-top plasty.

  9. Brain injuries caused by spherical bolts.

    Roth, Jonathan; Mayo, Ami; Elran, Hanoch; Razon, Nissim; Kluger, Yoram


    Metallic particles contained in antihuman bombs increase the number of fatalities. The ballistics of these particles depends on the explosive that is used, the distance from the explosion, the shape of the particle projected, and the biomechanics of the injured tissue. The authors present their experience with penetrating spherical bolt injuries to the brain. The authors retrospectively reviewed clinical and radiological data obtained in eight patients with penetrating spherical bolt injuries to the cranium: four had Glasgow Coma Scale (GCS) scores less than 8 (three died, one from an unrelated injury) and four had a GCS score of 15 (all survived). Two of the latter patients suffered unique anatomical injuries attributed to the distinctive ballistics of spherical bolts: in one patient the bolt penetrated the cavernous sinus causing minimal cranial nerve injury, and in the other patient the bolt lodged in the fourth ventricle causing acute hydrocephalus without other neurological deficits. Penetrating spherical bolts to the brain may be lethal. Nevertheless, they have unique ballistics that cause highly delineated anatomical damage and minor neurological deficits.

  10. Nerve injury caused by mandibular block analgesia

    Hillerup, S; Jensen, Rigmor H


    : feather light touch, pinprick, sharp/dull discrimination, warm, cold, point location, brush stroke direction, 2-point discrimination and pain perception. Gustation was tested for recognition of sweet, salt, sour and bitter. Mandibular block analgesia causes lingual nerve injury more frequently than...

  11. Fishing-Injury-Related Flexor Tenosynovitis of the Hand: A Case Report and Review

    Danny A. Young-Afat


    Full Text Available Hand infections occurring after fishing and other marine-related activities may involve uncommon bacteria that are not susceptible to the conventional or empiric antibiotic therapy used to treat soft tissue infections. Therefore appropriate treatment is often delayed and could lead to severe hand damage. An illustrative case of fishing-related injury leading to complicated tenosynovitis and horseshoe abscess caused by Mycobacterium marinum and its treatment course is outlined. Laceration of the skin during boating is fairly common. Because of the rarity of some of the bacteria, referrals to the appropriate specialist including hand surgeons and infectious disease specialists should occur in early stages. M. marinum infections should always be considered in injuries related to seawater and fishing as this may lead to early appropriate treatment and prevent severe damage.

  12. Improvised Hand Injury Treatment Using Traditional Veterinary Medicine in Ethiopia.

    Aerts, Raf; November, Eva J J; Rayyan, Maissa


    In remote wilderness environments, local people with traditional knowledge of medicinal plants are potentially important first-line health care providers. We present a case of a 31-year-old man who fell off a horse while trekking through a remote mountain landscape in Ethiopia and sustained blunt force trauma to the hand. A local mountain hut keeper examined the patient's hand and used heated leaves of the succulent plant Kalanchoe petitiana to treat a suspected metacarpal fracture. As first responder in a low-resource setting, the hut keeper relied on his traditional knowledge of ethnoveterinary medicine to improvise a treatment for a human injury in a remote mountain environment. Although in this case the outcome of the traditional intervention was positive, our analysis shows that the massage component of the intervention could have led to complications. Conversely, reports from the use of related Kalanchoe species suggest that heated Kalanchoe leaves could be useful in the compression component of traditional care for hand injuries. Validation of traditional remedies and their therapeutic potential are needed if they are to complement wilderness wound care safely and reliably. The documentation and validation of these remedies are urgently needed, as many medicinal plants and indigenous knowledge of how to use these valuable natural resources are being lost. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  13. Causes of Hand Tingling in Visual Display Terminal Workers

    Oh, Sein; Kim, Hyung Kuk; Kwak, Jehwan; Kim, Taikon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog


    Objective To offer the basic data about the causes and distribution of hand tingling, symptoms and physical findings, and pressure pain threshold in desk workers. Methods Five physiatrists participated in the screening test composed of history and physical examination. A total of 876 desk workers were evaluated and of them 37 subjects with hand tingling were selected. For further analyzing, detailed history taking and meticulous physical examination were taken. Pressure pain threshold (PPT) at the infraspinatus, upper trapezius, flexor carpi radialis, rhomboideus, and flexor pollicis longus were examined. PPT measurements were repeated three times with two minute intervals by a pressure algometer. Electrodiagnostic study was done to detect potential neurologic abnormalities. Results The causes of hand tingling in order of frequency were: myofascial pain syndrome, 68%; cervical radiculopathy, 27%; rotator cuff syndrome, 11%; tenosynovitis, 8%; and carpal tunnel syndrome, 5%. The location of trigger points in the myofascial pain syndrome, which were proven to evoke a tingling sensation to the hand in order of frequency were: infraspinatus, 65.4%; upper trapezius, 57.7%; flexor carpi radialis, 38.5%; rhomboideus 15.4%; and flexor pollicis longus 11.5%. The PPT of the affected side was significantly lower than that of the unaffected side in myofascial pain syndrome (pmyofascial pain syndrome rather than carpal tunnel syndrome. Common trigger points to evoke hand tingling were in the infraspinatus and upper trapezius. PMID:23705117

  14. Mixed Fungal Infection (Aspergillus, Mucor, and Candida of Severe Hand Injury

    Milana Obradovic-Tomasev


    Full Text Available Severe hand injuries are almost always heavily contaminated and hence wound infections in those patients are frequent. Fungal wound infections are rare in immunocompetent patients. A case of mixed fungal infection (Aspergillus, Mucor, and Candida was documented in a young male patient, with a severe hand injury caused by a corn picker. The diagnosis of fungal infection was confirmed microbiologically and histopathologically. The treatment was conducted with repeated surgical necrectomy and administration of antifungal drugs according to the antimycogram. After ten weeks the patient was successfully cured. The aggressive nature of Mucor and Aspergillus skin infection was described. A high degree of suspicion and a multidisciplinary approach are necessary for an early diagnosis and the initiation of the adequate treatment. Early detection, surgical intervention, and appropriate antifungal therapy are essential in the treatment of this rare infection that could potentially lead to loss of limbs or even death.


    S. A. Valiulina


    Full Text Available Background: Currently, analyzing the economic losses caused by health problems in population is of particular importance since it stipulates calculations of the volumes invested in healthcare systems in order to improve population’s health. Objective: The aim of our study was to find out economic losses caused by traumatic brain injury (TBI in children. Methods: The given work has utilized governmental statistical reports for Russia, for federal regions as well as for individual subjects. Direct medical expenses (medical services and indirect expenses (losses due to a temporary disability of parents having a sick child were calculated both in general and per patient. Results: Among all the direct medical costs of treatment of children with TBI inpatient care costs account for 85%. In the Central and Volga Federal District accounted for half of nationwide spending in general, brain injury and to provide certain kinds of healthcare. The structure of Russian costs as a result of the incidence of TBI children Moscow accounts for 20%. In Moscow, the cost of treating cases of traumatic brain injury in children is 3.2 times higher than the average for Russia. The resulting calculations of the value of health care costs attributable to a case of child head injury, behind the cost of treatment of the case of a child with head trauma, calculated according to the standards of Russia and the territories. This difference in the whole RF is 23%. Conclusion: The obtained findings have shown that in 2010 in Russia the magnitude of losses caused by TBI incidence in children amounted to 3 billion roubles or 0.008% of the gross product 1.2 billion roubles of which were direct expenses. However, this figure is considerably lower of the real amount; it becomes evident after the analysis of direct medical expenses per one case of pediatric TBI. Our calculations have shown that in Russia and in its regions the amount of expenses per one TBI patient is a quarter less

  16. Does organophosphate poisoning cause cardiac injury?

    Aghabiklooei, Abbas; Mostafazadeh, Babak; Farzaneh, Esmaeil; Morteza, Afsaneh


    Organophosphates are insecticides which are widely used as a suicidal agent in Iran. They are associated with different types of cardiac complications including cardiac arrest and arrhythmia, however their role in cardiac injury is not known yet. The aim of this study was to investigate the presence of myocardial damage in patients with cholinesterase poisoning.It was a prospective study conducted from January 2008 to March 2010. Cohorts of patients with cholinesterase poisoning due to suicidal attempt who have been referred to Loghman hospital were selected. Patients who have taken more than one poison or were used concomitant drugs were excluded. Physical examination was performed on admission to discover warning sign. Peripheral arterial blood gases, creatine kinase, creatine kinase-myocardial band, troponin-T measurements were performed in all cases. There were 24 patients, 7 of them women, with the mean age of 41.2±15.05 who were included in this study. Non-survivors had significantly higher levels of systolic blood pressure, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide, bicarbonate Glasgow Coma Scale scoring and longer duration of mechanical ventilation. Our findings showed that cardiac injury is an important cause of death in organophosphate poisoning. It could be hypothesized that cardiac injury is a strong predictor of death in patients with organophosphate poisoning.

  17. Return to Play After Forearm and Hand Injuries in the National Basketball Association.

    Morse, Kyle W; Hearns, Krystle A; Carlson, Michelle Gerwin


    Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Descriptive epidemiology study. The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play (P basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries.

  18. Esophageal Foreign Body Causing Direct Aortic Injury

    ECS Lam


    Full Text Available Foreign bodies in the esophagus are uncommon causes of esophageal perforation. Many nonperforating cases are successfully managed by flexible gastroscopy. However, complicated foreign bodies such as those that result in esophageal perforation and vascular injury are best managed surgically. Gastroscopy remains the primary method of diagnosis. A case of a 59-year-old woman who developed retrosternal and intrascapular pain, odynophagia and hematemesis after eating fish is reported. Flexible gastroscopy showed arterial bleeding from the midthoracic esophagus. Computed tomography scan localized a 3 cm fish bone perforating the esophagus with surrounding hematoma. An aortogram did not reveal an actively bleeding aortoesophageal fistula. The fish bone was surgically removed and the patient recovered with no postoperative complications. This case illustrates the importance of early consideration for surgical intervention when confronted with a brisk arterial bleed from the esophagus with suggestive history of foreign body ingestion.

  19. Acute kidney injury: A rare cause

    Satish Mendonca


    Full Text Available We present a young lady who consumed hair dye, which contained paraphenylene diamine (PPD, as a means of deliberate self-harm. This resulted in severe angio-neurotic edema for which she had to be ventilated, and thereafter developed rhabdomyolysis leading to acute kidney injury (AKI. The unusual aspect was that the patient continued to have flaccid quadriparesis and inability to regain kidney function. Renal biopsy performed 10 weeks after the dye consumption revealed severe acute tubular necrosis with myoglobin pigment casts. This suggests that PPD has a long-term effect leading to ongoing myoglobinuria, causing flaccid paralysis to persist and preventing the recovery of AKI. In such instances, timely treatment to prevent AKI in the form alkalinization of urine should be initiated promptly. Secondly, because PPD is a nondialyzable toxin, and its long-term effect necessitates its speedy removal, hemoperfusion might be helpful and is worth considering

  20. Cerebral damage caused by nail gun injury

    Andersen Chris Hedeman


    Full Text Available Background Accidents with nail guns are rather common, especially in the construction industry. Most injuries involve the extremities and several present with intracerebral injuries. When the patient is unconscious, it can be a big challenge to determine whether the injury is an accident, self-inflicted or a criminal act.

  1. Return to Play After Forearm and Hand Injuries in the National Basketball Association

    Morse, Kyle W.; Hearns, Krystle A.; Carlson, Michelle Gerwin


    Background: Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. Purpose: To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Study Design: Descriptive epidemiology study. Methods: The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. Results: One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play (P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days (P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Conclusion: Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries. PMID:28251168

  2. Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series.

    Cockenpot, Eric; Lefebvre, Guillaume; Demondion, Xavier; Chantelot, Christophe; Cotten, Anne


    Hand and wrist injuries are common occurrences in amateur and professional sports and many of them are sport-specific. These can be divided into two categories: traumatic injuries and overuse injuries. The aim of this article is to review the most common hand and wrist sports-related lesions. Acute wrist injuries are predominantly bone fractures, such as those of the scaphoid, hamate hook, and ulnar styloid. Ligament lesions are more challenging for radiologists and may lead to carpal instability if undiagnosed. Overuse wrist injuries are mainly represented by tendinous disorders, with De Quervain syndrome and extensor carpi ulnaris tendon disorders being the most common among them; however, there are other possible disorders such as impaction syndromes, stress fractures, and neurovascular lesions. Finally, finger lesions, including closed-tendon injuries (mallet and boutonniere injuries, jersey finger, and boxer's knuckle), flexor pulley injuries, and skier's thumb, should also be detected. (©) RSNA, 2016 Online supplemental material is available for this article.

  3. A Rare Minor Trauma Causing Diabetic Hand Ulcer

    Kemal Ozyurt; Halit Baykan; Mehmet Ozkose; Emin Silay; Ali Murat Kalender; Mehmet Akif Buyukbese


    A high prevalence of foot ulcers was confirmed among patients with diabetes, which are common indications for hospitalization, and usually associated with a long hospital stay with adverse outcomes including amputation and death. However, a diabetic hand is less recognized and is usually overlooked by clinicians. We see rare serials and case reports about a hand ulcer in diabetic patients. The aim of this case presentation is to explore clinical and treatment elements for a hand ulcer as well...

  4. Survey of Hand and Upper Extremity Injuries Among Rock Climbers.

    Nelson, Clayton E; Rayan, Ghazi M; Judd, Dustin I; Ding, Kai; Stoner, Julie A


    Rock climbing first evolved as a sport in the late 18th century. With its growing popularity, the number of rock climbing-related injuries has potential to increase, spurring a rise in the number of articles associated with it. Despite the available literature, there remains a paucity of information about upper extremity injuries sustained by rock climbers, and no studies to date have focused on gender-specific injuries. A 24-question online survey was distributed to rock climbers about upper extremity injuries sustained during rock climbing. Statistical analysis was used to study association between participants' demographics and injuries. A total of 397 participants responded to the survey. Mean age was 32.5 years with males comprising 85%. No significant differences in demographics or climbing behaviors were found between males and females. Ninety percent of participants reported sustaining an upper extremity injury. Fingers were the most common injury followed by shoulder/arm and elbow/forearm. Our study found females to be more likely to report a rock climbing-related injury, and more likely to undergo surgery for it. Female rock climbers were significantly more likely to report a shoulder/upper arm injury and were also more likely to report undergoing surgery compared with males, where these differences were not due to age or climbing behaviors. Further investigation is warranted into the association between shoulder injuries and female athletes to determine how the gender differences relate to extent of injury as well as health service utilization behaviors.

  5. Golf Injuries to the Hand, Wrist, or Elbow

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is ... by exercises designed to stretch and strengthen the muscles and tendons, which can be recommended by a hand therapist. Changing grips on the golf club may ...

  6. Camp Sports Injuries: Analysis of Causes, Modes and Frequencies

    Panagiota Papageorgiou


    Full Text Available The purpose of this study was the description of sports injuries sustained by campers at summer camps, aged 7-15 years. A sample of 8 camps from the Greek camp population participated in this sport injury surveillance study. Doctors and camp directors completed reports detailing the number of sports injuries events sustained and provided specific information about each event. During the period of the study, 337 sport injury reports were completed. A total of 237 (70.3% boys and 100 (29.7% girls reported having a sport injury. Age of campers sustaining a sport injury was 10-12 years old (60.8%. The frequency of sports injuries was highest during the first camp season. The leading causes of sports injuries in children’s were: falls, crushed by object, collision with other person and slips. Cut/scratch injuries were the most common diagnoses (38.9%. Football, basketball and volleyball were the most frequent sport activities for injuries. Reports based surveillance systems can be successfully used to conducts sport injury surveillance among children attending summer camps. Data collected via such systems can be used to calculate sports injury rates, to describe patterns of sport injury and to identify risk factors for camper – related sport injuries. The results provide necessary information to develop prevention interventions to decrease the number of youth whose camp experiences are negatively affected by sport injury.

  7. Causes and consequences of injuries in children in Western Australia

    Angalakuditi MV


    Full Text Available Mallik V Angalakuditi1, Nupur Angalakuditi21Georgia State University, Atlanta, Georgia, 2New York Medical College, Valhalla, New York, USAObjective: To identify the common causes and consequences of pediatric injury-related admission to an Australian children's hospital.Methods: A retrospective study was conducted at a pediatric teaching hospital. Patients , 18 years of age hospitalized between March 1, 2007 and April 30, 2007 were included. Patient medical records were reviewed if an admission diagnosis was injury related. Data collected included date of birth, gender, date of admission, date of discharge, diagnosis, procedure, and causes and outcomes of the injury.Results: A total of 184 patients were admitted as a result of injury during the study period. Of these, one neonate, six infants, 38 toddlers, 111 children, and 28 teenagers were included in this study. The most common cause of injury-related hospital admission was a fall (n = 109, 59%. Other causes of injury included crushing (8%, n = 15, the spilling of fluids (5.4%, n = 10, and bites (4.3%, n = 8. The most common consequence of an injury for children (43/111, 38.7% and teenagers (12/28, 43% was bone fracture. However, head injuries were the most common injury in toddlers (11/38, 29%, infants (5/6, 83.3%, and neonates (1/1, 100%. The radius and/ or ulna (36/63, 57% were the most common bones fractured. The majority (32/37, 86.5% of patients who suffered head injuries were diagnosed as having a minor injury.Conclusion: The main cause of injury-related admission to the hospital for children was a fall, with the most common consequences being fractures and head injuries.Keywords: injury, falls, head injuries, fractures

  8. Physio-therapeutical methods after injuries of the flexor and extensor tendons of a hand

    MUROŇOVÁ, Markéta


    This diploma thesis entitled ``Physio-therapeutical methods after injuries of the flexor and extensor tendons of a hand{\\crqq} describes the anatomy of forearm and hand muscles, as well as fascia and tendon loops. The main objective is to summarize a basic knowledge on injuries of the hand{\\crq}s flexor and extensor tendons and physiotherapy of this problem. The work also includes the application of this knowledge into practice by elaboration of case reports of patients with injuries of the h...

  9. Injury caused by airbag VS. injuries associated with airbag deploys

    M.F. Popa


    Full Text Available Implementation of airbags systems in motor vehicles designed to transport of persons led in time to a significant decrease of the rate of death among passengers involved in car accidents. However airbag systems are not harmless, it produces lesions that vary in intensity depending on many factors. But decidedly, we can meet injuries associated with the triggering of the airbag system. Therefore, it must be made a clear difference between the two types of injuries, this being particularly important in terms of medico-legal especially regarding the mechanism of injury.

  10. A Rare Minor Trauma Causing Diabetic Hand Ulcer

    Kemal Ozyurt


    Full Text Available A high prevalence of foot ulcers was confirmed among patients with diabetes, which are common indications for hospitalization, and usually associated with a long hospital stay with adverse outcomes including amputation and death. However, a diabetic hand is less recognized and is usually overlooked by clinicians. We see rare serials and case reports about a hand ulcer in diabetic patients. The aim of this case presentation is to explore clinical and treatment elements for a hand ulcer as well as a review of the literature. [Arch Clin Exp Surg 2013; 2(3.000: 207-209

  11. Measurement, evaluation, and assessment of peripheral neurological disorders caused by hand-transmitted vibration.

    Griffin, Michael J


    Regular exposure to hand-transmitted vibration can result in symptoms and signs of peripheral vascular, neurological and other disorders collectively known as the hand-arm vibration syndrome. The measurement of the effects of hand-transmitted vibration involves converting the evidence of disorder (symptoms and signs) into information that can be stored. Evaluation requires the use of scales on which to indicate the severity of the various symptoms and signs. Assessment involves a judgement of severity relative to a criterion, usually for a specific purpose (e.g. to decide on removal from work or compensation). The measurement and evaluation of symptoms and signs is necessary when monitoring patient health and when performing epidemiological studies for research. The assessment of the severity of the hand-arm vibration syndrome is currently performed with staging systems, but the criteria are not clear and not related to defined methods for measuring or evaluating the symptoms and signs. Recognizing that similar symptoms can occur without injury from occupational exposures to hand-transmitted vibration, this paper attempts to define significant peripheral neurological symptoms caused by hand-transmitted vibration (i.e. 'unusual symptoms') and how these symptoms and related signs may be measured. Scales for evaluating the symptoms (e.g. their extent) and the related signs (e.g. their probability relative to the probability of the sign being present in persons not exposed to vibration) are defined. A method of relating unusual symptoms to both the signs of disorder and the pattern of vibration exposure is illustrated. Assessments of severity will vary according to the reasons for assessing the health effects of vibration, and will depend on local practice and convenience, but a way of combining evaluations of symptoms and signs is demonstrated in a staging system. Although inherently complex, the methods may assist the collection of data required to improve

  12. The ICF and Postsurgery Occupational Therapy after Traumatic Hand Injury

    Fitinghoff, Helene; Lindqvist, Birgitta; Nygard, Louise; Ekholm, Jan; Schult, Marie-Louise


    Recent studies have examined the effectiveness of hand rehabilitation programmes and have linked the outcomes to the concept of ICF but not to specific ICF category codes. The objective of this study was to gain experience using ICF concepts to describe occupational therapy interventions during postsurgery hand rehabilitation, and to describe…

  13. The ICF and Postsurgery Occupational Therapy after Traumatic Hand Injury

    Fitinghoff, Helene; Lindqvist, Birgitta; Nygard, Louise; Ekholm, Jan; Schult, Marie-Louise


    Recent studies have examined the effectiveness of hand rehabilitation programmes and have linked the outcomes to the concept of ICF but not to specific ICF category codes. The objective of this study was to gain experience using ICF concepts to describe occupational therapy interventions during postsurgery hand rehabilitation, and to describe…

  14. Archery-related injuries of the hand, forearm, and elbow.

    Rayan, G M


    The five patients reported herein had various archery-related injuries of the upper extremities. Acute injuries included arrow laceration of a digital nerve and artery, contusion of forearm skin and subcutaneous tissue, and compression neuropathy of digital nerves from the bowstring. Chronic injuries included bilateral medial epicondylitis and median nerve compression at the wrist, de Quervain's tenosynovitis, and median nerve compression at the elbow. Essential measures for archery safety include use of archery protective gear, use of a light-weight bow, conditioning of the forearm flexor muscles, and modifications in drawing the bowstring.

  15. What Causes Some People to be Left-handed,and Why Are Fewer People Left-handed than Right-handed?

    J.Tan Manila; Philippines; 李伟


    @@ Clare Porac, a professor of psychology at Pennsylvania State University who studies handedness①, explains. Researchers who study human hand preference agree that the side of the preferred hand (right versus left) is produced by biological and, most likely,genetic causes.

  16. Treatment of open hand injuries: does timing of surgery matter? A single-centre prospective analysis.

    Juon, Bettina H; Iseli, Michelle; Kreutziger, Janett; Constantinescu, Mihai A; Vögelin, Esther


    The 6-hour paradigm for surgical treatment of open injuries should be re-evaluated in the era of systematic use of antiseptic solutions and systemic antibiotics. The current study investigates prospectively the impact of timing of surgery on the outcome of open hand injuries. The prospective evaluation included adult patients presenting with open hand injuries between 1 September 2009 and 30 June 2010 to the emergency department of the University Hospital of Berne, Switzerland. Multiple trauma, bilateral hand injuries, bite injuries, and infections were excluded. All patients underwent a standardised treatment protocol with antiseptic solution, sterile dressing, antibiotic prophylaxis, and surgical treatment upon admission. Demographic data, injury details, and delay from trauma to therapy were recorded. Microbiology was gained at surgery. Outcome measurements included infections, complications, pain, and function (clinically, DASH, Mayo score). From 116 patients (mean age 43 years) six patients suffered an infection (5.2%). The observed infections were statistically not associated with delay to surgery, treatment protocol, or to injury complexity. Neither complications, pain, nor functional outcome were statistically associated with delay to surgery, wound disinfection, or administration of antibiotics. In conclusion, early or late timing of surgical treatment of open hand injuries did not show any impact on outcome (infections, complications, pain, function) in this prospective single-centre patient evaluation.

  17. Smoked marijuana as a cause of lung injury.

    Tashkin, D P


    In many societies, marijuana is the second most commonly smoked substance after tobacco. While delta9-tetrahydrocannabinol (THC) is unique to marijuana and nicotine to tobacco, the smoke of marijuana, like that of tobacco, consists of a toxic mixture of gases and particulates, many of which are known to be harmful to the lung. Although far fewer marijuana than tobacco cigarettes are generally smoked on a daily basis, the pulmonary consequences of marijuana smoking may be magnified by the greater deposition of smoke particulates in the lung due to the differing manner in which marijuana is smoked. Whereas THC causes modest short-term bronchodilation, regular marijuana smoking produces a number of long-term pulmonary consequences, including chronic cough and sputum, histopathologic evidence of widespread airway inflammation and injury and immunohistochemical evidence of dysregulated growth of respiratory epithelial cells, that may be precursors to lung cancer. The THC in marijuana could contribute to some of these injurious changes through its ability to augment oxidative stress, cause mitochondrial dysfunction, and inhibit apoptosis. On the other hand, physiologic, clinical or epidemiologic evidence that marijuana smoking may lead to chronic obstructive pulmonary disease or respiratory cancer is limited and inconsistent. Habitual use of marijuana is also associated with abnormalities in the structure and function of alveolar macrophages, including impairment in microbial phagocytosis and killing that is associated with defective production of immunostimulatory cytokines and nitric oxide, thereby potentially predisposing to pulmonary infection. In view of the growing interest in medicinal marijuana, further epidemiologic studies are needed to clarify the true risks of regular marijuana smoking on respiratory health.

  18. [Neurosurgical position causes peripheral nerve injuries?

    Esquivel-Enríquez, Pedro; Pérez-Neri, Iván; Manrique-Carmona, Luisa


    Positioning during neurosurgical procedures is a challenge for surgical teams even if precautions are taken, the mechanisms underlying peripheral nerve injury (elongation, compression or ischaemia) are latent and it is important to know the frequency of occurrence in our environment. To analyze the frequency of peripheral nerve injury secondary to surgical positioning. Prospective study including 163 patients scheduled for neurosurgical procedures. Four groups: supine, lateral, ventral and park bench were analyzed by neurological exploration in order to detect injury and relate with risk factors already described. In this study 112 patients were included, two patients who were under park bench position experienced paresthesias in ulnar region of less than 24 hours' duration; statistically significant correlation with body weight greater than 85kg. The incidence of peripheral nerve injury is low, understanding the mechanisms that may originate it helps towards prevention and early detection of complications. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Early intensive hand rehabilitation after spinal cord injury ("Hands On": a protocol for a randomised controlled trial

    Hsueh Ya-Seng


    Full Text Available Abstract Background Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. Methods/design A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. Discussion The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. Trial registration NCT01086930 (12th March 2010 ACTRN12609000695202 (12th August 2009

  20. Serious brain injury coexisting with multiple injuries caused by traffic accidents in 69 cases

    张浚; 张鹤飞; 等


    Objective To explore the speciality,diagnosis,cure principle of serious brain injury coexisting with nultiple injuries caused by traffic accidents.Methods To analyze the clinic data of 69 cases of serious rain injury combined by oter parts of injuries caused by traffic accidents received from January 1998 to April 1999.Results This type of injury took up 11.5 percent of brain injuries in the same term and 33.6 percent of serious brain injuries.The specialities of the injury are that most of them were pedestrians crashed by vehicles.Coesisting injuries including chest injury and limb fractures accounted for a large part.The brain injury usally presented profound disturbance of consciousness,being dangerous and complicated,and a high ISS value.After treatment 13 cases died,9 cases was heavily crippled,11 cases lightly crippled,and 36 cases recovered.The death was usually caused by brain injury.Conclusions Road traffic accidents increased substantially every year.Most of them are related with violating drive rules and regulations.It is important to decrease the road traffic accidents by strengthening propaganda on traffic safety and traffic management.The main principles for salvage should emphasize the importance of pre-hospital emergency rescue and the accurate diagnosis rate,especially the distinction between coma and shock.The priority should be put on those injuries threatening to life.

  1. The expanding role of occupational therapy in the treatment of industrial hand injuries.

    Bear-Lehman, J; McCormick, E


    A recent survey of members of the American Society of Hand Therapists revealed an expanding role for the therapist in the treatment of industrial hand injuries. In the traditional role of treatment provider, occupational therapists are using their assessment tools and work capacity programming to aid in predicting return to work readiness. This is aimed at preventing reinjury of the present patient population. In addition to this, therapists have begun to identify relationships between specific injuries and work that produced them. This gives rise to a specified goal of preventing the injury from ever occuring. To reach this goal therapists are becoming involved in industrial settings and are working with industrial safety teams.


    K. S. Melikhov


    Full Text Available Results of surgical treatment of 35 victims who had received serious blunt open and closed injuries of hand were analyzed. All injuries of hand were divided into three types, depending on mechanism and circumstances of trauma. On the basis of the data received at direct measurement of compartment pressure, indirect signs of a menacing ischemia of intrinsic muscles have been defined, and the technique of preventive maintenance of an ischemic lesion of own hand muscles were developed. High efficiency of the offered medical approaches at the expense of the maximum restoration of function of the injured extremity was proved.

  3. Bilateral multiligament injury of knee caused by entangled dupatta.

    Vaidya, Shrinand V; Mathesul, Ambarish A; Panghate, Atul N; Wade, Roshan; Sonawane, Dhiraj V


    We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  4. Bilateral multiligament injury of knee caused by entangled dupatta

    Shrinand V Vaidya


    Full Text Available We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  5. Accidental hand grenade blast injuries in the Transkei region of ...

    Six of the eight children died instantly, while the other two sustained minor injuries. The M26 ... 50% casualty radius of 15 m; however, the fragments can disperse to ... They had perhaps been bending on one knee at the time of the explosion.

  6. Burn Injury Caused by Laptop Computers

    dry skin, with no blisters, on his left leg was reported [Figure 1]. ... can indeed cause it. in very rare cases, the condition can cause damage leading to skin cancer. ... After an extensive work‑up, burning caused by use of a laptop was observed.

  7. A case of cellulitis of the hands caused by a predatory bird attack

    M Adil Abbas Khan; Mohammed Farid; Zain A Sobani; Syed Nadir Ali; Huzaifa Malick; Maryam Baqir; Hasanat Sharif; M Asim Beg


    Many species have been drastically affected by rapid urbanization. Harris's hawks from their natural habitat of open spaces and a supply of rodents, lizards and other small prey have been forced to change their natural environment adapting to living in open spaces in sub- and peri-urban areas. Specific areas include playgrounds, parks and school courtyards. The migration of this predatory species into these areas poses a risk to individuals, and especially the children are often attacked by claws, talons and beaks intentionally or as collateral damage while attacking rodent prey. In addition, the diverse micro-organisms harbored in the beaks and talons can result in wound infections, presenting a challenge to clinical management. Here we would like to present a case of an80-year-old man with cellulitis of both hands after sustaining minor injuries from the talons of a Harris's hawk and review the management options. We would also like to draw attention to the matter that, even though previously a rarity, more cases of injuries caused by birds of prey may be seen in hospital settings.

  8. A case of cellulitis of the hands caused by a predatory bird attack

    M Adil Abbas Khan


    Full Text Available Many species have been drastically affected by rapid urbanization. Harris's hawks from their natural habitat of open spaces and a supply of rodents, lizards and other small prey have been forced to change their natural environment adapting to living in open spaces in sub- and peri-urban areas. Specific areas include playgrounds, parks and school courtyards. The migration of this predatory species into these areas poses a risk to individuals, and especially the children are often attacked by claws, talons and beaks intentionally or as collateral damage while attacking rodent prey. In addition, the diverse micro-organisms harbored in the beaks and talons can result in wound infections, presenting a challenge to clinical management. Here we would like to present a case of an 80-year-old man with cellulitis of both hands after sustaining minor injuries from the talons of a Harris's hawk and review the management options. We would also like to draw attention to the matter that, even though previously a rarity, more cases of injuries caused by birds of prey may be seen in hospital settings.

  9. Burn Injury Caused by Laptop Computers

    Sharma, G


    Laptop burn is a real condition and medical reports indicate that using a laptop across the legs can indeed cause it. in very rare cases, the condition can cause damage leading to skin cancer. A 24-year-old man presented with an asymptomatic reddish brown pigmentation on the thighs. After an extensive work-up, burning caused by use of a laptop was observed. Burning was induced in 3 days by using laptop for 4 h daily. Laptop should be used in properly ventilated and air-conditioned rooms. The ...

  10. Cerebral damage caused by nail gun injury

    Andersen, Chris


    . The forensic examination showed lesions of intracranial surgery and minor bruises on the arms. No sign of defense injuries was found. There were no signs of malfunction of the nail gun-wielding robot. On the side of the machine, there were a handheld nail gun and the police investigated the case as a possible......-inflicted or a criminal act. Case presentation A 43-year-old male worker was brought to the emergency department after his coworkers had found him on the floor in the cafeteria at work. He was admitted to the hospital due to a possible apoplexy. The CT scan revealed a nail in his skull and acute surgery was performed...

  11. Cerebral damage caused by nail gun injury

    Andersen, Chris


    . The forensic examination showed lesions of intracranial surgery and minor bruises on the arms. No sign of defense injuries was found. There were no signs of malfunction of the nail gun-wielding robot. On the side of the machine, there were a handheld nail gun and the police investigated the case as a possible......-inflicted or a criminal act. Case presentation A 43-year-old male worker was brought to the emergency department after his coworkers had found him on the floor in the cafeteria at work. He was admitted to the hospital due to a possible apoplexy. The CT scan revealed a nail in his skull and acute surgery was performed...

  12. Flexor tendon injuries of hand: experience at Pakistan Institute of Medical Sciences, Islamabad, Pakistan.

    Ahmad, Muhammad; Hussain, Syed Shahid; Tariq, Farhan; Rafiq, Zulqarnain; Khan, M Ibrahim; Malik, Saleem A


    Flexor tendon injury is one of the most common hand injuries. This initial treatment is of the utmost importance because it often determines the final outcome; inadequate primary treatment is likely to give poor long tem results. Various suture techniques have been devised for tendon repair but the modified Kessler's technique is the most commonly used. This study was conducted in order to know the cause, mechanism and the effects of early controlled mobilization after flexor tendon repair and to assess the range of active motion after flexor tendon repair in hand. This study was conducted at the department of Plastic Surgery, Pakistan Institute of Medical Sciences, Islamabad from 1st March 2002 to 31st August 2003. Only adult patients of either sex with an acute injury were included in whom primary or delayed primary tendon repair was undertaken. In all the patients, modified Kessler's technique was used for the repair using non-absorbable monofilament (Prolene 4-0). The wound was closed with interrupted non-absorbable, polyfilament (Silk 4-0) suture. A dorsal splint extending beyond the finger tip to proximal forearm was used with wrist in 20-30 degrees palmer flexion, metacarpophalangeal (MP) joint flexed at 60 degrees. Passive movements of fingers were started from the first post operative day, and for controlled, active movements, a dynamic splint was applied. During this study, 33 patients with 39 digits were studies. 94% of the patients had right dominated hand involvement. 51% had the complete flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) injuries. Middle and ring fingers were most commonly involved. Thumb was involved in 9% of the patients. Zone III(46%) was the commonest to be involved followed by zone II (28%). Laceration with sharp object was the most frequent cause of injury. Finger tip to distal palmer crease distance (TPD) was < 2.0 cm in 71% cases (average 2.4cm) at the end of 2nd postoperative week. Total number of

  13. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction

    Hong Yan


    Full Text Available This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group, or burn injury combined with seawater immersion (BI group, or only immersion in seawater (I group, or control animals with no injury or immersion (C group. The circulating endothelial cell (CEC count and coagulation-fibrinolysis parameters were measured. The CEC count in B group increased at 4 h, 7 h, and 10 h after injury and then reduced, whereas it continuously increased to a greater extent in BI group (P<0.05. The von Willebrand factor (vWF activity, plasminogen activator inhibitor (PAI-1, and the ratio of thromboxane B2 (TXB2 to 6-keto-prostaglandin F1α (6-K-PGF1α in BI group had a marked increase after injury, and the tissue-type plasminogen activator (tPA in the BI group decreased. Microscope observations revealed thrombus formation in lungs of the animals in BI group, but not in C, I, or B groups. Burn injury causes endothelial dysfunction, and seawater immersion lastingly aggravates this injury, leading to a higher risk of developing thrombosis.

  14. Isolated hand injuries on operational deployment: an examination of epidemiology and treatment strategy.

    Penn-Barwell, Jowan G; Bennett, Philippa M; Powers, Dominic; Standley, David


    This study presents an analysis of 6 years of isolated hand injuries repatriated from Afghanistan or Iraq. Of a total of 6,337 medical cases evacuated back to the United Kingdom, 414 (6.5%) cases were identified as hand injuries; from these exclusions were: 207 who did not return to Royal Centre for Defence Medicine, 12 who were incorrectly coded, 1 was an old injury, and 41 whose notes were unavailable. The notes of the remaining 153 patients were reviewed: only 9% had battle injuries; nearly half involved fractures; overall, 73% required surgery, a total of 171 surgical episodes, a third of these operations occurred in deployed facilities. Patients with primary nerve or tendon repairs in deployed medical facilities had a trend toward significantly worse outcomes than those whose primary repair was delayed until repatriation. This study supports the current recommendation of delaying tendon and nerve repair until repatriation.

  15. Burn injuries caused by a hair-dryer--an unusual case of child abuse.

    Darok, M; Reischle, S


    About 1.4-26% burn injuries in children appear to be abusive in origin. A 2.5-year-old girl was referred to our institute because of suspected child abuse. Clinical examination and later interrogation of the mother revealed non-recent deep second degree burn injuries on both gluteal regions, caused by the partner of the mother by pressing a hand-held hair-dryer against the skin. The authors present the findings of this unusual method of child abuse.

  16. A new perspective in the understanding of hand dysfunction following neurological injury.

    Sangole, Archana P; Levin, Mindy F


    The human hand is inherently complex and versatile. Its use in everyday activities requires its careful positioning relative to the arm and fine adjustments of the fingers to secure the object in the hand to perform a desired task. Understanding the mechanics of prehension requires an appreciation of the anatomy, biomechanics, kinematics, and control of the hand. This article summarizes these complex mechanisms as well as the central nervous system control of hand movement. We propose a measure to characterize the biomechanics of palmar arch modulation during grasping. We also highlight questions to be investigated in future studies to stimulate further understanding of the motor control of hand function and of the recovery of hand functioning after neurological injury.

  17. Athletes' perception of the causes of injury in gymnastics.

    Kolar, Edvard; Pavletič, Mitija S; Smrdu, Maja; Atiković, Almir


    Gymnastics requires a high level of flexibility, conditioning and complete body recruitment that is infrequently matched by other sports. Artistic gymnastics has a relatively high incidence of injuries, which are generally of minor or medium severity. With all its complexity, it poses a unique diagnostic and treatment challenge to medical practitioners. The present study examined athletes' perception of the causes of injury and of the possible ways to reduce their incidence. The research involved 63 quality athletes, of whom 20 were in men's artistic gymnastics, 21 in women's artistic gymnastics, and 22 in rhythmic gymnastics. We used the self-assessment method. Factors inducing injury were grouped into three different categories: training, the athlete himself, and the environment. We used the χ2 test to test the association between a risk factor and injuries. The association between injuries and risk factors was also tested using a multivariate logistic regression analysis. Overall, an incidence of 184 injuries was found, of which 67 (36.4%) were acute and 117 (63.5%) were chronic injuries. According to binary logistic regression analyses, psychological factors significantly associated with the prevalence of acute and chronic injury in both sexes for all disciplines were: a poor technique, improper methods of teaching, and an inadequate load. In our study, higher rates of acute and chronic injury were observed among male gymnasts, who reported their occurrence during training by overload, and among female gymnasts, who reported a poor technique, improper methods of teaching, and an inadequate load as main causes of their occurrence. Improving the communication between athletes and coaches, taking the opinion of an athlete into account, and the athlete's active involvement in preparation of the program include the most crucial points for reducing the incidence of injuries.

  18. Serious eye injuries caused by bottles containing carbonated drinks

    Kuhn, F; Mester, V; Morris, R; Dalma, J


    Aim: To analyse serious eye injuries caused by bottles containing pressurised drinks. Methods: Retrospective review of the databases of US, Hungarian, and Mexican eye injury registries. Results: In the combined database (12 889 injuries), 90 cases (0.7%) were caused by bottle tops or glass splinters. The incidence varied widely: 0.3% (United States), 3.1% (Hungary), and 0.9% (Mexico), as did the agent. Champagne bottle corks were responsible in 20% (United States), 71% (Hungary; p<0.0001), and 0% (Mexico). Most eyes improved, but 26% remained legally blind. Conclusions: The presence of warning labels on champagne bottles appears to reduce cork related eye injuries, as does using plastic bottles and caps. PMID:14693777

  19. Supplementary motor area deactivation impacts the recovery of hand function from severe peripheral nerve injury

    Ye-chen Lu; Han-qiu Liu; Xu-yun Hua; Yun-dong Shen; Wen-dong Xu; Jian-guang Xu; Yu-dong Gu


    Although some patients have successful peripheral nerve regeneration, a poor recovery of hand function often occurs after peripheral nerve injury. It is believed that the capability of brain plasticity is crucial for the recovery of hand function. The supplementary motor area may play a key role in brain remodeling after peripheral nerve injury. In this study, we explored the activation mode of the supplementary motor area during a motor imagery task. We investigated the plasticity of the central nervous system after brachial plexus injury, using the motor imagery task. Results from functional magnetic resonance imaging showed that after brachial plexus injury, the motor imagery task for the affected limbs of the patients triggered no obvious activation of bilateral supplementary motor areas. This result indicates that it is dififcult to excite the supplementary motor areas of brachial plexus injury patients during a motor imagery task, thereby impacting brain remodeling. Deactivation of the supplementary motor area is likely to be a serious problem for brachial plexus injury patients in terms of preparing, initiating and executing certain movements, which may be partly responsible for the unsatisfactory clinical recovery of hand function.

  20. Entry into vocational rehabilitation program following work-related hand injury: Potential candidates

    Yueh-Hsia Chen


    Full Text Available Objectives: This case-control study aimed to investigate the predictors of return to work (RTW following work-related major forearm, wrist or hand injury at the preparation stage of return to work. Material and Methods: A total of 80 clients were recruited and divided into 2 groups depending on their readiness of RTW. The groups were compared with each other with regard to their demographics, compensation status, hand injury severity, health perception, and time off work (TOW using correlation coefficient. Predictors of RTW were measured by logistic regression analysis. Results: There were no significant differences in demographics and the severity of hand injury between 2 groups. Self-perceived physical functioning (p = 0.04, vitality (p = 0.01, mental health (p = 0.03 and TOW (p = 0.001 were significantly different between Action group and Preparation group. With binary logistic regression analysis, self-perceived vitality (odds ratio (OR = 1.041 and TOW (OR = 0.996 were shown to be strongly predictive of RTW at the preparation stage of return to work. Conclusions: This study has shown that shorter TOW and better self-perceived vitality could predict early readiness for RTW after major work-related forearm, wrist or hand injury.

  1. Symptoms of Acute Posttraumatic Stress Disorder in Patients With Acute Hand Injuries

    Opsteegh, Lonneke; Reinders-Messelink, Heleen A.; Groothoff, Johan W.; Postema, Klass; Dijkstra, Pieter U.; van der Sluis, Corry K.


    Purpose Symptoms of posttraumatic stress disorder (PTSD) in patients with hand injuries may delay return to work, even when criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV are not met. This study investigated which biomedical and psychosocial factors relate to symptoms of ac

  2. Work-related hand and lower-arm injuries in New Zealand, 1979 to 1988.

    Burridge, J D; Marshall, S W; Laing, R M


    The aim of this study was to describe the epidemiology of work-related hand and lower-arm injuries in New Zealand. Nonfatal hand and lower-arm injuries were identified from New Zealand's national database of hospital admissions for the period 1979 to 1988. Thirty-seven per cent (9714) of all such injuries (26,228) were work-related. Piercing and cutting instruments (38.5 per cent) and machinery (37.2 per cent) were the two most common agents of work-related hand and lower-arm injury. Specific occupations in which the number of cases was high included meat workers (n = 1020, 3.3 per 1000 employees), carpenters (n = 548, 2.2 per 1000), machine operators (n = 450, 11.9 per 1000) and sawmill workers (n = 498, 7.7 per 1000). The injury rate for meat workers, carpenter-joiners, machine operators and sawmillers increased significantly over the 10-year study period.

  3. Do resuscitation attempts in children who die, cause injury?

    Ryan, M P; Young, S J; Wells, D L


    To determine the incidence, type, and pattern of injury related to resuscitation attempts in children who die. Retrospective review of ambulance, hospital, and necropsy case records. All children who died aged 0-14 years between 1994 and 1996, and underwent a full necropsy at the Victorian Institute of Forensic Medicine (Melbourne, Australia) were identified. Children who were subject to recognised trauma before resuscitation or died because of a congenital abnormality were excluded. The records of all remaining children were reviewed. Children were grouped according to whether resuscitation was attempted or not. From a total of 346 children who died, 204 (58.6%) were identified as meeting the inclusion criteria. Resuscitation was performed in 153 (75%) children and was started before ambulance arrival in 123 (60.3%) children. Injuries were detected at necropsy in 65 (42.5%) of children who had resuscitation compared with six (11.7%) of children who had no resuscitation (pcauses minor injuries such as superficial bruises and abrasions and the likelihood of such injury increases with the duration of the cardiopulmonary resuscitation. This information should reassure parents and caregivers that basic life support may be instituted without fear of causing significant injury or adversely affecting outcome in the child with cardiorespiratory arrest. Caution must be exercised when attributing significant injuries to resuscitation attempts and alternative causes must be fully investigated.

  4. Post chemotherapy extravasation injuries: Hypogastric flap for reconstruction of wounds over dorsum of hand.

    Salunke, Abhijeet Ashok; Nambi, G I; Sudhakar, N


    Management of extravasation injuries over the dorsum of hand after administration of chemotherapeutic agents. To study the results of hypogastric flap reconstruction in chemotherapy extravasation wounds over dorsum of hand. Retrospective study. At our center over 3-years period, 32 patients were treated for chemotherapy extravasation wounds. Out of these 32 patients, seven had wound over dorsum of hand. There were five males and two females, and their mean age was 45 years (range, 19 - 64 years). These patients with wound over the dorsum of hand were treated with multiple debridements and hypogastric flap reconstruction. The mean interval between extravasation wound and surgical treatment was 6.28 days (range, 4 - 10). The mean size of extravasation wound defect was 14 × 8 (range, 12 × 7 to 18 × 8). Non-dominant hand was involved in six patients and dominant hand in one patient. In four patients, the hypogastric flap was supplemented with skin graft. The hypogastric flap settled well in all patients and enabled a good wound cover. Complete division of the flap and final insetting was done under local anesthesia after 3 weeks; this was followed by limb mobilization exercises. Contour difference over the dorsum of hand was present in all the cases. The range of movement of the hand was functionally restricted in one patient. No patient in current series developed wound infection. Hypogastric flap is a reliable flap to cover wound over dorsum of hand after extravasation of chemotherapeutic agents.

  5. Hand, foot, and mouth disease caused by coxsackievirus A6, Thailand, 2012.

    Puenpa, Jiratchaya; Chieochansin, Thaweesak; Linsuwanon, Piyada; Korkong, Sumeth; Thongkomplew, Siwanat; Vichaiwattana, Preyaporn; Theamboonlers, Apiradee; Poovorawan, Yong


    In Thailand, hand, foot, and mouth disease (HFMD) is usually caused by enterovirus 71 or coxsackievirus A16. To determine the cause of a large outbreak of HFMD in Thailand during June-August 2012, we examined patient specimens. Coxsackievirus A6 was the causative agent. To improve prevention and control, causes of HFMD should be monitored.

  6. 手部高压注射伤损伤机制及治疗进展%Mechanism and therapeutic advance of high pressure injection injuries of hands

    王勇; 侯春林


    @@ High pressure injection injury (HPII) is a rare injury of hands. It is reported by Ress in 1973 firstly.It is easy to be neglected with potential dangers,and happens mainly at non dominant hand.The slight clinical manifestation in early stage,such as small wound in the end of finger,usually conceals the range and degree of damage,which could lead to severe results even to finger amputating.Early decompression and debridement are main treatments[1,2].The studies of HPII are rare in our country[1,2].We review the advance of HPII as follows. 1 Incidence rate and the causes.

  7. A cause of severe thigh injury: Battery explosion

    Tahsin Görgülü


    Discussion: Battery explosion causing lower extremity tissue defect is a type of injury that is rarely seen in the literature. Regardless of battery size and energy level, they should be considered as potential explosive material and protector masks, clothing should be worn during contact with this type of material.

  8. Physiological and environmental causes of freezing injury in red spruce

    Paul G. Schaberg; Donald H. DeHayes


    For many, concerns about the implications of "environmental change" conjure up scenarios of forest responses to global warming, enrichment of greenhouse gases, such as carbon dioxide and methane, and the northward migration of maladapted forests. From that perspective, the primary focus of this chapter, that is, causes of freezing injury to red spruce (

  9. Another cause of occupational entrapment neuropathy: la main du cuisinier (the chef's hand).

    Krishnan, Arun V; Fulham, Michael J; Kiernan, Matthew C


    Recent studies have raised the possibility of a predisposition to mononeuropathies in a number of professions including musicians, cleaners, and industrial workers. There are, however, no previous reports of increased rates of mononeuropathies in the culinary arts. The authors report three cases of mononeuropathies occurring in professional chefs that presented over a 3-month period in the same outpatient clinic, with a case each of distal ulnar neuropathy, distal median motor neuropathy (thenar motor syndrome) and posterior interosseous neuropathy. There was no history of direct hand trauma in any of the patients. In all three patients, the injuries occurred exclusively in the dominant hand, further strengthening the argument for an occupational link.

  10. Bilateral macular injury caused by a femtosecond laser.

    de Juan-Marcos, L; Cañete-Campos, C; Cruz-González, F; López-Corral, A; Hernández-Galilea, E


    We describe the case of a 35-year-old man who arrived in the Emergency Department with bilateral macular injury caused by accidental exposure to an industrial femtosecond laser. Workers operating industrial lasers must protect their eyes properly when handling these devices. Otherwise, retina damage may occur which usually is recoverable. However, sometimes this damage causes permanent visual loss. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  11. Contact allergens causing hand eczema in ethnic Kashmiri population: A study of 7-years

    Imran Majid


    Full Text Available Background: Hand eczema is one of the commonest eczemas encountered in dermatology practice. Contact allergens responsible for causing hand eczema vary from one geographical area of the world to another. Aim: The study tries to identify the commonest allergens causing hand eczema in ethnic Kashmiri population. Material and Methods: A total of 800 patients were patch tested at a sole patch testing facility for the local population over a 7-year period out of which 278 were diagnosed with hand eczema. The morphological type of hand eczema was noted and the patch testing results were analyzed. Past or present relevance of the patch-test result to the clinical diagnosis was also analyzed. Results: Hand eczema was the most common type of eczema patch tested over the 7-year period, constituting 34.75% of the patch-tested population. A positive patch-test result was obtained in 135 patients (48.5% out of which it was found to be clinically relevant in about 65% cases. Nickel and potassium dichromate were found to be the two commonest allergens causing hand eczema in our population with positive patch test reactions in 45 and 27 patients respectively. Females showed a much higher incidence of hand eczema as well as higher patch test positivity than males (54.1% vs. 38.1%. Conclusions: Hand eczema with a positive patch-test report was found to be much more common in females than males and nickel and potassium dichromate were seen to be the commonest allergens causing hand eczema in ethnic Kashmiri population.

  12. Elective amputation and bionic substitution restore functional hand use after critical soft tissue injuries

    Aszmann, Oskar C.; Vujaklija, Ivan; Roche, Aidan D.; Salminger, Stefan; Herceg, Malvina; Sturma, Agnes; Hruby, Laura A.; Pittermann, Anna; Hofer, Christian; Amsuess, Sebastian; Farina, Dario


    Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries. Clinical tests conducted before, during and after the procedure, evaluating both functional and psychometric parameters, document the benefits of this approach. Additionally, in one of the patients, we show the possibility of implementing a highly functional and natural control of an advanced prosthesis providing both proportional and simultaneous movements of the wrist and hand for completing tasks of daily living with substantially less compensatory movements compared to the traditional systems. It is concluded that the proposed procedure is a viable solution for re-gaining highly functional hand use following critical soft tissue injuries when existing surgical measures fail. Our results are clinically applicable and can be extended to institutions with similar resources. PMID:27721419

  13. [Foreign bodies--uncommon causes of GIT injuries].

    Hasala, P; Hadwiger, J; Gryga, A; Folprecht, M


    Injuries to various parts of the digestive tract caused by foreign bodies, frequently deliberately swallowed or inserted using various practics, are less common, however serious injuries. The symptomatology may be vague, credibility is often limited or anamnestic data may be intentionaly missing, which makes the diagnostic process tricky. Undefined, vague signs are related to specificities during the GIT perforation, so called hidden perforation. The recovery is commonly complicated, with a resulting handicap of stool incontinence or of colostomy. This is demonstrated on several subjects, treated in our surgical department.

  14. Disabling hand injuries in boxing: boxer's knuckle and traumatic carpal boss.

    Melone, Charles P; Polatsch, Daniel B; Beldner, Steven


    This article describes the treatment of the two most debilitating hand-related boxing injuries: boxer's knuckle and traumatic carpal boss. Recognition of the normal anatomy as well as the predictable pathology facilitates an accurate diagnosis and precision surgery. For boxer's knuckle, direct repair of the disrupted extensor hood, without the need for tendon augmentation, has been consistently employed; for traumatic carpal boss, arthrodesis of the destabilized carpometacarpal joints has been the preferred method of treatment. Precisely executed operative treatment of both injuries has resulted in a favorable outcome, as in the vast majority of cases the boxers have experienced relief of pain, restoration of function, and an unrestricted return to competition.

  15. A novel myoelectric pattern recognition strategy for hand function restoration after incomplete cervical spinal cord injury.

    Liu, Jie; Zhou, Ping


    This study presents a novel myoelectric pattern recognition strategy towards restoration of hand function after incomplete cervical spinal cord Injury (SCI). High density surface electromyogram (EMG) signals comprised of 57 channels were recorded from the forearm of nine subjects with incomplete cervical SCI while they tried to perform six different hand grasp patterns. A series of pattern recognition algorithms with different EMG feature sets and classifiers were implemented to identify the intended tasks of each SCI subject. High average overall accuracies (> 97%) were achieved in classification of seven different classes (six intended hand grasp patterns plus a hand rest pattern), indicating that substantial motor control information can be extracted from partially paralyzed muscles of SCI subjects. Such information can potentially enable volitional control of assistive devices, thereby facilitating restoration of hand function. Furthermore, it was possible to maintain high levels of classification accuracy with a very limited number of electrodes selected from the high density surface EMG recordings. This demonstrates clinical feasibility and robustness in the concept of using myoelectric pattern recognition techniques toward improved function restoration for individuals with spinal injury.

  16. [Injury pattern on the hand after slipping onto the blade during a knife attack--a contribution to the differential diagnostic classification of sharp force injuries of the upper extremities].

    Tsokos, Michael; Braun, Christian


    Differential diagnosis of injuries caused by accidental slipping of the hand onto the blade of a knife includes self-inflicted injuries (e.g. to simulate an offense) as well as active and passive defense injuries indicative of the involvement of another party. The injury pattern on the hands of five perpetrators who suffered accidental cuts during knife attacks, as seen by the authors during the clinical forensic examination, is presented. The injuries were localized on the ulnar aspect of the thumb facing the index finger, the radial aspect of the index finger facing the thumb and variable sites on the flexor or extensor side of the middle and ring fingers. Especially in those cases in which the injuries of the victim (e.g. involvement of bony structures) and the dominant hand of the perpetrator are known, additional information for the reconstruction of the course of events may be derived from the cut wounds occurring during the knife attack as the hand slipped onto the blade.

  17. Glutamine Attenuates Acute Lung Injury Caused by Acid Aspiration

    Chih-Cheng Lai


    Full Text Available Inadequate ventilator settings may cause overwhelming inflammatory responses associated with ventilator-induced lung injury (VILI in patients with acute respiratory distress syndrome (ARDS. Here, we examined potential benefits of glutamine (GLN on a two-hit model for VILI after acid aspiration-induced lung injury in rats. Rats were intratracheally challenged with hydrochloric acid as a first hit to induce lung inflammation, then randomly received intravenous GLN or lactated Ringer’s solution (vehicle control thirty min before different ventilator strategies. Rats were then randomized to receive mechanical ventilation as a second hit with a high tidal volume (TV of 15 mL/kg and zero positive end-expiratory pressure (PEEP or a low TV of 6 mL/kg with PEEP of 5 cm H2O. We evaluated lung oxygenation, inflammation, mechanics, and histology. After ventilator use for 4 h, high TV resulted in greater lung injury physiologic and biologic indices. Compared with vehicle treated rats, GLN administration attenuated lung injury, with improved oxygenation and static compliance, and decreased respiratory elastance, lung edema, extended lung destruction (lung injury scores and lung histology, neutrophil recruitment in the lung, and cytokine production. Thus, GLN administration improved the physiologic and biologic profiles of this experimental model of VILI based on the two-hit theory.

  18. Circulating Mitochondrial DAMPs Cause Inflammatory Responses to Injury

    Zhang, Qin; Raoof, Mustafa; Chen, Yu; Sumi, Yuka; Sursal, Tolga; Junger, Wolfgang; Brohi, Karim; Itagaki, Kiyoshi; Hauser, Carl J.


    Injury causes a systemic inflammatory response syndrome (SIRS) clinically much like sepsis 1. Microbial pathogen-associated molecular patterns (PAMPs) activate innate immunocytes through pattern recognition receptors 2. Similarly, cellular injury can release endogenous damage-associated molecular patterns (DAMPs) that activate innate immunity 3. Mitochondria are evolutionary endosymbionts that were derived from bacteria 4 and so might bear bacterial molecular motifs. We show here that injury releases mitochondrial DAMPs (MTD) into the circulation with functionally important immune consequences. MTD include formyl peptides and mitochondrial DNA. These activate human neutrophils (PMN) through formyl peptide receptor-1 and TLR9 respectively. MTD promote PMN Ca2+ flux and phosphorylation of MAP kinases, thus leading to PMN migration and degranulation in vitro and in vivo. Circulating MTD can elicit neutrophil-mediated organ injury. Cellular disruption by trauma releases mitochondrial DAMPs with evolutionarily conserved similarities to bacterial PAMPs into the circulation. These can then signal through identical innate immune pathways to create a sepsis-like state. The release of such mitochondrial ‘enemies within’ by cellular injury is a key link between trauma, inflammation and SIRS. PMID:20203610

  19. A novel cortical target to enhance hand motor output in humans with spinal cord injury.

    Long, Jinyi; Federico, Paolo; Perez, Monica A


    A main goal of rehabilitation strategies in humans with spinal cord injury is to strengthen transmission in spared neural networks. Although neuromodulatory strategies have targeted different sites within the central nervous system to restore motor function following spinal cord injury, the role of cortical targets remain poorly understood. Here, we use 180 pairs of transcranial magnetic stimulation for ∼30 min over the hand representation of the motor cortex at an interstimulus interval mimicking the rhythmicity of descending late indirect (I) waves in corticospinal neurons (4.3 ms; I-wave protocol) or at an interstimulus interval in-between I-waves (3.5 ms; control protocol) on separate days in a randomized order. Late I-waves are thought to arise from trans-synaptic cortical inputs and have a crucial role in the recruitment of spinal motor neurons following spinal cord injury. Motor evoked potentials elicited by transcranial magnetic stimulation, paired-pulse intracortical inhibition, spinal motor neuron excitability (F-waves), index finger abduction force and electromyographic activity as well as a hand dexterity task were measured before and after both protocols in 15 individuals with chronic incomplete cervical spinal cord injury and 17 uninjured participants. We found that motor evoked potentials size increased in spinal cord injury and uninjured participants after the I-wave but not the control protocol for ∼30 to 60 min after the stimulation. Intracortical inhibition decreased and F-wave amplitude and persistence increased after the I-wave but not the control protocol, suggesting that cortical and subcortical networks contributed to changes in corticospinal excitability. Importantly, hand motor output and hand dexterity increased in individuals with spinal cord injury after the I-wave protocol. These results provide the first evidence that late synaptic input to corticospinal neurons may represent a novel therapeutic target for improving motor function

  20. Hand injuries in foreign labour workers in an Irish university hospital.

    Sattler, Thorsten


    The present study reports on a new, rapidly growing patient subpopulation presenting with hand injuries to the Department of Plastic Surgery in Cork University Hospital (Ireland). The impact of the 10 new European Union accession states on the trauma workload is examined. The associated growth in expenditure on interpreter services is also examined. Potential risk factors in the foreign workers\\' new working environment is explored.

  1. Sensory dysfunction associated with repetitive strain injuries of tendinitis and focal hand dystonia: a comparative study.

    Byl, N; Wilson, F; Merzenich, M; Melnick, M; Scott, P; Oakes, A; McKenzie, A


    Repetitive strain injuries are reaching epidemic levels among workers who perform heavy schedules of rapid alternating movements (eg., computer programmers, data entry workers) or repetitive, sustained, coordinated movements (eg., editors, writers, salespeople). The purpose of this study was to determine if patients with repetitive strain injury demonstrated degraded sensory motor performance with their hands. Sixty age-matched adults were recruited, with 15 each assigned to a healthy adult control group, a healthy musician control group, a tendinitis group, or a focal dystonia group. Four sensory motor subtests from the Sensory Integration and Praxis Test were given to the subjects according to a standardized protocol. Using multiple one-factor analyses of variance in the parametric or nonparametric mode followed by post hoc pairwise testing, no significant differences were found between the healthy controls and the musician controls. On the test of kinesthesia, using the left hand, subjects with tendinitis performed significantly worse than controls and subjects with focal dystonia. Compared with controls, subjects with focal dystonia did significantly worse on graphesthesia and manual form perception (part 1 and part 2). Subjects with focal dystonia also did significantly worse than subjects with tendinitis when using the left hand on graphesthesia and manual form perception (part 2). When treating patients with repetitive strain injury, discriminative sensory motor skills must be carefully assessed and may need to be addressed as part of an effective treatment program.


    Sinku Kumar Singh


    Full Text Available The present study deals with comparison of causes of injuries among three groups of competitive footballers. Accordingly three groups of footballers were targeted. International, National and State groups footballers aged between 14 to 30 years. The data was collected with the help of questionnaires prepared by Cromwell, F.J. Walsh Gromley for Elite Gaelic footballers (2000 and it was modified by the investigator and utilized. In this study total 300 hundred players were targeted ; of which 100 footballers of each group. Total 318 injuries out of 300 hundred footballers were found out over the one year period; 125 injuries out of 84 footballers were found in international group footballers. 108 injuries out of 82 footballers were found in national group and 85 injuries out of 78 footballers were found in State group. The mean (SDs age of International group to State group footballers were 21.25 (7.08, 23.33 (7.78 and 19.91 (6.29 in years respectively. Their weight were 58.35 (18.45, 58.23 (19.01, and 53.99 (17.33 kg. respectively, their height were 167.33 (55.33, 166.09 (55.10 and 164.87 (54.66 cm. respectively, their training were 4.61 (1.47, 4.31 (1.43, and 4.10 (1.33 days in a week respectively, their training durations were 2.74 (.58, 2.34 (.78, and 1.99 (.66 hours respectively, their warm-up were 28.53 (9.33, 36.05 (11.05 and 22.8 (7.8 minutes respectively, and competition was 8.67 (2.81, 8.68 (2.78, and 6.58 (2.11 in one year respectively. The results revealed that only significant difference of occurrence of injuries was found (F=3.65, P <.05 in foul play. International group footballers were found to have got more occurrences of injuries as compared to the state group footballers. The study suggest that their was no fair play at high level competition. However, no significant difference of occurrence of injuries were observed among three groups of competitive footballers with respect to causes like collision, running, contact with ball

  3. Epilepsia partialis continua triggered by traumatic hand injury: a peripheral tuning of brain excitability?

    Paglioli, Eliseu; Martins, William Alves; Cruz, Walter De la; Andrade, Victor; Silva, Vinicius Duval da; Nunes, Rafael Menezes; Palmini, André


    Epilepsia partialis continua is often refractory to antiepileptic medication and its causal relation to peripheral sensory stimuli has only rarely been suggested. We report a man who received surgery for temporal lobe epilepsy 10 years ago, who presented "de novo" epilepsia partialis continua following mild traumatic injury of the left hand. Continuous myoclonus of the left upper limb started the day after injury and persisted unabated for several weeks. Non-invasive evaluation was inconclusive. Acute electrocorticography during surgery under local anaesthesia revealed continuous, rhythmic spiking over the right sensorimotor cortex. Tailored excision of the posterior bank of the motor and adjacent sensory cortex immediately stopped the continuous myoclonus. Histopathology showed abnormal radial lamination and was compatible with focal cortical dysplasia type IA. Epilepsia partialis continua did not recur for seven years. Afferent stimuli from peripheral injury can disinhibit hyperexcitable sensorimotor cortex leading to epilepsia partialis continua. [Published with video sequences online].

  4. [Injuries caused by acids and bases - emergency treatment].

    Reifferscheid, Florian; Stuhr, Markus; Kaiser, Guido; Freudenberg, Matthias; Kerner, Thoralf


    Emergency medical care for injuries caused by acids and bases is challenging for rescue services. They have to deal with operational safety, detection of the toxic agent, emergency medical care of the patient and handling of the rescue mission. Because of the rareness of such situations experience and routine are largely missing. This article highlights some basic points for the therapy and provides support for such rescue missions. © Georg Thieme Verlag Stuttgart · New York.

  5. Stiffness in the Hand

    ... include: Arthritis Fractures Dislocations Bad sprains Tendon and muscle injuries Evaluating Hand Stiffness Your doctor will ask when the stiffness ... scan. CAUSES SIGNS AND ... stretching exercises for the joints and muscles to help loosen them. Different types of splints ...

  6. 手外伤职业康复研究进展%Research Progress of Occupation Rehabilitation of Hand Injury

    王志军; 黄文柱; 严文


    This paper discusses research progress in hand injury rehabilitation from occupation rehabilitation in clinical application and occupation training in hand injury rehabilitation, providing a reference for the comprehensive, reasonable, objective evaluation of occupation training application in hand injury.%  本文就职业康复的临床应用和职业训练在手外伤康复中的应用两方面探讨手外伤职业康复的研究进展,以为全面、合理、客观评价职业训练应用于手外伤提供参考。

  7. [Comparative research of traumatic injury of open hand-assisted laparoscopic anterior resection of the rectum].

    Khitar'yan, A G; Glumov, E E; Veliev, K S


    The article made a comparative assessment of traumatic injury of open hand-assisted laparoscopic anterior resection of the rectum in lateral and spinal positions. The presented technique of hand-assisted laparoscopic colon and rectal surgery is simple. There are advantages in case of obesity presence (IMT more than 30 kg/m2), in significant shortening of the mesocolon and mesentery, high fixation of splenic flexure and intimate fixation of the spleen, in case of bad preparation of the bowels in partial intestinal obstruction or in case of emergency operation, big cancer size, expressed perifocal inflammation. A comparative analysis of dynamics of hormone stress content and metabolism (cortisol, adrenaline, thyrothrophic hormone) showed their expressed increase in blood during operation after traditional surgery. Less stressed reaction was noted after hand-assisted surgery, especially in overweight patients. An application of low invasive method allowed reduction of hemorrhage, pain syndrome, terms of patient's activation and restoration of intestinal motility after operation.

  8. [Medical care of injuries caused intentionally by domestic violence].

    Híjar-Medina, Martha; Flores-Regata, Lilí; Valdez-Santiago, Rosario; Blanco, Julia


    To describe and analyze the causes of emergency care services for intentional injuries, especially those caused by domestic violence, at four public hospitals in Mexico City. A cross-sectional study was conducted between January and April 1998, which included variables related with the victim, the aggressor, and the medical care provided to the victim. A questionnaire was applied to individuals who had been injured intentionally. Statistical analysis of data consisted of simple frequencies, the chi 2 test, and odds ratios (OR) with 95% confidence intervals (CI). A logistic regression model was also used to adjust for variables associated with the injury requiring emergency medical care. A total of 598 cases of intentional injuries were analyzed, 16% of which were due to domestic violence. Females were the most frequent victims (76%), followed by young people between 15 and 29 years old (46%). Variables associated with medical care due to injuries by domestic violence were: age 30 or older (OR 2.36, 95% CI 1.13-4.90), female gender (OR 8.60 95% CI 4.25-17.40), history of injuries (OR 4.93 95% CI 2.03-11.95), home as place of occurrence (OR 36.25 95% CI 16.59-79.18), and low education level (OR 2.33 95% CI 1.03-5.26). Study findings are consistent with those from other studies and call for enforcement of the Mexican Official Norm for Medical Care of Domestic Violence (Norma Oficial Mexicana para la Atención Médica de la Violencia Familiar) established in March 2000.

  9. Stingray barb injury: a cause of late coronary occlusion and stent failure.

    Saunders, Craig R; Saro, Enrique; Patel, Parag; Swidryk, John; Bacani, Victor O; Russo, Mark J; Stone, Jay H


    Stingray injuries to the heart are rare, and survivors of this injury are even rarer. To date, there are only three reported survivors of this mode of penetrating cardiac injury, all inflicted by the living animal itself. The following is a report of a stingray injury, inflicted by a human, causing coronary complications 17 years after the injury was sustained.

  10. Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome

    Dahlin Lars B


    Full Text Available Abstract Background Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS and in normal subjects. Methods Responses to the Cold Intolerance Symptom Severity (CISS questionnaire, Potential Work Exposure Scale (PWES, Disability of the Arm, Shoulder and Hand (DASH and Short-Form 36 questionnaire (SF-36 were investigated in normal subjects (n = 94, hand injured patients (amputation and nerve injuries, n = 88 and patients with HAVS (n = 30. The results are presented as median (range, percent and mean deviation from norms. The Kruskal Wallis Test or Mann-Whitney U-Test were used to identify significant differences between multiple groups or subgroups. The Spearman rank correlation was used to study the relationship between cold sensitivity and disability. Results Abnormal cold sensitivity (CISS score > 50 was seen in 75% and 45% of patients with HAVS and a traumatic hand injury, respectively. Patients were significantly more exposed to cold in their work environment than the normal population, with a consequently negative effect on work ability due to cold sensitivity. Patients with abnormal cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity [higher DASH scores and e.g. significantly larger mean deviation from norms in the subscales Role Physical and Bodily Pain (SF-36]. Conclusion Severe and abnormal cold sensitivity may have a profound impact on work capacity, leisure, disability and health-related quality of life. It is frequently seen in patients with traumatic hand injuries and particularly apparent in patients with HAVS.

  11. Cerebral Salt-Wasting Syndrome Caused by Minor Head Injury.

    Fukuoka, Toshiki; Tsurumi, Yuko; Tsurumi, Arihito


    A 34-year-old woman was admitted to hospital after sustaining a head injury in a motor vehicle accident (day 1). No signs of neurological deficit, skull fracture, brain contusion, or intracranial bleeding were evident. She was discharged without symptoms on day 4. However, headache and nausea worsened on day 8, at which time serum sodium level was noted to be 121 mEq/L. Treatment with sodium chloride was initiated, but serum sodium decreased to 116 mEq/L on day 9. Body weight decreased in proportion to the decrease in serum sodium. Cerebral salt-wasting syndrome was diagnosed. This case represents the first illustration of severe hyponatremia related to cerebral salt-wasting syndrome caused by a minor head injury.

  12. Cerebral Salt-Wasting Syndrome Caused by Minor Head Injury

    Toshiki Fukuoka


    Full Text Available A 34-year-old woman was admitted to hospital after sustaining a head injury in a motor vehicle accident (day 1. No signs of neurological deficit, skull fracture, brain contusion, or intracranial bleeding were evident. She was discharged without symptoms on day 4. However, headache and nausea worsened on day 8, at which time serum sodium level was noted to be 121 mEq/L. Treatment with sodium chloride was initiated, but serum sodium decreased to 116 mEq/L on day 9. Body weight decreased in proportion to the decrease in serum sodium. Cerebral salt-wasting syndrome was diagnosed. This case represents the first illustration of severe hyponatremia related to cerebral salt-wasting syndrome caused by a minor head injury.

  13. [Dissemination pathways in high-pressure injection injuries of the hand: an experimental animal model].

    Bekler, Halil; Gökçe, Alper; Beyzadeoğlu, Tahsin


    High-pressure injection injuries of the hand may compromise the function of the hand or even result in amputations. Based on our clinical observations, we aimed to demonstrate neurovascular dissemination in an animal model. Ten adult New Zealand rabbits with a mean weight of 200 g were used. Under xylazine-ketamine anesthesia and using a triple connection system, the rabbits were injected one milliliter of black Indian ink in the third finger tip of the upper limbs at 4 atmospheric pressure. The rabbits were sacrificed via intracardiac injections for transhumeral amputation of all the upper limbs. All amputations were fixed in 10% formalin, decalcified, and specimens obtained from fingers and distal and proximal regions of the wrist were stained with hematoxylin and eosin for histopathologic examination. Transverse sections of the third finger showed subcutaneous deposition of Indian ink particularly in the pulp in all the specimens. In addition, all specimens from the distal wrist showed penetration into fascia, tendon sheaths, and neurovascular bundles of the third finger. Our results suggest that, in addition to the tissues mentioned in the literature, neurovascular bundles are primarily and seriously affected by high-pressure injection injuries of the hand.

  14. Regular use of a hand cream can attenuate skin dryness and roughness caused by frequent hand washing

    Kampf Günter


    Full Text Available Abstract Background Aim of the study was to determine the effect of the regular use of a hand cream after washing hands on skin hydration and skin roughness. Methods Twenty-five subjects washed hands and forearms with a neutral soap four times per day, for 2 minutes each time, for a total of two weeks. One part of them used a hand cream after each hand wash, the others did not (cross over design after a wash out period of two weeks. Skin roughness and skin hydration were determined on the forearms on days 2, 7, 9 and 14. For skin roughness, twelve silicon imprint per subject and time point were taken from the stratum corneum and assessed with a 3D skin analyzer for depth of the skin relief. For skin hydration, five measurements per subject and time point were taken with a corneometer. Results Washing hands lead to a gradual increase of skin roughness from 100 (baseline to a maximum of 108.5 after 9 days. Use of a hand cream after each hand wash entailed a decrease of skin roughness which the lowest means after 2 (94.5 and 14 days (94.8. Skin hydration was gradually decreased after washing hands from 79 (baseline to 65.5 after 14 days. The hand wash, followed by use of a hand cream, still decreased skin hydration after 2 days (76.1. Over the next 12 days, however, skin hydration did not change significantly (75.6 after 14 days. Conclusion Repetitive and frequent hand washing increases skin dryness and roughness. Use of a hand cream immediately after each hand wash can confine both skin dryness and skin roughness. Regular use of skin care preparations should therefore help to prevent both dry and rough skin among healthcare workers in clinical practice.

  15. The Intersection between Ocular and Manual Motor Control: Eye–Hand Coordination in Acquired Brain Injury

    John-Ross Rizzo


    Full Text Available Acute and chronic disease processes that lead to cerebral injury can often be clinically challenging diagnostically, prognostically, and therapeutically. Neurodegenerative processes are one such elusive diagnostic group, given their often diffuse and indolent nature, creating difficulties in pinpointing specific structural abnormalities that relate to functional limitations. A number of studies in recent years have focused on eye–hand coordination (EHC in the setting of acquired brain injury (ABI, highlighting the important set of interconnected functions of the eye and hand and their relevance in neurological conditions. These experiments, which have concentrated on focal lesion-based models, have significantly improved our understanding of neurophysiology and underscored the sensitivity of biomarkers in acute and chronic neurological disease processes, especially when such biomarkers are combined synergistically. To better understand EHC and its connection with ABI, there is a need to clarify its definition and to delineate its neuroanatomical and computational underpinnings. Successful EHC relies on the complex feedback- and prediction-mediated relationship between the visual, ocular motor, and manual motor systems and takes advantage of finely orchestrated synergies between these systems in both the spatial and temporal domains. Interactions of this type are representative of functional sensorimotor control, and their disruption constitutes one of the most frequent deficits secondary to brain injury. The present review describes the visually mediated planning and control of eye movements, hand movements, and their coordination, with a particular focus on deficits that occur following neurovascular, neurotraumatic, and neurodegenerative conditions. Following this review, we also discuss potential future research directions, highlighting objective EHC as a sensitive biomarker complement within acute and chronic neurological disease processes.

  16. Epidemiologic features of lethal head injury caused by highway traffic accidents


    Objective:To study the epidemiologic features of highway traffic accidents by analyzing the clinical data of the patients died of head injury.Methods:The reatures of the cases' age,occupation,status of head injury and complications.and the rescue procedures were retrospectively analyzed based on the data of 214 patients died of head injury.Results:The main victime were adults(78%)and peasants(52.8%).And the ost common head injuries were severe cerebral contusion with intracranial hematomas(73.4%).The mean arrival time from the accident spots to hospitals was(2.2±1.9)h.And the mean interval time between the arrival and operation was(1.9±0.9)h.Primary and secondary brainstem damage were the main causes of early death.Yet pulmonary infection and multiple organs failure were the common reasons for late death.Conclusions:Enhancing the propaganda for traffic regulations,establishing perfect pre-hospital and in-hospital EMS(emergency medical service)system,catching the opportunity of operation,and preventing complications are essential to reduce the mortality of traffic accidents induced head trauma.

  17. Effects of hand cycle training on wheelchair capacity during clinical rehabilitation in persons with a spinal cord injury

    Valent, Linda; Dallmeijer, Annet; Houdijk, Han; Slootman, Hans J.; Janssen, T. W.; Van Der Woude, Lucas H. V.


    Purpose. To evaluate the effects of a structured hand cycle training programme on physical capacity in subjects with spinal cord injury (SCI) during clinical rehabilitation. Method. Twenty subjects with SCI who followed hand cycle training were compared with matched control subjects from a Dutch

  18. Effects of hand cycle training on wheelchair capacity during clinical rehabilitation in persons with a spinal cord injury

    Valent, Linda; Dallmeijer, Annet; Houdijk, Han; Slootman, Hans J.; Janssen, T. W.; Van Der Woude, Lucas H. V.


    Purpose. To evaluate the effects of a structured hand cycle training programme on physical capacity in subjects with spinal cord injury (SCI) during clinical rehabilitation. Method. Twenty subjects with SCI who followed hand cycle training were compared with matched control subjects from a Dutch lon

  19. Research progress on evaluation of hand function in patients with hand injury%手外伤病人手功能评估的研究进展

    刘兴红; 喻姣花


    It described the research progress on evaluation index and evaluation tools of hand function in patients with hand injury.It summarized the advantages and disadvantages of objective and subjective evaluation meth-ods,and provided some guidance for the clinical and rehabilitation workers choosing appropriate assessment tools,so as to implement individualized rehabilitation measures and promote the social rehabilitation in patients with hand injury.%阐述了手外伤病人手功能评价指标以及评估工具的研究进展,总结了客观与主观评估方法的优缺点,为临床和康复工作者选择合适的评估工具提供指导以实施个性化的康复措施,促进手外伤病人的社会化康复。

  20. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

    Loosemore, Michael; Lightfoot, Joseph; Gatt, Ian; Hayton, Mike; Beardsley, Chris


    Background: The purpose of this investigation was to explore prospectively the nature and duration of hand and wrist injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2012. Methods: Longitudinal prospective injury surveillance of the GB boxing squad was performed from 2005 to 2012. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 hours. Results: Finger carpometacarpal instability and finger metacarpophalangeal joint extensor hood and capsule sprain also known as "boxer's knuckle" injuries were significantly more common than other injury diagnoses. The number of injuries during training or competition was similar, which is remarkable given the far greater number of training hours than competition hours performed. Injury rate for hand and wrist injuries in competition was 347 injuries per 1000 hours, while the estimated injury rate in training was <0.5 injuries per 1000 hours. Conclusion: Carpometacarpal instability and boxer's knuckle were more common than any other kind of hand and wrist injury in this cohort of elite amateur boxers. The rate of hand and wrist injuries was higher in competition than in training. Our study highlights the importance of hand and wrist injury prevention in the competition environment.

  1. Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change.

    Guo, Chunlan; Deng, Hongyan; Yang, Jian


    To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.

  2. Epididymitis caused by coxsackievirus A6 in association with hand, foot, and mouth disease.

    Vuorinen, Tytti; Osterback, Riikka; Kuisma, Jani; Ylipalosaari, Pekka


    Coxsackievirus A6 (CV-A6) caused hand, foot, and mouth disease (HFMD) with a unique manifestation of epididymitis. The patient underwent operation due to suspicion of testicular torsion. Epididymitis was diagnosed by ultrasound examination. Enterovirus was detected from epididymal fluid by PCR and typed by partial sequencing of viral protein 1 as CV-A6. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  3. Pyridoxine for Prevention of Hand-Foot Syndrome Caused by Chemotherapy: A Systematic Review


    BACKGROUND: Hand-foot syndrome (HFS) is a relatively frequent dermatologic toxic reaction to certain anti-cancer chemotherapies. The syndrome can evolve into a distressing condition that limits function and affects quality of life. Pyridoxine (vitamin B6) has been used empirically for the prevention of HFS caused by anti-cancer therapy. However, evidence of its efficacy remains controversial. METHODOLOGY//PRINCIPAL FINDINGS: Systematic literature searches were conducted on the Cochrane Librar...

  4. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction


    This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group), or burn injury combined with seawater immersion (BI group), or only immersion in seawater (I group), or control animals with no injury or immersion (C group). The circulating endothelial cell (CEC) count and coagulation-fibrinolysis paramet...

  5. Acceleration-caused injury of the cervical spine. Whiplash injury; Beschleunigungsverletzung der Halswirbelsaeule. HWS-Schleudertrauma

    Wedig, Hans-Dieter (eds.) [Kanzlei Dr. W.G. Schmidt, Sonthofen (Germany); Graf, Michael; Grill, Christian


    Acceleration injuries of the cervical spine are mostly caused by car accidents. Due to the high traffic density and the increasing number of car accidents with personal injuries the number of concerned persons is also increasing. A large percentage of injured persons suffer ongoing troubles following ineffective therapy trials up to occupational disability. Therefore the whiplash injury is a significant medical and legal problem. The book includes contributions of international experts on the latest state of research and the actual knowledge on the controversial discussed field. An interdisciplinary forum discusses medical, injury-mechanical, consultant-related and legal questions and therapeutic approaches that might be successful. [German] Beschleunigungsverletzungen der Halswirbelsaeule treten ueberwiegend nach Autounfaellen auf. Aufgrund der hohen Verkehrsdichte und der steigenden Anzahl an Verkehrsunfaellen mit Personenschaeden steigt auch die Zahl der Betroffenen stetig an. Einer grossen Zahl von Unfallgeschaedigten, die nach kurzer Zeit beschwerdefrei leben koennen, steht leider eine wachsende Zahl von Betroffenen mit anhaltenden Beschwerden, erfolglosen Therapieversuchen bis hin zur Berufsunfaehigkeit gegenueber. Das 'HWS-Schleudertrauma' stellt nach wie vor ein erhebliches medizinisches und rechtliches Problem dar. In diesem Buch beschreiben international ausgewiesene Experten den neuesten Forschungsstand, das aktuelle Wissen und die Lehrmeinungen auf diesem kontrovers diskutierten und komplexen Gebiet. In einem interdisziplinaeren Ansatz werden medizinische, verletzungsmechanische, gutachterliche und gerichtliche Fragestellungen diskutiert und Erfolg versprechende Therapieansaetze eroertert. Aerzte, Juristen, Versicherungen und Betroffene werden in einen gemeinsamen Dialog gebracht, mit dem Ziel, konstruktive Loesungen zu erarbeiten. Eine praktische Arbeitshilfe - das Buch fuer alle, die mit dieser Problematik befasst sind. (orig.)

  6. Measurement error in grip and pinch force measurements in patients with hand injuries.

    Schreuders, Ton A R; Roebroeck, Marij E; Goumans, Janine; van Nieuwenhuijzen, Johan F; Stijnen, Theo H; Stam, Henk J


    There is limited documentation of measurement error of grip and pinch force evaluation methods. The purposes of this study were (1) to determine indexes of measurement error for intraexaminer and interexaminer measurements of grip and pinch force in patients with hand injuries and (2) to investigate whether the measurement error differs between measurements of the injured and noninjured hands and between experienced and inexperienced examiners. The subjects were a consecutive sample of 33 patients with hand injuries who were seen in the Department of Rehabilitation Medicine of Erasmus MC-University Medical Center Rotterdam in the Netherlands. Repeated measurements were taken of grip and pinch force, with a short break of 2 to 3 minutes between sessions. For the grip force in 2 handle positions (distance between handles of 4.6 and 7.2 cm, respectively), tip pinch (with the index finger on top and the thumb below, with the other fingers flexed) and key pinch force (with the thumb on top and the radial side of the index finger below) data were obtained on both hands of the subjects by an experienced examiner and an inexperienced examiner. Intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and associated smallest detectable differences (SDDs) were calculated and compared with data from previous studies. The reliability of the measurements was expressed by ICCs between .82 and .97. For grip force measurements (in the second handle position) by the experienced examiner, an SDD of 61 N was found. For tip pinch and key pinch, these values were 12 N and 11 N, respectively. For measurements by the inexperienced examiner, SDDs of 56 N for grip force and 13 N and 18 N for tip pinch and key pinch were found. Based on the SEMs and SDDs, in individual patients only relatively large differences in grip and pinch force measurements can be adequately detected between consecutive measurements. Measurement error did not differ between injured and

  7. Alterations in multidimensional motor unit number index of hand muscles after incomplete cervical spinal cord injury.

    Li, Le; Li, Xiaoyan; Liu, Jie; Zhou, Ping


    The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX) technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI). The MD-MUNIX was estimated from the compound muscle action potential (CMAP) and different levels of surface interference pattern electromyogram (EMG) at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI), thenar and hypothenar muscles of SCI (n = 12) and healthy control (n = 12) subjects. The results showed that the SCI subjects had significantly smaller CMAP and MD-MUNIX in all the three examined muscles, compared to those derived from the healthy control subjects. The multidimensional motor unit size index (MD-MUSIX) demonstrated significantly larger values for the FDI and hypothenar muscles in SCI subjects than those from healthy control subjects, whereas the MD-MUSIX enlargement was marginally significant for the thenar muscles. The findings from the MD-MUNIX analyses provide an evidence of motor unit loss in hand muscles of cervical SCI patients, contributing to hand function deterioration.

  8. The sensory consequences of repetitive strain injury in musicians: focal dystonia of the hand.

    Byl, N; Hamati, D; Melnick, M; Wilson, F; McKenzie, A


    Some individuals with repetitive strain injury (RSI) develop focal dystonia of the hand (FDh), a disorder of motor control manifested in a specific context during skilled, hand movements. This descriptive study was designed to determine if musicians with FDh had reduced tactile discrimination. Ten healthy adults and ten patients with FDh participated in the study. From the standardized Sensory Integration and Praxis Test, five subtests were selected to measure tactile discrimination. The Paired Wilcoxon Test was used to analyze, meaningful, planned pairwise differences by side and by group. The two groups performed similarly on the three tests measuring tactile motor perception (Finger Identification, Localization and Kinesthesia). However, those with FDh performed significantly worse than the healthy comparison group on two tactile perceptual tasks: (1) Graphesthesia, right affected (P < 0.003) and left unaffected (p < 0.005); and (2) Manual Form Perception (stereognosis) on the right affected (P < 0.002) and left unaffected (P < 0.002). It is possible that the somatosensory differences as measured by tactile discrimination tasks represent some degradation of the hand representation following prolonged, repetitive, near simultaneous sensory stimulation of adjacent digits. Tactile discrimination should be tested in patients with RSI to detect potential risks for developing FDh. Effective treatment of patients with RSI including FDh may need to target the somatosensory deficits in order to restore stress-free motor movements.

  9. Assessment of Oro-Maxillofacial Trauma According to Gender, Age, Cause and Type of the Injury

    Matijević, Marko; Sikora, Miroslav; Leović, Dinko; Mumlek, Ivan; Macan, Darko


    Objectives The occurrence and causes of maxillofacial trauma varies in different regions of the world. The aim of this study was to identify the occurrence, types and causes of maxillofacial injuries according to the age and gender differences in patients treated at the Department of Maxillofacial Surgery, University Hospital Center Osijek, between January 2011 and December 2013. Materials and methods A total of 64 patients, 41 males (64.1%) and 23 females (35.9%), aged from 18 to 86 years (mean age 42) participated in the study. Data collected and analyzed included gender, age, cause of injury and the type of maxillofacial injuries. Results The most common cause of injuries in both gender groups was falling down (39% males; 65% females). The second leading cause of injuries in males was interpersonal violence (29%) and in females traffic accident (26%) (p0.05). The most common causes of injuries in the youngest patients was violence (43%), and in others fall (50-70%; p0.05). The majority of the falls and violence caused bone tissue injuries, and soft tissue and dentalveolar injuries were detected in traffic and sports accidents (p>0.05). Conclusion Falling down was the most common cause of oro-maxillofacial injuries in both men and women and in all three age groups. The leading type of injury was bone injury. The data obtained from this study provide important information for future prevention from injuries. PMID:27688419

  10. [Star fruit as a cause of acute kidney injury].

    Scaranello, Karilla Lany; Alvares, Valeria Regina de Cristo; Carneiro, Daniely Maria Queiroz; Barros, Flávio Henrique Soares; Gentil, Thais Marques Sanches; Thomaz, Myriam José; Pereira, Benedito Jorge; Pereira, Mariana Batista; Leme, Graziella Malzoni; Diz, Mary Carla Esteves; Laranja, Sandra Maria Rodrigues


    The star fruit belongs to the family Oxalidacea, species Averrhoa carambola. It is rich in minerals, vitamin A, C, B complex vitamins and oxalic acid. Recent studies show that the toxicity of the fruit differs between the patients and may be explained by single biological responses, age, and the intake quantity of the neurotoxin in each fruit in addition to glomerular filtration rate given by each patient. Additionally, the nephrotoxicity caused by the fruit is dose-dependent and may lead to the deposition of crystals of calcium oxalate intratubular, as well as by direct injury to the renal tubular epithelium, leading to apoptosis of the same. We report the case of a patient who after ingestion of the juice and fresh fruit, developed acute renal failure requiring dialysis, evolving with favourable outcome and recovery of renal function.

  11. Second-hand tobacco smoke in Oklahoma: a preventable cause of morbidity and mortality and means of reducing exposure.

    Miner, Robert N; Crutcher, James M


    Evidence has mounted in recent years establishing second-hand tobacco smoke exposure as a cause of morbidity and mortality in nonsmokers. The ratio of deaths is approximately one nonsmoker dying from illness caused by second-hand smoke exposure for every eight smokers who die from diseases caused by tobacco use. This is equivalent to about 750 nonsmoker deaths each year in Oklahoma caused by exposure to second-hand smoke. This article reviews the components of second-hand smoke, its health effects, its prevalence in Oklahoma, and the means of protecting children and nonsmoking adults from exposure. Oklahoma physicians are encouraged to advise their patients about the harmful effects of second-hand smoke and to actively support public policies that decrease exposure to second-hand smoke in public places and workplaces.

  12. Paintball Causes Many Vision-Robbing Eye Injuries

    ... News) -- Paintball guns pose the greatest risk of vision loss among the sports most commonly associated with eye injuries, a new ... Human Services. More Health News on: Eye Injuries Sports Injuries Vision Impairment and Blindness Recent Health News Related MedlinePlus ...

  13. Traumatic Brain Injury as a Cause of Behavior Disorders.

    Nordlund, Marcia R.

    There is increasing evidence that many children and adolescents who display behavior disorders have sustained a traumatic brain injury. Traumatic brain injury can take the following forms: closed head trauma in which the brain usually suffers diffuse damage; open head injury which usually results in specific focal damage; or internal trauma (e.g.,…

  14. Pancreatitis in hand-foot-and-mouth disease caused by enterovirus 71.

    Zhang, Yu-Feng; Deng, Hui-Ling; Fu, Jia; Zhang, Yu; Wei, Jian-Qiang


    Some viruses, including certain members of the enterovirus genus, have been reported to cause pancreatitis, especially Coxsackie virus. However, no case of human enterovirus 71 (EV71) associated with pancreatitis has been reported so far. We here report a case of EV71-induced hand-foot-and-mouth disease (HFMD) presenting with pancreatitis in a 2-year-old girl. This is the first report of a patient with acute pancreatitis in HFMD caused by EV71. We treated the patient conservatively with nasogastric suction, intravenous fluid and antivirals. The patient's symptoms improved after 8 d, and recovered without complications. We conclude that EV71 can cause acute pancreatitis in HFMD, which should be considered in differential diagnosis, especially in cases of idiopathic pancreatitis.

  15. A descriptive study of hand injuries presenting to the adult emergency department of a tertiary care center in urban India

    Ghiya, Murtuza N.; Murty, Shakuntala; Shetty, Naren; D'Cunha, Rodney


    Background: Despite having a dedicated Plastic Surgery Unit, emergency physicians (EPs) manage many of the acute, traumatic hand injuries. Further very minimal information exists about the extent to which tetanus recommendations as per Advisory Committee on Immunization Practices are followed in emergency departments (EDs). Furthermore, the management of pain is often neglected. Objectives: To provide a clinical description of hand injuries with etiology and mechanism; and describe the trends of ED management, including analgesia and tetanus prophylaxis. Methodology: Records of eighty patients with hand injuries were reviewed. SPSS version 18 was used for statistical analysis. Wilcoxon signed rank test, and Pearson Chi-square test were used to compare left with right-hand injuries and validate associations, respectively. Results: The mean age of the patients was 27.41 years and median delay in presentation was 2 h. Occupational injury was the predominant mode of injury (74%) most patients (59 of the 86) received intravenous analgesia; while very few (6) received local anesthesia and (24) received no analgesia at all. A majority of patients (56) received tetanus toxoid prophylaxis, while only four patients (4.6%) also received tetanus immunoglobulin intramuscular. Most patients (71%) were admitted, while only a small number of patients (14%) were discharged from the ED. Conclusion: Proper training and sensitization towards the need and technique of anesthesia (particularly local anesthesia) would improve the quality of patient care. Printed guidelines and periodic review of the charts would help to overcome poor adherence to tetanus prophylaxis. Hand injuries could be managed better by the EP, with training through rotations to the Plastic Surgery Unit.

  16. A descriptive study of hand injuries presenting to the adult emergency department of a tertiary care center in urban India

    Murtuza N Ghiya


    Full Text Available Background: Despite having a dedicated Plastic Surgery Unit, emergency physicians (EPs manage many of the acute, traumatic hand injuries. Further very minimal information exists about the extent to which tetanus recommendations as per Advisory Committee on Immunization Practices are followed in emergency departments (EDs. Furthermore, the management of pain is often neglected. Objectives: To provide a clinical description of hand injuries with etiology and mechanism; and describe the trends of ED management, including analgesia and tetanus prophylaxis. Methodology: Records of eighty patients with hand injuries were reviewed. SPSS version 18 was used for statistical analysis. Wilcoxon signed rank test, and Pearson Chi-square test were used to compare left with right-hand injuries and validate associations, respectively. Results: The mean age of the patients was 27.41 years and median delay in presentation was 2 h. Occupational injury was the predominant mode of injury (74% most patients (59 of the 86 received intravenous analgesia; while very few (6 received local anesthesia and (24 received no analgesia at all. A majority of patients (56 received tetanus toxoid prophylaxis, while only four patients (4.6% also received tetanus immunoglobulin intramuscular. Most patients (71% were admitted, while only a small number of patients (14% were discharged from the ED. Conclusion: Proper training and sensitization towards the need and technique of anesthesia (particularly local anesthesia would improve the quality of patient care. Printed guidelines and periodic review of the charts would help to overcome poor adherence to tetanus prophylaxis. Hand injuries could be managed better by the EP, with training through rotations to the Plastic Surgery Unit.

  17. Patterns of maxillofacial injuries caused by terrorist attacks in Iraq: retrospective study.

    Gataa, I S; Muassa, Q H


    Over the past 5 years, Iraq has witnessed daily terrorist attacks mainly using improvised explosive devices. The aim of this study was to analyze the patterns of maxillofacial injuries caused by terrorist attacks in a sample of Iraqi casualties. Records from two hospitals, including 551 patients who sustained maxillofacial injuries due to terrorists attacks, were analyzed according to the patients' age, sex, site of injury, type of injury and cause of injury. Concomitant injuries and mortality were also considered. The most common age group affected was those aged 15-29 years. Most of these injuries were caused by improvised explosive devices (71%). More than one facial zone was injured in 212 patients (38%). Isolated soft tissues injuries were detected in (54%) of victims. Pure maxillofacial injuries comprised 33%. The most common injuries associated with this type of trauma were eye injuries (29%). The mortality rate was 2% from pure maxillofacial injuries. Terrorist attacks cause unique maxillofacial injuries, which should be considered a new entity in the trauma field.

  18. Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia.

    Nmn NikNadia; I-Ching Sam; Sanjay Rampal; Wmz WanNorAmalina; Ghazali NurAtifah; Khebir Verasahib; Chia Ching Ong; MohdAidinniza MohdAdib; Yoke Fun Chan


    Enterovirus A71 (EV-A71) is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2–3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence). Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples c...

  19. Early intensive hand rehabilitation is not more effective than usual care plus one-to-one hand therapy in people with sub-acute spinal cord injury (‘Hands On’: a randomised trial

    Lisa A Harvey


    Full Text Available Question: What is the effect of adding an intensive task-specific hand-training program involving functional electrical stimulation to a combination of usual care plus three 15-minute sessions per week of one-to-one hand therapy in people with sub-acute tetraplegia? Design: A parallel group, randomised, controlled trial. Participants were randomly assigned (1:1 via a computer-generated concealed block randomisation procedure to either a control or experimental intervention. Participants: Seventy people with C2 to T1 motor complete or incomplete tetraplegia within 6 months of injury. Participants were recruited from seven spinal units in Australia and New Zealand. Intervention: Experimental participants received intensive training for one hand. Intensive training consisted of training with an instrumented exercise workstation in conjunction with functional electrical stimulation for 1 hour per day, 5 days per week for 8 weeks. Both groups received usual care and 15 minutes of one-to-one hand therapy three times per week without functional electrical stimulation. Outcome measures: The primary outcome was the modified Action Research Arm Test reflecting arm and hand function, which was assessed at the end of the intervention, that is, 11 weeks after randomisation. Secondary outcomes were measured at 11 and 26 weeks. Results: Sixty-six (94% participants completed the post-intervention assessment and were included in the primary intention-to-treat analysis. The mean modified Action Research Arm Test score for experimental and control participants at the post-intervention assessment was 36.5 points (SD 16.0 and 33.2 points (SD 17.5, respectively, with an adjusted mean between-group difference of 0.9 points (95% CI –4.1 to 5.9. Conclusion: Adding an intensive task-specific hand-training program involving functional electrical stimulation to a combination of usual care plus three 15-minute sessions per week of one-to-one hand therapy does not improve

  20. A giant abdominal hematoma caused by seatbelt injury led to the development of shock.

    Nishino, Tomoya; Morita, Seiji; Sakurai, Keiji; Watanabe, Yasue


    Trauma to soft tissues is an important consideration in cases of seatbelt injury, as soft-tissue injury can cause shock. Careful observation for hours in the clinic at least, along with appropriate imaging studies, is necessary if signs of a seatbelt injury exist.

  1. Sports injuries: An important cause of morbidity in urban youth. District of Columbia Child/Adolescent Injury Research Network.

    Cheng, T L; Fields, C B; Brenner, R A; Wright, J L; Lomax, T; Scheidt, P C


    Sports injuries account for substantial morbidity and medical cost. To direct intervention, a population-based study of the causes and types of sports injuries was undertaken. An injury surveillance system was established at all trauma center hospitals that treat residents 10 to 19 years old in the District of Columbia and the Chief Medical Examiner's Office. Medical record abstractions were completed for those seen in an emergency department, admitted to the hospital, or who died from injury June 1996 through June 1998. Seventeen percent (n = 2563) of all injuries occurred while participating in 1 of 6 sports (baseball/softball, basketball, biking, football, skating, and soccer) resulting in an event-based injury rate of 25.0 per 1000 adolescents or 25.0/1000 population year. Rates were higher in males for all sports. The most common mechanisms were falls (E880-888) and being struck by or against objects (E916-918). Hospitalization was required in 2% of visits and there were no deaths. Of those requiring hospitalization, 51% involved other persons, 12% were equipment-related, and 8% involved poor field/surface conditions. Of all baseball injuries, 55% involved ball or bat impact often of the head. Basketball injuries included several injuries from striking against the basketball pole or rim or being struck by a falling pole or backboard. Biking injuries requiring admission included 2 straddle injuries onto the bike center bar and collision with motor vehicles. Of all football injuries, 48 (7%) involved being struck by an opponent's helmet and 63 (9%) involved inappropriate field conditions including falls on or against concrete, glass, or fixed objects. In soccer there were 4 goal post injuries and a large proportion of intracranial injuries. There were 51 probable or clear assaults during sports and an additional 30 to 41 injuries from baseball bat assaults. Many sports including noncontact sports involved injuries of the head suggesting the need for improved

  2. Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters

    Golubović Zoran


    Full Text Available 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

  3. [An information system for injuries from external causes (SILEX): a successful project in El Salvador].

    Salinas, Oscar; de Cosío, Gerardo; Clavel-Arcas, Carme; Montoya, Jeannette; Serpas, Mario; Morán de García, Silvia; Concha-Eastman, Alberto


    This article examines the stages in developing an information system for injuries from external causes (Sistema de Información de Lesiones de Causa Externa-SILEX), as well as its limitations and achievements. SILEX is a Web-based application for collection, quality control, presentation, and analysis of data available from the hospital system for surveillance of injuries from external causes created by Ministry of Health of El Salvador with data from the hospital emergency services. This system maintains comprehensive information on the injured person-type of injury, intention, injury site, activity being performed at the time of injury, risk factors, etc.-in the form of tables, graphs, and maps, which streamlines the development of intervention plans and prevention initiatives for these types of injuries in El Salvador. This experience is an example of what can be done to close the information gap on injuries by external causes in the Region of the Americas.

  4. Repeated mild injury causes cumulative damage to hippocampal cells

    E.J. Matser (Amy); C.I. de Zeeuw (Chris); J.T. Weber (John)


    textabstractAn interesting hypothesis in the study of neurotrauma is that repeated traumatic brain injury may result in cumulative damage to cells of the brain. However, post-injury sequelae are difficult to address at the cellular level in vivo. Therefore, it is necessary to compl

  5. TLR2 deficiency aggravates lung injury caused by mechanical ventilation

    Kuipers, Maria Theresa; Jongsma, Geartsje; Hegeman, Maria A; Tuip-de Boer, Anita M; Wolthuis, Esther K; Choi, Goda; Bresser, Paul; van der Poll, Tom; Schultz, Marcus J; Wieland, Catharina W


    Innate immunity pathways are found to play an important role in ventilator-induced lung injury. We analyzed pulmonary expression of Toll-like receptor 2 (TLR2) in humans and mice and determined the role of TLR2 in the pathogenesis of ventilator-induced lung injury in mice. Toll-like receptor 2 gene

  6. Bath Salts: A Newly Recognized Cause of Acute Kidney Injury

    Jonathan McNeely


    Full Text Available Bath salts are substance of abuse that are becoming more common and are difficult to recognize due to negative toxicology screening. Acute kidney injury due to bath salt use has not previously been described. We present the case of a previously healthy male who developed acute kidney injury and dialysis dependence after bath salt ingestion and insufflation. This was self-reported with negative toxicology screening. Clinical course was marked by severe hyperthermia, hyperkalemia, rhabdomyolysis, disseminated intravascular coagulation, oliguria, and sepsis. We discuss signs and symptoms, differential diagnoses, potential mechanisms of injury, management, and review of the literature related to bath salt toxicity.

  7. Bath salts: a newly recognized cause of acute kidney injury.

    McNeely, Jonathan; Parikh, Samir; Valentine, Christopher; Haddad, Nabil; Shidham, Ganesh; Rovin, Brad; Hebert, Lee; Agarwal, Anil


    Bath salts are substance of abuse that are becoming more common and are difficult to recognize due to negative toxicology screening. Acute kidney injury due to bath salt use has not previously been described. We present the case of a previously healthy male who developed acute kidney injury and dialysis dependence after bath salt ingestion and insufflation. This was self-reported with negative toxicology screening. Clinical course was marked by severe hyperthermia, hyperkalemia, rhabdomyolysis, disseminated intravascular coagulation, oliguria, and sepsis. We discuss signs and symptoms, differential diagnoses, potential mechanisms of injury, management, and review of the literature related to bath salt toxicity.

  8. Severe head injury caused by motorcycle traffic accident



    Objective To explore the characteristic and treatment of the severe head injury due to motorcycle accident.Methods Review and analysis of 27 motorcycle traffic trauma cases who were admitted to our hospital from Oct.1995 to Sep.1997.Results Young men were the main composition of these patients.Multiple injuries associated with brain ste or diffuse axonal injury were common,which were the main factors influencing the consciousness and prognosis of the patients.The wound was usually severely contaminated.Evacuation of hematomas,decompression by depleting skull flap,hypotheymia and artificial hibernation were conducted in this series.Among them,14 cases were cured ,3 cases were seriously disabled,10 cases died.Conclusions Motorcycle's weight is light so it easily loses its balance.The riders and the passengers are exposed and lack protection.Driving against traffic regulations is frquently seen.All these are the reasons why the motorcycle traffic accidents often take place. When the traffic accident happens,the patients' head generally is thrown a long distance and dashed against the barrier or the ground.The psture nd mechanism of injury were complicated and varied.The decelerated injury and rolling injury occurred frequently and they were the main reasons for brain stem or diffuse axonal injury.The patients who have surgical indication should be operated upon as soon as possible.Hibernation and low temoerature therapy are conducive to the protection of the brain function at the early stage of postinjury or postoperation.A careful epluchage is essential to reduce infection of the open injury.

  9. Robotic training and kinematic analysis of arm and hand after incomplete spinal cord injury: a case study.

    Kadivar, Z; Sullivan, J L; Eng, D P; Pehlivan, A U; O'Malley, M K; Yozbatiran, N; Francisco, G E


    Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic training in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be catalyzed by repetitive movement training such as that available with robotic devices, it is probable that robotic upper-extremity training of persons with SCI could be clinically beneficial. The primary goal of this pilot study was to test the feasibility of using a novel robotic device for the upper extremity (RiceWrist) and to evaluate robotic rehabilitation using the RiceWrist in a tetraplegic person with incomplete SCI. A 24-year-old male with incomplete SCI participated in 10 sessions of robot-assisted therapy involving intensive upper limb training. The subject successfully completed all training sessions and showed improvements in movement smoothness, as well as in the hand function. Results from this study provide valuable information for further developments of robotic devices for upper limb rehabilitation in persons with SCI. © 2011 IEEE

  10. Reducing the incidence of Obstetric Sphincter Injuries using a hands-on technique: an interventional quality improvement project

    Rasmussen, Ole Bredahl; Yding, Annika; Anh Ø, Jacob; Sander Andersen, Charlotte; Boris, Jane


    A main concern for women giving birth is the risk of obstetric anal sphincter injuries. In our department the incidence of sphincter injuries was around 8 % among vaginally delivering first time mothers. We aimed to halve the incidence to 4 % or less. A prospective interventional program was instituted. We implemented a hands-on technique with four elements in a bundle of care together with a certification process for all staff on the delivery ward. The incidence of episiotomies served as a balancing indicator. The adherence to three of the four elements of the care bundle rose significantly while the all-or-nothing indicator leveled around 80 %. The median number of deliveries between cases with a sphincter injury increased from 9.5 in the baseline period to 20 during the intervention period. This corresponded with a reduction in the incidence from 7.0 % to 3.4 %. The rate of episiotomy remained low at 8.4 % in this group. By implementing the hands-on technique, we halved the risk of obstetric anal sphincter injuries. Our data suggest that further improvement may be anticipated. The study has demonstrated how implementation of a hands-on technique can be carried out within a quality improvement framework with rapid and sustainable results. PMID:28074131

  11. [Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand].

    Zhu, C; Yi, N; Shi, M N; Liang, Y Y; Zhou, Y B; Dang, R; Qi, Z S; Zhao, H Y


    Objective: To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand. Methods: Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n=18) and comprehensive training group (CT, n=28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test. Results: (1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups (t=0.834, P>0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in group CT

  12. Cardiac injuries caused by blunt trauma: an autopsy based assessment of the injury pattern.

    Turan, Arzu Akcay; Karayel, Ferah Anik; Akyildiz, Elif; Pakis, Isil; Uzun, Ibrahim; Gurpinar, Kagan; Atilmis, Umit; Kir, Ziya


    Nonpenetrating chest trauma with injury to the heart and aorta has become increasingly common, particularly as a result of rapid deceleration in high-speed vehicular accidents, over the past 2-3 decades. The high mortality rate of cardiac injuries and possible late onset complications make blunt cardiac injuries an important challenging point for legal medicine. One hundred and ninety cases with blunt cardiac injuries in a period of 3 years were analyzed retrospectively in terms of patterns of cardiac injury, survival times, and demographic profiles of the cases in this study.

  13. Analysis of the causes of ocular injuries in various armed services in China

    Huai-yu QIU


    Full Text Available Objective To study the causes of ocular injuries in various armed forces for more effective prevention of the occurrence of ocular injuries.Methods Twenty-one military hospitals were selected as the objects of study,and the questionnaires were distributed to the hospitals before Jan.1,2009.The data of soldiers with ocular trauma who had visited the hospitals from Jan.1,2009 to Dec.31,2009 were collected and statistically analyzed with WPSS 13.0 software.Results Five hundred and two cases(549 eyes of ocular injury were investigated.Sport-related injury was on the top rank of causes(181/502,36.1%,and it was more often seen in navy and air-force.Of sport-related injuries,69.1% of them were caused by playing basket-ball and 18.8% by playing football.Work-related injury was the second cause(140/502,27.9%.The highest ratio of work-related injury was in marine force(31/67,46.3%.The ratios of military training-related injury in army and armed police were 21.4% and 21.3%,respectively,but the incidence was only 4.4% in navy.The analysis of training subjects showed that about 49.2% was skill related training,such as parachuting,manipulation of firearms;and 29.5% was physical exercise or confrontational exercises.It was also found that the ratio of sport-related injury increased and military training-related injury decreased with a raise of education level of soldiers.Conclusions It is important to pay attention to ocular injury in military personnel during physical exercise and sport.Also,it will be more effective to prevent ocular injury according to different causes in various armed forces.

  14. Vascular Injuries Caused by Tear Gas Shells: Surgical Challenge and Outcome

    Mohd Lateef Wani


    Full Text Available Background: Tear gas shells are used to disperse the mob during any type of street protests. Vascular injuries due to tear gas shells have not been reported. The present study was un-dertaken to analyse the pattern, presentation, management and outcome of vascular injury due to tear gas shells. Methods: Eighteen patients with vascular injury caused by tear gas shells from 1st Jan. 2008 to 31st Dec 2009 were studied. Patients with vascular injuries caused by causes other than tear gas shells were excluded from the study. Results: All patients were treated with reverse saphenous vein graft as segmental loss was less than 2.5 cm. Wound infection was the most common complication, followed by graft occlusion. Amputation rate was 16.66%. Associated nerve injury occurred in 44.44% of the patients. Conclusion: Tear gas shell injuries should not be taken lightly. They can cause injuries as serious as vascular injuries. Vascular injuries cased by tear gas shells require prompt revascularisation to improve limb salvage. De-spite proper revascularisation, patients have significant morbidity and need proper rehabilitation in the follow ups.

  15. Dyselectrolytemia in acute kidney injury causing tetany and quadriparesis.

    Palkar, Atul Vijay; Mewada, Mayur; Thakur, Sonal; Shrivastava, Makardhwaj Sarvadaman


    A 40-year-old female, presented with prerenal acute kidney injury secondary to diarrhoea. With appropriate hydration, she went into diuretic phase and subsequently developed hypokalemic quadriparesis with hypocalcaemic tetany due to hypomagnesemia and subclinical vitamin D deficiency. The patient improved with oral potassium, magnesium, calcium and vitamin D supplementation.

  16. Correlates of undefined cause of injury coded mortality data in Australia.

    McKenzie, Kirsten; Chen, Linping; Walker, Susan M


    The objective of this research was to identify the level of detail regarding the external causes of death in Australia and ascertain problematic areas where data quality improvement efforts may be focused. The 2003 national mortality dataset of 12,591 deaths with an external cause of injury as the underlying cause of death (UCOD) or multiple cause of death (MCOD) based on ICD-10 code assignment from death certificate information was obtained. Logistic regression models were used to examine the precision of coded external cause of injury data. It was found that overall, accidents were the most poorly defined of all intent code blocks with over 30% of accidents being undefined, representing 2,314 deaths in 2003. More undefined codes were identified in MCOD data than for UCOD data. Deaths certified by doctors were more likely to use undefined codes than deaths certified by a coroner or government medical office. To improve the quality of external cause of injuries leading to or associated with death, certifiers need to be made aware of the importance of documenting all information pertaining to the cause of the injury and the intent behind the incident, either through education or more explicit instructions on the death certificate and accompanying instructional materials. It is important that researchers are aware of the validity of the data when they make interpretations as to the underlying causes of fatal injuries and causes of injury associated with deaths.

  17. DoD Military Injury Prevention Priorities Working Group: Leading Injuries, Causes and Mitigation Recommendations


    basketball, volleyball , soccer, etc.). Service Mitigation Initiatives The Services, already aware of their leading injury challenges, have initiated a...Training Interventions to Enhance Military Task Performance and Reduce Musculoskeletal Injuries,” evaluates the development of biomechanical - and physiology...interpreting these findings. First, the study time period of one-year (CY 2004) provides a “snap shot ” of injury occurrence in the DoD. This timeframe

  18. Estimating the distribution of external causes in hospital data from injury diagnosis.

    Bhalla, Kavi; Shahraz, Saeid; Naghavi, Mohsen; Lozano, Rafael; Murray, Christopher


    Hospital discharge datasets are a key source for estimating the incidence of non-fatal injuries. While hospital records usually document injury diagnosis (e.g. traumatic brain injury, femur fracture, etc.) accurately, they often contain poor quality information on external causes (e.g. road traffic crashes, falls, fires, etc.), if such data is recorded at all. However, estimating incidence by external causes is essential for designing effective prevention strategies. Thus, we developed a method for estimating the number of hospital admissions due to each external cause based on injury diagnosis. We start with a prior probability distribution of external causes for each case (based on victim age and sex) and use Bayesian inference to update the probabilities based on the victim's injury diagnoses. We validate the method on a trial dataset in which both external causes and injury diagnoses are known and demonstrate application to two problems: redistribution of cases classified to ill-defined external causes in one hospital data system; and, estimation of external causes in another hospital data system that only records nature of injuries. In comparison with age-sex proportional distribution (the method usually employed), we found the Bayesian method to be a significant improvement for generating estimates of incidence for many external causes (e.g. fires, drownings, poisonings). But the method, performed poorly in distinguishing between falls and road traffic injuries, both of which are characterized by similar injury codes in our datasets. While such stop gap methods can help derive additional information, hospitals need to incorporate accurate external cause coding in routine record keeping.

  19. Hand function after nerve repair.

    Lundborg, Göran; Rosén, Birgitta


    Treatment of injuries to major nerve trunks in the hand and upper extremity remains a major and challenging reconstructive problem. Such injuries may cause long-lasting disabilities in terms of lost fine sensory and motor functions. Nowadays there is no surgical repair technique that can ensure recovery of tactile discrimination in the hand of an adult patient following nerve repair while very young individuals usually regain a complete recovery of functional sensibility. Post-traumatic nerve...

  20. Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.

    Min Chen

    Full Text Available BACKGROUND: Hand-foot syndrome (HFS is a relatively frequent dermatologic toxic reaction to certain anti-cancer chemotherapies. The syndrome can evolve into a distressing condition that limits function and affects quality of life. Pyridoxine (vitamin B6 has been used empirically for the prevention of HFS caused by anti-cancer therapy. However, evidence of its efficacy remains controversial. METHODOLOGY//PRINCIPAL FINDINGS: Systematic literature searches were conducted on the Cochrane Library, PUBMED, EMBASE, LILACS, CBM, CNKI, VIP, WANFANG and the U.S. website. We included all related randomized controlled trials (RCTs irrespective of language. Reviewers from different professions independently assessed all potential studies and extracted data. Subgroup analysis was planned according to dose of pyridoxine. 5 RCTs involving 607 patients were contributed to the meta-analysis. No significant differences were found between patients receiving pyridoxine and placebo for prevention of incidence of HFS and grade 2 or worse HFS (relative risk (RR 0.96, 95%confidence interval (CI 0.86-1.06; RR0.95, 95%CI 0.73-1.24, respectively. Similarly, no significant improvement in quality of life was detected among patients. However, significant difference was found for prevention of grade 2 or worse HFS with pyridoxine 400 mg daily compared to 200 mg (RR0.55, 95%CI 0.33-0.92. CONCLUSIONS/SIGNIFICANCE: There is inadequate evidence to make any recommendation about using pyridoxine for prevention of HFS caused by chemotherapy. However, pyridoxine 400 mg may have some efficacy. Further studies of large sample sizes are needed to evaluate the efficacy and safety of pyridoxine, especially at high dose, in comparison with placebo.

  1. Piriformis syndrome surgery causing severe sciatic nerve injury.

    Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E


    Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury.

  2. Low Voltage Electric Current Causing Ileal Perforation: A Rare Injury

    Mathur, Vinay; Tanger, Ramesh; Gupta, Arun Kumar


    Post-electric burn ileal perforation is a rare but severe complication leading to high morbidity and mortality if there is delay in diagnosis and management. We are describing a case of electric current injury of left forearm, chest, and abdominal wall with perforation of ileum in an 8-year old boy. Patient was successfully managed by primary closure of the ileal perforation. PMID:27170922

  3. Low Voltage Electric Current Causing Ileal Perforation: A Rare Injury

    Aditya Pratap Singh


    Full Text Available Post-electric burn ileal perforation is a rare but severe complication leading to high morbidity and mortality if there is delay in diagnosis and management. We are describing a case of electric current injury of left forearm, chest, and abdominal wall with perforation of ileum in an 8-year old boy. Patient was successfully managed by primary closure of the ileal perforation.

  4. Lawn mower injuries as a cause of serious visual acuity impairment – Case reports

    Monika Jasielska


    Lawn mower induced eye injuries are a significant cause of serious visual acuity impairment or blindness. The presented study shows that lawn mower eye injuries are still a therapeutic, social and economic problem, yet are very preventable with proper eye protection and patients’ education. Current prevention strategies are inadequate, and therefore should be updated.

  5. [Scapular/parascapular double skin-paddle free flap for transfixing blast injuries of the hand. A case report].

    Colson, T; Pozetto, M; Gibert, N; Dautel, G


    Balistic transfixing hand traumas require a complex reconstruction management. Stabilization and reconstruction of the injuried tissues need a double skin-paddle coverage. We present an original case report of a double skin-paddle scapular/parascapular free flap used to cover a through and through gunshot injury of the right hand. A 14-years-old patient presents a severe and extensive wound with full-thickness palmar and dorsal skin defects, dislocation of the carpal bones, median nerve and flexor tendons losses. Distal vascularization is maintained by the deep palmar arch system supplied by the ulnar artery. The radial artery is severed at the level of the first dorsal interosseous space. The measured defect of the dorsal skin was 12×7cm and the palmar one was 6×3cm. After skeletal stabilization, tendinous and nerve preparation, the hand coverage was performed using a double skin-paddle scapular/parascapular free flap. The vascular anastomoses include an end-to-side arterial suture between the circumflex scapular and the radial arteries, and an end-to-end venous suture between the circumflex scapular and the dorsal radial veins. The scapular/parascapular double skin-paddle free flap is a safe and reliable technique to achieve a dorsal and palmar hand coverage in lack of local flaps alternatives. It can be used as a good option prior to bone graft, tendinous and nervous reconstruction. Copyright © 2013. Published by Elsevier Masson SAS.

  6. AFSC/NMML: Known human-caused marine mammal injury and mortalities from 2007 to present

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Marine Fisheries Service (NMFS) is required under the MMPA to estimate the annual human-caused mortality and serious injury of marine mammal stocks by...

  7. Grievous Temporal and Occipital Injury Caused by a Bear Attack

    Sampath Chandra Prasad


    Full Text Available Bear attacks are reported from nearly every part of the world. The chance of a human encountering a bear increases as the remote bear territory diminishes. The sloth bear is one of the three species of bears found in India, which inhabits the forests of India and its neighboring countries. Here we describe a teenager who came to us with a critical injury involving the face, temporal and occipital bones inflicted by a sloth bear attack. He underwent a temporal exploration, facial nerve decompression, pinna reconstruction, and occipital bone repair to save him from fatality.

  8. Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia.

    Nmn NikNadia


    Full Text Available Enterovirus A71 (EV-A71 is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2-3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence. Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples collected from children ≤12 years old between 1995 and 2012 to determine the seroprevalence of EV-A71. Reported national HFMD incidence was highest in children <2 years, and decreased with age; in support of this, EV-A71 seroprevalence was significantly associated with age, indicating greater susceptibility in younger children. EV-A71 epidemics are also characterized by peaks of increased genetic diversity, often with genotype changes. Cross-sectional time series analysis was used to model the association between EV-A71 epidemic periods and EV-A71 seroprevalence adjusting for age and climatic variables (temperature, rainfall, rain days and ultraviolet radiance. A 10% increase in absolute monthly EV-A71 seroprevalence was associated with a 45% higher odds of an epidemic (adjusted odds ratio, aOR1.45; 95% CI 1.24-1.69; P<0.001. Every 10% decrease in seroprevalence between preceding and current months was associated with a 16% higher odds of an epidemic (aOR = 1.16; CI 1.01-1.34 P<0.034. In summary, the 2-3 year cyclical pattern of EV-A71 epidemics in Malaysia is mainly due to the fall of population immunity accompanying the accumulation of susceptible children between epidemics. This study will impact the future planning, timing and target populations for vaccine programs.

  9. Biliary tract injury caused by different relative warm ischemia time in liver transplantation in rats

    Hong-Feng Zhao; Guo-Wei Zhang; Jie Zhou; Jian-Hua Lin; Zhong-Lin Cui; Xiang-Hong Li


    BACKGROUND: There is a controversy over the degree of liver and biliary injury caused by the period of secondary warm ischemia. A liver autotransplantation model was adopted because it excludes the effects of infection and immunological rejection on bile duct injury. This study was undertaken to assess biliary tract injury caused by relative warm ischemia (secondary warm ischemia time in the biliary tract) and reperfusion. METHODS: One hundred and two rats were randomly divided into 5 groups: groupⅠ (control); groupsⅡ toⅤ, relative warm ischemia times of 0 minute, 30 minutes, 1 hour and 2 hours. In addition to the levels of serum alkaline phosphatase, and total bilirubin, pathomorphology assessment and TUNEL assay were performed to evaluate biliary tract damage. RESULTS: Under the conditions that there were no signiifcant differences in warm ischemia time, cold perfusion time and anhepatic phase, group comparisons showed statistically signiifcant differences. The least injury occurred in groupⅡ (portal vein and hepatic artery reperfused simultaneously) but the most severe injury occurred in groupⅤ (biliary tract relative warm ischemia time 2 hours). CONCLUSIONS: Relative warm ischemia is one of the factors that result in bile duct injury, and the relationship between relative warm ischemia time the bile injury degree is time-dependent. Simultaneous arterial and portal reperfusion is the best choice to avoid the bile duct injury caused by relative warm ischemia.

  10. A case of perforating injury of eyeball and traumatic cataract caused by acupuncture

    Han Shuang


    Full Text Available Perforating globe injury is the leading cause of monocular blindness and vision loss. A 58-year-old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. To the best of our knowledge, this is the first case report of perforating injury of the eyeball and traumatic cataract caused by acupuncture. The patient was hospitalized due to diagnosis of perforating ocular injury, traumatic cataract, and corneal and iris perforating injury. Moreover, he had to accept treatments of phacoemulsification, anterior vitrectomy along with intraocular lens implantation in the sulcus to improve his visual acuity. As acupuncture therapy has been widely performed for various diseases and achieved highly approval, the aim of this report is to remind acupuncturists operating accurately to avoid unnecessary injury during the treatment process, or the cure can also become the weapon.

  11. Suprascapular nerve injury: A cause to consider in shoulder pain and dysfunction.

    Yao, Kaihan; Yew, Wei Ping


    Suprascapular nerve injury is increasingly being recognized as an important cause of shoulder dysfunction. The non-specific clinical features of suprascapular nerve injury can make diagnosis difficult. However, it is essential for clinicians to consider it as part of the differential diagnoses in patients with vague pain or sensory disturbances over the posterosuperior part of their shoulder or have unexplained atrophy and weakness of their supraspinatus or infraspinatus muscle. Electrodiagnostic studies are useful in confirming and localising the nerve injury, while MRIs can be employed to determine the cause of nerve injury and assess the integrity of the rotator cuff muscles. Isolated suprascapular nerve injury can be managed with a trial of conservative management for at least 6 months. Subsequently, decompression of the nerve through open or arthroscopic techniques can be considered - both are associated with high rates of pain relief and functional improvement.


    巨积辉; 李建宁; 王海文; 侯瑞兴


    目的 总结全手皮肤脱套伤的伤情特点,探讨全手皮肤脱套伤的分型标准及治疗方法. 方法 1999年12月-2010年5月,收治41例全手皮肤脱套伤.男28例,女13例;年龄18~58岁,平均35岁.致伤原因:碾压伤28例,挤压伤13例.受伤至手术时间1~10h,平均3h.根据自定全手皮肤脱套伤分型标准:Ⅰ型11例,Ⅱ型5例,Ⅲ型4例,Ⅳ型8例,Ⅴ型13例.Ⅰ型采用吻合血管回植术;Ⅱ型采用带足背皮瓣的(足母)甲瓣、第2趾甲瓣再造术;Ⅲ型采用双足带足背皮瓣的第2趾甲瓣再造术;Ⅳ型采用吻合血管回植术;Ⅴ型采用带足背皮瓣的躅甲瓣再造(8例)或腹部皮瓣修复术(5例).足背皮瓣切取范围为9cm×6cm~17cm×11cm,足背供区游离植皮修复. 结果 术后Ⅰ型6例发生部分手指坏死,Ⅳ型6例发生部分手指及手掌皮肤坏死;其余患者皮瓣、再造指及回植皮肤均成活.足背供区及腹部供区均顺利愈合.40例患者获随访,随访时间6个月~7年,平均14个月.采用吻合血管回植治疗者,手部皮肤颜色、质地接近正常,功能恢复佳,感觉恢复至S2~S4;采用(足母)甲瓣及趾甲瓣再造手指者,手功能基本恢复,再造指感觉恢复至S2~S3;采用腹部皮瓣者,手功能恢复欠佳,手部感觉恢复至S1~S2. 结论 采用自定标准对全手皮肤脱套伤程度进行分型,并指导临床治疗方案的选择,可获得较好临床疗效.%Objective To summarize the injury characteristics of the whole hand degloving injury and to explore its classification and treatment. Methods Between December 1999 and May 2010, 41 cases of the whole hand degloving injury were admitted for treatment. There were 28 males and 13 females with an average age of 35 years (range, 18-58 years). The causes of injury included mangled injury in 28 cases and crush injury in 13 cases. The interval between injury and surgery was 1-10 hours (mean, 3 hours). According to self-made classification

  13. Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.

    Francisco, Gerard E; Yozbatiran, Nuray; Berliner, Jeffrey; OʼMalley, Marcia K; Pehlivan, Ali Utku; Kadivar, Zahra; Fitle, Kyle; Boake, Corwin


    The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.

  14. Dual energy CT imaging analysis of tendon injury in hand%手肌腱损伤DECT成像分析

    罗军德; 邓亚; 解天梅; 淦登卫


    目的 初步探讨双能CT(DECT)在显示手肌腱韧带损伤中的临床应用价值.方法 对20例手部外伤患者行手DECT扫描,观察肌腱及周围组织情况.所有病例诊断均经手术或结合临床及其他影像学资料证实.结果 DECT对肌腱整体外形、迂曲、粘连、受压及断裂显示较好,但对肌腱内部及周围腱鞘、滑膜改变显示不如MRI.结论 DECT能显示大多数手肌腱正常解剖结构及异常病变,对临床诊断手肌腱损伤或病变具有一定价值.%Objective To discuss the clinical application value of dual energy CT (DECT) in diagnosis of the tendon injury in hand. Methods Twenty patients with hand injuries received the DECT scanning, and the situations of tendon and surrounding tissues were observed. The diagnosis for all cases was identified by operation or clinical manifestations and other imaging data. Results DECT displayed very well the complete shape of tendons and the situations of circuity, adherence, and rupture. But MRI was more sensitive than DECT in displaying the situations within the tendons and changes in the surrounding tendinous sheath and synovial membrane. Conclusion DECT can display most anatomic structure and abnormal lesions of hand tendon and has certain value in the clinical diagnosis of injury and lesion in hand tendon.

  15. An epidemiological study of acute hand injuries%急诊手外伤的流行病学调查

    易传军; 李忠哲; 田光磊; 陈山林; 郑炜; 田文; 朱瑾


    Objective To study the incidence,composition,distribution and influence of acute hand injuries. Methods From April 1st 2005 to September 30th 2005,all patients with acute hand injuries treated at Beijing Jishuitan Hospital were investigated by filling out a questionnaire focusing on all related epidemiological elements. Results A total of 5 233 patients were identified,accounting for 34.1% of all acute orthopedic injuries. Patients were typically (31.0±12.5) years old. They were mostly male,with a male to female hand injures. 21.3% were injured at home,14.2% injured on the road,9.9% injured at leisure places,2.5% injured during sports activities,and 1.3% injured at shopping places.Cutting (44.4%) and crushing (27.7%) were the most common injury mechanisms. Conclusion Acute hand injuries were common injuries,occurring mainly in male adults. Most of these injuries were occupational hand injuries. Prevention should be emphasized.%目的 了解手外伤的发生、构成、分布及影响因素.方法 对2005年4月1日至9月30日在我院就诊的所有手外伤患者进行问卷调查,统计并分析其流行病学特点.结果 共5 233例手外伤患者,占骨科急诊的34.1%,平均年龄为(31.0±12.5)岁,男∶女为4.2∶1,83.0%为开放性损伤,就诊距受伤时间(2.5±4.0)h.职业性损伤占50.8%,家庭生活伤占21.3%,道路交通伤占14.2%,在餐饮及娱乐场受伤占9.9%,运动伤占2.5%,购物场所占1.3%.损伤机制以切割伤(44.4%)和压砸伤(27.7%)最常见.损伤以双侧示指和中指最易受累.结论 手外伤是一种高发损伤,主要发生在青壮年男性中,以职业性损伤多见.职业性损伤和生活性损伤均是预防的重点.

  16. A Subcortical Oscillatory Network Contributes to Recovery of Hand Dexterity after Spinal Cord Injury

    Nishimura, Yukio; Morichika, Yosuke; Isa, Tadashi


    Recent studies have shown that after partial spinal-cord lesion at the mid-cervical segment, the remaining pathways compensate for restoring finger dexterity; however, how they control hand/arm muscles has remained unclear. To elucidate the changes in dynamic properties of neural circuits connecting the motor cortex and hand/arm muscles, we…

  17. A Subcortical Oscillatory Network Contributes to Recovery of Hand Dexterity after Spinal Cord Injury

    Nishimura, Yukio; Morichika, Yosuke; Isa, Tadashi


    Recent studies have shown that after partial spinal-cord lesion at the mid-cervical segment, the remaining pathways compensate for restoring finger dexterity; however, how they control hand/arm muscles has remained unclear. To elucidate the changes in dynamic properties of neural circuits connecting the motor cortex and hand/arm muscles, we…

  18. Chronic lymphoedema caused by recurrent infections in a patient with allergic hand eczema

    Beatrice Dyring-Andersen


    Full Text Available Allergic contact dermatitis is very common and may be complicated by secondary infections. Chronic lymphoedema is a potentially debilitating condition, which may occur due to secondary infections or the dermatitis itself. The problem of chronic lymphoedema following allergic contact dermatitis has been infrequently reported. We report a case of a 47-year-old woman with severe allergic contact dermatitis complicated by chronic, intractable lymphoedema of the hands and forearms. This case report reminds us that allergic hand dermatitis may be complicated by a chronic and debilitating state of lymphoedema. Also, it underlines the importance of fast and adequate treatment of both the dermatitis and the secondary infections.

  19. [Stab wounds of the hand and forearm due to Kuluna in Kinshasa (Democratic Republic of Congo): types of injuries and treatment].

    Kibadi, K; Portaels, F; Pichot, Y; Kapinga, M; Moutet, F


    Democratic Republic of Congo (DRC), a particular form of juvenile delinquency and insecurity intensifies in the city of Kinshasa. This is the phenomenon Kuluna. It is organized gangs equipped with machetes and other weapons. The main objective of this study is to know the phenomenon Kuluna and describe the upper limb injuries caused by machetes, while insisting on the specifics of the management of these lesions in our communities. This retrospective descriptive study examines 14 cases of wounds of the hand and forearm due to stab phenomenon Kuluna, in Kinshasa. It covers the period from 1 November 2010 to 1 November 2013. Among the 14 patients with lesions in the hand and forearm admitted and treated at the Unit of Plastic Reconstructive and Aesthetic Surgery, Hand Surgery and Burns, University Clinics of Kinshasa to attacks due to the phenomenon Kuluna. We have 11 men and 3 women. The average age was 33, 5 years (extremes of 21 and 56 years). The right upper limb is reached that the left upper limb, respectively 12 patients and 2 patients. The lesions are localized to the wrist in the majority of cases (10 patients) in the palm of hand and in 3 patients in the fingers in 1 patient. The palmar surface is reached (10 cases) and the dorsal (4 cases). Zone 5 of the International Classification of flexor and Zone 8 topographic classification extensors at hand are the predilection sites of lesions respectively the palmar surface (6 out of 10) and the dorsal (2 case 4). The median nerve at the wrist is cut in half the cases. On bone lesions localized to the forearm, we observed a high incidence of fracture of the ulna (62.5%). The treatment begins with the stabilization of bone pieces, gestures revascularization and nerve sutures and suture tendon and finally skin coverage. Rehabilitation was mandatory, she supervises the actions of repair and it continues until the recovery of function.

  20. An unusual cause of acute kidney injury due to oxalate nephropathy in systemic scleroderma.

    Mascio, Heather M; Joya, Christie A; Plasse, Richard A; Baker, Thomas P; Flessner, Michael F; Nee, Robert


    Oxalate nephropathy is an uncommon cause of acute kidney injury. Far rarer is its association with scleroderma, with only one other published case report in the literature. We report a case of a 75-year-old African-American female with a history of systemic scleroderma manifested by chronic pseudo-obstruction and small intestinal bacterial overgrowth (SIBO) treated with rifaximin, who presented with acute kidney injury with normal blood pressure. A renal biopsy demonstrated extensive acute tubular injury with numerous intratubular birefringent crystals, consistent with oxalate nephropathy. We hypothesize that her recent treatment with rifaximin for SIBO and decreased intestinal transit time in pseudo-obstruction may have significantly increased intestinal oxalate absorption, leading to acute kidney injury. Oxalate nephropathy should be considered in the differential diagnosis of acute kidney injury in scleroderma with normotension, and subsequent evaluation should be focused on bowel function to include alterations in gut flora due to antibiotic administration.

  1. Leading causes of injury hospitalisation in children aged 0-4 years in New South Wales by injury submechanism: a brief profile by age and sex.

    Schmertmann, Marcia; Williamson, Ann; Black, Deborah


    To identify the leading causes of injury in children aged 0-4 years by single year of age using injury submechanisms and present a brief epidemiologic profile of each cause. Hospitalisation data for New South Wales from 1999 to 2009 were used to identify the leading causes of injury for children aged 0-4 years by single year of age. For each leading cause, rates over time and by sex were calculated by single year of age. Associated age and sex risk ratios were estimated. The leading causes of injury for children aged leading injury cause exhibited an age pattern that remained stable over time and by sex. Age predicted falls while being carried and both age and sex predicted the remaining leading injury causes, with age and sex interacting to predict burns by hot non-aqueous substances. Epidemiologic analysis using single-year age intervals and injury submechanisms results in a clearer picture of injury risk for young children. The findings of this study provide detailed information regarding the leading causes of hospitalised injury in young children by age and sex. Child health-care providers can use this information to focus discussions of child development and injury risk with families of young children and suggest appropriate prevention measures in terms of a child's age and sex. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Spinal cord injury caused by direct damage by local anaesthetic infiltration needle

    Absalom, AR; Martinelli, G; Scott, NB


    We describe a case of spinal cord injury caused by direct trauma from a local anaesthetic infiltration needle. During local anaesthetic infiltration before placement of an epidural catheter, the patient suddenly rolled over onto her back, causing the infiltrating needle to advance all the way to its

  3. Road collisions as a cause of traumatic spinal cord injury in ireland, 2001-2010.

    Smith, Eimear


    Road collisions remain the leading cause of traumatic spinal cord injury (TSCI) in the world. Half of all TSCIs in Ireland in 2000 were caused by road collisions. Since then, there has been a downward trend in road fatalities coincident with implemented road safety strategies.

  4. Semi-skeletonized Internal Mammary Grafts and Phrenic Nerve Injury: Cause-and-effect analysis

    DENG Yongzhi; SUN Zongquan; MA Jie; Hugh S PATERSON


    Phrenic nerve injury after cardiac surgery increases postoperative pulmonary complications. The purpose of this study was to analyze the causes and effects of phrenic nerve injury after cardiac surgery. Prospectively collected data on 2084 consecutive patients who underwent cardiac surgery from Jan. 1995 to Feb. 2002 were analyzed. Twenty-eight preoperative and operation related variables were subjected to logistic analysis with the end point being phrenic nerve injury. Then phrenic nerve injury and 6 perioperative morbidities were included in the analysis as variables to determine their independent predictive value for perioperative pulmonary morbidity. An identical approach was used to identify the independent risk factors for perioperative mortality. There were 53 phrenic nerve injuries (2.5 %). There was no phrenic nerve injury in non-coronary surgery or coronary surgery using conduits other than the internal mammary artery. The independent risk factors for phrenic nerve injury were the use of internal mammary artery (Odds ratio (OR)=14.5) and the presence of chronic obstructive pulmonary disease (OR=2.9). Phrenic nerve injury was an independent risk factor (OR=8.1) for perioperative pulmonary morbidities but not for perioperative mortality. Use of semi-skeletonized internal mammary artery harvesting technique and drawing attention to possible vascular or mechanical causes of phrenic nerve injury may reduce its occurrence. Unilateral phrenic nerve injury, although rarely life-threatening, is an independent risk factor for postoperative respiratory complications. When harvesting internal mammary arteries, it should be kept in mind avoiding stretching, compromising, or inadvertently dissecting phrenic nerve is as important as avoiding damage of internal mammary artery itself.

  5. Acute Liver Injury with Severe Coagulopathy in Marasmus Caused by a Somatic Delusional Disorder

    Lance L. Stein


    Full Text Available Marasmus is a severe form of protein-calorie malnutrition characterized by the depletion of fat stores, muscle wasting, and the lack of edema. In developed countries, marasmus is often the result of anorexia nervosa. Abnormal transaminases with liver synthetic dysfunction have rarely been reported with anorexia nervosa. To our knowledge, we report the first detailed case of acute liver injury with severe coagulopathy (INR>1.5 in a patient with marasmus due to self-induced calorie restriction caused by a somatic delusional disorder. This case highlights the severity of liver injury that may occur with significant weight loss from self-induced calorie restriction and the rapid normalization of this injury with treatment. It is important for clinicians to be aware of patterns of acute liver injury in patients with severe protein-calorie malnutrition, regardless of the underlying cause.

  6. A Wearable Vibration Glove for Improving Hand Sensation in Persons with Spinal Cord Injury Using Passive Haptic Rehabilitation

    Tanya Estes


    Full Text Available We define Passive Haptic Rehabilitation (PHR as an improvement in haptic sensations or abilities using methods which require little or no attention on the part of the user. We present a study that suggests improvement in hand sensation in participants with partial Spinal Cord Injury (SCI in C4 - T1 after use of our Mobile Music Touch (MMT glove. The MMT glove is designed to teach piano melodies passively. It stimulates the participant's fingers repeatedly in the order of notes in the songs to be learned. In a study of ten hands, seven people with incomplete SCI participate in simple piano lessons three times a week for thirty minutes a session for eight weeks. The experimental group also attends these lessons but also wear our Mobile Music Touch (MMT glove for two hours a day, five times a week to reinforce these lessons passively. Participants were injured over a year before the beginning of the study. The Semmes-Weinstein test is used to measure sensation at eight points on the hand before and after the piano lessons. The mean improvements between the experimental group and control group show a difference that is statistically significant. All hand areas in the experimental group show an improvement in average Semmes-Weinstein scores.

  7. Mortality from suicide and other external cause injuries in China: a prospective cohort study

    Duan Xiufang


    Full Text Available Abstract Background Premature death from suicide is a leading cause of death worldwide. However, the pattern and risk factors for suicide and other external cause injuries are not well understood. This study investigates mortality from suicide and other injuries and associated risk factors in China. Methods A prospective cohort study of 169,871 Chinese adults aged 40 years and older was conducted. Mortality due to suicide or other external cause injuries was recorded. Results Mortality from all external causes was 58.7/100,000 (72.3 in men and 44.4 in women: 14.1/100,000 (14.2 in men and 14.2 in women for suicide and 44.6/100,000 (58.1 in men and 30.2 in women for other external cause injuries. Transport accidents (17.2/100,000 overall, 23.4 in men and 10.8 in women, accidental poisoning (7.5/100,000 overall, 10.2 in men and 4.8 in women, and accidental falls (5.7/100,000 overall, 6.5 in men and 5.0 in women were the three leading causes of death from other external cause injuries in China. In the multivariable analysis, male sex (relative risk [RR] 1.56, 95% confidence interval [CI] 1.03-2.38, age 70 years and older (2.27, 1.29-3.98, living in north China (1.68, 1.20-2.36 and rural residence (2.82, 1.76-4.51 were associated with increased mortality from suicide. Male sex (RR 2.50, 95% CI 1.95-3.20, age 60-69 years (1.93, 1.45-2.58 and 70 years and older (3.58, 2.58-4.97, rural residence (2.29, 1.77-2.96, and having no education (1.56, 1.00-2.43 were associated with increased mortality from other external cause injuries, while overweight (0.60, 0.43-0.83 was associated with decreased risk of mortality from other external cause injuries. Conclusions External cause mortality has become a major public health problem in China. Developing an integrated national program for the prevention of mortality due to external cause injuries in China is warranted.

  8. Acute myocardial injury caused by Sydney funnel-web spider (Atrax robustus) envenoming.

    Isbister, G K; Warner, G


    A 67-year-old female suffered envenoming by a Sydney funnel-web spider (Atrax robustus), complicated by ST elevation and elevated troponin levels consistent with an acute myocardial injury. She was treated primarily with funnel-web spider antivenom, admission to intensive care and initial respiratory support for acute pulmonary oedema. The mechanism by which funnel-web spider envenomation caused myocardial injury is unclear but follow-up nuclear studies in the patient demonstrated that she had minimal atherosclerotic disease.

  9. Role of sulfhydryls in mucosal injury caused by ethanol: relation to microvascular permeability, gastric motility and cytoprotection

    Takeuchi, K.; Okada, M.; Niida, H.; Okabe, S.


    The relationship between gastric mucosal glutathione (GSH) levels, vascular permeability, gastric motility and mucosal injury caused by ethanol was investigated in rats. Oral administration of 50% ethanol (1 ml) produced elongated reddish bands of lesions in the mucosa with a significant reduction of GSH levels and increase of microvascular permeability. These lesions were significantly inhibited by pretreatment with s.c. administered diethylmaleate (DEM: 1 ml/kg), cysteamine (100 mg/kg) and 16, 16-dimethyl prostaglandin E2 (dmPGE2, 10 micrograms/kg) but worsened markedly by N-ethylmaleimide (NEM: 10 mg/kg). Irrespective of whether the animals were treated with 50% ethanol or not, the mucosal GSH levels were significantly decreased or increased, respectively, by DEM or cysteamine, and were not affected by both NEM and dmPGE2. NEM significantly enhanced the vascular permeability in the absence or presence of ethanol (greater than 10%), whereas other agents significantly inhibited only the increased vascular permeability caused by ethanol. On the other hand, gastric motility was potently and persistently inhibited by either DEM, cysteamine or dmPGE2 at the doses which prevented ethanol-induced mucosal injury, whereas NEM had no effect on the motility. These results suggest that 1) the mucosal GSH levels do not relate directly to either development or prevention of ethanol-induced gastric injury, 2) potentiation by NEM of the mucosal injury may be accounted for by its enhancement of the vascular permeability and 3) inhibition of gastric motility may be associated with prevention of mucosal lesions.

  10. Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury: A case report and review of literature

    Uday Guled; Nirmal Raj Gopinathan; Vijay G.Goni; Arjun Rhh; Rakesh John; Prateek Behera


    Either proximal tibial or tibial physeal injuries are rare.The combination of both is even rarer,let alone causes a vascular injury.Early intervention is the key for management.We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury.The present case is important in two aspects:firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury;secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients.

  11. Injuries caused by venomous animals and folk medicine in farmers from Cuité, State of Paraiba, Northeast of Brazil

    Hellyson Fidel Araújo de Oliveira


    Full Text Available Injuries caused by venomous animals reported by the agricultural workers from the municipality of Cuité, Curimataú region of Paraiba State, Northeast of Brazil, and the practices of folk medicine which they use to treat these cases were studied in this work from June to August 2010. The farmers studied aged from 11 to 90 years. The number of people who reported cases of injury by these animals in their families was high (89.3%. Scorpions, wasps, bees and snakes were the most cited and the extremities of the body (hands, feet, legs and head were the most affected. The practice of folk medicine to treat these injuries includes various procedures ranging from ritualistic treatments, use of animals or parts of them, and some herbal preparations. The folk treatment was reported as effective by most of the workers injured (63.9%. Body parts of dead snakes are used in various zootherapic treatments. In the imaginary of the agricultural workers the venomous animals are considered hazardous (48.7% or disgusting (11.3%, and several parts of such animals as the rattle, bee sting or snake leather are used as amulet. Several legends have also been reported about snakes, scorpions and bees. The need for educational activities that aim to clarify these workers about the dangers of such practices is urgent.

  12. Injuries caused by venomous animals and folk medicine in farmers from Cuité, State of Paraiba, Northeast of Brazil.

    de Oliveira, Hellyson Fidel Araujo; da Costa, Cristiane Francisca; Sassi, Roberto


    Injuries caused by venomous animals reported by the agricultural workers from the municipality of Cuité, Curimataú region of Paraiba State, Northeast of Brazil, and the practices of folk medicine which they use to treat these cases were studied in this work from June to August 2010. The farmers studied aged from 11 to 90 years. The number of people who reported cases of injury by these animals in their families was high (89.3%). Scorpions, wasps, bees and snakes were the most cited and the extremities of the body (hands, feet, legs and head) were the most affected. The practice of folk medicine to treat these injuries includes various procedures ranging from ritualistic treatments, use of animals or parts of them, and some herbal preparations. The folk treatment was reported as effective by most of the workers injured (63.9%). Body parts of dead snakes are used in various zootherapic treatments. In the imaginary of the agricultural workers the venomous animals are considered hazardous (48.7%) or disgusting (11.3%), and several parts of such animals as the rattle, bee sting or snake leather are used as amulet. Several legends have also been reported about snakes, scorpions and bees. The need for educational activities that aim to clarify these workers about the dangers of such practices is urgent.

  13. Stereomicroscopic evaluation of defects caused by torsional fatigue in used hand and rotary nickel-titanium instruments

    Geeta Asthana


    Full Text Available Objective: The aim of this study was to evaluate defects caused by torsional fatigue in used hand and rotary nickel-titanium (Ni-Ti instruments by stereomicroscopic examination. Materials and Methods: One hundred five greater taper Ni-Ti instruments were used including Protaper universal hand (Dentsply Maillefer, Ballaigues, Switzerland, Protaper universal rotary (Dentsply Maillefer, Ballaigues, Switzerland, and Revo-S rotary (MicroMega, Besanηon, France files. Files were used on lower anterior teeth. After every use, the files were observed with both naked eyes and stereomicroscope at 20Χ magnification (Olympus, Shinjuku, Tokyo, Japan to evaluate defects caused by torsional fatigue. Scoring was assigned to each file according to the degree of damage. Statistics: The results were statistically analyzed using the Mann-Whitney U test and the Kruskal-Wallis test. Results: A greater number of defects were seen under the stereomicroscope than on examining with naked eyes. However, the difference in methods of evaluation was not statistically significant. Revo-S files showed minimum defects, while Protaper universal hand showed maximum defects. The intergroup comparison of defects showed that the bend in Protaper universal hand instruments was statistically significant. Conclusion: Visible defects in Ni-Ti files due to torsional fatigue were seen by naked eyes as well as by stereomicroscope. This study emphasizes that all the files should be observed before and after every instrument cycle to minimize the risk of separation.

  14. [Characteristics of co-morbid psychiatric disability and injury caused disability in Chinese population].

    Liu, Tianli; Pang, Lihua; Wen, Xu; Chen, Gong; Zheng, Xiaoying


    To investigate the relations between psychiatric disability and co-morbid disability caused by injury, severity of the disabilities, as well as the unmet health care need among people living with both disabilities. Data collected through both the Second China National Sample Survey on Disabilities in 2006 and the Follow-up Studies in 2009, were utilized. Sampling weights were considered to appropriately estimate situations in the total Chinese population. Among people with psychiatric disability, 2.7% of them were affected by other injury-caused disabilities as visual, hearing, speech, psychical and intellectual disabilities. Among people with disability that caused by injuries, 1.8% of them were living with psychiatric disability as well. The prevalence rates of psychiatric disability and injury caused disability were as 0.94% and 0.63%, respectively. More than half of the co-morbid people were living with profound disabilities while 46.32% of the people living with both disabilities developed co-morbid disabilities in the same year. Data from the follow-up program showed that 56.25% of the people living with co-morbid disabilities did not receive any psychiatric treatment which were in need. There seemed a close but bidirectional relationship existed between the mental disorders and injuries that calling for better mental health services provided for people with psychiatric disabilities.

  15. Types and severity of operated supraclavicular brachial plexus injuries caused by traffic accidents.

    Kaiser, Radek; Waldauf, Petr; Haninec, Pavel


    Brachial plexus injuries occur in up to 5% of polytrauma cases involving motorcycle accidents and in approximately 4% of severe winter sports injuries. One of the criteria for a successful operative therapy is the type of lesion. Upper plexus palsy has the best prognosis, whereas lower plexus palsy is surgically untreatable. The aim of this study was to evaluate a group of patients with brachial plexus injury caused by traffic accidents, categorize the injuries according to type of accident, and look for correlations between type of palsy (injury) and specific accidents. A total of 441 brachial plexus reconstruction patients from our department were evaluated retrospectively(1993 to 2011). Sex, age, neurological status, and the type and cause of injury were recorded for each case. Patients with BPI caused by a traffic accident were assessed in detail. Traffic accidents were the cause of brachial plexus injury in most cases (80.7%). The most common type of injury was avulsion of upper root(s) (45.7%) followed by rupture (28.2%), complete avulsion (16.9%) and avulsion of lower root(s) (9.2%). Of the patients, 73.9% had an upper,22.7% had a complete and only 3.4% had a lower brachial plexus palsy. The main cause was motorcycle accidents(63.2%) followed by car accidents (23.5%), bicycle accidents(10.7%) and pedestrian collisions (3.1%) (paccidents had a higher percentage of lower avulsion (22.7%) and a lower percentage of upper avulsion (29.3%), whereas cyclists had a higher percentage of upper avulsion (68.6%) based on the data from the entire group of patients (paccidents (9.3%,paccidents),significantly more upper and fewer lower palsies were present. In the bicycle accident group, upper palsy was the most common (89%). Study results indicate that the most common injury was an upper plexus palsy. It was characteristic of bicycle accidents, and significantly more common in car and motorcycle accidents. The results also indicate that it is important to consider the

  16. Rethinking airbag safety: Airbag injury causing bilateral blindness

    Olufunmilola Abimbola Ogun


    Full Text Available A healthy 40-year-old man, restrained in the front passenger seat, suffered visually disabling blunt ocular trauma following spontaneous release of the passenger side air-bag module, during vehicular deceleration, without an automobile crash. Though the driver-side airbag was also released, the driver was unharmed. The passenger suffered bilateral hyphema, bilateral vitreous hemorrhage and suspected posterior scleral rupture in the left eye and also had an eyebrow laceration, from impact with the dashboard panel covering the air-bag module, which was detached by the force of airbag deployment. This is the first reported case from West Africa and the first case in which part of the airbag module detached to cause additional trauma. This report adds to the growing burden of evidence world-wide, for a review of the safety aspects of the automobile airbag. This case clearly illustrates that although airbags reduce mortality, they carry a high risk of ocular morbidity, even with seat belt restraint.

  17. Impairment and disability after severe hand injuries with multiple phalangeal fractures.

    Oosterom, F.J. van; Ettema, A.M.; Mulder, P.G.H.; Hovius, S.E.


    PURPOSE: Upper-extremity impairment evaluation is performed mostly by using guidelines provided by the American Medical Association (AMA). Recently, subjective disability tests, such as the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, have been developed that appreciate the limita

  18. Quill injury - cause od death of captive indian crested porcupine(Hystrix indica, Kerr, 1792

    Tanja Švara


    Full Text Available Indian crested porcupine (Hystrix indica is a member of the family of Old World porcupines (Hystricidae. Its body is covered with multiple layers of quills, which serve for warning and attack if animal is threatened. However, the literature data on injuries caused by Indian crested porcupine are absent. We describe pathomorphological lesions in an Indian crested porcupine from the Ljubljana Zoo, which died after a fight with a younger male that caused a perforative quill injury of the thoracic wall, followed by septicaemia. Macroscopic, microscopic and bacteriological findings were detailed

  19. Causes and Severity of Fatal Injuries in Autopsies of Victims of Fatal Traffic Accidents

    F Panahi


    Full Text Available Introduction: In this retrospective study, we decided to determine the death causes and severity of injuries in traffic accidents according to reports of the forensic medical center of Yazd. Methods: A total of 251 fatalities due to traffic accidents that had undergone autopsy examinations at the Yazd forensic medicine center from2006 till 2008 were included in the study by census method. Data regarding gender, road user type, type of vehicle (car, motorcycle, autobus or minibus, consciousness level, and intensive care unit (ICU admission was gathered. For evaluation of injury severity, we used Injury Severity Score (ISS. Results: The population under study consisted of 202 men (80.5% and 49 women (19.5% with an average age of 34.1 years (range: 1-89 years. Motorcycle-pedestrian accidents were the most common type of injury (100, 39.8%. Head (220, 87.6% and face (169, 67.3% were the two most common sites of injuries. Mean (±SD of ISS was 23.2 (±10.4. According to autopsy records, the main cause of death was head trauma (146, 58.1%. Conclusion: Public awareness in terms of primary prevention of road accidents should be considered important. Also, regarding the high prevalence of brain injuries and complications associated with skull fractures, accessibility to neurosurgeons and availability of imaging devices have an important role in decreasing the mortality rate of traffic accidents.

  20. Ocean Acidification: Hands-On Experiments to Explore the Causes and Consequences

    Bruno, Barbara C.; Tice, Kimberly A.; Puniwai, Noelani; Achilles, Kate


    Ocean acidification is one of the most serious environmental issues facing the planet (e.g., Doney 2006; Guinotte and Fabry 2009). It is caused by excess carbon dioxide (CO[subscript 2]) in the atmosphere. Human activities such as burning fossil fuels put CO[subscript 2] and other heat-trapping gases into the atmosphere, which causes the Earth's…

  1. Ocean Acidification: Hands-On Experiments to Explore the Causes and Consequences

    Bruno, Barbara C.; Tice, Kimberly A.; Puniwai, Noelani; Achilles, Kate


    Ocean acidification is one of the most serious environmental issues facing the planet (e.g., Doney 2006; Guinotte and Fabry 2009). It is caused by excess carbon dioxide (CO[subscript 2]) in the atmosphere. Human activities such as burning fossil fuels put CO[subscript 2] and other heat-trapping gases into the atmosphere, which causes the Earth's…

  2. Pediatric Hereditary Angioedema as a Cause of Acute Compartment Syndrome of the Hand and Forearm: A Case Report.

    Venditto, Chelsea; Jager, Zachary; LoGiudice, John; Matloub, Hani


    Compartment syndrome of the upper extremity is a surgical emergency that, when left untreated, can have dire consequences. Its causes are numerous, one of which is the uncommon entity hereditary angioedema, an autosomal dominant disease resulting in edema in a variety of potential locations, including the extremities. This is only the second time hereditary angioedema has been mentioned in the literature as a cause of compartment syndrome. We present a case of hereditary angioedema leading to hand and forearm compartment syndrome in a 13-year-old pediatric patient. Diagnosis of hereditary angioedema was made by our Rheumatology colleagues with physical exam and a thorough history, and confirmed by laboratory studies. Our patient presented with compartment syndrome of the hand and forearm and underwent hand and volar forearm fasciotomies. She was subsequently worked up for hereditary angioedema with laboratory results confirming the diagnosis. She was discharged after a 5-day hospitalization with prophylactic C1-inhibitor therapy. Hereditary angioedema is a rare but known cause of compartment syndrome of the upper extremity, and must be considered when patients present with compartment syndrome of unknown etiology. This disease can be diagnosed by laboratory studies and symptoms can be controlled with medical therapy.

  3. Recovery from azoospermia caused by a testicular injury: a case report.

    Hagiuda, J; Ishikawa, H; Hanawa, Y; Marumo, K


    Some cases of testicular trauma cause infertility especially when the injured testes are not removed. However, only a few long-term follow-up studies investigating endocrinological and semen parameters in patients who had testicular trauma have been conducted. Herein, we report an interesting case of a patient who spontaneously recovered from azoospermia due to a traffic injury and present in detail the results of the hormonal examination and semen analysis. The patient was a 22-year-old man with a history of left testicular injury and bilateral orchidopexy. Four months after the injury, the semen parameters improved but azoospermia occurred 1 year later. However, spermatogenesis spontaneously recovered without any treatment or without undergoing orchiectomy 6 months after the testicular injury.

  4. Self-management strategies used by patients who are hypersensitive to cold following a hand injury. A prospective study with two years follow-up.

    Vaksvik, Tone; Kjeken, Ingvild; Holm, Inger


    Prospective cohort study. Knowledge of the strategies used by patients with injuries of the hand to manage cold hypersensitivity should guide information given by health-care workers. To explore the use of cold-associated self-management strategies in patients with severe hand injuries. Seventy patients being cold hypersensitive following a hand injury, reported use of strategies to limit cold-induced symptoms in the injured hand(s) and the severity of cold-associated activity limitations one and two years after surgery. The patients used several strategies, including clothing (100%), use of own body (movement/use of muscles to produce heat or massage of the fingers) (94%), and heating aids (48%), but were still limited in valued cold-associated activities two years after surgery. The number of patients staying indoors, using heating aids and hand wear indoors and during summer-time increased with severity of cold hypersensitivity. Patients both implemented and discontinued different strategies after the first year, but for most strategies, the proportions of users were quite stable. The most common strategies used to limit cold-induced symptoms in the injured hand(s) were clothing and use of own body. Many patients also seemed to benefit from using heating aids. After one year, a number of patients still experimented in finding the best strategies and were still limited in valued cold-associated activities. 2b. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  5. Left-handed polyproline-II helix revisited: proteins causing proteopathies.

    Adzhubei, Alexei A; Anashkina, Anastasia A; Makarov, Alexander A


    Left-handed polyproline-II type helix is a regular conformation of polypeptide chain not only of fibrous, but also of folded and natively unfolded proteins and peptides. It is the only class of regular secondary structure substantially represented in non-fibrous proteins and peptides on a par with right-handed alpha-helix and beta-structure. In this study, we have shown that polyproline-II helix is abundant in several peptides and proteins involved in proteopathies, the amyloid-beta peptides, protein tau and prion protein. Polyproline-II helices form two interaction sites in the amyloid-beta peptides, which are pivotal for pathogenesis of Alzheimer's disease (AD). It also with high probability is the structure of the majority of tau phosphorylation sites, important for tau hyperphosphorylation and formation of neurofibrillary tangles, a hallmark of AD. Polyproline-II helices form large parts of the structure of the folded domain of prion protein. They can undergo conversion to beta-structure as a result of relatively small change of one torsional angle of polypeptide chain. We hypothesize that in prions and amyloids, in general polyproline-II helices can serve as structural elements of the normal structure as well as dormant nuclei of structure conversion, and thus play important role in structure changes leading to the formation of fibrils.

  6. [Prehospital emergency care injuries from external causes in a region of Venezuela].

    Herrera, Rafael; Bastidas, Daniel; Arteaga, Everilda; Bastidas, Gilberto


    Worldwide, approximately 3 500 000 people die every year as a result of injuries from external causes, in Venezuela these arte the third leading cause of overall morbidity. Nevertheless, in the country there are no records of the defining aspects of prehospital emergency care as a tool to address this socio-health problem, the aim of this investigation. A descriptive, transversal, field study based on the information recorded daily for a year paramedics was performed. A total 1493 injured by external causes were reported, with a mean age of 29.5 ± 12 years, 84.5% male. Injuries mostly less-moderate (69.4%) were due to severe land transport accidents (70.9%) occurred during the day (75.9%), between monday and friday (72.9%), attended in 20 minutes or less, and transferred in 97.3% of cases. The economically productive young men in areas with higher population density and urbanism are mostly affected by injuries from external causes. In both genres land transport accidents are the most common causes of injury with lower-moderate severity. The care that paramedics provide can be considered adequate.

  7. Brachial Plexus Injuries

    ... Disability, Independent Living, and Rehabilitation Research (NIDILRR) National Rehabilitation Information ... is a network of nerves that conducts signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to ...

  8. Progesterone-independent avidin induction in chick tissues caused by tissue injury and inflammation.

    Elo, H A; Kulomaa, M S; Tuohimaa, P J


    Progesterone was administered to oestrogen-treated and untreated chicks, or inflammation in the abdominal cavity was caused by intestine and liver injury or intraperitoneal actinomycin D administration. Local injury to the pectoral muscle was also carried out. Chicks were killed 24--26 h after the treatment and the biotin-binding egg white protein, avidin, was assayed in a number of tissues using a [14C]biotin-binding method and radioimmunoassay. Ovalbumin was also assayed with a radioimmunoassay. Avidin was not found in the tissues of control chicks. Progesterone induced avidin only in the oviducts of oestrogen-treated chicks. After intestine and liver injury avidin was found, however, in all the tissues of oestrogen-treated and untreated chicks studied except for the brain. The concentrations were highest in the oviduct, lung, intestine and bursa of Fabricius. Actinomycin D (200 microgram/kg) caused ascites and subcutaneous oedema in 40--60% of the chicks, and avidin was found only in the tissues of these inflamed animals. Avidin production caused by the local muscular injury was restricted to the injured area. Tissue injury and inflammation did not induce ovalbumin in any tissue. The study shows that avidin can be induced besides the oviduct also in non-oviductal chick tissues, and it is proposed that there are both progesterone-dependent and -independent avidin induction mechanisms.

  9. Beneficial effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin in rats: A histological and biochemical study.

    Elbe, H; Dogan, Z; Taslidere, E; Cetin, A; Turkoz, Y


    Ciprofloxacin is a broad-spectrum quinolone antibiotic commonly used in clinical practice. Quercetin is an antioxidant belongs to flavonoid group. It inhibits the production of superoxide anion. In this study, we aimed to evaluate the effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin. Twenty-eight female Wistar albino rats were divided into four groups: control, quercetin (20 mg kg(-1) day(-1) gavage for 21 days), ciprofloxacin (20 mg kg(-1) twice a day intraperitoneally for 10 days), and ciprofloxacin + quercetin. Samples were processed for histological and biochemical evaluations. Malondialdehyde (MDA) and glutathione (GSH) levels, superoxide dismutase (SOD), and catalase (CAT) activities were measured in kidney tissue. The ciprofloxacin group showed histopathological changes such as infiltration, dilatation in tubules, tubular atrophy, reduction of Bowman's space, congestion, hemorrhage, and necrosis. In the ciprofloxacin + quercetin group, these histopathological changes markedly reduced. MDA levels increased in the ciprofloxacin group and decreased in the ciptofloxacin + quercetin group. SOD and CAT activities and GSH levels significantly decreased in the ciprofloxacin group. On the other hand, in the ciprofloxacin + quercetin group, SOD and CAT activities and GSH levels significantly increased with regard to the ciprofloxacin group. We concluded that quercetin has antioxidative and therapeutic effects on renal injury and oxidative stress caused by ciprofloxacin in rats.

  10. Pantoea ananatis as a Cause of Corneal Infiltrate after Rice Husk Injury

    Manoharan, Geetha; Jeganathan, Lakshmi Priya; DSilva, Sean Socrates; Prajna, N. Venkatesh


    We report a case of an agricultural worker presenting with corneal infiltrate following ocular injury with a rice husk. On examination, a superficial corneal foreign body was removed and sent for culture, which grew Pantoea ananatis. This is, to our knowledge, the first clinical case report of Pantoea ananatis causing corneal infiltrate. PMID:22461671

  11. Oral mucosal injury caused by cancer therapies: current management and new frontiers in research

    Jensen, Siri Beier; Peterson, Douglas E.


    This invited update is designed to provide a summary of the state-of-the-science regarding oral mucosal injury (oral mucositis) caused by conventional and emerging cancer therapies. Current modeling of oral mucositis pathobiology as well as evidence-based clinical practice guidelines for prevention...

  12. Injuries on Seedlings Caused by Potential Weed in Tropical Rain Forest Regeneration Areas

    Sumardi Sumardi


    Full Text Available The experiment aimed to assess the injuries on Shorea seedlings caused by weed in artificial regeneration of tropical rain forest in Jambi. Four planting systems, strip nurse planting (using Acacia mangium, Paraserianthes falcataria and Gmelina arborea, line planting, gap planting and natural regeneration, were used. Seedling injuries were assessed based on part of seedling suppressed. Results indicated that Shorea seedling suffered from varying degrees of injuries, depending on weed species and part of the seedling suppressed. The dominance of weed and damage intensity were determined by the level of canopy opening on the planting systems. Ground cover dominated rapidly in open canopy, causing up to 55.27% injuries on the seedlings in the strips of G. arborea and P. falcataria. Whereas creepers and vines became dominant in moderate canopy opening. The injury of Shorea seedling planted under nurse tree was determined by the species and planting density of nurse tree used. Light canopy nurse tree such as P. falcataria failed to suppress ground weed, but in the contrary, A. mangium with heavy canopy still allowed creepers and vines to grow.

  13. Contact events in rugby union and their propensity to cause injury.

    Fuller, Colin W; Brooks, John H M; Cancea, Rebecca J; Hall, John; Kemp, Simon P T


    The objective of this study was to determine the incidence of contact events in professional rugby union matches and to assess their propensity to cause injury. The study was a two-season (2003/2004 and 2005/2006) prospective cohort design. It included 645 professional rugby union players from 13 English Premiership rugby union clubs. The main outcome measures were: incidence of match contact events (events per game); incidence (injuries per 1000 player-hours and per 1000 contact events), risk (days lost per 1000 player-hours and per 1000 contact events) and diagnosis of injury; referee's decision. Risk factors were player-player contact, position on pitch and period of play. Tackles (221.0 events/game) and rucks (142.5 events/game) were the most common events and mauls (13.6%) and scrums (12.6%) the most penalised. Tackles (701.6 days/1000 player-hours) were responsible for the greatest loss of time but scrums (213.2 days lost/1000 events) and collisions (199.8 days lost/1000 events) presented the highest risk per event. Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union because they were by far the most common contact event. Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle. The relative propensities for contact events to cause injury were rated as: lineout--very low; ruck--low; maul and tackle--average; collision and scrum--high.

  14. Spinal Cord Injury Caused by Stab Wounds: Incidence, Natural History, and Relevance for Future Research.

    McCaughey, Euan J; Purcell, Mariel; Barnett, Susan C; Allan, David B


    Spinal cord injury caused by stab wounds (SCISW) results from a partial or complete transection of the cord, and presents opportunities for interventional research. It is recognized that there is low incidence, but little is known about the natural history or the patient's suitability for long-term clinical outcome studies. This study aims to provide population-based evidence of the demographics of SCISW, and highlight the issues regarding the potential for future research. The database of the Queen Elizabeth National Spinal Injuries Unit (QENSIU), the sole center for treating SCI in Scotland, was reviewed between 1994 and 2013 to ascertain the incidence, demographics, functional recovery, and mortality rates for new SCISW. During this 20 year period, 35 patients with SCISW were admitted (97.1% male, mean age 30.0 years); 31.4% had a cervical injury, 60.0% had a thoracic injury, and 8.6% had a lumbar injury. All had a neurological examination, with 42.9% diagnosed as motor complete on admission and 77.1% discharged as motor incomplete. A total of 70.4% of patients with an American Spinal Injury Association Impairment Scale (AIS) level of A to C on admission had an improved AIS level on discharge. Nine (25.7%) patients have died since discharge, with mean life expectancy for these patients being 9.1 years after injury (20-65 years of age). Patients had higher levels of comorbidities, substance abuse, secondary events, and poor compliance compared with the general SCI population, which may have contributed to the high mortality rate observed post-discharge. The low incidence, heterogeneous nature, spontaneous recovery rate, and problematic follow-up makes those with penetrating stab injuries of the spinal cord a challenging patient group for SCI research.

  15. Fall or shaken: traumatic brain injury in children caused by falls or abuse at home - a review on biomechanics and diagnosis.

    Oehmichen, M; Meissner, C; Saternus, K-S


    In cases of traumatic brain injuries in children it may be difficult to differentiate between physical abuse and accidental occurrence. This review will shed light on discriminating epidemiological as well as biomechanical data, morphological findings, and clinical features. As a basic principle, simple injuries are caused by simple mechanisms like falls whereas life-threatening injuries should be attributed to abuse until proven otherwise. Implausibilities between reported events and mechanisms by caregivers as well as more than one explanation of injury indicate suspicion of child abuse. From reviewing the literature, it can be stated that falls from less than 1.5 m lead only in few cases to severe brain injuries. Children who experienced a fall at home seldom exhibit fractures of the skull but just minor intracranial injuries without neurological deficits. Regarding biomechanical aspects, multiple or complex skull fractures, depression fractures, additional fractures of the body, and intracranial hemorrhages as a consequence of an impact are the most important findings in child abuse. Moreover, additional specific morphological criteria give evidence of clinical and/or post-mortem diagnosis of the shaken baby syndrome. These include subdural hemorrhage and laceration of the brain and retinal bleeding, epidural hemorrhage of the cervical cord, gripping marks (bruises) on chest and/or shoulders, and tearing injuries of the throat and neck muscles. Post-mortem signs of recurrent shaken baby syndrome are indicated by iron-positive cells or microglial cells in neuronal or retinal tissue. A clinical diagnosis will be dependent on the one hand on the exclusion of coagulation diseases, on the other hand on the demonstration of a subdural hemorrhage by means of neuroimaging techniques, i.e., CT and MRI, as well as retinal hemorrhage. The shaken baby syndrome will usually be observed within the first year of life. The doctor has to manifest his diagnosis to the caregivers

  16. Impact of changes in specificity of data recording on cause-specific injury mortality in the United States, 1999–2010

    Hu, Guoqing; Mamady, Keita


    Background We aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010. Methods A longitudinal study was designed to analyze injury mortality data of 1999-2010. Mortality rates for unspecified injury and for cause-specific injury were obtained using CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™). The proportion of unspecified injury was used to measure the specificity of injury data recordi...

  17. Cost per case or total cost? The potential of prevention of hand injuries in young children – Retrospective and prospective studies

    Carlsson Katarina


    Full Text Available Abstract Background Health-care costs for hand and forearm injuries in young children are poorly documented. We examined costs in 533 children injured years 1996–2003. Methods Health-care costs and costs for lost productivity were retrospectively calculated in children from three catchment areas in Sweden. Seven case categories corresponding to alternative prevention strategies were constructed. Results Over time, diminishing number of ward days reduced the health-care cost per case. Among children, the cost of lost productivity due to parental leave was 14 percent of total cost. Fingertip injuries had low median costs but high total costs due to their frequency. Complex injuries by machine or rifle had high costs per case, and despite a low number of cases, total cost was high. Type of injury, surgery and physiotherapy sessions were associated with variations in health-care cost. Low age and ethnic background had a significant effect on number of ward days. Conclusion The costs per hand injury for children were lower compared to adults due to both lower health-care costs and to the fact that parents had comparatively short periods of absence from work. Frequent simple fingertip injuries and rare complex injuries induce high costs for society. Such costs should be related to costs for prevention of these injuries.

  18. Causes of fatal childhood accidents involving head injury in northern region, 1979-86.

    Sharples, P M; Storey, A; Aynsley-Green, A; Eyre, J A


    OBJECTIVE--To examine the causes and circumstances surrounding fatal accidents involving head injuries in children in the Northern region. DESIGN--Retrospective review of the hospital case notes, necropsy reports, and records of the coroners' inquests. SETTING--Northern Regional Health Authority. PATIENTS--All 255 children aged less than 16 years who died with a head injury during 1979-86. MAIN OUTCOME MEASURES--Cause of injury and circumstances of accident according to reports of inquests; injury severity score; number of fatal accidents and mortality per 100,000 children in 10 groups of local authority wards ranked according to their score on the overall deprivation index; and distance of site of accident from child's home. RESULTS--Of the 255 children who died after a head injury, 136 (53%) children were playing at the time of the accident. 195 (76%) children sustained the head injury in road traffic accidents, 135 as pedestrians, 35 as cyclists, and 25 as passengers in a vehicle. In 120 accidents in child pedestrians the primary cause of accident was the unsafe behaviour of the child. 172 (67%) accidents occurred within one to two km of the child's home and 153 (63%) between 3 pm and 9 pm. The mortality was significantly related to social deprivation; excluding eight children injured while on holiday in the region, 15-fold decrease in mortality was recorded between the local authority wards that ranked highest on the overall deprivation index and those that ranked lowest (14.0/100,000 children, group 10 v 0.9/100,000, group 1 respectively, p less than 0.00001). CONCLUSIONS--The finding that most accidents occurred in children living in deprived areas who were playing unsupervised near their home suggests that childhood mortality might be appreciably reduced if children at play were protected from traffic, particularly in socially deprived areas. PMID:2261557

  19. A non-opioid pathway for dynorphin-caused spinal cord injury in rats

    Yu Chen; Liangbi Xiang; Jun Liu; Dapeng Zhou; Hailong Yu; Qi Wang; Wenfeng Han; Mingming Guo


    Intrathecal injection of dynorphin into rats via subarachnoid catheter induces damage to spinal cord tissue and motor function. Injection of the kappa opioid receptor antagonist nor-binaltorphine, or the excitatory amino acid N-methyl-D-aspartate receptor antagonist MK-801 into rats alleviated the pathological changes of dynorphin-caused spinal cord tissue injury and reduced the acid phosphatase activity in the spinal cord. The experimental findings indicate that there are opioid and non-opioid pathways for dynorphin-induced spinal cord injury, and that the non-opioid receptor pathway may be mediated by the excitatory amino acid N-methyl-D-aspartate receptor.

  20. [A case of death due to mitral regurgitation caused by traumatic mitral valve injury].

    Iwasaki, Y; Kojima, T; Yasui, W; Nagasawa, N; Yashiki, M


    A 51-year-old male, who had been driving a motor bicycle, was involved in a traffic accident with a trailer, and he died immediately after the accident. According to the external examination of the victim, no fatal injuries were found. The medico-legal autopsy revealed a rupture of the left side of the pericardium, and a tear of the posterior leaflet of the mitral valve. There were no injuries of the papillary muscles and chordae. The cause of death was due to traumatic mitral regurgitation.

  1. MR imaging of overuse injuries in the skeletally immature gymnast: spectrum of soft-tissue and osseous lesions in the hand and wrist

    Dwek, Jerry R. [Department of Radiology, Rady Children' s Hospital and Health Center, San Diego, CA (United States); Cardoso, Fabiano; Chung, Christine B. [University of California at San Diego, Department of Radiology, San Diego, CA (United States)


    In the pediatric gymnast, stress-related physeal injuries have been well described with characteristic imaging findings. However, a spectrum of overuse injuries, some rarely reported in the literature, can be encountered in the gymnast's hand and wrist. To demonstrate the MR appearance of a spectrum of overuse injuries in the skeletally immature wrist and hand of pediatric gymnasts. A total of 125 MR exams of the hand and wrist in skeletally immature children were performed at our institution during a 2-year period. Clinical histories were reviewed for gymnastics participation. MR studies of that subpopulation were reviewed and abnormalities tabulated. Of the MR studies reviewed, ten gymnasts were identified, all girls age 12-16 years (mean age 14.2 years) who presented with wrist or hand pain. Three of these children had bilateral MR exams. Abnormalities included chronic physeal injuries in three children. Two girls exhibited focal lunate osteochondral defects. Triangular fibrocartilage tears were present in three girls, one of whom had a scapholunate ligament tear. Two girls manifested metacarpal head flattening and necrosis. A variety of soft-tissue and osseous lesions can be encountered in the skeletally immature gymnast. Familiarity with these stress-related injuries is important for accurate diagnosis. (orig.)

  2. Outcome and clinical changes in patients 3, 6, 12 months after a severe or major hand injury - can sense of coherence be an indicator for rehabilitation focus?

    Rosberg Hans-Eric


    Full Text Available Abstract Background Our objective was to explore outcome and clinical changes in hand function, satisfaction in daily occupations, sleep disturbances, health and quality of life in consecutive patients after a severe or major hand injury. Our objective was also to investigate possible differences between groups according to severity of injury, presence of peripheral nerve injury and the patients' sense of coherence. Methods A postal questionnaire, including demographic data, disabilities of the arm, shoulder and hand (DASH, QoL (SF-36, EuroQol (EQ-5D VAS, hand function (VAS, satisfaction in daily occupation (SDO, was sent out 3, 6 and 12 months after injury to 45 consecutive patients with a severe or major hand injury. Sense of coherence (SOC was evaluated at 6 months. For the descriptive study, non-parametric tests were used since almost all results were measured with ordinal scales, the study sample was small, and most variables not normally distributed. Results Almost all self-assessed aspects of hand function, satisfaction in daily occupations, health (DASH, and physical QoL (SF-36 improved statistically for the whole group over time. Large clinical improvement was seen for physical QoL and health, while a low or no improvement was observed for mental QoL, and cold sensitivity. Few differences were found between participants with a severe or major of hand injury or with or without a major nerve injury. No significant differences in demographic data were observed between participants with high or low SOC, but participants with low SOC showed significantly lower satisfaction in daily occupations, higher DASH scores, lower mental QoL, more sleep disturbances, and bodily pain. Correlation was found between SOC, and QoL, health and satisfaction in daily occupations. Conclusions SOC had a significant influence on patients with a severe or major traumatic hand injury. Patients with lower SOC would probably benefit from extra support and help to

  3. Ten years follow-up of health and disability in people with acute traumatic hand injury: pain and cold sensitivity are long-standing problems.

    Gustafsson, M; Hagberg, L; Holmefur, M


    The aim of this study was to investigate health and disability in people with acute traumatic hand injury 10 years after the accident. A consecutive sample of patients from the Department of Hand Surgery was followed up by means of a postal questionnaire containing the instruments EQ-5D for assessment of health and DASH for assessment of disability. Questions were added about cold sensitivity, numbness and aesthetic problems. The 97 people with various acute hand injuries had greater problems with impairments of hand function than with limitations of activities and participation in daily life. Pain was more common than among the general Swedish population. Cold sensitivity was reported by 78% and was associated with both worse impairments and greater limitations on activity and participation. Despite problems with pain and cold sensitivity, they reported good health and a low degree of disability.

  4. Coxsackievirus A6 and enterovirus 71 causing hand, foot and mouth disease in Cuba, 2011-2013.

    Fonseca, Magilé C; Sarmiento, Luis; Resik, Sonia; Martínez, Yenisleidys; Hung, Lai Heng; Morier, Luis; Piñón, Alexander; Valdéz, Odalys; Kourí, Vivian; González, Guelsys


    Hand, foot and mouth disease (HFMD) is usually caused by coxsackievirus A16 or enterovirus 71 (EV71). Between 2011 and 2013, HFMD cases were reported from different Cuban provinces. A total of 42 clinical specimens were obtained from 23 patients. Detection, identification and phylogenetic analysis of enterovirus-associated HFMD were carried out by virus isolation, specific enterovirus PCR and partial VP1 sequences. HEV was detected in 11 HFMD cases. Emerging genetic variants of coxsackievirus A6 and EV71 were identified as the causative agents of the Cuban HFMD cases.

  5. Chaparral ingestion. The broadening spectrum of liver injury caused by herbal medications.

    Gordon, D W; Rosenthal, G; Hart, J; Sirota, R; Baker, A L


    Unconventional medical practices, including the use of herbal remedies, are prevalent in the United States. Chaparral is an herbal preparation made from a desert shrub and used for its antioxidant properties. We report the case of a 60-year-old woman who took chaparral for 10 months and developed severe hepatitis for which no other cause could be found. Despite aggressive supportive therapy, the patient deteriorated and required orthotopic liver transplantation. She is now well, more than 1 year after her transplant. This case suggests that chaparral can cause serious liver injury and fulminant hepatic failure. Herbal medications should be considered as potential causes of liver toxicity.

  6. Experimental study on brain injury in Beagle dogs caused by adjacent cabin explosion in warship

    Yan-teng LI


    Full Text Available Objective  Through the establishment of adjacent cabin blast injury model of Beagle dog, to investigate the pathophysiological changes in the experimental animals in this scenario, then speculate on the mechanisms of injury. Methods  Several adjacent cabins were built in the same size with the real warship. Seven Beagle dogs were subjected to injuries from the explosion, from whom one was selected randomly to implant intracranial pressure transducers before blast, the others were tested on the pathophysiological changes after blast. The dogs were mounted on the platform of a cabinet in the adjacent cabin, subjected to injury from 650g bare TNT explosive blast. The transducers recorded the value of space and intracranial shock wave pressure. Following blast treatment, the serum levels of IL -6, IL -8, neuron specific enolase (NSE, brain and chest CT and pathological changes of the brain tissue were observed. Results  Serum levels of IL-6, IL-8 and NSE were elevated to varying degrees after blast. All of them increased significantly at different time points after blast (P<0.05. Brain and chest CT examinations did not show any significant positive results. Pathological results showed that there was a little necrosis in the brain, some neurons had karyopycnosis, karyolysis or disappearance of the nucleoli, and the cell boundaries were blurred. The blast wave was blocked greatly by the scalp and skull (about 90%, but could still penetrate them and cause brain injuries. Conclusions  Explosion in the adjacent cabin causes mainly mild traumatic brain injuries. Blast wave can be blocked by the scalp and skull greatly. DOI: 10.11855/j.issn.0577-7402.2017.03.11

  7. Reproduction and evaluation of a rat model of inhalation lung injury caused by black gunpowder smog

    Yi-fan LIU


    Full Text Available Objective To reproduce and evaluate a rat model of inhalation lung injury caused by black gunpowder smog. Methods The smog composition was analyzed and a rat model of inhalation lung injury was reproduced. Forty two healthy male Wistar rats were randomly divided into normal control (NC group and 1h, 2h, 6h, 24h, 48h and 96h after inhalation group (n=6. The arterial blood gas, wet to dry weight ratio (W/D of lung, leukocyte count, and protein concentration in broncho-alveolar lavage fluid (BALF were determined. Macroscopic and microscopic changes in lung tissue were observed. Results The composition of black gunpowder smog was composed mainly of CO2 and CO, and their concentrations remained stable within 12 minutes. Smog inhalation caused a significant hypoxemia, the concentration of blood COHb reached a peak value 1h, and the W/D of lung reached peak value 2h after inhalation (P<0.05. The amount of leukocytes and content of protein in BALF increased significantly within 24h after inhalation (P<0.05. Histopathological observation showed diffuse hemorrhage, edema and inflammatory cell infiltration in lung tissue as manifestations of acute lung injury, and the injury did not recover at 96h after inhalation. Conclusion The rat model of inhalation lung injury can be reproduced using black gunpowder smog, and it has the advantages of its readiness for reproduction, reliability and stability, and it could be used for the experiment of inhalation injury in a battlefield environment.

  8. Eumycetoma of the hand caused by Leptosphaeria tompkinsii and refractory to medical therapy with voriconazole.

    Cartwright, Katharine E; Clark, Tristan W; Hussain, Abid M; Wiselka, Martin; Borman, Andrew; Johnson, Elizabeth M


    We report on the first case of eumycetoma caused by the organism Leptosphaeria tompkinsii to be diagnosed and possibly acquired within the United Kingdom. Conventional culture of fungal grains and surgical tissue specimens was negative and the diagnosis was achieved using panfungal polymerase chain reaction and sequencing technology. Despite limited surgical resection and prolonged antifungal therapy with voriconazole, the patient developed progressive disease with mycetoma bone involvement. This case highlights the usefulness of molecular diagnostic techniques in eumycetoma where organisms may fail to grow with conventional culture or be difficult to identify morphologically. It also reminds us that eumycetoma is a difficult infection to treat and despite optimism regarding the efficacy of the newer triazole antifungals in this condition, treatment failures may still occur.

  9. [Costs of hand emergencies].

    Raimbeau, G


    In France at the present time, there is no comprehensive registry of hand injuries. Three types of occurrences; motor vehicle accidents, work accidents, and accidents incident to activities of daily living, are covered by different types of insurance. It is the individual insurance companies, payers of the indemnification, who maintain registries of these accidents. Statistics on work accidents are very detailed and consistent, but they are oriented toward risk management. The aggregate cost of traumatic injuries to the hand is not known. Only large financial institutions are equipped to determine appropriate preventive measures and to establish premium rates based on loss experience. In 2001, hand injuries accounted for 27% of work accidents causing loss of work of at least 1 day. About 29.8% of these work accidents caused permanent partial impairment. About 17.7% of total days lost and 18.2% of the total costs of permanent impairment were due to hand injuries. In the system of compensation for work accidents, there is a major difference in the cost according to the severity of the impairment. If the permanent impairment is equal to or less than 9%, a lump sum payment is made, but if the permanent impairment is over 9%, the worker receives regular payments for the rest of his life. In 2000, the average cost of a work injury with partial permanent impairment of over 9% was [symbol: see text] 85,405, while the average cost of a lump sum settlement was only [symbol: see text] 1479, a ratio of 57 to 1. The compensation costs represent 80% of the cost of work accidents, while the cost of treatment, including all providers and institutions, makes up only 20% of the cost. Compensation for sequelae of accidents in the course of daily life is new for the insurance companies, although these accidents are frequent and often cause significant repercussions in the professional lives of victims because of the loss of hand function. Provision of optimal treatment for these

  10. Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock

    Li, L.L.; Zhang, C.H.; Liu, J.C.; Yang, L.N.; Niu, C.Y.; Zhao, Z.G. [Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei, China, Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei (China)


    The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO) shock. We hypothesized that mesenteric lymph reperfusion (MLR) is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA) for 1 h, followed by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD) for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1) splenic structure injury, 2) increased levels of malondialdehyde, nitric oxide (NO), intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14), lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3) enhanced activities of NO synthase and myeloperoxidase, and 4) decreased activities of superoxide dismutase and ATPase. MLR following SMAO shock further aggravated these deleterious effects. We conclude that MLR exacerbates spleen injury caused by SMAO shock, which itself is associated with oxidative stress, excessive release of NO, recruitment of polymorphonuclear neutrophils, endotoxin translocation, and enhanced inflammatory responses.

  11. Machine to the Epidemiology characteristics of hand external injury%机械致手外伤的流行病学特点

    刘景臣; 谭旭昌; 唐宏; 宋芳华


    目的 探讨机械致手外伤的流行病学特点.方法 分析深圳市宝安区西乡人民医院自2002年1月至2008年12月因机械致手外伤的7692例病史.根据致伤机械的类别、受伤特点,分析该群体的流行病学特征.结果 该类手外伤占手外科疾病的95%以上,外伤高发月为第一季度.每天以交接班前后为高发时段.最常见的致伤机械为模具,多指复合伤为其特点.结论 重视外企及国企的手外伤预防工作,是减少事故发生的有效方法.%Objective Inquiry into a machine to the Epidemiology characteristics of hand external inju-ry. Methods Analytical Anne from treasure in Shenzhen City area west villager people hospital from January, 2002 to December,2008 because of machine to 7692 histories of diseases of hand external injury. According to to harm mechanical of category, get hurt characteristics, analyze the Epidemiology characteristic of that community. Results That type of hand external injury shares hand surgery the paroxysm is above 95%, external injury Gao Fa Yue is the first quarter degree. Every day with hand over to take over shift duty before or after for Gan Fa's time. The most familiar of to harm machine is molding tool,point compound more to harm for its characteristics. Conclusion The hand external injury prevent froming that values outside Qi and state-owners enterprise is the effective method that reduces trouble occurrence.

  12. Explaining away the body: experiences of supernaturally caused touch and touch on non-hand objects within the rubber hand illusion.

    Jakob Hohwy

    Full Text Available BACKGROUND: In rubber hand illusions and full body illusions, touch sensations are projected to non-body objects such as rubber hands, dolls or virtual bodies. The robustness, limits and further perceptual consequences of such illusions are not yet fully explored or understood. A number of experiments are reported that test the limits of a variant of the rubber hand illusion. METHODOLOGY/PRINCIPAL FINDINGS: A variant of the rubber hand illusion is explored, in which the real and foreign hands are aligned in personal space. The presence of the illusion is ascertained with participants' scores and temperature changes of the real arm. This generates a basic illusion of touch projected to a foreign arm. Participants are presented with further, unusual visuotactile stimuli subsequent to onset of the basic illusion. Such further visuotactile stimulation is found to generate very unusual experiences of supernatural touch and touch on a non-hand object. The finding of touch on a non-hand object conflicts with prior findings, and to resolve this conflict a further hypothesis is successfully tested: that without prior onset of the basic illusion this unusual experience does not occur. CONCLUSIONS/SIGNIFICANCE: A rubber hand illusion is found that can arise when the real and the foreign arm are aligned in personal space. This illusion persists through periods of no tactile stimulation and is strong enough to allow very unusual experiences of touch felt on a cardboard box and experiences of touch produced at a distance, as if by supernatural causation. These findings suggest that one's visual body image is explained away during experience of the illusion and they may be of further importance to understanding the role of experience in delusion formation. The findings of touch on non-hand objects may help reconcile conflicting results in this area of research. In addition, new evidence is provided that relates to the recently discovered psychologically

  13. Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following a sports injury

    McAteer Eamon


    Full Text Available Abstract Background Ankle pain and swelling following sports injuries are common presenting complaints to the accident and emergency department. Frequently these are diagnosed as musculoskeletal injuries, even when no definitive cause is found. Vascular injuries following trauma are uncommon and are an extremely rare cause of ankle swelling and pain. These injuries may however be limb threatening and are important to diagnose early, in order that appropriate treatment can be delivered. We highlight the steps to diagnosis of these injuries, and methods of managing these injuries. It is important for clinicians to be aware of the potential for this injury in patients with seemingly innocuous trauma from sports injuries, who have significant ankle pain and swelling. Case presentation A young, professional sportsman presented with a swollen, painful ankle after an innocuous hyper-plantar flexion injury whilst playing football, which was initially diagnosed as a ligamentous injury after no bony injury was revealed on X-Ray. He returned 2 days later with a large ulcer at the lateral malleolus and further investigation by duplex ultrasound and transfemoral arteriogram revealed a Pseudo-Aneurysm of the Anterior Tibial Artery. This was initially managed with percutaneous injection of thrombin, and later open surgery to ligate the feeding vessel. The patient recovered fully and was able to return to recreational sport. Conclusion Vascular injuries remain a rare cause of ankle pain and swelling following sports injuries, however it is important to consider these injuries when no definite musculo-skeletal cause is found. Ultrasound duplex and Transfemoral arteriogram are appropriate, sensitive modalities for investigation, and may allow novel treatment to be directed percutaneously. Early diagnosis and intervention are essential for the successful outcome in these patients.

  14. Management of a Low-Energy Penetrating Brain Injury Caused by a Nail

    V. R. Ferraz


    Full Text Available Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

  15. Application Effect Analysis of TCM Hand Massage in Patients With Hand Injury%中医手部按摩在手外伤患者康复过程中的应用效果分析



    ObjectiveTo investigate application effect of TCM hand massage in patients with hand injury rehabilitation process.Methods Selected 110 patients with hand injuries from the December 2014 to December 2015 in our hospital,according to a double-blind study were divided into two groups. The control group received conventional rehabilitation treatment,study group received TCM hand massage interventions on this basis.Results The excelent and good rate of the study group was 94.55%,and it was significantly higher than the 80.00% of control group(P<0.05).Conclusion TCM hand massage can effectively improve hand injury for rehabilitation patients,and the application has exact effect.%目的:探讨中医手部按摩在手外伤患者康复过程中的应用效果。方法选择2014年12月~2015年12月我院收治的手外伤患者110例,根据双盲法将其平均分为研究组与对照组。对照组采取常规康复治疗措施,研究组在此基础上给予中医手部按摩干预。结果研究组优良率为94.55%,高于对照组的80.00%(P<0.05)。结论中医手部按摩能够有效提高手外伤患者的康复效果,应用效果确切。

  16. Trends in the leading causes of injury mortality, Australia, Canada, and the United States, 2000-2014.

    Mack, Karin; Clapperton, Angela; Macpherson, Alison; Sleet, David; Newton, Donovan; Murdoch, James; Mackay, J Morag; Berecki-Gisolf, Janneke; Wilkins, Natalie; Marr, Angela; Ballesteros, Michael; McClure, Roderick


    The aim of this study was to highlight the differences in injury rates between populations through a descriptive epidemiological study of population-level trends in injury mortality for the high-income countries of Australia, Canada and the United States. Mortality data were available for the US from 2000 to 2014, and for Canada and Australia from 2000 to 2012. Injury causes were defined using the International Classification of Diseases, Tenth Revision external cause codes, and were grouped into major causes. Rates were direct-method age-adjusted using the US 2000 projected population as the standard age distribution. US motor vehicle injury mortality rates declined from 2000 to 2014 but remained markedly higher than those of Australia or Canada. In all three countries, fall injury mortality rates increased from 2000 to 2014. US homicide mortality rates declined, but remained higher than those of Australia and Canada. While the US had the lowest suicide rate in 2000, it increased by 24% during 2000-2014, and by 2012 was about 14% higher than that in Australia and Canada. The poisoning mortality rate in the US increased dramatically from 2000 to 2014. Results show marked differences and striking similarities in injury mortality between the countries and within countries over time. The observed trends differed by injury cause category. The substantial differences in injury rates between similarly resourced populations raises important questions about the role of societal-level factors as underlying causes of the differential distribution of injury in our communities.

  17. Fatal injuries caused by guns using shotshell: case reports and ballistic studies.

    Rougé, D; Telmon, N; Alengrin, D; Marril, G; Bras, P M; Arbus, L


    The authors present six cases of homicide and suicide in which the weapon involved was a handgun using shotshell. The injuries caused are described and the ballistic characteristics of the weapons are studied. Such weapons, which are relatively easy to obtain, are not as innocuous as they may appear, since they may be modified either by changing the barrel or by removal of the device inside the barrel which is intended to prevent the firing of solid slugs.

  18. Shaken baby syndrome: re-examination of diffuse axonal injury as cause of death.

    Oehmichen, Manfred; Schleiss, Daniela; Pedal, Ingo; Saternus, Klaus-Steffen; Gerling, Ivana; Meissner, Christoph


    The discussion surrounding shaken baby syndrome (SBS) arose from the lack of evidence implicating diffuse axonal injury (DAI) as a cause of death. It was assumed instead that injury to the cervical cord, medulla, and nerve roots played a causal role. The present pathomorphological study examines 18 selected infants (<1-year-old) whose deaths were highly suspicious for SBS, exhibiting the classical SBS triad of acute subdural hemorrhage (SDH), retinal bleeding, and encephalopathy. Gross autopsy and microscopic findings of these infants were compared with those of 19 victims of sudden infant death syndrome (SIDS; control group 1) and of 14 infants who died of disease or injuries/violence not involving the head, neck or eyes (control group 2). Symptoms of mechanical impact to the head were evident in seven of the SBS infants, but in none of the control infants. DAI was not detected in either the SBS or control cases. Localized axonal injury (AI) was regularly present in the brains of the SBS infants surviving longer than 1.5-3.0 h, but only occasionally in the craniocervical junction and within the nerve roots of the upper cervical cord; it was never present in the medulla. Epidural hemorrhage of the cervical cord was seen in four of the ten examined SBS cases, but in none of the control cases. Based on the absence of DAI in the brain and of signs of generalized cervical cord or nerve root injuries, we conclude that the cause of death in the SBS victims was a global cerebral ischemia secondary to SDH, focal vasospasm, trauma-induced transitory respiratory and/or circulatory failure.

  19. Hand chemical burns.

    Robinson, Elliot P; Chhabra, A Bobby


    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.

  20. Loss of the intestinal mucus layer in the normal rat causes gut injury but not toxic mesenteric lymph nor lung injury.

    Sharpe, Susan M; Qin, Xiaofa; Lu, Qi; Feketeova, Eleonora; Palange, David C; Dong, Wei; Sheth, Sharvil U; Lee, Marlon A; Reino, Diego; Xu, Da-Zhong; Deitch, Edwin A


    There is substantial evidence that gut barrier failure is associated with distant organ injury and systemic inflammation. After major trauma or stress, the factors and mechanisms involved in gut injury are unknown. Our primary hypothesis is that loss of the intestinal mucus layer will result in injury of the normal gut that is exacerbated by the presence of luminal pancreatic proteases. Our secondary hypothesis is that the injury produced in the gut will result in the production of biologically active mesenteric lymph and consequently distant organ (i.e., lung) injury. To test this hypothesis, five groups of rats were studied: 1) uninstrumented naive rats; 2) control rats in which a ligated segment of distal ileum was filled with saline; 3) rats with pancreatic proteases placed in their distal ileal segments; 4) rats with the mucolytic N-acetylcysteine (NAC) placed in their distal ileal segments; and 5) rats exposed to NAC and pancreatic proteases in their ileal segments. The potential systemic consequences of gut injury induced by NAC and proteases were assessed by measuring the biological activity of mesenteric lymph as well as gut-induced lung injury. Exposure of the normal intestine to NAC, but not saline or proteases, led to increased gut permeability, loss of mucus hydrophobicity, a decrease in the mucus layer, as well as morphological evidence of villous injury. Although proteases themselves did not cause gut injury, the combination of pancreatic proteases with NAC caused more severe injury than NAC alone, suggesting that once the mucus barrier is impaired, luminal proteases can injure the now vulnerable gut. Because comparable levels of gut injury caused by systemic insults are associated with gut-induced lung injury, which is mediated by biologically active factors in mesenteric lymph, we next tested whether this local model of gut injury would produce active mesenteric lymph or lead to lung injury. It did not, suggesting that gut injury by itself may not

  1. Causes of ring-related leg injuries in birds - evidence and recommendations from four field studies.

    Michael Griesser

    Full Text Available One of the main techniques for recognizing individuals in avian field research is marking birds with plastic and metal leg rings. However, in some species individuals may react negatively to rings, causing leg injuries and, in extreme cases, the loss of a foot or limb. Here, we report problems that arise from ringing and illustrate solutions based on field data from Brown Thornbills (Acanthiza pusilla (2 populations, Siberian Jays (Perisoreus infaustus and Purple-crowned Fairy-wrens (Malurus coronatus. We encountered three problems caused by plastic rings: inflammations triggered by material accumulating under the ring (Purple-crowned Fairy-wrens, contact inflammations as a consequence of plastic rings touching the foot or tibio-tarsal joint (Brown Thornbills, and toes or the foot getting trapped in partly unwrapped flat-band colour rings (Siberian Jays. Metal rings caused two problems: the edges of aluminium rings bent inwards if mounted on top of each other (Brown Thornbills, and too small a ring size led to inflammation (Purple-crowned Fairy-wrens. We overcame these problems by changing the ringing technique (using different ring types or larger rings, or using different adhesive. Additionally, we developed and tested a novel, simple technique of gluing plastic rings onto metal rings in Brown Thornbills. A review of studies reporting ring injuries (N = 23 showed that small birds (35 g tend to get rings stuck over their feet. We give methodological advice on how these problems can be avoided, and suggest a ringing hazard index to compare the impact of ringing in terms of injury on different bird species. Finally, to facilitate improvements in ringing techniques, we encourage online deposition of information regarding ringing injuries of birds at a website hosted by the European Union for Bird Ringing (EURING.

  2. A retrspective study of rescuing severe open craniocerebral injuries caused by traffic accidents

    陈长才; 宁可; 等


    Objective:To investigate the rescuing principles of severe open craniocerebral injuries caused by traffic accidents.Methods:A retrospective study was performed for 36 patients admitted to our hospital from January 1986 to December 1995,who suffered from severe open craniocerebral injuries in traffic accidents.Results:These 36 cases occupied 52.10% of all the severe open craniocerebral injuries during the same period.The clinical features included confusion of consciousness, extensive cerebral contusion and laceration,severe contamination of the wound,high incidence of intracranial hematoma and multiple system injuries.Nineteen patients.(63.34%)ecovered normal neurological function,7 were (23.33%)mild disabled,4(13.33%)severe disabled,2(5.56%) vegetative survival,and 4(11.11%)dead.Conclusions:The main principles of salvage should emphasize the importance of emergent prehospital rescue,and be transfered to a specialized hospital as soon as possible.Postoperative complications included severe brain edema,intracerebral infection,and pneumonia,Debriding thoroughly at early stage and treating complications effectively would lower the rate of mortality and disability.

  3. MicroRNA dysregulation in Spinal Cord Injury: causes, consequences and therapeutics

    Manuel eNieto-Díaz


    Full Text Available Trauma to the spinal cord causes permanent disability to more than 180,000 people every year worldwide. The initial mechanical damage triggers a complex set of secondary events involving the neural, vascular, and immune systems that largely determine the functional outcome of the spinal cord injury (SCI. Cellular and biochemical mechanisms responsible for this secondary injury largely depend on activation and inactivation of specific gene programs. Recent studies indicate that microRNAs function as gene expression switches in key processes of the SCI. Microarray data from rodent contusion models reveal that SCI induces changes in the global microRNA expression patterns. Variations in microRNA abundance largely result from alterations in the expression of the cells at the damaged spinal cord. However, microRNA expression levels after SCI are also influenced by the infiltration of immune cells to the injury site and the death and migration of specific neural cells after injury. Evidences on the role of microRNAs in the SCI pathophysiology have come from different sources. Bioinformatic analysis of microarray data has been used to identify specific variations in microRNA expression underlying transcriptional changes in target genes, which are involved in key processes in the SCI. Direct evidences on the role of microRNAs in SCI are scarcer, although recent studies have identified several microRNAs (miR-21, miR/486, miR-20 involved in key mechanisms of the SCI such as cell death or astrogliosis, among others. From a clinical perspective, different evidences make clear that microRNAs can be potent therapeutic tools to manipulate cell state and molecular processes in order to enhance functional recovery. The present article reviews the actual knowledge on how injury affects microRNA expression and the meaning of these changes in the SCI pathophysiology, to finally explore the clinical potential of microRNAs in the SCI.

  4. [Urethral injuries secondary to implantation of penile prosthesis. Analysis of the causes, prevention and treatment].

    Vitarelli, Antonio; Divenuto, Lucia; Palminteri, Enzo; Lorusso, Giovanni; Pagliarulo, Arcangelo


    Urethral injuries due to penile prosthesis implant represent a rare complication of the intervention to position penile prosthesis, but unfortunately scientific literature about this is poor. This rare complication may occur during surgery and in the postoperative period, both early and late. It recognizes a variety of causes that may include anatomical or functional conditions, for example cavernosal fibrosis or outcomes of inflammations or previous urethral lesions and pathological sensibility due to diabetic neuropathy or other forms of neuropathy including those from spinal cord injury or myelopathy. This review evaluates the possible predisposing conditions, the clinical presentations, and the devices in the surgical procedures to use to minimize the risk of onset of this lesions and the measures to take if they occur.

  5. Hand function after nerve repair.

    Lundborg, G; Rosén, B


    Treatment of injuries to major nerve trunks in the hand and upper extremity remains a major and challenging reconstructive problem. Such injuries may cause long-lasting disabilities in terms of lost fine sensory and motor functions. Nowadays there is no surgical repair technique that can ensure recovery of tactile discrimination in the hand of an adult patient following nerve repair while very young individuals usually regain a complete recovery of functional sensibility. Post-traumatic nerve regeneration is a complex biological process where the outcome depends on multiple biological and environmental factors such as survival of nerve cells, axonal regeneration rate, extent of axonal misdirection, type of injury, type of nerve, level of the lesion, age of the patient and compliance to training. A major problem is the cortical functional reorganization of hand representation which occurs as a result of axonal misdirection. Although protective sensibility usually occurs following nerve repair, tactile discriminative functions seldom recover--a direct result of cortical remapping. Sensory re-education programmes are routinely applied to facilitate understanding of the new sensory patterns provided by the hand. New trends in hand rehabilitation focus on modulation of central nervous processes rather than peripheral factors. Principles are being evolved to maintain the cortical hand representation by using the brain capacity for visuo-tactile and audio-tactile interaction for the initial phase following nerve injury and repair (phase 1). After the start of the re-innervation of the hand (phase 2), selective de-afferentation, such as cutaneous anaesthesia of the forearm of the injured hand, allows expansion of the nerve-injured cortical hand representation, thereby enhancing the effects of sensory relearning. Recent data support the view that training protocols specifically addressing the relearning process substantially increase the possibilities for improved


    Mamaladze, M; Nizharadze, N; Vadachkoria, O


    Trauma related injuries of permanent teeth occur frequently and are the most pressing issue the dentists are facing today. In different age groups the same type of trauma affects the teeth with different frequencies. For instance, accident related dental trauma in children and adults affected permanent teeth in 30% and deciduous teeth in 20%, respectively. It should also be noted that front teeth are more susceptible to traumatic injuries compared to the incisors. Upper front teeth were injured in 72% of cases, while lower central, upper lateral incisors, canines and premolars only in 6-8%. The severity of dental injury depends on the type and extent of the trauma. Dental injury can be result of either direct or indirect trauma. A strong, «fast as lightning» impact most often affects the dental crown. A weak and dull impact (thump) extends toward the root apical direction resulting in avulsion of the tooth and root fracture. Dental injury caused by trauma has been always considered as an emergency condition. It requires prompt complex treatment methods from maintaining pulp vitality to tooth extraction option. Treatment plan always depends on the type and severity of the injury and on current clinical condition of tooth. In all cases, the combined treatment includes: care of visible wound, fixation of teeth, performance of surgical manipulations, determining of the need of endodontic treatment, restorations and orthodontic consultation. The recorded clinical cases include descriptions of dental injuries of various types, as well as performed diagnostic and treatment procedures. In both cases root was fractured by impact. In Clinical Case 1 the tooth 2.1 vertical partial displacement of the tooth (extrusion) with root fracture in the apical third was observed; Clinical Case 2 - 1.1 dental root fracture in its middle third and vertical extrusion. Treatment strategy is dictated by pulp condition (Assessment of pulp vitality and status). In both cases, the

  7. Injury Risk Assessment of Extravehicular Mobility Unit (EMU) Phase VI and Series 4000 Gloves During Extravehicular Activity (EVA) Hand Manipulation Tasks

    Kilby, Melissa


    Functional Extravehicular Mobility Units (EMUs) with high precision gloves are essential for the success of Extravehicular Activity (EVA). Previous research done at NASA has shown that total strength capabilities and performance are reduced when wearing a pressurized EMU. The goal of this project was to characterize the human-space suit glove interaction and assess the risk of injury during common EVA hand manipulation tasks, including pushing, pinching and gripping objects. A custom third generation sensor garment was designed to incorporate a combination of sensors, including force sensitive resistors, strain gauge sensors, and shear force sensors. The combination of sensors was used to measure the forces acting on the finger nails, finger pads, finger tips, as well as the knuckle joints. In addition to measuring the forces, data was collected on the temperature, humidity, skin conductance, and blood perfusion of the hands. Testing compared both the Phase VI and Series 4000 glove against an ungloved condition. The ungloved test was performed wearing the sensor garment only. The project outcomes identified critical landmarks that experienced higher workloads and are more likely to suffer injuries. These critical landmarks varied as a function of space suit glove and task performed. The results showed that less forces were acting on the hands while wearing the Phase VI glove as compared to wearing the Series 4000 glove. Based on our findings, the engineering division can utilize these methods for optimizing the current space suit glove and designing next generation gloves to prevent injuries and optimize hand mobility and comfort.

  8. [Injuries from external causes in minors (less than 18 years of age) and adults at a hospital in Colombia].

    Bejarano, Mónica; Rendón, Luis Fernando


    To define and compare the types of injuries from external causes in patients more than and less than 18 years of age treated by the Mario Correa Rengifo Hospital. An analysis was conducted of data retrieved from the Sistema de Vigilancia de Lesiones de Causa Externa (Surveillance System for Injuries from External Causes) maintained by the Mario Correa Rengifo Hospital in Cali, Colombia, to compare minors (less than 18 years of age) with adults during January 2004-December 2007. A total of 4 507 minors were seen, most of whom (69.3%) were boys, with unintentional injuries (75.5%); however, 88% of the intentional injuries were person-to-person and 12% were self-inflicted. Injuries had occurred most frequently in the home (44.1%) and on the street (39.5%); the most frequent activity was recreation (53.3%). The minors had more head injuries (odds ratio [OR] = 1.62; P = 0.0000) and maxillofacial injuries (OR = 1.49; P = 0.0000) than did the adults. Alcohol had been consumed in 5.8% and drugs in 2.6%, both of which increased intentional injuries (alcohol OR = 4.25 and drugs OR = 1.56). The number of patients less than 18 years of age with injuries from external causes being treated at the Mario Correa Rengifo Hospital is constantly rising. The circumstances regarding injuries seen in children and adolescents differ from those of adults in that minors tend to suffer more unintentional injuries in the home or in the street where they play regularly. It is important that special educational and structural strategies be implemented to prevent injuries of this type.

  9. Defining the cause of death in hospitalised patients with acute kidney injury.

    Nicholas M Selby

    Full Text Available BACKGROUND: The high mortality rates that follow the onset of acute kidney injury (AKI are well recognised. However, the mode of death in patients with AKI remains relatively under-studied, particularly in general hospitalised populations who represent the majority of those affected. We sought to describe the primary cause of death in a large group of prospectively identified patients with AKI. METHODS: All patients sustaining AKI at our centre between 1(st October 2010 and 31(st October 2011 were identified by real-time, hospital-wide, electronic AKI reporting based on the Acute Kidney Injury Network (AKIN diagnostic criteria. Using this system we are able to generate a prospective database of all AKI cases that includes demographic, outcome and hospital coding data. For those patients that died during hospital admission, cause of death was derived from the Medical Certificate of Cause of Death. RESULTS: During the study period there were 3,930 patients who sustained AKI; 62.0% had AKI stage 1, 20.6% had stage 2 and 17.4% stage 3. In-hospital mortality rate was 21.9% (859 patients. Cause of death could be identified in 93.4% of cases. There were three main disease categories accounting for three quarters of all mortality; sepsis (41.1%, cardiovascular disease (19.2% and malignancy (12.9%. The major diagnosis leading to sepsis was pneumonia, whilst cardiovascular death was largely a result of heart failure and ischaemic heart disease. AKI was the primary cause of death in only 3% of cases. CONCLUSIONS: Mortality associated with AKI remains high, although cause of death is usually concurrent illness. Specific strategies to improve outcomes may therefore need to target not just the management of AKI but also the most relevant co-existing conditions.

  10. Gunshot injuries to the head and brain caused by low-velocity handguns and rifles. A review.

    Oehmichen, M; Meissner, C; König, H G; Gehl, H-B


    Reconstruction of brain injuries is a basic task of forensic neuropathology. For better understanding of the wound ballistics of gunshot injuries to the brain caused by low-velocity firearms (E(o) 90 min). (1) Imaging procedures provided valuable information on entrance and exit wounds, the missile track and secondary changes. (2) Biometry revealed a destruction zone of ca. 3.6 cm around the permanent track corresponding to the "temporary cavity". (3) Microscopic studies of reactive changes demonstrated axonal injury at sites remote from the permanent cavity that could explain the very early respiratory arrest following low-velocity gunshot injury.

  11. The consequence of spatial visual processing dysfunction caused by traumatic brain injury (TBI).

    Padula, William V; Capo-Aponte, Jose E; Padula, William V; Singman, Eric L; Jenness, Jonathan


    A bi-modal visual processing model is supported by research to affect dysfunction following a traumatic brain injury (TBI). TBI causes dysfunction of visual processing affecting binocularity, spatial orientation, posture and balance. Research demonstrates that prescription of prisms influence the plasticity between spatial visual processing and motor-sensory systems improving visual processing and reducing symptoms following a TBI. The rationale demonstrates that visual processing underlies the functional aspects of binocularity, balance and posture. The bi-modal visual process maintains plasticity for efficiency. Compromise causes Post Trauma Vision Syndrome (PTVS) and Visual Midline Shift Syndrome (VMSS). Rehabilitation through use of lenses, prisms and sectoral occlusion has inter-professional implications in rehabilitation affecting the plasticity of the bi-modal visual process, thereby improving binocularity, spatial orientation, posture and balance Main outcomes: This review provides an opportunity to create a new perspective of the consequences of TBI on visual processing and the symptoms that are often caused by trauma. It also serves to provide a perspective of visual processing dysfunction that has potential for developing new approaches of rehabilitation. Understanding vision as a bi-modal process facilitates a new perspective of visual processing and the potentials for rehabilitation following a concussion, brain injury or other neurological events.

  12. Serotonin syndrome caused by minimum doses of SSRIS in a patient with spinal cord injury

    Satoh, Koichiro; Takano, Shizuko; Onogi, Takashi; Ohtsuki, Koji; Kobayashi, Toshio


    There have been only a few reports of serotonin syndrome developing after mono-therapy with a selective serotonin reuptake inhibitor (SSRI). We report a case of serotonin syndrome caused by long-term therapy with fluvoxamine prior to treatment with paroxetine. An 18-year-old man with spinal cord injury (SCI) at thoracic level 2-3 presented with onset of serotonin syndrome after taking fluvoxamine (50 mg per day) for 8 weeks prior to treatment with paroxetine (10 mg per day) for 6 days. He had...

  13. Why most traumatic brain injuries are not caused by linear acceleration but skull fractures are.

    Svein eKleiven


    Full Text Available Injury statistics have found the most common accident situation to be an oblique impact. An oblique impact will give rise to both linear and rotational head kinematics. The human brain is most sensitive to rotational motion. The bulk modulus of brain tissue is roughly five to six orders of magnitude larger than the shear modulus so that for a given impact it tends to deform predominantly in shear. This gives a large sensitivity of the strain in the brain to rotational loading and a small sensitivity to linear kinematics. Therefore, rotational kinematics should be a better indicator of traumatic brain injury risk than linear acceleration. To illustrate the difference between radial and oblique impacts, perpendicular impacts through the center of gravity of the head and 45o oblique impacts were simulated. It is obvious that substantially higher strain levels in the brain are obtained for an oblique impact, compared to a corresponding perpendicular one, when impacted into the same padding using an identical impact velocity. It was also clearly illustrated that the radial impact causes substantially higher stresses in the skull with an associated higher risk of skull fractures, and traumatic brain injuries secondary to those.

  14. Acute cigarette smoke exposure causes lung injury in rabbits treated with ibuprofen

    Witten, M.L.; Lemen, R.J.; Quan, S.F.; Sobonya, R.E.; Magarelli, J.L.; Bruck, D.C.


    We studied lung clearance of aerosolized technetium-labeled diethylenetriamine pentaacetic acid (/sup 99m/TcDTPA), plasma concentrations of 6-keto-PGF1 alpha and thromboxane B2, and pulmonary edema as indices of lung injury in rabbits exposed to cigarette smoke (CSE). Forty-six rabbits were randomly assigned to 4 groups: control sham smoke exposure (SS, N = 9), sham smoke exposure ibuprofen-pretreated (SS-I, N = 10), CSE (N = 9), sham smoke exposure ibuprofen-pretreated (SS-I, N = 10), CSE (N = 9), and CSE ibuprofen-pretreated (CSE-I, N = 19). Ibuprofen (cyclooxygenase eicosanoid inhibitor) was administered as a single daily intramuscular injection (25 mg/kg) for 7 days before the experiment. Cigarette or sham smoke was delivered by syringe in a series of 5, 10, 20, and 30 tidal volume breaths with a 15-min counting period between each subset of breaths to determine /sup 99m/TcDTPA biological half-life (T1/2). In the ibuprofen pretreated group, CSE caused significant decreases in /sup 99m/TcDTPA T1/2 and dynamic lung compliance. Furthermore, these changes in lung function were accompanied by severe injury to type I alveolar cell epithelium, pulmonary edema, and frequently death of the rabbits. These findings suggest that inhibition of the cyclooxygenase pathway before CSE exacerbates lung injury in rabbits.

  15. The role of eNOS phosphorylation in causing drug-induced vascular injury.

    Tobin, Grainne A McMahon; Zhang, Jun; Goodwin, David; Stewart, Sharron; Xu, Lin; Knapton, Alan; González, Carlos; Bancos, Simona; Zhang, Leshuai; Lawton, Michael P; Enerson, Bradley E; Weaver, James L


    Previously we found that regulation of eNOS is an important part of the pathogenic process of Drug-induced vascular injury (DIVI) for PDE4i. The aims of the current study were to examine the phosphorylation of eNOS in mesentery versus aorta at known regulatory sites across DIVI-inducing drug classes and to compare changes across species. We found that phosphorylation at S615 in rats was elevated 35-fold 2 hr after the last dose of CI-1044 in mesentery versus 3-fold in aorta. Immunoprecipitation studies revealed that many of the upstream regulators of eNOS activation were associated with eNOS in 1 or more signalosome complexes. Next rats were treated with drugs from 4 other classes known to cause DIVI. Each drug was given alone and in combination with SIN-1 (NO donor) or L-NAME (eNOS inhibitor), and the level of eNOS phosphorylation in mesentery and aorta tissue was correlated with the extent of vascular injury and measured serum nitrite. Drugs or combinations produced altered serum nitrite levels as well as vascular injury score in the mesentery. The results suggested that phosphorylation of S615 may be associated with DIVI activity. Studies with the species-specific A2A adenosine agonist CI-947 in rats versus primates showed a similar pattern.

  16. Kickboxing sport as a new cause of traumatic brain injury-mediated hypopituitarism.

    Tanriverdi, Fatih; Unluhizarci, Kursad; Coksevim, Bekir; Selcuklu, Ahmed; Casanueva, Felipe F; Kelestimur, Fahrettin


    Traumatic brain injury, which is a frequent and a worldwide important public health problem, may result in pituitary dysfunction. Concussion, a common type of lesion after traumatic brain injury, is an injury associated with sports including boxing and kickboxing. Kickboxing is one of the most popular martial arts and approximately 1-million people around the world participate in kickboxing sport. Head is the most common site of injury in amateur and professional kickboxers. Pituitary consequences of chronic repetitive head trauma in kickboxing have not been investigated until now. Therefore, the present study was designed to investigate the pituitary function in both retired and active amateur kickboxers. Twenty-two amateur kickboxers who have boxed in national and international championships (16 men, 6 women) with a mean age of 27.3 +/- 7.1 years, and 22 age- and sex-matched healthy controls were included in the study. Basal hormone levels were obtained from the participants. To assess GH-IGF-I axis, GHRH + GHRP-6 test and glucagon stimulation tests were used. Hypothalamo-pituitary-adrenal axis was assessed by glucagon stimulation test. When mean basal hormone levels were compared between kickboxers and the controls, IGF-I level was significantly lower in kickboxers (P kickboxers had GH deficiency had ACTH deficiency, respectively. There were significant negative correlations between IGF-I levels and age, duration of sports and number of bouts (P kickboxing is a novel cause of hypopituitarism and kickboxers are at a risk for hypopituitarism especially isolated GH deficiency. Therefore, participants of the combative sports who were exposed to chronic repetitive head trauma need to be screened.

  17. Protective effects of penehyclidine hydrochloride on acute lung injury caused by severe dichlorvos poisoning in swine

    CUI Juan; LI Chun-sheng; HE Xin-hua; SONG Yu-guo


    Background Organophosphate poisoning is an important health problem in developing countries which causes death mainly by inducing acute lung injury.In this study,we examined the effects of penehyclidine hydrochloride (PHC),a selective M-receptor inhibitor,on dichlorvos-induced acute lung injury in swine.Methods Twenty-two female swines were randomly divided into control (n=5),dichlorvos (n=6),atropine (n=6),and PHC (n=5) groups.Hemodynamic data,extravascular lung water index (EVLWI),and pulmonary vascular permeability index (PVPI) were monitored; blood gas analysis and acetylcholinesterase (AchE) levels were measured.PaO2/FiO2,cardiac index (Cl),and pulmonary vascular resistance indices (PVRI) were calculated.At termination of the study,pulmonary tissue was collected for ATPase activity determination and wet to dry weight ratio (W/D) testing 6 hours post-poisoning.TUNEL assay,and Bax,Bcl-2,and caspase-3 expression were applied to pulmonary tissue,and histopathology was observed.Results After poisoning,PHC markedly decreased PVRI,increased CI more effectively than atropine.Anticholinergic treatment reduced W/D,apoptosis index (AI),and mitigated injury to the structure of lung; however,PHC reduced AI and caspase-3 expression and improved Bcl-2/Bax more effectively than atropine.Atropine and PHC improved ATPase activities; a significant difference between groups was observed in Ca2+-ATPase activity,but not Na+-K+-ATPase activity.Conclusions The PHC group showed mild impairment in pathology,less apoptotic cells,and little impact on cardiac function compared with the atropine group in dichlorvos-induced acute lung injury.

  18. A Proposed Treatment for Visual Field Loss caused by Traumatic Brain Injury using Interactive Visuotactile Virtual Environment

    Farkas, Attila J.; Hajnal, Alen; Shiratuddin, Mohd F.; Szatmary, Gabriella

    In this paper, we propose a novel approach of using interactive virtual environment technology in Vision Restoration Therapy caused by Traumatic Brain Injury. We called the new system Interactive Visuotactile Virtual Environment and it holds a promise of expanding the scope of already existing rehabilitation techniques. Traditional vision rehabilitation methods are based on passive psychophysical training procedures, and can last up to six months before any modest improvements can be seen in patients. A highly immersive and interactive virtual environment will allow the patient to practice everyday activities such as object identification and object manipulation through the use 3D motion sensoring handheld devices such data glove or the Nintendo Wiimote. Employing both perceptual and action components in the training procedures holds the promise of more efficient sensorimotor rehabilitation. Increased stimulation of visual and sensorimotor areas of the brain should facilitate a comprehensive recovery of visuomotor function by exploiting the plasticity of the central nervous system. Integrated with a motion tracking system and an eye tracking device, the interactive virtual environment allows for the creation and manipulation of a wide variety of stimuli, as well as real-time recording of hand-, eye- and body movements and coordination. The goal of the project is to design a cost-effective and efficient vision restoration system.

  19. Injury/Fatality-Causing Incidents Involving the Rearward Movement of Agricultural Machinery: Types, Causes, and Preventive Measures

    Shawn G. Ehlers


    Full Text Available The research reported here sought to more fully understand the types and causative factors of injury/fatality incidents resulting from the rearward-movement of tractors and other self-propelled agricultural machinery, with the view that such findings might lead to the development, improvement, and/or better utilization of safety procedures, design principles, and technologies that would prevent—or at least markedly reduce—their occurrence. Thus, the scope of this study focused only on rearward-travel (not mechanical malfunction incidents, and principally on agricultural equipment (although cases involving similar equipment in industrial or construction settings were also drawn upon. Applying these two criteria, a search of published and online sources uncovered more than 100 documented cases, 35 of which could clearly be identified as rearward-movement incidents, of which 28 (80% were fatal. Each of these 35 cases were then assessed, based on the type of machine, type of worksite, and type/description of incident (i.e., ‘scenario’, which fell into one of three distinct categories or classifications—(1 co-worker run over/crushed/otherwise injured because operator loses visual contact with co-worker; (2 bystander run over/crushed/otherwise injured because operator is unaware of bystander’s presence; and (3 operator run over/crushed/otherwise injured because operator loses visual contact with, or is unaware of, a stationary object or a hazard. Then, from each scenario, a representative incident (i.e., case study was selected for a more in-depth analysis. The collective findings, from these three case studies and all 35 machinery rearward-movement incidents, were as follows: (1 The ‘victim’ could be the machine operator as well as a co-worker or a bystander; (2 The specific site of the co-worker or bystander injury/fatality was at the base of the machine’s rear tires or tracks, at the hitching point, or behind a towed implement; (3

  20. Acute ocular injuries caused by 60-Ghz millimeter-wave exposure.

    Kojima, Masami; Hanazawa, Masahiro; Yamashiro, Yoko; Sasaki, Hiroshi; Watanabe, Soichi; Taki, Masao; Suzuki, Yukihisa; Hirata, Akimasa; Kamimura, Yoshitsugu; Sasaki, Kazuyuki


    The goal of this study was to examine the clinical course of 60-GHz millimeter-wave induced damages to the rabbit eye and to report experimental conditions that allow reproducible induction of these injuries. The eyes of pigmented rabbits (total number was 40) were irradiated with 60-GHz millimeter-waves using either a horn antenna or one of two lens antennas (6 and 9 mm diameter; phi6, phi9) Morphological changes were assessed by slit-lamp microscopy. Additional assessments included corneal fluorescein staining, iris fluorescein angiography, and lens epithelium light microscopy. Under the standardized eye-antenna positioning, the three antennas caused varying damages to the eyelids or eyeglobes. The most reproducible injuries without concurrent eyelid edema and corneal desiccation were achieved using the phi6 lens antenna: irradiation for 6 min led to an elevation of the corneal surface temperature (reaching 54.2 +/- 0.9 degrees C) plus corneal edema and epithelial cell loss. Furthermore, mitotic cells appeared in the pupillary area of the lens epithelium. Anterior uveitis also occurred resulting in acute miosis (from 6.6 +/- 1.4 to 2.2 +/- 1.4 mm), an increase in flares (from 6.7 +/- 0.9 to 334.3 +/- 130.8 photons per second), and iris vasodilation or vessel leakage. These findings indicate that the three types of millimeter-wave antennas can cause thermal injuries of varying types and levels. The thermal effects induced by millimeter-waves can apparently penetrate below the surface of the eye.




    Full Text Available The mechanical harvesting causes injuries on seeds and may affect their quality. Different threshing mechanisms and their adjustments may also affect the intensity of impacts that machines cause on seeds. So, this study aimed at diagnosing and evaluating the effect of two combines: the first one with a threshing system of axial flow and the other one with a threshing system of tangential flow, under adjustments of concave opening (10 mm, 30 mm and 10 mm for a combine with axial flow and 3.0 mm, 15 mm and 3.0 mm for a combine with tangential flow and three cylinder rotations on the quality of soybean seeds harvested at two moisture contents. Soybean seeds of cultivar 'ND 4910' were harvested at 16.6% moisture (mid - morning and 13.7% moisture in the afternoon. The seeds quality was evaluated by germination tests, germination speed index (GSI, germination rate, moisture content, percentage of purity and vigor by tetrazolium test. Despite the combine, the results showed that the mechanical injury has most reduced seeds quality, at 16.6% moisture content, concave opening of 30 mm (axial and 10 mm (tangential and cylinder rotation of 1100 rpm (axial and 1000 (tangential, both with the highest rotations used. The combine with tangential flow had the highest degree of seeds purity. When seeds moisture content at harvest was close to 13.7%, there was the highest seed injury, while, at 16.6%, there was the highest number of crushed soybeans, regardless the combine adjustment.

  2. Effects of erigeron breviscapus (Vant.) Hand-Mazz pretreatment on pathology and oxyradical level following spinal cord ischemia-reperfusion injury in rabbits


    Objective To investigate the effects of erigeron breviscapus (Vant.) Hand-Mazz (erigeron breviscapus) pretreatment on pathology and oxyradical level in the spinal cord after ischemia-reperfusion (I/R) injury in rabbits. Methods A total of 40 New Zealand white rabbits were randomly divided into three groups: sham-operation group with 10 rabbits treated with only abdominal aorta exposure without occlusion,control group with 15 rabbits that underwent ischemia for 50 minutes and treated with matched saline,and ...

  3. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks.

    Haninec, Pavel; Mencl, Libor; Bačinský, Peter; Kaiser, Radek


    A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months.

  4. Protective effect of natural flavonoids on rat peritoneal macrophages injury caused by asbestos fibers.

    Kostyuk, V A; Potapovich, A I; Speransky, S D; Maslova, G T


    Exposure of macrophages to asbestos fibers resulted in enhancement of the production of oxygen radicals, determined by a lucigenin enhanced chemiluminescence (LEC) assay, a formation of thiobarbituric acid reactive substances (TBARS), a LDH release into the incubation mixture, and a rapid lysis of the cells. Rutin (Rut) and quercetin (Qr) were effective in inhibiting LEC, TBARS formation, and reducing peritoneal macrophages injury caused by asbestos. The concentrations pre-treatment of antioxidants that were required to prevent the injury of peritoneal macrophages caused by asbestos by 50% (IC50) were 90 microM and 290 microM for Qr and Rut, respectively. Both flavonoids were found to be oxidized during exposure of peritoneal macrophages to asbestos and the oxidation was SOD sensitive. The efficacy of flavonoids as antioxidant agents as well as superoxide ion scavengers was also evaluated using appropriate model systems, and both quercetin and rutin were found to be effective in scavenging O2.-. These findings indicate that flavonoids are able to prevent the respiratory burst in rat peritoneal macrophages exposed to asbestos at the stage of activated oxygen species generation, mainly as superoxide scavengers. On the basis of this study it was concluded that natural flavonoids quercetin and rutin would be promising drug candidates for a prophylactic asbestos-induced disease.

  5. Kinesiological study of the push-up motion in spinal cord injury patients: involving measurement of hand pressure applied to a force plate.

    Kotani Y


    Full Text Available We studied the pressure exerted by hands during push-ups in 21 paraplegic and 2 tetraplegic patients employing 4 different hand positions. In the fingers-spread position, the initial force exerted was a vertical force (Fz, followed by a medio-lateral force (Fy and then an antero-posterior force (Fx. In the other 3 positions, the order of force type exertion was Fz, Fx, and then Fy. All subjects with neurological injury levels above T4 and subjects between T5 and T10 without spinal instrumentation could not push themselves up in the fingers-spread position. The fact that Fy is initiated before Fx in the fingers-spread position indicates that lateral balancing of the trunk is critical in this position, thus explaining why subjects without spinal instrumentation with neurological injury at a level higher than T10 could not control their spinal columns while performing push-ups. In contrast, antero-posterior balancing takes priority in the other hand positions. We believe that spinal instrumentation helps balance the trunk in the lateral direction, converting the thoracic spine into a rigid body in subjects with neurological injury at levels above T10.

  6. [Analysis of factors of elder patients with lumbar vertebrae fractures caused by low-energy injury in plateau area].

    Yan, W; Xu, W S; Hu, H X


    Objective: To analyse the factors of elder patients with lumbar vertebrae fractures caused by low-energy injury in plateau area. Methods: From March 2013 to September 2016, 124 elder patients with lumbar vertebrae fractures caused by low-energy injury in our hospital were selected as observation group, in the corresponding period, 98 elderly patients who had no fractures were considered as control group .The bone mineral density (BMD) was examined by whole body bone mineral density tester, and univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of lumbar fractures caused by low-energy injury. Results: BMD and T value of lateral projection of lumbar vertebrae in observation group were significantly lower than those in control group (Penergy injury. Logistic regression analysis showed that age (OR=1.215), bone mineral density (OR=3.215) and calcium supplementation (OR=4.904) were independent risk factors for lumbar fractures caused by low-energy injury (Pindependent risk factors of lumbar fractures caused by low-energy injury, and individual medical intervention is needed.

  7. An Investigation of the Mechanism of Traumatic Brain Injury Caused by Blast in the Open Field

    Feng, Ke

    Blast-induced traumatic brain injury (bTBI) is a signature wound of modern warfare. The current incomplete understanding of its injury mechanism impedes the development of strategies for effective protection of bTBI. Despite a considerable amount of experimental animal studies focused on the evaluation of brain neurotrauma caused by blast exposure, there is very limited knowledge on the biomechanical responses of the gyrenecephalic brain subjected to primary free-field blast waves imposed in vivo, and the correlation analysis between the biomechanical responses and its injury outcomes. Such information is crucial to the development of injury criteria of bTBI. This study aims to evaluate the external and internal mechanical responses of the brain against different levels of blast loading with Yucatan swine in free field, and to conduct correlational studies with brain tissue damage. To better understand primary bTBI, we have implemented an open field experimental model to apply controlled shock waves on swine head. The applied pressure levels of shock waves were predicted by finite element modeling and verified with calibrated testing. Biomechanical responses of primary blasts such as intracranial pressure (ICP), head kinetics, strain rate of skull, were measured in vivo during the blasts. A positive correlation between incident overpressure (IOP) and its corresponding biomechanical responses of the brain was observed. A parallel group of non-instrumented animals were used to collect injury data 72 hours post experiment. Cellular responses governed by primary blasts, such as neuronal degeneration and apoptosis were studied via immunohistochemistry. Representative fluorescent-stained images were examined under microscope. A positive correlation was found between the amount of degenerative neurons and the blast level. Significant elevation of apoptosis was found in the high-level blast. Comparisons between brains with varies ICP readings demonstrate differences of the

  8. Frequency of lower limb injuries and their Causes among motorcycle accident admitted into Imam Hossein hospital during one year

    Ali Arhami Dolatabadi


    Full Text Available Abstract Background and Aim: Motor vehicle accidents are common cause of mortality, morbidity and disability. Human factors are principle cause for frequency of motor vehicle accident. In most studies, 52-40% lower limb injuries are trauma from a motorcycle accident. These accidents cause high financial cost and harm for society. Materials and Methods: In this study, patients with lower limb injuries referred to the hospital trauma ward of Imam Hussein were evaluated during one year. Questionnaire forms were designed and completed for patients then data of these forms was inserted in a database. The information was analyzed by statistical software SPSS 18. Results: from 766 patients with lower limb traumas which were examined and evaluated, 92 % were male and mean age of patients was 25± 12 years. 156 patients suffered from head and neck trauma and 134 persons had skin damage in addition to lower limb trauma. Injury to leg was most common injuries in lower leg and tibia shaft fracture was more frequent than lower bone fracture. Most injuries in pelvic trauma associated with fractures of the superior pubic ramus and coccyx bone. Seventy percent of related knee injuries included injury to patella and tibia plateau. The most observed injuries in ankle and foot were lateral malleolus fracture and lisferanc injuries. About 11 percent of patients were discharged from emergency room after primary management and other patients were admitted in hospital.Conclusion: Given the high incidence of lower extremity injuries, especially the leg, in the accident of motorcycle riders, procurement and construction of an efficient protective equipment, especially protective guard can be effective in reducing accidents.

  9. Injuries and their probable causes in undergraduates of the Physical Education course at the State University of Maringá

    Alberto Saturno Madureira


    Full Text Available The aim of this study to analyse the occurrence of injuries in undergraduates of the Physical Education Course at the State University of Maringá. Types of injuries were diagnosed, the opinion of students and professors with regard to their probable causes was taken and the factors that could render injuries less damaging were identified. Research was carried out in the second semester of 1991 when 231 students were regularly enlisted. Data were collected by means of questionnaires for professors and for students. Forty injury cases were verified, 13 with males and 27 with females. The most common type of injury was bruises (55% followed by strain (18%. The inferior members were the most affected region. Judo was the subject in which the greatest number of injuries occurred. Students stated that salient probable causes were: agressivity of colleages in practical exercises (33% and defective sports facilities (25%. In the professors opinion, however, the two chief causes were: students’ distraction (20% and physical inability (20%. The establishment of an Internal Commission for the Prevention of Accidents has been suggested made up of professors, under graduate students and personnel of the Physical Education Department at the State University of Maringá. Its aims are to carry out a following up of this situation, to promote the prevention of injuries and to suggest possible improvements in the premises.

  10. Suicidal single gunshot injury to the head: differences in site of entrance wound and direction of the bullet path between right- and left-handed--an autopsy study.

    Nikolić, Slobodan; Zivković, Vladimir; Babić, Dragan; Juković, Fehim


    The aim of this study was to determine the differences in the anatomical site of a gunshot entrance wound and the direction of the bullet path between right- and left-handed subjects who committed a suicide by a single gunshot injury to the head. The retrospective autopsy study was performed for a 10-year period, and it included selected cases of single suicidal gunshot head injury, committed by handguns. We considered only contact or near-contact wounds. The sample included 479 deceased, with average age 47.1 ± 19.1 years (range, 12-89 years): 432 males and 47 females, with 317 right-handed, 25 left-handed, and 137 subjects with unknown dominant hand. In our observed sample, most cases involved the right temple as the site of entrance gunshot wound (about 67%), followed by the mouth (16%), forehead (7%), left temple (6%), submental (2%), and parietal region (1%). The left temple, right temple, and forehead were the sites of the gunshot entrance wounds, which were the best predictors of the handedness of the deceased (Spearman ρ = 0.149, P = 0.006). Our study showed that the direction of the bullet intracranial path in cases of suicide was even a more potent predictor of the handedness of the deceased (Spearman ρ = 0.263, P = 0.000; Wald = 149.503, P = 0.000).

  11. Sports, Exercise, and Other Causes of Injuries: Results of a Population Survey.

    Uitenbroek, Daan G.


    Telephone interviews with individuals representing various age and sex groups in Scotland examined how sport and exercise injury rates compared with injury rates for other activities. Results indicated that 46% of male and 14% of female injuries were sport or exercise related. Such injuries decreased with increasing age. (SM)

  12. An innovative surgical technique for treating penile incarceration injury caused by heavy metallic ring

    S J Baruah


    Full Text Available Penile incarceration injury by heavy metallic ring is a rare genital injury. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing erection, and due to psychiatric disturbances are some of the reasons for a penile incarceration injury. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into four groups. Surgical techniques are reserved for the advanced grades (Grades IV and V. We describe an innovative surgical technique, which can be adopted in Grades II and III injuries.

  13. Nerve injury-induced neuropathic pain causes disinhibition of the anterior cingulate cortex.

    Blom, Sigrid Marie; Pfister, Jean-Pascal; Santello, Mirko; Senn, Walter; Nevian, Thomas


    Neuropathic pain caused by peripheral nerve injury is a debilitating neurological condition of high clinical relevance. On the cellular level, the elevated pain sensitivity is induced by plasticity of neuronal function along the pain pathway. Changes in cortical areas involved in pain processing contribute to the development of neuropathic pain. Yet, it remains elusive which plasticity mechanisms occur in cortical circuits. We investigated the properties of neural networks in the anterior cingulate cortex (ACC), a brain region mediating affective responses to noxious stimuli. We performed multiple whole-cell recordings from neurons in layer 5 (L5) of the ACC of adult mice after chronic constriction injury of the sciatic nerve of the left hindpaw and observed a striking loss of connections between excitatory and inhibitory neurons in both directions. In contrast, no significant changes in synaptic efficacy in the remaining connected pairs were found. These changes were reflected on the network level by a decrease in the mEPSC and mIPSC frequency. Additionally, nerve injury resulted in a potentiation of the intrinsic excitability of pyramidal neurons, whereas the cellular properties of interneurons were unchanged. Our set of experimental parameters allowed constructing a neuronal network model of L5 in the ACC, revealing that the modification of inhibitory connectivity had the most profound effect on increased network activity. Thus, our combined experimental and modeling approach suggests that cortical disinhibition is a fundamental pathological modification associated with peripheral nerve damage. These changes at the cortical network level might therefore contribute to the neuropathic pain condition.

  14. Characterization and Comparison of Injuries Caused by Accidental and Non-accidental Blunt Force Trauma in Dogs and Cats.

    Intarapanich, Nida P; McCobb, Emily C; Reisman, Robert W; Rozanski, Elizabeth A; Intarapanich, Pichai P


    Motor vehicle accidents (MVA) are often difficult to distinguish from non-accidental injury (NAI). This retrospective case-control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion, abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, damage to claws, and evidence of older fractures. Odds ratios are reported for these injuries. MVA rib fractures were found to occur in clusters on one side of the body, with cranial ribs more likely to fracture, while NAI rib fractures were found to occur bilaterally with no cranial-caudal pattern. Establishing evidence-based patterns of injury may help clinicians differentiate causes of trauma and may aid in the documentation and prosecution of animal abuse. © 2016 American Academy of Forensic Sciences.

  15. Characterization of Feeding Injuries Caused by Ceresa nigripectus Remes Lenicov (Hemiptera: Membracidae) on Alfalfa Stems.

    Grosso, T P; Mercado, M I; Ponessa, G I; Conci, L R; Virla, E G


    Piercing-sucking insects cause mechanical and physiological injury to plants. Ceresa nigripectus Remes Lenicov is a pest of alfalfa in subtropical regions of South America and a carrier of the ArAWB phytoplasma. The aim of this study was to determine the feeding habits of this treehopper and to describe the effects of the feeding injuries on stem vascular tissues in alfalfa. Adults and nymphs of C. nigripectus inserted their stylets repeatedly girdling the stem. One week after feeding, alfalfa stems exhibited numerous feeding canals with salivary deposits, most of which reached the phloem. Two weeks after feeding, cortex and phloem cells next to the salivary sheath collapsed, mature tracheal elements became sparse and appeared with an increased cross-section area, and phenolic compounds increased in cells and cell walls compared to undamaged plants. Three weeks after feeding, an annular callus, formed by abnormal cell division and hypertrophy of preexisting cortex and vascular cambium cells, appeared immediately above the stem girdle. Parenchyma cells from the outer layers of the callus differentiated to form secondary anomalous amphicribal bundles in the wound. The aerial parts above the stem girdle eventually withered and died.


    芮永军; 施海峰; 糜菁熠; 陈光; 王骏; 钱俊


    Objective To discuss the surgical procedures and curative effect of stiff 2-5 metacarpophalangeal (MP)oints after crash injury in hand. Methods Between January 2006 and June 2009, 7 cases of stiff2-5 MP joints were treated by releasing the stiff MP joints and reconstructing the function of lumbrical muscle in one stage. There were 6 males and 1 female with an average age of 32 years (range, 18-56 years). All injuries were caused by crash. Six cases suffered from multiple metacarpal fracture or complex dislocation of MP joint and 1 case suffered from complete amputation at level of middle palm of hand. The interval from initial wound healing to hospitalization was 3 to 15 months. Before operation, the X-ray films showed fracture healed and the results of nipping paper test were positive. All hands were treated with physical therapy for 1 month. After the plaster external fixation for 6 weeks, the physical therapy and function training were given. Results All wounds healed by first intention. The patients had no joint instability and extensor tendon side-slipping with normal finger function. Six patients were followed up from 6 months to 3 years. The extension and flexion of MP joint were 0° and 67-90°, respectively. The average grip strength of injured dominant hand reached 86.70% of normal side and non-dominant hand reached 66.70% of normal side.The average injured dominant tip pinch strength reached 83.52% of normal side and non-dominant tip pinch strength reached 61.30% of normal side. Based on total active motion (TAM) system of Chinese Medical Association for Hand Surgery, the results were excellent in 4 cases, good in 1 case, and fair in 1 case; the excellent and good rate was 83.33%. Conclusion In patients with stiff MP joint and lumbrical muscle defect, releasing stiff MP joint and reconstructing lumbrical function in one stage can recover the function of MP joint and achieve good outcome. Physical therapy plays an important role before operation


    郑炜; 易传军; 田光磊; 田文; 李忠哲; 朱瑾


    Objective To study the composition, distribution, and influencing factors of acute hand injuries in daily life in the Beijing area by analyzing the clinical data from patients with acute hand injuries.Methods Between April 1st 2005 to September 30th 2005, 2 575 patients with acute hand injuries in daily life from Beijing area were investigated by questionnaire.The epidemiological factors were analyzed, including gender, age, injury time, injury cause, accident place, injury mechanism,and location.Results The 2 575 patients injuried in daily life accounted for 49.2% of all.Most of them were young males,and the male to female ratio was 3.3 ∶ 1.Most of the patients were 21-30 years old.The most common accident place was resting place (43.3%), and next was outdoors (28.8%) and leisure place (20.0%).Accidental injury was the major injury cause,accounted for 51.0%, followed by injury after drinking (16.1%) and violence (15.5%).The major injury mechanism was cutting (52.23%), followed by collision (16.04%) and falling (15.18%).A total of 2 405 patients were right hander, and handedness affected the distribution of injured hands significantly.Open injuries accouonted for 70.7% of the patients, and the tissues in deep layer were involved in the injury in 54.4% of all.Condusion Hand injury in daily life is a common problem, which has its own epidemiological features.More appropriate measures should be taken to decrease the incidence.%目的 通过分析手外伤患者就诊的临床资料,分析北京地区生活性手外伤的构成、分布特征及其影响因素.方法 对2005年4月1日-9月30日北京积水潭医院急诊手外伤患者进行问卷调查,对其中的2 575例生活性手外伤患者的性别、年龄、损伤时间、地点、机制和部位等因素进行流行病学分析.结果 生活性手外伤占急诊手外伤的49.2%,男女比例为3.3:1,21~30岁高发,一天中10:00~11:00和21:00~22:00为高发

  18. Vitamin B(12) deficiency as a cause of delirium in a patient with spinal cord injury.

    Harrington, Amanda L; Dixon, Thomas M; Ho, Chester H


    A man with spinal cord injury (SCI) and multiple medical comorbidities had new-onset delirium during his 14th month of hospitalization. Diagnostic workup did not elicit an obvious etiology for mental status changes. Delirium persisted despite psychiatry intervention, and he was unable to be weaned from the ventilator because of prolonged agitation. Routine anemia workup revealed a possible untreated vitamin B(12) deficiency, although laboratory values were inconclusive. Empiric treatment with cyanocobalamin injections was initiated, and his delirium remarkably resolved after 3 weeks of treatment. We provide a concise review of the etiologies and varied clinical presentations of vitamin B(12) deficiency. As illustrated in this case, classic laboratory findings may not appear, and neurologic impairments from SCI can obscure the physical signs of deficiency, making diagnosis difficult. Empiric treatment may be indicated in cases of neuropsychiatric abnormalities not explained by other causes. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Early Stage of Chronic Kidney Disease with Renal Injury Caused by Hypertension in a Dog

    Akira Yabuki


    Full Text Available A 10-year-old spayed female Papillon weighing 4.0 kg presented with a history of persistent hematuria and pollakiuria. Concurrent bladder calculi, a mammary gland tumor, and nonazotemic early stage of chronic kidney disease with contracted kidneys were noted in this dog. The dog underwent cystectomy, unilateral mastectomy, and intraoperative renal biopsy. On the basis of histopathological analysis of renal biopsy results, it was suspected that renal injury of the dog was caused by persistent hypertension, and a follow-up examination revealed severe hypertension. The dog was treated with a combination of an angiotensin-converting enzyme inhibitor and calcium channel blocker. The treatment produced a good outcome in the dog, and there has been no progression of the chronic kidney disease for over 2 years.

  20. Niacinamide abrogates the organ dysfunction and acute lung injury caused by endotoxin.

    Kao, Shang-Jyh; Liu, Demeral David; Su, Chain-Fa; Chen, Hsing I


    Poly (ADP-ribose) synthabse (PARS) or polymerase (PARP) is a cytotoxic enzyme causing cellular damage. Niacinamide inhibits PARS or PARP. The present experiment tests the effects of niacinamide (NCA) on organ dysfunction and acute lung injury (ALI) following lipopolysaccharide (LPS). LPS was administered to anesthetized rats and to isolated rat lungs. In anesthetized rats, LPS caused systemic hypotension and increased biochemical factors, nitrate/nitrite (NOx), methyl guanidine (MG), tumor necrosis factoralpha (TNFalpha), and interleukin-1beta (IL-1beta). In isolated lungs, LPS increased lung weight (LW) to body weight ratio, LW gain, protein and dye tracer leakage, and capillary permeability. The insult also increased NOx, MG, TNFalpha, and IL-1beta in lung perfusate, while decreased adenosine triphosphate (ATP) content with an increase in PARP activity in lung tissue. Pathological examination revealed pulmonary edema with inflammatory cell infiltration. These changes were abrogated by posttreatment (30 min after LPS) with NCA. Following LPS, the inducible NO synthase (iNOS) mRNA expression was increased. NCA reduced the iNOS expression. Niacinamide exerts protective effects on the organ dysfunction and ALI caused by endotoxin. The mechanisms may be mediated through the inhibition on the PARP activity, iNOS expression and the subsequent suppression of NO, free radicals, and proinflammatory cytokines with restoration of ATP.

  1. Causes and characteristics of work-related eye injuries in western Turkey

    Mustafa Serinken


    Full Text Available Objectives: To analyze descriptive data and characteristics of work-related eye injuries (WREI admitted into the emergency department (ED and obtain information to utilize in planning measures to prevent WREI. Materials and Methods: This prospective study recruited patients with WREI admitted to the center in the two-year study period. Only the casualties occurred at the workplace and while working constituted the sample. The data were collected via face-to-face contact in the ED. Results: Males comprised the majority of the sample (95.3%, n = 778 and mean age of the patients was 28.1 ± 6.5 (range: 15-54 with the biggest percentage in between 25 and 34 years of age (46.2%, n = 377. Most patients were working in the metal and machinery sectors (66.4%, n = 542. Nearly half of the patients had less than 1 year of experience (50.4%, n = 411. The most common mechanism of WREI was noted to be exposures to welding light (26.9%, n = 219, followed by drilling/cutting injuries (21.1%, n = 172. "Carelessness" and "hurrying up" were the most commonly reported causes of WREIs among ′worker-related causes′ (21.4% and 16.1%, respectively. Lack of protective measures ranked the highest among workplace-related causes (18.7%, n = 207. Conclusions: Programs to increase awareness on workplace safety and sound preventive strategies for both parties-employers and employees are to be pursued. Occupational safety efforts should include training on workplace eye safety and campaigns to raise knowledgeability on this disease among workers.

  2. Human-Wildlife Conflicts in Nepal: Patterns of Human Fatalities and Injuries Caused by Large Mammals.

    Acharya, Krishna Prasad; Paudel, Prakash Kumar; Neupane, Prem Raj; Köhl, Michael


    Injury and death from wildlife attacks often result in people feeling violent resentment and hostility against the wildlife involved and, therefore, may undermine public support for conservation. Although Nepal, with rich biodiversity, is doing well in its conservation efforts, human-wildlife conflicts have been a major challenge in recent years. The lack of detailed information on the spatial and temporal patterns of human-wildlife conflicts at the national level impedes the development of effective conflict mitigation plans. We examined patterns of human injury and death caused by large mammals using data from attack events and their spatiotemporal dimensions collected from a national survey of data available in Nepal over five years (2010-2014). Data were analyzed using logistic regression and chi-square or Fisher's exact tests. The results show that Asiatic elephants and common leopards are most commonly involved in attacks on people in terms of attack frequency and fatalities. Although one-horned rhinoceros and bears had a higher frequency of attacks than Bengal tigers, tigers caused more fatalities than each of these two species. Attacks by elephants peaked in winter and most frequently occurred outside protected areas in human settlements. Leopard attacks occurred almost entirely outside protected areas, and a significantly greater number of attacks occurred in human settlements. Attacks by one-horned rhinoceros and tigers were higher in the winter, mainly in forests inside protected areas; similarly, attacks by bears occurred mostly within protected areas. We found that human settlements are increasingly becoming conflict hotspots, with burgeoning incidents involving elephants and leopards. We conclude that species-specific conservation strategies are urgently needed, particularly for leopards and elephants. The implications of our findings for minimizing conflicts and conserving these imperiled species are discussed.

  3. Obesity-Induced Endoplasmic Reticulum Stress Causes Lung Endothelial Dysfunction and Promotes Acute Lung Injury.

    Shah, Dilip; Romero, Freddy; Guo, Zhi; Sun, Jianxin; Li, Jonathan; Kallen, Caleb B; Naik, Ulhas P; Summer, Ross


    Obesity is a significant risk factor for acute respiratory distress syndrome. The mechanisms underlying this association are unknown. We recently showed that diet-induced obese mice exhibit pulmonary vascular endothelial dysfunction, which is associated with enhanced susceptibility to LPS-induced acute lung injury. Here, we demonstrate that lung endothelial dysfunction in diet-induced obese mice coincides with increased endoplasmic reticulum (ER) stress. Specifically, we observed enhanced expression of the major sensors of misfolded proteins, including protein kinase R-like ER kinase, inositol-requiring enzyme α, and activating transcription factor 6, in whole lung and in primary lung endothelial cells isolated from diet-induced obese mice. Furthermore, we found that primary lung endothelial cells exposed to serum from obese mice, or to saturated fatty acids that mimic obese serum, resulted in enhanced expression of markers of ER stress and the induction of other biological responses that typify the lung endothelium of diet-induced obese mice, including an increase in expression of endothelial adhesion molecules and a decrease in expression of endothelial cell-cell junctional proteins. Similar changes were observed in lung endothelial cells and in whole-lung tissue after exposure to tunicamycin, a compound that causes ER stress by blocking N-linked glycosylation, indicating that ER stress causes endothelial dysfunction in the lung. Treatment with 4-phenylbutyric acid, a chemical protein chaperone that reduces ER stress, restored vascular endothelial cell expression of adhesion molecules and protected against LPS-induced acute lung injury in diet-induced obese mice. Our work indicates that fatty acids in obese serum induce ER stress in the pulmonary endothelium, leading to pulmonary endothelial cell dysfunction. Our work suggests that reducing protein load in the ER of pulmonary endothelial cells might protect against acute respiratory distress syndrome in obese

  4. Effect of single-session repetitive transcranial magnetic stimulation applied over the hand versus leg motor area on pain after spinal cord injury.

    Jetté, Fanny; Côté, Isabelle; Meziane, Hadj Boumediene; Mercier, Catherine


    Neuropathic pain often follows spinal cord injury (SCI). To compare the effect of repetitive transcranial magnetic stimulation (rTMS) applied over different motor cortex targets (hand vs leg area) versus sham stimulation on neuropathic pain and local neurophysiological changes in patients with SCI. A total of 16 patients with complete or incomplete motor SCI and chronic neuropathic pain participated in a double-blind, cross-over randomized study. Three single sessions of sham or active rTMS (10 Hz, total of 2000 stimuli) were applied in random order over the hand or leg area with a minimal 2-week interval. THE MAIN OUTCOME MEASURES: were the numeric rating scale for pain sensation and parameters derived from motor mapping of the first dorsal interosseous muscle, including maximal amplitude of evoked response as well as map area, volume, and location. rTMS applied to either the hand or the leg area, but not sham stimulation, induced a significant but equivalent reduction in pain for the first 48 hours postintervention (P stimulation of the hand area (P = .04) but not for the other conditions. rTMS applied over the hand or leg motor cortex decreased neuropathic pain regardless of any change in cortical excitability, suggesting that the analgesic effect is not associated with local changes at the motor cortex level itself.

  5. Closed-loop afferent electrical stimulation for recovery of hand function in individuals with motor incomplete spinal injury: early clinical results.

    Schildt, Christopher J; Thomas, Sarah H; Powell, Elizabeth S; Sawaki, Lumy; Sunderam, Sridhar


    Afferent electrical stimulation is known to augment the effect of rehabilitative therapy through use-dependent cortical plasticity. Experiments pairing transcranial magnetic stimulation (TMS) with peripheral nerve stimulation (PNS) have shown a timing-dependent effect on motor evoked potential (MEP) amplitude suggesting that PNS applied in closed-loop (CL) mode could augment this effect through positive reinforcement. We present early results from a clinical trial in which an EEG brain-machine interface (BMI) was used to apply PNS to two subjects in response to motor intent detected from sensorimotor cortex in a cue-driven hand grip task. Both subjects had stable incomplete cervical spinal cord injury (SCI) with impaired upper limb function commensurate with the injury level. Twelve sessions of CL-PNS applied over a 4-6 week period yielded results suggesting improved hand grip strength and increased task-related modulation of the EEG in one hand of both subjects, and increased TMS-measured motor map area in one. These observations suggest that rehabilitation using such interactive therapies could benefit affected individuals.

  6. Lung injury caused by greenstick fracture of the scapular body in a 6-year-old boy.

    Shin, Sung Jin; Wang, Sung Il; Kim, Jung Ryul


    Complications caused by a scapular body fracture are rare, and usually occur due to concomitant injuries or nonunion. Intrathoracic displacement of a fractured scapula has only been described in two reports involving adolescents. In this report, we describe a 6-year-old boy with a parenchymal lung injury caused by a greenstick fracture fragment of the scapular body after being struck by a dump truck. Three-dimensional CT (3D CT) scan showed an incomplete fractured fragment impaling the left lung parenchyma resulting in pneumothorax, parenchymal contusion, and pneumatocele in the left upper lobe. The patient underwent emergency open reduction of the scapular fracture and chest tube insertion. A rare subtype of scapular fracture with resultant fragment rotation and intrathoracic penetration can injure the lung parenchyma. To the best of our knowledge, lung injury caused by incomplete fracture of the scapula in patients younger than 10 years has not been reported previously.

  7. Injuries caused by animals to young imbuzeiro (Spondias tuberosa Arruda plants in native and degraded caatinga areas

    Luiza Teixeira de Lima Brito


    Full Text Available This study had the objective of evaluating the injuries caused by animals to young imbu tree (Spondias tuberosa Arruda plants in native and degraded Caatinga areas, between the years 1997 and 2002. One thousand imbu tree scions were planted, being 500 in a degraded Caatinga area at the community of Alto do Angico, Petrolina-PE, and 500 in a native Caatinga area at the Caatinga Experimental Station of Embrapa Tropical Semi-Arid, Petrolina-PE. At every 30 days after having planted the scions, data were collected regarding survival and injuries caused by animals to the plants. The results showed that goats are responsible for the reduction on survival rates and for the slow development of young imbu tree in the degraded Caatinga area. In the native Caatinga area, of the collared peccary (Tayassu tajacu and armadillo (Euphractus sexcinctus caused the highest injury levels.

  8. Difficulty in Clinical Evaluation of Radial Nerve Injury due to Multiple Trauma to the Humerus, Wrist, and Hand

    Balik Mehmet Sabri


    Full Text Available Radial nerve damage is frequently encountered in humeral fractures. The radial nerve is primarily damaged when the humerus gets fractured, while secondary damage maybe due to post-traumatic manipulations and surgical exploration. High impact traumatic nerve injury, serious neuropathic pain, lack of response to therapeutic interventions, and indifference to the Tinel test are indications for surgical intervention. Since most humeral fracture-induced low impact radial nerve injuries resolve spontaneously, conservative therapy is preferred. We present a patient with humeral fracture-associated radial nerve injury, accompanied with digital amputation and flexor tendon avulsion on the same arm. These injuries required immediate surgery, thus rendering the clinical evaluation of the radial nerve impossible. We would like to highlight and discuss the inherent difficulties associated with multiple trauma of the upper arm.

  9. Mitigation Effect of Proanthocyanidin on Secondary Heart Injury in Rats Caused by Mechanical Trauma

    Ma, Shuo; Chen, Chong; Cao, Tingting; Bi, Yue; Zhou, Jicheng; Li, Xintao; Yu, Deqin; Li, Shuzhuang


    Multiple organ dysfunctional syndrome secondary to mechanical trauma (MT) has attracted considerable research attention. The heart is one of the most important organs of the body, and secondary cardiac insufficiency caused by MT seriously affects the quality of life. This study aims to investigate whether proanthocyanidin can alleviate myocardial injury and improve heart function in the process of MT leading to secondary cardiac insufficiency. Noble-Collip drum wasused to prepare MT model in rats. And myocardial apoptosis index was calculated after TUNEL staining. Ventricular intubation was employed to detect heart function. Changes in myocardial ultrastructure were observed using an electron microscope. ELISA was used to detect the content of TNF-α and reactive oxygen species generated from monocytes and cardiomyocytes. The changes in Ca2+ concentration in cardiomyocyte were observed by confocal microscope. Compared with trauma group, the administration group had a decreased apoptosis index of cardiomyocytes, and increased ±dp/dtmax. Meanwhile, proanthocyanidin can inhibit monocytes’ TNF-α production, and reduce plasma TNF-α concentration. Moreover, proanthocyanidin can attenuate the excessive oxidative stress reaction of cardiomyocyte, and inhibit calcium overload in cardiomyocytes. In conclusion, proanthocyanidin can effectively ease myocardial damage and improve cardiac function, through anti-inflammatory and antioxidant effects in secondary cardiac insufficiency caused by MT. PMID:28294148

  10. Breviscapine reduces neuronal injury caused by traumatic brain injury insult: partly associated with suppression of interleukin-6 expression

    Ling Jiang


    Full Text Available Breviscapine, extracted from the herb Erigeron breviscapus, is widely used for the treatment of cardiovascular diseases, cerebral infarct, and stroke, but its mechanism of action remains unclear. This study established a rat model of traumatic brain injury induced by controlled cortical impact, and injected 75 μg breviscapine via the right lateral ventricle. We found that breviscapine significantly improved neurobehavioral dysfunction at 6 and 9 days after injection. Meanwhile, interleukin-6 expression was markedly down-regulated following breviscapine treatment. Our results suggest that breviscapine is effective in promoting neurological behavior after traumatic brain injury and the underlying molecular mechanism may be associated with the suppression of interleukin-6.

  11. Electrical Injuries

    ... it can pass through your body and cause injuries. These electrical injuries can be external or internal. You may have one or both types. External injuries are skin burns. Internal injuries include damage to ...

  12. Moderate traumatic brain injury causes acute dendritic and synaptic degeneration in the hippocampal dentate gyrus.

    Xiang Gao

    Full Text Available Hippocampal injury-associated learning and memory deficits are frequent hallmarks of brain trauma and are the most enduring and devastating consequences following traumatic brain injury (TBI. Several reports, including our recent paper, showed that TBI brought on by a moderate level of controlled cortical impact (CCI induces immature newborn neuron death in the hippocampal dentate gyrus. In contrast, the majority of mature neurons are spared. Less research has been focused on these spared neurons, which may also be injured or compromised by TBI. Here we examined the dendrite morphologies, dendritic spines, and synaptic structures using a genetic approach in combination with immunohistochemistry and Golgi staining. We found that although most of the mature granular neurons were spared following TBI at a moderate level of impact, they exhibited dramatic dendritic beading and fragmentation, decreased number of dendritic branches, and a lower density of dendritic spines, particularly the mushroom-shaped mature spines. Further studies showed that the density of synapses in the molecular layer of the hippocampal dentate gyrus was significantly reduced. The electrophysiological activity of neurons was impaired as well. These results indicate that TBI not only induces cell death in immature granular neurons, it also causes significant dendritic and synaptic degeneration in pathohistology. TBI also impairs the function of the spared mature granular neurons in the hippocampal dentate gyrus. These observations point to a potential anatomic substrate to explain, in part, the development of posttraumatic memory deficits. They also indicate that dendritic damage in the hippocampal dentate gyrus may serve as a therapeutic target following TBI.

  13. Endotoxin-induced lung alveolar cell injury causes brain cell damage

    Rodríguez-González, Raquel; Ramos-Nuez, Ángela; Martín-Barrasa, José Luis; López-Aguilar, Josefina; Baluja, Aurora; Álvarez, Julián; Rocco, Patricia RM; Pelosi, Paolo


    Sepsis is the most common cause of acute respiratory distress syndrome, a severe lung inflammatory disorder with an elevated morbidity and mortality. Sepsis and acute respiratory distress syndrome involve the release of inflammatory mediators to the systemic circulation, propagating the cellular and molecular response and affecting distal organs, including the brain. Since it has been reported that sepsis and acute respiratory distress syndrome contribute to brain dysfunction, we investigated the brain-lung crosstalk using a combined experimental in vitro airway epithelial and brain cell injury model. Conditioned medium collected from an in vitro lipopolysaccharide-induced airway epithelial cell injury model using human A549 alveolar cells was subsequently added at increasing concentrations (no conditioned, 2%, 5%, 10%, 15%, 25%, and 50%) to a rat mixed brain cell culture containing both astrocytes and neurons. Samples from culture media and cells from mixed brain cultures were collected before treatment, and at 6 and 24 h for analysis. Conditioned medium at 15% significantly increased apoptosis in brain cell cultures 24 h after treatment, whereas 25% and 50% significantly increased both necrosis and apoptosis. Levels of brain damage markers S100 calcium binding protein B and neuron-specific enolase, interleukin-6, macrophage inflammatory protein-2, as well as matrix metalloproteinase-9 increased significantly after treating brain cells with ≥2% conditioned medium. Our findings demonstrated that human epithelial pulmonary cells stimulated with bacterial lipopolysaccharide release inflammatory mediators that are able to induce a translational clinically relevant and harmful response in brain cells. These results support a brain-lung crosstalk during sepsis and sepsis-induced acute respiratory distress syndrome. PMID:25135986

  14. [Hand bones disorders in vibrational disease caused by local vibration should be considered as pathogenetic characteristic of the disease].

    Liubchenko, P N; Evlashko, Iu P; Dmitruk, L I


    Opposite to the authors of the publication, that dystrophic changes in locomotory apparatus of hands and shoulders girdle could not be considered as vibration disease signs, the article authors believe that hand bone changes--tuberosity of distal finger bones, cystic transparency, local osteoporosis--could be pathogenetic signs of vibration disease, along with vascular and neurologic signs. The authors agree that periarthrosis, miofibrosis, if characterized properly through sanitary and hygienic regulations in new List of Occupational diseases, that will be put into practical medicine in the nearest future, could be considered as second occupational disease in the same patient.

  15. Basing the treatment of stereotypic and self-injurious behaviors on hypotheses of their causes.

    Repp, A C; Felce, D; Barton, L E


    Stereotypic and self-injurious behaviors are common forms of maladaptive responding demonstrated by severely handicapped persons. Various review papers suggest that no single treatment procedure is universally effective. Although there may be many reasons for this finding, one could be that people engage in these behaviors for various reasons, and that procedures that are incompatible with the cause of the behavior are unlikely to be effective. These studies also suggest many hypotheses for the development and maintenance of these behaviors, three of which are the self-stimulation, positive reinforcement, and negative reinforcement hypotheses. The purpose of this paper was to determine whether one of these hypotheses could be matched to the cause of the behavior and used as an effective treatment procedure. We therefore compared one hypothesis with one other for 3 subjects in a three-phase study. During baseline, data were taken in two classrooms for each subject, and a judgement was made about the hypothesis most likely to be related to the cause of the behavior. During the second phase, a treatment based on that hypothesis was used in one classroom, and a treatment based on another hypothesis was used in the second classroom. During the third phase, the treatment that was most effective in the second phase was used in both classrooms. Results showed that a successful treatment program can be developed on an hypothesis of why the behavior occurred during baseline. Results are discussed in terms of supporting the argument that treatment programs should be based on a functional analysis of the behavior in its environmental context.

  16. Validity of death certificates for injury-related causes of death.

    Moyer, L A; Boyle, C A; Pollock, D A


    Exploration of the validity of death certificate information for classifying underlying causes of death has historically focused on "natural" or disease-related causes of death. Current interest in injury-related deaths has emphasized the need for proper certification and coding of these deaths. In this study, the authors compared agreement of the underlying cause of death as determined from death certificate information with that determined from an independent review of all relevant medical and legal documents of death by a panel of physicians. The study sample included all deaths (n = 446) occurring over an approximately 18-year follow-up period (1965-1983) in a randomly selected cohort of 18,313 US Army Veterans of the Vietnam era. Using the physician panel as the "gold standard," sensitivity and specificity were 90% or greater for broad groupings of motor vehicle crash deaths (International Classification of Diseases, Ninth Revision (ICD-9), codes E810-E825), suicides (codes E950-E959), and homicides (codes E960-E969). Agreement for deaths from unintentional poisonings (codes E850-E869), mostly drug- and alcohol-related, was poor (sensitivity, 50 percent); in general, the ICD-9 drug- and alcohol-specific nomenclature is difficult to apply. The specificity and sensitivity for the individual three-digit suicide and homicide codes were all greater than 90%, and although the specificity for three-digit motor vehicle crash deaths was also above 90%, the sensitivity was lower, from 29% to 83%. Agreement on the fourth digit of ICD-9--for example, the role of the decedent in a motor vehicle crash death--was generally poor. The lack of descriptive information on death certificates to allow detailed coding was chiefly responsible for the poor agreement.

  17. Homozygous mutations in IHH cause acrocapitofemoral dysplasia, an autosomal recessive disorder with cone- shaped epiphyses in hands and hips

    Hellemans, J; Coucke, PJ; Giedion, A; De Paepe, A; Kramer, P; Beemer, F; Mortier, GR


    Acrocapitofemoral dysplasia is a recently delineated autosomal recessive skeletal dysplasia, characterized clinically by short stature with short limbs and radiographically by cone-shaped epiphyses, mainly in hands and hips. Genome-wide homozygosity mapping in two consanguineous families linked the

  18. Resveratrol reestablishes spermatogenesis after testicular injury in rats caused by 2,5-hexanedione

    JIANG Yong-guang; PENG Tao; LUO Yong; LI Ming-chuan; LIN Yun-hua


    Background Environmental toxins can destroy the physiological process of spermatogenesis and even lead to male infertility.Resveratrol(RES)is a natural phytoalexin with a wide range of biological activities.Some recent researches have demonstrated that RES can increase sperm output and protect sperm from apoptosis caused by physical damage.However,there is no evidence indicating that it can also exhibit a similar activity in testis injury caused by environmental toxins.This study was designed to evaluate the protective effect of resveratrol on testis damaged by environmental toxins and to elucidate the possible mechanism of its protective effect.Methods In this study 2,5-hexanedione(2,5-HD)was used as the injury agent.Forty male SD rats were randomly divided into 5 groups.During the first 5 weeks,group A was raised normally,groups B,C,D and E were exposed to 1% 2,5-HD;during the following 9 weeks,group C,D,E received intragastric administration of different concentrations of carboxymethylcellulose.Physical signs,body weight gain and testis weight were comparatively obsewed.Numbers and diameters of seminiferous tubules were analyzed following HE staining.In addition,expression of the c-kit protein and gene in spermatogenic cells jn every group was detected with immunohistochemistry,Western blot or RT-PCR.Results The 2,5-HD treatment resulted in physical signs that became worse and in emarciated testis.HE staining and immunohistochemistry showed that seminiferous tubules became emarcid,obsolete spermatogonia being stagnant and expression of c-kit protein being depressed.After oral administration of resveratrol,the 2,5-HD.induced physical signs were improved and close to the normal rats.The gain of body weight increased(P<0.01).The recovery of testis weight was significant(P<0.01).At the histological level,the seminiferous epithelia began to differentiate(P<0.01):and even the physiological process of spermatogenesis restarted.Moreover,expression of c-kit protein

  19. 'Crashing' the rugby scrum -- an avoidable cause of cervical spinal injury. Case reports.

    Scher, A T


    Deliberate crashing of the opposing packs prior to a rugby scrum is an illegal but commonly practised manoeuvre which can lead to abnormal flexion forces being applied to players in the front row, with resultant cervical spine and spinal cord injury. Two cases of cervical spinal cord injury sustained in this manner are presented. The mechanism of injury, the forces involved and preventive measures are discussed.

  20. “Tennis leg”: gastrocnemius injury is a far more common cause than plantaris rupture

    Joelle R. Harwin, BS


    Full Text Available We report a typical case of “tennis leg”, in which the main finding was a fluid collection between the medial head of the gastrocnemius and soleus muscles. Since the first clinical description of this entity in 1883, the injury has been attributed to rupture of the plantaris tendon. However, recent studies of this condition with sonography and magnetic resonance imaging have shown that most of these cases are actually due to injury to the gastrocnemius and/or soleus muscles, and up to 10% are due to deep venous thrombosis masquerading as muscle injury. The plantaris muscle and tendon are only rarely involved in this injury.

  1. Inhalation of hydrogen gas suppresses hepatic injury caused by ischemia/reperfusion through reducing oxidative stress.

    Fukuda, Kei-ichi; Asoh, Sadamitsu; Ishikawa, Masahiro; Yamamoto, Yasuhiro; Ohsawa, Ikuroh; Ohta, Shigeo


    We have recently showed that molecular hydrogen has great potential for selectively reducing cytotoxic reactive oxygen species, such as hydroxyl radicals, and that inhalation of hydrogen gas decreases cerebral infarction volume by reducing oxidative stress [I. Ohsawa, M. Ishikawa, K. Takahashi, M. Watanabe, K. Nishimaki, K. Yamagata, K.-I. Katsura, Y. Katayama, S. Asoh, S. Ohta, Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals, Nat. Med., 13 (2007) 688-694]. Here we show that the inhalation of hydrogen gas is applicable for hepatic injury caused by ischemia/reperfusion, using mice. The portal triad to the left lobe and the left middle lobe of the liver were completely occluded for 90min, followed by reperfusion for 180min. Inhalation of hydrogen gas (1-4%) during the last 190min suppressed hepatic cell death, and reduced levels of serum alanine aminotransferase and hepatic malondialdehyde. In contrast, helium gas showed no protective effect, suggesting that the protective effect by hydrogen gas is specific. Thus, we propose that inhalation of hydrogen gas is a widely applicable method to reduce oxidative stress.

  2. Cerebrovascular injury caused by a high strain rate insult in the thorax

    Courtney, Amy


    Primary blast-induced traumatic brain injury (TBI) has increased in documented incidence and public prominence in recent conflicts. Evidence for a thoracic mechanism of blast-induced TBI was recently reviewed and, while the totality is compelling, data from experiments isolating this mechanism is sparse. Notably, one recent study showed pericapillar haemorrhage in brain tissue from victims of single, fatal gunshot wounds to the chest. Here, qualitative results are reported for a small field study that isolated a thoracic mechanism for TBI caused by a high strain rate insult in white-tailed deer (Odocoileus virginianus, mass 49-80 kg) in a natural environment. In each of three cases, petechiae were present on the surface of the frontal, occipital and/or left parietal lobes, along with capillary damage in the choroid plexus. The location of the projectile impact to the thorax seemed to affect the degree of damage. This may be due to the proximity to the great vessels. The data reported here provides direct evid...

  3. Contributing Causes of Injury or Death in Grain Entrapment, Engulfment, and Extrication.

    Issa, Salah Fuad; Field, William E; Schwab, Charles V; Issa, Fadi S; Nauman, Eric A


    Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities, with over 1,140 such entrapments/engulfments documented since the 1970s. The objective of the study was to determine the factors that contribute to injury or death in grain entrapment, engulfment, and extrication cases. A literature review, including data contained in the Purdue Agricultural Confined Spaces Incident Database (PACSID), was conducted to determine the conditions that the body experiences during an entrapment or engulfment in grains and during extrication efforts. Based on the review, the conditions a human body faces during an entrapment, engulfment, or extraction can be split into two broad categories-environmental and physiological/psychological. The environmental factors depend on the grain's properties, depth of entrapment or engulfment, position of the victim's body, and characteristics of the storage unit, which include the grain's lateral pressure, vertical pressure, and weight, as well as friction, oxygen availability and diffusion rate, and grain temperature. The physiological and psychological factors are related to the individual's age and physical and psychological conditions, and manifest themselves in terms of oxygen consumption, asphyxiation (including aspiration, lack of oxygen, compression or splinting of the thorax), blood flow, and heart rate. Of all the above factors, a review of fatality data contained in the PACSID indicate that aspiration, asphyxiation, grain weight, and lateral pressure are most likely the primary cause of death for most entrapment victims. Research gaps found by this study include an understanding of the impact of lateral pressure on lung expansion and oxygen availability and consumption rate, and the need for more case studies to accurately determine cause of death.

  4. Chronic plus binge ethanol exposure causes more severe pancreatic injury and inflammation.

    Ren, Zhenhua; Yang, Fanmuyi; Wang, Xin; Wang, Yongchao; Xu, Mei; Frank, Jacqueline A; Ke, Zun-Ji; Zhang, Zhuo; Shi, Xianglin; Luo, Jia


    Alcohol abuse increases the risk for pancreatitis. The pattern of alcohol drinking may impact its effect. We tested a hypothesis that chronic ethanol consumption in combination with binge exposure imposes more severe damage to the pancreas. C57BL/6 mice were divided into four groups: control, chronic ethanol exposure, binge ethanol exposure and chronic plus binge ethanol exposure. For the control group, mice were fed with a liquid diet for two weeks. For the chronic ethanol exposure group, mice were fed with a liquid diet containing 5% ethanol for two weeks. In the binge ethanol exposure group, mice were treated with ethanol by gavage (5g/kg, 25% ethanol w/v) daily for 3days. For the chronic plus binge exposure group, mice were fed with a liquid diet containing 5% ethanol for two weeks and exposed to ethanol by gavage during the last 3days. Chronic and binge exposure alone caused minimal pancreatic injury. However, chronic plus binge ethanol exposure induced significant apoptotic cell death. Chronic plus binge ethanol exposure altered the levels of alpha-amylase, glucose and insulin. Chronic plus binge ethanol exposure caused pancreatic inflammation which was shown by the macrophages infiltration and the increase of cytokines and chemokines. Chronic plus binge ethanol exposure increased the expression of ADH1 and CYP2E1. It also induced endoplasmic reticulum stress which was demonstrated by the unfolded protein response. In addition, chronic plus binge ethanol exposure increased protein oxidation and lipid peroxidation, indicating oxidative stress. Therefore, chronic plus binge ethanol exposure is more detrimental to the pancreas.

  5. Capybara Bites: Report of Human Injury Caused by a Hydrochoerus hydrochaeris.

    de Oliveira Vieira, Camille; Bernardes Filho, Fred; Azulay-Abulafia, Luna


    Health care demand due to animal bites is frequent, especially in the emergency department (ED). In addition to the physical trauma caused by bites, one should be concerned with infectious diseases that can be transmitted. The range of the lesions depends on the animal species. Bites of Hydrochoerus hydrochaeris (capybaras) in humans are relatively uncommon. Capybaras are docile animals; however, their large rodent incisive teeth could cause serious injury. Localized care, antibiotic therapy when necessary, careful examination of the structures, tetanus and rabies immunization as indicated, and follow-up are recommended for wild animal bites. The authors hereby describe and discuss the medical management of a case of multiple lesions from capybara bites on the right thigh of a man. A 54-year-old male patient was admitted to the ED with a compression bandage soaked with blood after being bitten by a capybara. At the clinical examination, the patient had two lacerating wounds and multiple abrasions on the anterior face of the right thigh. Rabies prophylaxis was administered and the wounds were irrigated and closed with sterile dressings. Oral amoxicillin/clavulanate potassium for 7 days was administered to the patient. The patient was followed up; 3 months after the attack he returned to his previous level of activity without any complication. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We recommend that practitioners and physicians should provide prompt attention due to potentially significant morbidities, particularly rabies. The adequate care of the wound will allow better aesthetic and functional results to victims of wild animal bites. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. A 92-year-old man with retropharyngeal hematoma caused by an injury of the anterior longitudinal ligament

    Seiji Morita; Shinichi lizuka; Haruna Hirakawa; Shigeo Higami; Takeshi Yamagiwa; Sadaki Inokuchi


    Traumatic retropharyngeal hematoma is a rare condition and may be lethal in some cases.In patients with this condition, the absence of a vertebral fracture or a major vascular injury is extremely rare.We present the case of a 92-year-old man who hit his forehead by slipping on the floor in his house.He had no symptoms at the time; however, he experienced throat pain and dyspnea at 6 hours after the injury.On arrival, he complained of severe dyspnea; therefore, an emergency endotracheal intubation was performed.A lateral neck roentgenogram after intubation showed dilatation of the retropharyngeal and retrotracheal space and no evidence of a cervical vertebral fracture.Cer-vical computed tomography (CT) with contrast medium re-vealed a massive hematoma extending from the retropharyngeal to the superior mediastinal space but no evidence of contrast medium extravasation or a vertebral fracture.However, sagittal magnetic resonance imaging (MRI) revealed an anterior longitudinal ligament (C levels)injury.We determined that the cause of the hematoma was an anterior longitudinal ligament injury and a minor vascu-lar injury around the injured ligament.Therefore, we recom-mend that patients with retropharyngeal hematoma undergo sagittal cervical MRI when roentgehography and CT reveal no evidence of injury.

  7. Reducing slide sheet injury.

    Varcin-Coad, Lynn


    Slide sheets are often stated to be the cause of hand and forearm injuries. While there are many other possible reasons injuries to nursing staff, carer and client occur, the most important linking factors relating to musculoskeletal disorders and manual handling of people is the ongoing inappropriateness or lack of suitably designed and equipped work areas. As physiotherapist Lynn Varcin-Coad writes, staff are bearing the brunt of inefficiencies of design and lack of high order risk control.

  8. Characteristics and mechanisms of cardiopulmonary injury caused by mine blasts in shoals: a randomized controlled study in a rabbit model.

    Gengfen Han

    Full Text Available BACKGROUND: Because the characteristics of blast waves in water are different from those in air and because kinetic energy is liberated by a pressure wave at the water-air interface, thoracic injuries from mine blasts in shoals may be serious. The aim of the present study was to investigate the characteristics and mechanisms of cardiopulmonary injury caused by mine blasts in shoals. METHODS: To study the characteristics of cardiopulmonary injury, 56 animals were divided randomly into three experimental groups (12 animals in the sham group, 22 animals in the land group and 22 animals in the shoal group. To examine the biomechanics of injury, 20 animals were divided randomly into the land group and the shoal group. In the experimental model, the water surface was at the level of the rabbit's xiphoid process, and paper electric detonators (600 mg RDX were used to simulate mines. Electrocardiography and echocardiography were conducted, and arterial blood gases, serum levels of cardiac troponin I and creatine kinase-MB and other physiologic parameters were measured over a 12-hour period after detonation. Pressures in the thorax and abdomen and the acceleration of the thorax were measured. CONCLUSION: The results indicate that severe cardiopulmonary injury and dysfunction occur following exposure to mine blasts in shoals. Therefore, the mechanisms of cardiopulmonary injury may result from shear waves that produce strain at the water-air interface. Another mechanism of injury includes the propagation of the shock wave from the planta to the thorax, which causes a much higher peak overpressure in the abdomen than in the thorax; as a result, the abdominal organs and diaphragm are thrust into the thorax, damaging the lungs and heart.

  9. Podocyte injury caused by indoxyl sulfate, a uremic toxin and aryl-hydrocarbon receptor ligand.

    Osamu Ichii

    Full Text Available Indoxyl sulfate is a uremic toxin and a ligand of the aryl-hydrocarbon receptor (AhR, a transcriptional regulator. Elevated serum indoxyl sulfate levels may contribute to progressive kidney disease and associated vascular disease. We asked whether indoxyl sulfate injures podocytes in vivo and in vitro. Mice exposed to indoxyl sulfate for 8 w exhibited prominent tubulointerstitial lesions with vascular damage. Indoxyl sulfate-exposed mice with microalbuminuria showed ischemic changes, while more severely affected mice showed increased mesangial matrix, segmental solidification, and mesangiolysis. In normal mouse kidneys, AhR was predominantly localized to the podocyte nuclei. In mice exposed to indoxyl sulfate for 2 h, isolated glomeruli manifested increased Cyp1a1 expression, indicating AhR activation. After 8 w of indoxyl sulfate, podocytes showed foot process effacement, cytoplasmic vacuoles, and a focal granular and wrinkled pattern of podocin and synaptopodin expression. Furthermore, vimentin and AhR expression in the glomerulus was increased in the indoxyl sulfate-exposed glomeruli compared to controls. Glomerular expression of characteristic podocyte mRNAs was decreased, including Actn4, Cd2ap, Myh9, Nphs1, Nphs2, Podxl, Synpo, and Wt1. In vitro, immortalized-mouse podocytes exhibited AhR nuclear translocation beginning 30 min after 1 mM indoxyl sulfate exposure, and there was increased phospho-Rac1/Cdc42 at 2 h. After exposure to indoxyl sulfate for 24 h, mouse podocytes exhibited a pro-inflammatory phenotype, perturbed actin cytoskeleton, decreased expression of podocyte-specific genes, and decreased cell viability. In immortalized human podocytes, indoxyl sulfate treatment caused cell injury, decreased mRNA expression of podocyte-specific proteins, as well as integrins, collagens, cytoskeletal proteins, and bone morphogenetic proteins, and increased cytokine and chemokine expression. We propose that basal levels of AhR activity regulate

  10. Hand to hand.

    Bedell, Susanna E; Graboys, Thomas B


    Examination of the hands has the potential to transform the encounter between physician and patient. Taking the hands conveys a sense of warmth and connectedness and is a means to communicate the physician's mindfulness. The hands can focus the examination on the individual patient as a complete human being, and not merely a disease or a collection of symptoms. The hands provide readily accessible information that may not be available through other evaluations, and they offer clues to a patient's physical and mental health. Commonplace observations, such as those revealed in the hands, can unravel medical mysteries and provide profound clinical insights.

  11. Clustering of disability caused by unintentional injury among 15- to 60-year-old: a challenge in rapidly developing countries

    Yi-Lan Liao


    Full Text Available Little is known about disability caused by unintentional injury (accidents worldwide. This study estimates the prevalence of disability caused by unintentional injury amongst people aged 15-60 years across different cities in the People’s Republic of China with the aim of providing a scientific basis for developing prevention and control programmes. The prevalence of disability caused by unintentional injury in this target group in sampled cities across the country was estimated from data from the Second Chinese National Sample Survey on Disability. Using the statistical evolution tree approach, cities automatically clustered into a tree structure according to the level of social security and industrial structure. The Kruskal- Wallis test was applied to compare the prevalence in various types of city. The results show that the prevalence of disability due to unintentional injury in the target population group varied significantly across the 16 types of city investigated, but that it was particularly common among the unemployed and poor. With regard to occupational structure, cities with activities oriented towards transport and construction had the highest average prevalence despite access to local, relatively sound social security systems and adequate medical resources. It was also found that people struck by unintentional injury were treated in various ways depending on the availability of social assistance, medical care and job training, which differed widely between cities depending on each city’s main occupational activity. High-risk cities areas were identified for that would benefit particularly by additional medical resource allocation as it would reduce their burden of unintentional injury.

  12. Analysis of injuries and causes of death in fatal farm-related incidents in Lower Silesia, Poland

    Marta Rorat


    Full Text Available Introduction. Workers in the agriculture sector are among the groups at the highest risk of fatal occupational injuries. The aim of study is to show the most common causes of farm-related deaths in Poland, with the circumstances, injuries sustained and mechanisms of death. Materials and methods. There were 109 (90.8% males aged 19–81 and 11 females aged 19–73. 18.3% were over 60 years of age. There were 6 children (boys aged between 2–6. A retrospective review was undertaken of 16,140 medico-legal autopsy reports by the Department of Forensic Medicine in Wroclaw between 1991–2011, which included 120 fatal farm-related incidents. The study protocol included gender, age, date and cause of death, all injuries found, circumstances and mechanism of death, place of death and blood alcohol concentration. Results. The most common (33/120; 27.5% causes of death, both in men and women, were traffic accidents, the second being hit, crushed or buried by materials and falling objects. The most common injury was multi-organ damage (27/120; 22.5%, less common were cranio-cerebral injury (17/120; 14.2% and thoracic blunt trauma (11/120; 9.2%. In multi-organ and thoracic traumas the mechanism of death was almost always exsanguinations. 85.3% of victims died at the place found. 37.2% of victims were drunk. Conclusion. In Poland, fatal injuries occurring in agriculture are mostly related to the misuse of transport and machinery. The main efforts to prevent accidents are engineering improvements, use of personal protective equipment, alcohol intake prevention and appropriate education of the workforce. Special prevention programmes should take gender and age differences into account.

  13. [The regulation mechanism of protein kinase Cδ on arsenic liver injury caused by coal-burning].

    Hu, Yong; Zhang, Ai-hua; Yao, Mao-lin; Tang, Xu-dong; Huang, Xiao-xin


    To investigate the effects of mRNA transcriptional and protein expressions of protein kinase Cδ (PKCδ) on the development of arsenic liver injury caused by coal-burning. Population study:133 arsenic exposures were selected as arsenic exposure groups including the ward non-patient group (25 cases) , no obvious hepatopathy group (38 cases) , mild (43 cases) and moderate to severe hepatopathy group (27 cases) from the area with endemic arsenism in Guizhou province. Another 34 healthy residents were selected as the control group in non-arsenic pollution village. The urine and peripheral blood were collected from the subjects. The arsenic contents in urine and mRNA expressions of PKCδ in peripheral blood were detected. Animal experiment study:thirty wistar rats were randomly by random number table divided into control group, drinking water arsenic poisoning group and coal-burning arsenic poisoning group (i.e., low, medium and high arsenic contaminated grain group) by random number table method, including 6 rats in each group. The control group was fed normally for 3 months, drinking water arsenic poisoning group and coal-burning arsenic poisoning groups were fed respectively with 10 mg/kg As2O3 solution and different concentrations (25, 50 and 100 mg/kg) of arsenic-containing feed which was persisted 3 months. The arsenic contents in urine, mRNA expression levels of PKCδ in peripheral blood and liver tissue and the protein expression levels of phosphorylated protein kinase Cδ(pPKCδ) in liver tissue were detected. The median(quartile) of arsenic contents in urine were 25.58 (18.62-40.73), 56.66 (38.93-76.77), 64.90 (39.55- 98.37) and 75.47 (41.30-109.70) µg/g Cr respectively for the non-patient group, no obvious hepatopathy group, mild and moderate to severe hepatopathy group. The levels were higher than that in the control group (23.34 (17.84-37.45) µg/g Cr) (P arsenic contents in rat urine were 2223.61 (472.98-3976.73), 701.16 (194.01-1300.27), 1060.94 (246

  14. Seatbelt Injury Causing Small Bowel Devascularisation: Case Series and Review of the Literature

    Vincent O'Dowd


    Full Text Available The use of seatbelts has increased significantly in the last twenty years, leading to a decrease in mortality from road traffic accidents (RTA. However, this increase in seatbelt use has also led to a change in the spectrum of injuries from RTA; abdominal injuries, particularly intestinal injuries have dramatically increased with the routine use of seatbelts. Such intestinal injuries frequently result from improper placement of the “lap belt”. We present 3 cases in which passengers wearing a seatbelt sustained significant devascularisation injuries to the small bowel requiring emergency surgical intervention. A high index of suspicion is crucial in such cases to prevent delays in diagnosis that can lead to severe complications and adverse outcomes. It is evident that while advocating seatbelt use, the importance of education in correct seatbelt placement should also be a focus of public health strategies to reduce RTA morbidity and mortality.

  15. Seatbelt injury causing small bowel devascularisation: case series and review of the literature.

    O'Dowd, Vincent; Kiernan, Christine; Lowery, Aoife; Khan, Waqar; Barry, Kevin


    The use of seatbelts has increased significantly in the last twenty years, leading to a decrease in mortality from road traffic accidents (RTA). However, this increase in seatbelt use has also led to a change in the spectrum of injuries from RTA; abdominal injuries, particularly intestinal injuries have dramatically increased with the routine use of seatbelts. Such intestinal injuries frequently result from improper placement of the "lap belt". We present 3 cases in which passengers wearing a seatbelt sustained significant devascularisation injuries to the small bowel requiring emergency surgical intervention. A high index of suspicion is crucial in such cases to prevent delays in diagnosis that can lead to severe complications and adverse outcomes. It is evident that while advocating seatbelt use, the importance of education in correct seatbelt placement should also be a focus of public health strategies to reduce RTA morbidity and mortality.

  16. Seatbelt injury causing small bowel devascularisation: case series and review of the literature.

    O'Dowd, Vincent


    The use of seatbelts has increased significantly in the last twenty years, leading to a decrease in mortality from road traffic accidents (RTA). However, this increase in seatbelt use has also led to a change in the spectrum of injuries from RTA; abdominal injuries, particularly intestinal injuries have dramatically increased with the routine use of seatbelts. Such intestinal injuries frequently result from improper placement of the "lap belt". We present 3 cases in which passengers wearing a seatbelt sustained significant devascularisation injuries to the small bowel requiring emergency surgical intervention. A high index of suspicion is crucial in such cases to prevent delays in diagnosis that can lead to severe complications and adverse outcomes. It is evident that while advocating seatbelt use, the importance of education in correct seatbelt placement should also be a focus of public health strategies to reduce RTA morbidity and mortality.

  17. Two clinically relevant pressures of carbon dioxide pneumooperitoneum cause hepatic injury in a rabbit model

    Jun Li; Ying-Hai Liu; Zhan-Yong Ye; He-Nian Liu; Shan Ou; Fu-Zhou Tian


    hyperemia in the two experimental groups. Transmission electron microscopy showed mild mitochondrial swelling in hepatocytes off the 10 mmHg group, and this was more pronounced in the 15 mmHg group. No significant difference in ANT levels was ffound between the control and 10 mmHg groups. However, ANT concentration was significantly lower in the 15 mmHg group compared with the control group. The expression off hepatic Bax was significantly increased in the two experimental groups compared with the controls, but there were no difffferences in Bcl-2 levels among the three groups. Twelve hours affter CDPP induction, the expression off hepatic Bax was more significant in the 15 mmHg group than in the 10 mmHg group. CONCLUSION: A CDPP pressure off 15 mmHg caused more substantial hepatic injury, such as increased levels off acidosis, mitochondrial damage, and apoptosis; thereffore, 10 mmHg CDPP is prefferable ffor laparoscopic operations.

  18. Management of horizontal crown fracture caused by traumatic injury with endorestoration treatment

    Nanik Zubaidah


    Full Text Available Background: Traumatic injuries of teeth are the main cause of emergency treatment in dental practice. The horizontal crown fracture more frequently observed usually occurs in maxillary anterior region and young male patients. The most common type of coronal fracture is in the middle third, followed by root and apical part. Purpose: The aim of this case report is to present the management of crown fracture of teeth with pulp exposure caused by dental trauma with endorestoration treatment in order to reconstruct the shape and the function of the teeth. Case: A 22 years old male with horizontal crown fracture of anterior teeth. The patient asked for aesthetic dental treatment both for its form and function. Case management: This horizontal crown fracture of anterior teeth with pulp exposure caused by dental trauma still could be reconstructed, mainly by endorestoration treatment. The endodontic treatment with post and core insertion in the root canal then would increase its retention. Later, the porcelain crown would aesthetically recover its original form and function, therefore, it would improve the patient’s confidence and teeth function. Conclusion:  Endorestoration treatment on anterior teeth with harizontal crown fractures and pulp exposure is able to recover the normal function, aesthetic, and self-confidence.Latar belakang: Trauma pada gigi merupakan penyebab utama perawatan darurat dalam praktek dokter gigi. Fraktur mahkota horisontal pada umunya terjadi pada gigi anterior rahang atas dan terjadi pada penderita pria muda. Jenis yang paling sering dari fraktur mahkota adalah pada sepertiga tengah, daerah akar dan apical. Tujuan: Laporan kasus ini menjelaskan penatalaksanaan fraktur mahkota gigi dengan pulpa terbuka akibat trauma dengan perawatan endorestorasi untuk mengembalikan bentuk dan fungsi gigi. Kasus: Penderita pria umur 22 tahun dengan fraktur mahkota horizontal pada gigi anterior. Penderita tersebut menginginkan perawatan

  19. Injuries caused by the venomous catfish pintado and cachara (Pseudoplatystoma genus) in fishermen of the Pantanal region in Brazil.

    Aquino, Giuliano N R DE; Souza, Celso C DE; Haddad, Vidal; Sabino, José


    the fishing activity throughout the Upper Paraguay River Basin has huge financial and biological importance. This retrospective study investigated the occurrence of injuries caused by fish of the Pseudoplatystoma genus (spotted catfish or pintado and striped catfish or cachara) in professional fishermen of the Pantanal of Mato Grosso do Sul State. we collected information through a questionnaire, showing that fishing is carried out by workers with low level of education, mainly adults or seniors with low financial gains. in Miranda town, 126 of 315 fishermen were interviewed and 38 individuals reported injuries (30.16%). In Corumbá town, 355 of 627 fishermen were interviewed, and 111 (56,61%) reported injuries. The lacerated lesions were the most common, associate with edema, erythema, radiating pain to the root of the limb, paresthesias and local necrosis. More rarely, they reported the occurrence of fever, cardiac arrhythmias and cold sweating. These manifestations may be associated with late secondary infections or envenomations caused by the toxins in the stingers of the fish. Many questionable and inappropriate treatments are used, sometimes aggravating the injuries. the freshwater professional fishermen need guidance on first aid measures and prevention of accidents caused by these venomous fish.

  20. Injuries caused by the venomous catfish pintado and cachara (Pseudoplatystoma genus in fishermen of the Pantanal region in Brazil



    Full Text Available ABSTRACT INTRODUCTION: the fishing activity throughout the Upper Paraguay River Basin has huge financial and biological importance. This retrospective study investigated the occurrence of injuries caused by fish of the Pseudoplatystoma genus (spotted catfish or pintado and striped catfish or cachara in professional fishermen of the Pantanal of Mato Grosso do Sul State. METHODS: we collected information through a questionnaire, showing that fishing is carried out by workers with low level of education, mainly adults or seniors with low financial gains. RESULTS: in Miranda town, 126 of 315 fishermen were interviewed and 38 individuals reported injuries (30.16%. In Corumbá town, 355 of 627 fishermen were interviewed, and 111 (56,61% reported injuries. The lacerated lesions were the most common, associate with edema, erythema, radiating pain to the root of the limb, paresthesias and local necrosis. More rarely, they reported the occurrence of fever, cardiac arrhythmias and cold sweating. These manifestations may be associated with late secondary infections or envenomations caused by the toxins in the stingers of the fish. Many questionable and inappropriate treatments are used, sometimes aggravating the injuries. CONCLUSIONS: the freshwater professional fishermen need guidance on first aid measures and prevention of accidents caused by these venomous fish.

  1. Different cerebral plasticity of intrinsic and extrinsic hand muscles after peripheral neurotization in a patient with brachial plexus injury: A TMS and fMRI study.

    Li, Tie; Hua, Xu-Yun; Zheng, Mou-Xiong; Wang, Wei-Wei; Xu, Jian-Guang; Gu, Yu-Dong; Xu, Wen-Dong


    Contralateral C7 (CC7) neurotization has been an important approach for brachial plexus injury (BPI). Patients can achieve relatively good grasping function driven by the proximal extrinsic hand muscle (flexor digitorum, FD) after CC7 neurotization, whereas the thumb opposition function driven by the distal intrinsic muscle (abductor pollicis brevis, APB) is poor. The present study aimed to investigate the brain reorganization patterns of the recovery processes of intrinsic and extrinsic hand functions after repairing the median nerve by CC7 neurotization. Transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) were used to evaluate the cerebral plasticity in one BPI patient after CC7 neurotization. After the CC7 neurotization, the patient showed improvements in the paralyzed hand. Combination of TMS and fMRI investigations demonstrated different cortical reshaping patterns of APB and FD. It was also found that the activated cortical areas of FD were located in bilateral motor cortices, but the area of APB was only located in ipsilateral motor cortex. The cerebral plasticity procedure appeared to be different in the gross and fine motor function recovery processes. It provided a new perspective into the cerebral plasticity induced by CC7 neurotization. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  2. Record of postmortem injuries caused by the Neotropical social wasp Agelaia fulvofasciata (Degeer (Hymenoptera, Vespidae on pig carcasses in the Eastern Amazon region: implications in forensic taphonomy

    Rodrigo R. Barbosa


    Full Text Available ABSTRACTPostmortem injuries are a source of misinterpretations in forensic analysis and therefore are subject matter of taphonomic interest. Many types of injuries can cause different artifacts, which deserve attention of the forensic pathologists when evaluating corpses, either at the crime scene or during an autopsy. Insects can be important biotaphonomic agents and their activity may result in artifacts that resemble antemortem injuries. Here, we describe postmortem injuries caused by the Neotropical wasp Agelaia fulvofasciata (Degeer, 1773 on domestic pig carcasses weighting 15 kg. The specimens showed extensive injuries to the lower lip, similar to lacerations, and some minor lesions on the snout and anus. In addition, we observed the same wasp species preying on larvae of Sarcophagidae (Peckia sp.. Besides causing postmortem injuries, the ability of this species to detect carcasses in the early and fresh decomposition stages should be noted. Thus, future applications aiming criminal, any biotaphonomic events caused by carrion insects need to be disclosed.




    Full Text Available OBJECTIVE: To study the type and severity of ocular injuries in gun pellet victims. METHODOLOGY: It was a retrospective case series. The study was conducted in the department of Ophthalmology, SKIMC Medical College Bemina Srinagar. The study included gun pellet victims admitted in our department between January 2010 to September 2013. RESULTS: Total number of patients were 20 with 19 males and 1 female. Mean age of the subjects was 21.45 years. Ocular injury was unilateral in 17 cases and bilateral in 3 cases. The most common type of injuries encountered were hyphaema in 82.60% of eyes, followed by corneoscleral tear in 78.26% and vitreous hemorrhage in 47.82% of eyes. Out of the 23 eyes, 18 eyes (78.26% had an open globe injury, while only 3 eyes (13.04% had closed globe injury at presentation in our hospital. The most commonly performed surgery was corneoscleral repair in 18 eyes. Final corrected visual acuity remained unchanged in 34.78% and improved in 65.22% of eyes. About 47.83% of eyes had final visual acuity < 6/60. CONCLUSION: Gun pellet related ocular injuries are becoming increasingly common in Kashmir valley. In severely injured eyes the visual prognosis remained poor despite development of advanced micro-surgical techniques. The best preventive measure for such injuries involve reducing the level of violence in our society

  4. Broomstick injuries to the eye; An emerging cause of blindness among children in Nigeria

    Catherine U Ukponmwan


    Full Text Available Background: Ocular trauma among children is responsible for a high incidence of uni-ocular blindness. Objective: To evaluate the pattern of presentation and complications from broomstick eye injury at University of Benin Teaching Hospital (UBTH, Benin City with a view to proffering solutions on ways to reduce this trend. Materials and Methods: The hospital records of all consecutive patients who suffered ocular trauma from broomstick injury and presented at the eye clinic of the UBTH between 2003 and 2014 were evaluated. Information retrieved from the case records included social demographic characteristics, interval between the occurrence of injury and presentation, mechanism of injury, activity at time of injury, examination findings, treatments and complications. Data were analyzed using SPSS, IBM, Chicago, USA. Results: A total of 20 eyes in 20 patients were seen. They were all children <14 years old. The mean age was 7.10 ± 4.03 (standard deviation years. The male: female ratio was 3:1. Twelve children (60% sustained trauma from broomstick shot as a missile with a rubber band and/or catapult sling by other children and siblings while at play. Ten children (50% presented within 24 h of occurrence of the injury. Nineteen (95%, n = 19 of the children were blind at presentation in the affected eye with visual acuity ranging from count finger to no light perception. Ninety percent (90% of the cases were open globe injuries. Only 10% (n = 2 were closed (lamellar injuries. Most of the patients had multiple complications such as corneal laceration (80%, traumatic cataract (40%, endophthalmitis/panophthalmitis (55% and orbital cellulitis (15%. Conclusion: Ocular trauma from broomstick results in devastating, penetrating eye injury with loss of vision. Young male children are vulnerable as targets of dangerous game-play. Primary prevention is important by sensitization of caregivers and children of the risks. There is a need for effective

  5. Injuries caused by pets in Asian urban households: a cross-sectional telephone survey

    Chan, Emily Y Y; Gao, Yang; Li, Liping; Lee, Po Yi


    Objectives Little is known about pet-related injuries in Asian populations. This study primarily aimed to investigate the incidence rate of pet-related household injuries in Hong Kong, an urban Chinese setting. Setting Cantonese-speaking non-institutionalised population of all ages in Hong Kong accessible by telephone land-line. Participants A total of 43 542 telephone numbers were dialled and 6570 residents successfully completed the interviews. Primary and secondary outcome measures Data of pet-related household injuries in the previous 12 months, pet ownership and socio-demographic characteristics were collected with a questionnaire. Direct standardisation of the incidence rates of pet-related household injuries by gender and age to the 2009 Hong Kong Population Census was estimated. Univariate and multivariate analyses were performed to estimate risks of socio-demographic factors and pet ownership for the injury. Results A total of 84 participants experienced pet-related household injuries in the past 12 months, with an overall person-based incidence rate of 1.28%. The majority of the victims were injured once (69.6%). Cats (51.6%) were the most common pets involved. Pet owners were at an extremely higher risk after controlling for other factors (adjusted OR: 52.0, 95% CI 22.1 to 98.7). Females, the unmarried, those with higher monthly household income and those living in lower-density housing were more likely to be injured by pets. Conclusions We project a pet-related household injury incidence rate of 1.24% in the general Hong Kong population, with 86 334 residents sustaining pet-related injuries every year. Pet ownership puts people at extremely high risk, especially the unmarried. Further studies should focus on educating pet owners to reduce pet-related injuries in urban Greater China. PMID:28110284

  6. Physical and chemical injury as causes of sudden cardiac death: the forensic forum.

    Riddick, L


    Physical and chemical injuries account for the largest number of sudden, unexpected cardiac deaths in persons between the ages of 1 and 44 years. Blunt-force injuries, lacerations, avulsions, and contusions of the heart and great vessels sustained during motor vehicle crashes constitute the most prevalent type of lethal physical trauma to the cardiovascular system. The second most prevalent type of trauma is from penetrating and perforating wounds inflicted by firearms. The mechanisms of these injuries are discussed, with emphasis placed on those factors contributing to lethality. The three most prevalent chemicals associated with sudden cardiac death-ethyl alcohol, cocaine, and tricylic antidepressants-are briefly mentioned.

  7. The relationship between the expression of ethylene-related genes and papaya fruit ripening disorder caused by chilling injury.

    Zou, Yuan; Zhang, Lin; Rao, Shen; Zhu, Xiaoyang; Ye, Lanlan; Chen, Weixin; Li, Xueping


    Papaya (Carica papaya L.) is sensitive to low temperature and easy to be subjected to chilling injury, which causes fruit ripening disorder. This study aimed to investigate the relationship between the expression of genes related to ethylene and fruit ripening disorder caused by chilling injury. Papaya fruits were firstly stored at 7°C and 12°C for 25 and 30 days, respectively, then treated with exogenous ethylene and followed by ripening at 25°C for 5 days. Chilling injury symptoms such as pulp water soaking were observed in fruit stored at 7°C on 20 days, whereas the coloration and softening were completely blocked after 25 days, Large differences in the changes in the expression levels of twenty two genes involved in ethylene were seen during 7°C-storage with chilling injury. Those genes with altered expression could be divided into three groups: the group of genes that were up-regulated, including ACS1/2/3, EIN2, EIN3s/EIL1, CTR1/2/3, and ERF1/3/4; the group of genes that were down-regulated, including ACO3, ETR1, CTR4, EBF2, and ERF2; and the group of genes that were un-regulated, including ACO1/2, ERS, and EBF1. The results also showed that pulp firmness had a significantly positive correlation with the expression of ACS2, ACO1, CTR1/4, EIN3a/b, and EBF1/2 in fruit without chilling injury. This positive correlation was changed to negative one in fruit after storage at 7°C for 25 days with chilling injury. The coloring index displayed significantly negative correlations with the expression levels of ACS2, ACO1/2, CTR4, EIN3a/b, ERF3 in fruit without chilling injury, but these correlations were changed into the positive ones in fruit after storage at 7°C for 25 days with chilling injury. All together, these results indicate that these genes may play important roles in the abnormal softening and coloration with chilling injury in papaya.

  8. Does a sixth mechanism exist to explain lightning injuries?: investigating a possible new injury mechanism to determine the cause of injuries related to close lightning flashes.

    Blumenthal, Ryan; Jandrell, Ian R; West, Nicholas J


    Five mechanisms have been described in the literature regarding lightning injury mechanisms. A sixth mechanism is proposed in this article, namely, lightning barotrauma. A simple laboratory experiment was conducted using ordnance gelatin for ballistic studies. Lightning was simulated in a high-voltage laboratory using an 8/20-microsecond current impulse generator and discharged through ballistic gel. Temporary and permanent cavity formations were confirmed. The cavities formed were directly proportional to the currents used. Findings suggest that a sixth mechanism of lightning injury, namely, barotrauma, should be considered.

  9. Possible Causes of Ileal Injury in Two Models of Microbial Sepsis and Protective Effect of Phytic Acid

    Rasha Rashad Ahmed


    Full Text Available Background: Sepsis related-multiple organ dysfunction is associatedwith ileum injury. We aimed to determine the causes ofileal injury in two models of microbial sepsis resulted from infectionwith Aeromonas hydrophila or its endotoxin. We alsoevaluated the protective effect of phytic acid.Methods: Thin sections of ileum from 60 Swiss male mice incontrol, bacteria-infected or lipopolysaccharides (LPS andbacteria-infected or LPS-infected co-administered with phyticacid were subjected to histopathological and TdT-mediateddUTP nick-end labeling (TUNEL assay for apoptotic cellsdetection while ultra thin sections were stained with uranylacetate and lead citrate for cytological changes examination.Also, ileum images were exposed to the image analysis softwareto determine some related morphometric measures.Results: Necrosis and apoptosis were observed in ileum injuryin both examined sepsis models. The ileum injury was moresevere in LPS model. Phytic acid showed the ability to attenuateileum injury in Aeromonas hydrophila and its endotoxinmodels of sepsis after four weeks administration where itssupplementation significantly minimized the histopathologicaland cytological complications and morphometric alterationsresulted from the injury.Conclusion: The protective effects of phytic acid may becaused by increased mucous secretion, decreased apoptoticindex, attenuating the inflammatory and lymphocytic cellscount or increasing the renewal of the crypt cells and villousepithelial cells proliferation.

  10. Microtubule stabilization reduces scarring and causes axon regeneration after spinal cord injury

    F. Hellal (Farida); A. Hurtado (Andres); J. Ruschel (Jörg); K.C. Flynn (Kevin); C.J. Laskowski (Claudia); M. Umlauf (Martina); L.C. Kapitein (Lukas); D. Strikis (Dinara); V. Lemmon (Vance); J. Bixby (John); C.C. Hoogenraad (Casper); F. Bradke (Frank)


    textabstractHypertrophic scarring and poor intrinsic axon growth capacity constitute major obstacles for spinal cord repair. These processes are tightly regulated by microtubule dynamics. Here, moderate microtubule stabilization decreased scar formation after spinal cord injury in rodents through va

  11. 手外伤修复后的计划性康复%Systemic and planned rehabilitation following repair of hand injuries

    周礼荣; 蔡仁祥; 丁任; 王伟; 李峻


    目的 总结手外伤修复后的康复方法和效果。方法为不同种类的手外伤设计修复后计划性康复程序。该程序分为康复前期,连续被动活动期,等速肌力训练期和模拟职业训练恢复期。应用BTE康复评估仪对103例进行系统康复。结果断指再植康复后手指活动度恢复至健侧的77±9%,两指捏力恢复至健侧的81±12%,三指捏力恢复至健侧的83±7%。肌腱术后功能优良率71%。骨关节损伤后功能恢复良好。结论手外伤术后进行计划性康复能有效地促进手功能恢复,提高手术的成功率。%Objective To investigate the method and effectiveness of rehabiliation following hand injuries.Methods Systemic rehabilitation program following repair was designed for different hand injures, and divided into re-habilitation prophase, CPM training phase, isokinetic treatment phase and mimicking occupational therapy phase. 103cases were treated by BTE primus according to systemic program. Results After systemic rehabilitation, the replantedfingers had their total active motion restored up to 77 ± 12%, of uninjured fingers, lateral pinch strength up to 81 ±12%, jaw pinch strength up to 83 ± 7%. The function after tendon repair was good and excellent in 71%. The func-tional recovery was good after bone and joint injuries. Conclusion Systemic and planned rehabilitation program and in-dividualized rehabilitation methods can improve the function of hand injuries. (Shanghai Med J, 2000,23:728-730)

  12. [Contribution of ZHAO ji-an, a modern famous doctor handed down from ancestors, to the acupuncture and moxibustion cause ].

    Zhao, Shou-Mao


    ZHAO Jian was a modern famous doctor of Shanxi province, a family of TCM handed down from ancestors, with unique academic thought and manipulation of acupuncture and moxibustion, and made important contribution to the acup-moxibustion sciences, mainly including paying attention to medical ethics, noble character and high prestige, originating "the crimes of indiscriminately passing on acupuncture and moxibustion"; writing scholarly works, developing Chinese national culture; constantly creating needling instruments; paying attention to treating mind, regulating yin and yang, advocating treating both mind and form; promoting free circulation of qi to kill pain, combination of acupuncture with massage, originating "alternate application of mental needles and digital needling "; inheriting ancient medicine and ancient acupuncture and moxibustion methods, originating no-pain inserting needle method, and combination of acupuncture and moxibustion with massage.

  13. Tackling causes and costs of ED presentation for American football injuries: a population-level study.

    Smart, Blair J; Haring, R Sterling; Asemota, Anthony O; Scott, John W; Canner, Joseph K; Nejim, Besma J; George, Benjamin P; Alsulaim, Hatim; Kirsch, Thomas D; Schneider, Eric B


    American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set. Patients presenting for ED treatment of injuries sustained playing American tackle football (identified using International Classification of Diseases, Ninth Revision, Clinical Modification code E007.0) from 2010 to 2011 were studied in the Nationwide Emergency Department Sample. Patient-specific injuries were identified using the primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code and categorized by type and anatomical region. Standard descriptive methods examined patient demographics, diagnosis categories, and ED and inpatient outcomes and charges. During the study period 397363 football players presented for ED treatment, 95.8% of whom were male. Sprains/strains (25.6%), limb fractures (20.7%), and head injuries (including traumatic brain injury; 17.5%) represented the most presenting injuries. Overall, 97.9% of patients underwent routine ED discharge with 1.1% admitted directly and fewer than 11 patients in the 2-year study period dying prior to discharge. The proportion of admitted patients who required surgical interventions was 15.7%, of which 89.9% were orthopedic, 4.7% neurologic, and 2.6% abdominal. Among individuals admitted to inpatient care, mean hospital length of stay was 2.4days (95% confidence interval, 2.2-2.6) and 95.6% underwent routine discharge home. The mean total charge for all patients was $1941 (95% confidence interval, $1890-$1992) with substantial

  14. Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury.

    Aquilina, K


    Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.

  15. Prevalence, causes, and correlates of traumatic dental injuries among seven-to-twelve-year-old school children in Dera Bassi

    Dua, Rohini; Sharma, Sunila


    Aim: The paper aims to present a study conducted in Dera Bassi, Mohali, India. The purpose of the study was to ascertain the prevalence of traumatic dental injuries (TDI) in children of age group 7-12 years in private schools in Gulabgarh village. Material & Method: Age & sex distribution, etiological factors, risk factors and cause of injury were the parameters taken into consideration. The data collected was processed and analyzed using the SPSS statistical software program. Results: The overall prevalence of dental trauma was 14.5%, amongst the 880 subjects examined, out of which, 63.2% males and 36.4% females were found to be affected. The maxillary central incisor was found to be most commonly affected tooth (43.8%). The most common cause of injury reported was fall during playing (37.5%). Conclusion: Enamel fracture was most prevalent (50%). No risk factor was significantly higher than others; however children with Angle's class II div 1 malocclusion exhibited greater risk factor for traumatic injuries. PMID:22557895

  16. 手外伤术后患者焦虑和抑郁的原因分析及护理措施%Study and nursing measures of anxiety and depression of patients with hand injury after operation



    目的:研究手外伤患者实施手术后出现抑郁及焦虑的原因以及相关的护理措施。方法选择在浙江省慈溪市中医院2010年10月~2012年10月间进行诊治的700例手外伤患者,对其进行手术治疗,术后分别运用抑郁自评量表(SDS)和焦虑自评量表(SAS)对所选患者的心理状态进行分析,运用自行设计的问卷对每个手外伤术后的患者出现抑郁及焦虑的原因进行评估,同时进行相应的护理措施。结果本文所选的手外伤患者,术后出现抑郁和焦虑的原因主要为院淤术后伤口愈合不理想;于医疗费用相对较高,家庭负担相对较重;盂术后失去了原有的劳动能力;榆手的美观受到影响;虞疼痛难以忍受;愚考虑致伤纠纷,担心事故的责任。护士应对术期患者进行积极的心理护理,对患者实施心理疏导,克服其不良情绪。结论通过对患者实施相应的护理措施,可以有效缓解手外伤患者术后出现的抑郁、焦虑等心理情绪,提高患者的自信心,缓解其心理压力,帮助患者尽快度过心理创伤期,以良好的心理状态面对治疗。%Objective To cause depression and anxiety and the related nursing measures of patients with hand injury after operation. Methods 700 cases of hand trauma patients in the Chinese Medicine Hospital in Cixi City from Octo-ber 2010 to October 2012 between diagnosis and treatment, the operation on the postoperative was perform respective-ly, self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in selected patients psychological status were used to analyze, the self-designed questionnaire on patients with each hand trauma of reason for assessment of depres-sion and anxiety, and the corresponding nursing measures were used. Positive psychological care of patients were given operation time of nurses, patients with psychological counseling, to overcome the negative emotions. Results The pa

  17. Mole gun injury.

    Pistré, V; Rezzouk, J


    A mole gun is a weapon, which is used to trap and kill moles. This report provides an overview of the state of knowledge of mole gun injuries, comparable to blast injuries caused by fireworks, explosive or gunshot. Over a 2-year period, the authors reported their experience with ten hand injuries caused by mole gun. Radial side of the hand was often concerned, particularly the thumb. The authors explain their choices in the management of such lesions. Surgery was performed primarily and a large debridement currently seemed to offer the best outcome for the patient. Blast, crush, burns and lacerations may explain the higher rate of amputation to the digits. A long period of physiotherapy, specifically of the hand, was needed before the patient could return to work. This ballistic hand trauma encountered by surgeons requires knowledge and understanding of these injuries. It should be in accordance with firearms law because of severe injuries encountered and possible lethal wounds. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  18. Microparticles generated by decompression stress cause central nervous system injury manifested as neurohypophysial terminal action potential broadening

    Yang, Ming; Kosterin, Paul; Salzberg, Brian M.; Milovanova, Tatyana N.; Bhopale, Veena M.; Thom, Stephen R.


    The study goal was to use membrane voltage changes during neurohypophysial action potential (AP) propagation as an index of nerve function to evaluate the role that circulating microparticles (MPs) play in causing central nervous system injury in response to decompression stress in a murine model. Mice studied 1 h following decompression from 790 kPa air pressure for 2 h exhibit a 45% broadening of the neurohypophysial AP. Broadening did not occur if mice were injected with the MP lytic agent...

  19. Reconstruction of advanced-stage electrical hand injury in a one stage procedure using a prefabricated medial lateral crural composite flap.

    Jiang, Hao; Li, Qing Feng; Gu, Bin; Fu, Kaiding; Zheng, Danning; Liu, Kai; Shen, Guoxiong


    To explore the possibility of a one stage restoration of protective sensation and finger flexion after electrical burn of the hand, 5 patients with electrical injuries at the wrist were treated by a new free composite flap, originating from the medial lateral crural skin flap. This flap can repair skin, blood vessels, tendons, and nerves in a one-stage procedure. The harvest of the medial lateral crural flap is described. The posterior tibial vessels provide the arterial supply. The perforators to the flap and the branches to the plantaris tendon and the sural nerve were preserved, and the nerve and tendon were kept within the flap by careful dissection of the crural fascia. At the same time, 3 to 4 tendons of extensor digitorum longus were inserted into the layer between superficial and profundus crural fascia. Thus, blood vessels, nerves, and tendons were combined into the flap before transplantation. The composite flap was then transplanted into the recipient site of the injured hand to repair the complex defects in a single operation. Flexion and extension function of the fingers was evaluated. Sensory function was tested by the standards recommended by the British Medical Research Council System for evaluating sensibility. Follow-up ranged from 18 to 24 months. Results revealed all flaps survived. The flexion distance from tip to palmar crease and extension distance from tip to horizontal level of 3 patients were 4 to 5 cm and 3 to 4 cm, respectively. At 6 months, 2 patients improved from 6 cm and 5 cm to 4 cm and 4 cm, respectively. The sensation reached to S2 level, and skin temperature rose. The medial lateral crural composite flap is an ideal, one-stage method to restore protective sensation and finger flexion for advanced-stage patients who have suffered severe high voltage electrical injuries in the wrist.

  20. Evaluation of injuries caused by anthropic action in snakes from Brazil.

    Gouveia, R V; Neto-Silva, D A; Sousa, B M; Novelli, I A


    Human behavior toward wild animals is defined by cultural influences and often is affected by lack of knowledge, mainly in situations of confrontation. The present study was conducted between 2008 and 2013, involving analysis of snakes that had suffered injuries belonging to the reptile collections of Centro Universitário de Lavras and Universidade Federal de Juiz de Fora. The injuries were classified according to location on the body. Among the 449 specimens analyzed, 245 specimens showed injury to some part of the body. The nonvenomous snakes were the most representative and had a higher rate of injury (66.3%) than the venomous ones (18.2%). The body region where the greatest percentage of injuries was recorded was the anterior (39.6%), followed by the middle (36.5%) and posterior (8.4%). We believe this fact may have resulted due the lack of knowledge on how to differentiate species. Studies of the relationship between schooling level and contact with environmental education activities demonstrate reduction of attacks on these animals. This fact indicates that the preservation of many species is related to awareness and education of the population.

  1. Sports Injury and Its Causes of 3Goalball%三门球运动损伤及其成因



    Through case study on 30 male students, this paper found out that sports injury occurred in the upper extremity and torso, respectively, to the 45.45% and 30. 91 and the types of injury to scratches and abrasions mainly, respectively, to the 41.82% and 21.82%. Its causes closely related with character of 3goalball, play- ground, teach and students. Among them, specification for appearance and wearing protective gear can reduce the probability of producing sports injury, but the technology level of 3goalball and sports injury frequency is inversely proportional to. The result shows that sports injury of 3goalball is not inevitable. How to prevent sports injury of 3goalball produced recommendations.%通过对30名男生进行个案研究,结果表明:三门球运动损伤多发生于上肢和躯干部位,分别占到45.45%和30.91%,损伤类型以抓伤和擦伤为主,分别占到41.82%和21.82%。其产生原因与三门球特性、场地、教师、学生因素密切相关。其中,规范仪容仪表和佩戴护具能够降低算命球运动损伤产生的机率,而三门球技术水平与运动损伤频率呈反比。研究认为,三门球运动损伤并非不可避免,并对如何避免三门球运动损伤的产生提出了建议。

  2. Epidemiology of Injuries Caused by Mammals Treated in Emergency Departments in Marseille, France.

    Mendoza, Kenia; Benkouiten, Samir; Brouqui, Philippe; Gautret, Philippe


    A total of 304 patients with mammal-related injuries were included over the 2-year survey period (1.5% of total admissions) at the emergency departments of a large city in southern France. Admissions peaked during the summer months. Dogs accounted for 75.3% and cats for 16.8% of cases. Dog injuries were significantly more common in younger individuals. Overall, signs of infection were observed in 17.9% of cases and were more likely to occur in patients injured by cats and in patients injured more than 1 day before consulting. The majority of patients received an antibiotic prophylaxis, independent to the delay between injury and consultation. Only 1 out of 10 injured patients who consulted an emergency department were seen at the rabies treatment center. Emergency department surveillance data offers an effective and efficient method for conducting animal bite surveillance to monitor trends and characterize animal bite victims.

  3. [Pain caused by brachial plexus injury during coronary revascularization. Report of 3 cases].

    Martín, M A; Marí, C; Miranda, A F; Burón, J A; Fernández, F E; Suárez, R


    We report three cases of injury of the brachial plexus after coronary revascularization surgery. During the postoperative phase all patients presented plexopathy involving the left C8 and D1 roots. The symptoms were pain, paresthesia, and motor deficits. The proposed mechanisms for injury of the brachial plexus during cardiac surgery are: hyperabduction of the arm, direct traumatism produced by the needle during catheterization of the internal jugular vein, and traction and compression associated with sternal retraction. In the three patients we ruled out alterations during cannulation of the internal jugular vein and malposition of the arms. We think that in our cases the fundamental mechanism was an excessive and assymetrical opening of sternal and Favoloro's separators that were used in all cases during dissection of the left internal mammary artery. We conclude that injury of the brachial plexus can be minimized by reducing the opening of both separators and by placing Favaloro's separator in a lower position.

  4. Severe esophageal injuries caused by accidental button battery ingestion in children.

    Fuentes, Sara; Cano, Indalecio; Benavent, María Isabel; Gómez, Andrés


    Button batteries represent a low percentage of all foreign bodies swallowed by children and esophageal location is even less frequent. However, these cases are more likely to develop severe injuries. The aim of this essay is to report three cases treated in our institution and review previous reports. Chart review and literature search. We treated three children between 2-7- years old with button batteries lodged at esophagus. They all presented esophageal burns (EB), which evolved in esophageal stenosis in two out of the three cases. We found 29 more cases in literature and the injuries included EB, esophageal perforation (EP) and tracheoesophageal fistula (TEF). Swallowed button batteries rarely remain in esophagus, but these cases present a higher risk of tisular damage. Injuries can take place even after few hours; and therefore, endoscopy must be performed as soon as possible. Further study on button batteries' safety and the establishment of a maximum size for them would be good preventive measures.

  5. Appreciation of treating overall hand skin degloved injury%全手皮肤脱套伤的治疗体会

    曾林如; 谢庆平; 石仕元; 汪宇驰; 蒋大权


    目的报道全手皮肤脱套伤的手术方法及临床效果。方法通过重建手指动、静脉,并吻合脱套皮肤和前臂皮肤深、浅静脉建立静脉回流后,将脱套皮肤回植的方法治疗全手皮肤脱套伤3例。结果术后全手皮肤全部成活,外形、感觉恢复均较为满意。结论通过重建浅静脉回流的方式将脱套皮肤回植,为全手皮肤脱套伤提供了一个术式。%Objective To report the procedure and treatment outcome inpatients with overall hand skin degloved injury. Methods After anastomosis of finger artery and vein and anstomosis of profound and superficial vein between degloved skin and forearm skin were done, the degloved skin was reattached for 3 cases.Results All the skin survived with satisfactory restoration of appearance and sensation.Conclusions It was an effective procedure to reattach the superficial vein for treatment of skin degloved injury.

  6. Gunshot injury of the heart: an unusual cause of acute myocardial infarction.

    Bali, Harinder K; Vijayvergiya, Rajesh; Banarjee, Sunip; Kumar, Nikhil


    A 30-year-old man had multiple pellet injuries after being shot. An asymptomatic, acute, inferior-wall myocardial infarction was detected on an electrocardiogram at the time of a pre-anesthetic evaluation for eye surgery. A computed tomographic scan of the chest confirmed the presence of an intracardiac foreign body. Coronary angiography showed occlusion of the distal right coronary artery by a pellet. The patient was managed conservatively with aspirin and metoprolol. In conclusion, a single coronary lesion, the absence of other cardiac complications, and a favorable outcome with conservative medical treatment after a gunshot injury contribute to the rarity of this case of myocardial infarction.

  7. Cerebral salt wasting syndrome in brain injury patients: a potential cause of hyponatremia.

    Zafonte, R D; Mann, N R


    Hyponatremia is a common neuromedical problem seen in survivors of central nervous system injury. The etiology of this hyponatremia is often diagnosed as syndrome of inappropriate diuretic hormone (SIADH). Fluid restriction is usually the first line of treatment. However, this can exacerbate vasospasm and produce resultant ischemia. Cerebral salt wasting is a syndrome of renal sodium loss that may occur commonly after central nervous system injury, yet remains unrecognized. Treatment of cerebral salt wasting consists of hydration and salt replacement. This article uses a case report to discuss the importance of recognition of this syndrome, and treatment concerns are reviewed.




    Full Text Available Cut throat injuries are very common presentation with very high morbidity and mortality. Mostly adult males of productive age group are affected. We selected 40 cases of cut throat injury retrospectively in Pt. J.N.M. medical college Raipur and studied it s pattern, management and complication etc. Among total patients 80% were males and 20% were females, mean age group was 20 - 40yrs. Zone 2 was affected in maximum cases. Repair was done under general aneasthesia after teacheostomy in maximum patients. Perma nent treacheostomy, dysphagia, change in voice and pharyngocutaneous fistula are most common complication

  9. Prospects for studying how high-intensity compression waves cause damage in human blast injuries

    Brown, Katherine; Bo, Chiara; Ramaswamy, Arul; Masouros, Spiros; Newell, Nicolas; Hill, Adam; Clasper, Jon; Bull, Anthony; Proud, William


    Blast injuries arising from improvised explosive devices are often complex leading to long-term disability in survivors. There is an urgent need to mitigate against the effects of blast that lead to these injuries, and to also improve post-traumatic therapeutic treatments related to problems associated with damage and healing processes and infections. We have initiated multidisciplinary studies to develop experimental facilities and strategies for analyzing the effects blast waves upon the human body, from cellular through to skeletal functions. This work is supported by the Atomic Weapons Establishment and the Defence Science and Technology Laboratory, UK.

  10. Successful use of N-acetylcysteine to treat severe hepatic injury caused by a dietary fitness supplement.

    El Rahi, Cynthia; Thompson-Moore, Nathaniel; Mejia, Patricia; De Hoyos, Patricio


    In the absence of adequate premarketing efficacy and safety evaluations, adverse events from over-the-counter supplements are emerging as a public health concern. Specifically, bodybuilding products are being identified as a frequent cause of drug-induced liver injury. We present a case of a 20-year-old Hispanic male who presented with acute nausea and vomiting accompanied by severe right upper quadrant abdominal pain, shivering, and shortness of breath. Laboratory data pointed to mixed cholestatic and hepatocellular damage, and after exclusion of known alternate etiologies, the patient was diagnosed with acute drug-induced liver injury secondary to the use of "Friction," a bodybuilding supplement. Treatment with N-acetylcysteine (NAC) 20% oral solution was initiated empirically at a dose of 4000 mg [DOSAGE ERROR CORRECTED] (70 mg/kg) every 4 hours and was continued once the diagnosis was made. Within 48 hours of admission to our hospital, the patient began to show clinical resolution of right abdominal pain and tolerance to oral diet associated with a significant decline toward normal in his liver function tests and coagulopathy. The WHO-UMC causality assessment system suggested a "certain causality" between exposure to the supplement and the acute liver injury. In the event of suspected drug-induced liver injury, treatment with NAC should be considered given its favorable risk-benefit profile.

  11. Peripheral nerve injury and TRPV1-expressing primary afferent C-fibers cause opening of the blood-brain barrier

    Salter Michael W


    Full Text Available Abstract Background The blood-brain barrier (BBB plays the crucial role of limiting exposure of the central nervous system (CNS to damaging molecules and cells. Dysfunction of the BBB is critical in a broad range of CNS disorders including neurodegeneration, inflammatory or traumatic injury to the CNS, and stroke. In peripheral tissues, the vascular-tissue permeability is normally greater than BBB permeability, but vascular leakage can be induced by efferent discharge activity in primary sensory neurons leading to plasma extravasation into the extravascular space. Whether discharge activity of sensory afferents entering the CNS may open the BBB or blood-spinal cord barrier (BSCB remains an open question. Results Here we show that peripheral nerve injury (PNI produced by either sciatic nerve constriction or transecting two of its main branches causes an increase in BSCB permeability, as assessed by using Evans Blue dye or horseradish peroxidase. The increase in BSCB permeability was not observed 6 hours after the PNI but was apparent 24 hours after the injury. The increase in BSCB permeability was transient, peaking about 24-48 hrs after PNI with BSCB integrity returning to normal levels by 7 days. The increase in BSCB permeability was prevented by administering the local anaesthetic lidocaine at the site of the nerve injury. BSCB permeability was also increased 24 hours after electrical stimulation of the sciatic nerve at intensity sufficient to activate C-fibers, but not when A-fibers only were activated. Likewise, BSCB permeability increased following application of capsaicin to the nerve. The increase in permeability caused by C-fiber stimulation or by PNI was not anatomically limited to the site of central termination of primary afferents from the sciatic nerve in the lumbar cord, but rather extended throughout the spinal cord and into the brain. Conclusions We have discovered that injury to a peripheral nerve and electrical stimulation of C

  12. Comparison of Proinflammatory Gene Expression in Lesions Caused by either Burn Injuries or Cutaneous Leishmaniasis

    Akhzari; Rezvan; Zolhavarieh; Moafi


    Background Leishmaniasis is a worldwide disease prevalent in tropical and sub-tropical countries in the world. Characterization of inflammatory responses produced in cutaneous Leishmaniasis has not yet been completed. The current study aims to assess and compare pro-inflammatory cytokines between burning injuries and Leishmania infection. Methods the specific primers were designed for 10 proinflammatory genes including CCL4, CCL3,...

  13. Ischemia of the lung causes extensive long-term pulmonary injury: An experimental study

    N.P. van der Kaaij (Niels); J. Kluin (Jolanda); J.J. Haitsma (Jack); M.A. den Bakker (Michael); B.N.M. Lambrecht (Bart); B.F. Lachmann (Burkhard); R.W.F. de Bruin (Ron); A.J.J.C. Bogers (Ad)


    textabstractBackground: Lung ischemia-reperfusion injury (LIRI) is suggested to be a major risk factor for development of primary acute graft failure (PAGF) following lung transplantation, although other factors have been found to interplay with LIRI. The question whether LIRI exclusively results in

  14. Epidemiology of non-fatal injuries due to external causes in ...


    Apr 20, 1991 ... race has become a social reality. The sample. During the ...... education, but until the basic physical requirements of adequate and well-kerbed ... is augmented by the frequency of head injuries in the 'multiple body regions' ...

  15. Macro determinants of cause-specific injury mortality in the OECD countries: an exploration of the importance of GDP and unemployment.

    Muazzam, Sana; Nasrullah, Muazzam


    Gross Domestic Product (GDP) and unemployment has a strong documented impact on injury mortality. The aim of our study is to investigate the relationship of GDP per capita and unemployment with gender- and cause-specific injury mortalities in the member nations of Organization for Economic Cooperation and Development (OECD). Country-based data on injury mortality per 100,000 population, including males and females aged 1-74, for the 4 year period 1996-1999, were gathered from the World Health Organization's Statistical Information System. We selected fourteen cause-specific injury mortalities. Data on GDP, unemployment rate and population growth were taken from World Development Indicators. GDP and unemployment rate per 100 separately were regressed on total and cause-specific injury mortality rate per 100,000 for males and females. Overall in the OECD countries, GDP per capita increased 12.5% during 1996-1999 (P = 0.03) where as unemployment rate decreased by 12.3% (P = 0.05). Among males, most cause-specific injury mortality rates decreased with increasing GDP except motor vehicle traffic crashes (MTC) that increased with increasing GDP (coefficient = 0.75; P GDP (coefficient = 0.31; P = 0.04). When we modeled cause-specific injury mortality rates with unemployment, injuries due to firearm missiles (coefficient = 0.53; P GDP is more related to cause-specific injury mortality than unemployment. Injury mortality does not relate similarly to each diagnosis-specific cause among males and females. Further research on causation with more predictors is needed.

  16. Ozone causes needle injury and tree decline in Pinus hartwegii at high altitudes in the mountains around Mexico City

    de la l. Bauere, M.deL.; Tejeda, T.H.; Manning, W.J.


    Needles of P. hartwegii were examined for a two-year period at 22 plots at Ajusco, D.F., south of Mexico City, at 3000 m. Ozone injury symptoms, consisting of extensive yellow banding and mottling, were observed on mature needles. These also became evident on new needles as they matured. This resulted in premature needle loss, reduction in cone and seed production, loss of tree vigor, bark beetle infestations, and tree decline and death. P. montezumae var. lindleyi and a few P. hartwegii trees in the same area were less susceptible. The most severe ozone injury to P. hartwegii occurs west to southwest of Mexico City in the mountain forest reserve of Desierto de los Leones, at 3500 m. Based on observations, the authors feel that needle injury and decline of P. hartwegii at high elevations in the mountains around Mexico City is caused primarily by ozone and not acid rain. It resembles the ozone-caused decline of ponderosa pine in the San Bernardino Mountains in California.

  17. Frequency and Causes of Nonbattle Injuries Air Evacuated from Operations Iraqi Freedom and Enduring Freedom, U.S. Army, 2001-2006


    fghanistan. Three fourths of the injuries involved the pper and lower extremities. The kneewas the largest sub- ategory of the lower extremity and...overall, while the rist/hand/fıngers was the largest subcategory of the pper extremity and the second largest of all ubcategories. Tables 5 and 6 are

  18. Causes and incidence of maxillofacial injuries in India: 12-year retrospective study of 4437 patients in a tertiary hospital in Gujarat.

    Weihsin, Hu; Thadani, Sandeep; Agrawal, Mohit; Tailor, Suket; Sood, Ramita; Langalia, Akshay; Patel, Twinkle


    Maxillofacial injuries are unique because of the anatomical complexity of the area and their associated psychological effects. An understanding of the epidemiology of these injuries is important if we are to develop preventive measures, increase the efficiency and delivery of health services, improve the skills of healthcare providers, and better distribute resources. We retrospectively evaluated data on 4455 patients (aged between 3 and 84 years) who presented with maxillofacial injuries to a tertiary referral hospital in Ahmedabad, India, between 1 January 1999 and 31 January 2010. Of these, 18 needed only rest and medication so 4437 were included. Data included patients'characteristics and the cause of injury. Details on the presentation and severity of injury, associated injuries including head injuries, the influence of alcohol and other drugs, treatment, and outcome, were also included. Around one-third were aged between 21and 30 years, and the male to female ratio was 5:1. The main causes of injury were road traffic accidents (n=2347, 53%) and interpersonal violence (n=1041, 23%). Most road traffic accidents involved two-wheeled vehicles. Alcohol was associated with 11% of injuries. A total of 2546 patients (57%) had mandibular fractures. To reduce the number of injuries we need better road safety laws with stringent enforcement, and the public, particularly those between 15 and 45 years of age, must be educated about road safety.

  19. Thermal injuries caused by ignition of volatile substances by gas water heaters.

    Rutan, R L; Desai, M H; Herndon, D N


    Based on the cumulative data of this tertiary care facility over the past 25 years, one out of every 70 pediatric patients admitted to our institution sustained their injuries during an explosive event instigated by the ignition of volatile substances from gas water heaters. The majority of injuries related to gas water heaters can be prevented by decreasing the temperature setpoint of the heater, by protecting the heater element itself, and by elevating the water heater to 18 inches above the floor. The first two issues have been adequately addressed; however, gas-fueled water heaters continue to be installed at floor level. Current national guidelines are too rigid and do not adequately address water-heater installation in private residences. Although general prevention campaigns target appropriate storage of volatile substances, they rarely address the explosive potential of gas water heaters in combination with combustible fumes.

  20. Branched Chain Amino Acids Cause Liver Injury in Obese/Diabetic Mice by Promoting Adipocyte Lipolysis and Inhibiting Hepatic Autophagy

    Fuyang Zhang


    Full Text Available The Western meat-rich diet is both high in protein and fat. Although the hazardous effect of a high fat diet (HFD upon liver structure and function is well recognized, whether the co-presence of high protein intake contributes to, or protects against, HF-induced hepatic injury remains unclear. Increased intake of branched chain amino acids (BCAA, essential amino acids compromising 20% of total protein intake reduces body weight. However, elevated circulating BCAA is associated with non-alcoholic fatty liver disease and injury. The mechanisms responsible for this quandary remain unknown; the role of BCAA in HF-induced liver injury is unclear. Utilizing HFD or HFD + BCAA models, we demonstrated BCAA supplementation attenuated HFD-induced weight gain, decreased fat mass, activated mammalian target of rapamycin (mTOR, inhibited hepatic lipogenic enzymes, and reduced hepatic triglyceride content. However, BCAA caused significant hepatic damage in HFD mice, evidenced by exacerbated hepatic oxidative stress, increased hepatic apoptosis, and elevated circulation hepatic enzymes. Compared to solely HFD-fed animals, plasma levels of free fatty acids (FFA in the HFD + BCAA group are significantly further increased, due largely to AMPKα2-mediated adipocyte lipolysis. Lipolysis inhibition normalized plasma FFA levels, and improved insulin sensitivity. Surprisingly, blocking lipolysis failed to abolish BCAA-induced liver injury. Mechanistically, hepatic mTOR activation by BCAA inhibited lipid-induced hepatic autophagy, increased hepatic apoptosis, blocked hepatic FFA/triglyceride conversion, and increased hepatocyte susceptibility to FFA-mediated lipotoxicity. These data demonstrated that BCAA reduces HFD-induced body weight, at the expense of abnormal lipolysis and hyperlipidemia, causing hepatic lipotoxicity. Furthermore, BCAA directly exacerbate hepatic lipotoxicity by reducing lipogenesis and inhibiting autophagy in the hepatocyte.

  1. Branched Chain Amino Acids Cause Liver Injury in Obese/Diabetic Mice by Promoting Adipocyte Lipolysis and Inhibiting Hepatic Autophagy.

    Zhang, Fuyang; Zhao, Shihao; Yan, Wenjun; Xia, Yunlong; Chen, Xiyao; Wang, Wei; Zhang, Jinglong; Gao, Chao; Peng, Cheng; Yan, Feng; Zhao, Huishou; Lian, Kun; Lee, Yan; Zhang, Ling; Lau, Wayne Bond; Ma, Xinliang; Tao, Ling


    The Western meat-rich diet is both high in protein and fat. Although the hazardous effect of a high fat diet (HFD) upon liver structure and function is well recognized, whether the co-presence of high protein intake contributes to, or protects against, HF-induced hepatic injury remains unclear. Increased intake of branched chain amino acids (BCAA, essential amino acids compromising 20% of total protein intake) reduces body weight. However, elevated circulating BCAA is associated with non-alcoholic fatty liver disease and injury. The mechanisms responsible for this quandary remain unknown; the role of BCAA in HF-induced liver injury is unclear. Utilizing HFD or HFD+BCAA models, we demonstrated BCAA supplementation attenuated HFD-induced weight gain, decreased fat mass, activated mammalian target of rapamycin (mTOR), inhibited hepatic lipogenic enzymes, and reduced hepatic triglyceride content. However, BCAA caused significant hepatic damage in HFD mice, evidenced by exacerbated hepatic oxidative stress, increased hepatic apoptosis, and elevated circulation hepatic enzymes. Compared to solely HFD-fed animals, plasma levels of free fatty acids (FFA) in the HFD+BCAA group are significantly further increased, due largely to AMPKα2-mediated adipocyte lipolysis. Lipolysis inhibition normalized plasma FFA levels, and improved insulin sensitivity. Surprisingly, blocking lipolysis failed to abolish BCAA-induced liver injury. Mechanistically, hepatic mTOR activation by BCAA inhibited lipid-induced hepatic autophagy, increased hepatic apoptosis, blocked hepatic FFA/triglyceride conversion, and increased hepatocyte susceptibility to FFA-mediated lipotoxicity. These data demonstrated that BCAA reduces HFD-induced body weight, at the expense of abnormal lipolysis and hyperlipidemia, causing hepatic lipotoxicity. Furthermore, BCAA directly exacerbate hepatic lipotoxicity by reducing lipogenesis and inhibiting autophagy in the hepatocyte.

  2. Cerebrovascular Injury Caused by a High Strain Rate Insult in the Thorax


    al. Severe lung contusion and death after high-velocity behind-armor blunt trauma: relation to protection level. Mil Med 2007; 172 1110-1116 13...of increasing risk developed by Courtney and Courtney9 and the Bowen curves for risk of blast-induced lung injury.2 Figure 1. Experimental conditions...involvement of nitric oxide. Brain Inj 2001; 15 593-612 6. Cooper GJ. Protection of the lung from blast overpressure by thoracic stress wave decouplers. J

  3. Necrotrophic fungi associated with epidermal microcracking caused by chilling injury in pickling cucumber fruit


    The objective of this work was to visualize the association between microcracking and other epidermal chilling injury symptoms, and to identify rots in cucumber fruit (Cucumis sativus L.) by scanning electron microscopy (SEM). Depressed epidermal areas and surface cracking due to damages of subepidermal cells characterized the onset of pitting in cucumber fruit. The germination of conidia of Alternaria alternata, with some of them evident on the fractures in the cultivar Trópico, occurred aft...

  4. Human-Wildlife Conflicts in Nepal: Patterns of Human Fatalities and Injuries Caused by Large Mammals

    Acharya, Krishna Prasad; Paudel, Prakash Kumar; Neupane, Prem Raj; Köhl, Michael


    Injury and death from wildlife attacks often result in people feeling violent resentment and hostility against the wildlife involved and, therefore, may undermine public support for conservation. Although Nepal, with rich biodiversity, is doing well in its conservation efforts, human-wildlife conflicts have been a major challenge in recent years. The lack of detailed information on the spatial and temporal patterns of human-wildlife conflicts at the national level impedes the development of e...

  5. [Eye injuries caused by lasers in military and industrial environment. Apropos of 13 cases].

    Pariselle, J; Sastourne, J C; Bidaux, F; May, F; Renard, J P; Maurin, J F


    The aim of this study was to analyse the nature of wavelengths used by military forces, evaluate their clinical consequences in terms of ocular risk, and determine the therapeutic implications and specific preventative measures which should be implemented both in peace- and war-time-settings. We analyzed retrospectively 13 cases of laser injury (12 patients) treated in our unit over the past 10 years. We recorded the characteristics of the responsible lasers, effects on visual acuity and visual filed, initial ophthalmoscopic and angiographic aspects, treatment undertaken and patient follow-up. Wavelengths were know in only 10 cases. In 9 cases a NdYag laser operating at 1063 nm was involved. The tenth case was an Argon Coirorint laser accident. In three cases the wavelength could not be ascertained because it was confidential information or had been emitted by the enemy and had not been identified. Ocular injury was bilateral in 1 case and unilateral in 12. Retinal lesions were foveolar in 8 cases with an initial visual acuity varying from 1/10 to 10/10. Visual loss depended on the extent of the burn and did not tend to improve despite vasoprotector and corticosteroid treatments. In 2 cases the injury progressed without formation of an epimacular membrane. Retinal lesions were extra-foveolar in 5 cases and in 1 case vitreous hemorrhage required vitrectomy. With the widespread use of Yag lasers and the soon to be employed tuneable lasers, there in major risk of serious ocular injury resulting from foveolar burns or peripheral retina trauma with vitreous hemorrhage. In a war situation, a large number of laser casualties producing peripheral vitreous hemorrhage would create an important logistics problem for vitrectomy. The accent must therefore be focused on prevention. Personnel must be informed of the danger and instructed in wearing filter glasses adapted to the wavelengths being used, if known, or a universal photoactivated protective device, as yet a

  6. Human survival in volcanic eruptions: Thermal injuries in pyroclastic surges, their causes, prognosis and emergency management.

    Baxter, Peter J; Jenkins, Susanna; Seswandhana, Rosadi; Komorowski, Jean-Christophe; Dunn, Ken; Purser, David; Voight, Barry; Shelley, Ian


    This study of burns patients from two eruptions of Merapi volcano, Java, in 1994 and 2010, is the first detailed analysis to be reported of thermal injuries in a large series of hospitalised victims of pyroclastic surges, one of the most devastating phenomena in explosive eruptions. Emergency planners in volcanic crises in populated areas have to integrate the health sector into disaster management and be aware of the nature of the surge impacts and the types of burns victims to be expected in a worst scenario, potentially in numbers and in severity that would overwhelm normal treatment facilities. In our series, 106 patients from the two eruptions were treated in the same major hospital in Yogyakarta and a third of these survived. Seventy-eight per cent were admitted with over 40% TBSA (total body surface area) burns and around 80% of patients were suspected of having at least some degree of inhalation injury as well. Thirty five patients suffered over 80% TBSA burns and only one of these survived. Crucially, 45% of patients were in the 40-79% TBSA range, with most suspected of suffering from inhalation injury, for whom survival was most dependent on the hospital treatment they received. After reviewing the evidence from recent major eruptions and outlining the thermal hazards of surges, we relate the type and severity of the injuries of these patients to the temperatures and dynamics of the pyroclastic surges, as derived from the environmental impacts and associated eruption processes evaluated in our field surveys and interviews conducted by our multi-disciplinary team. Effective warnings, adequate evacuation measures, and political will are all essential in volcanic crises in populated areas to prevent future catastrophes on this scale. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  7. [Injuries to blood vessels near the heart caused by central venous catheters].

    Abram, J; Klocker, J; Innerhofer-Pompernigg, N; Mittermayr, M; Freund, M C; Gravenstein, N; Wenzel, V


    Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible. The subclavian catheter is at a somewhat lower risk of catheter-associated sepsis and symptomatic venous thrombosis than approaches via the internal jugular and femoral veins. Indeed, access via the subclavian vein carries a substantial risk of pneumo- and hemothorax. Damage to the subclavian vein or artery can also occur during deliberate and inadvertent punctures and result in life-threatening complications. Therefore, careful consideration of the access route is required in relation to the patient and the clinical situation, to keep the incidence of complications as low as possible. For catheterization of the subclavian vein, puncture of the axillary vein in the infraclavicular fossa is a good alternative, because ultrasound imaging of the target vessel is easier than in the subclavian vein and the puncture can be performed much further from the lung.

  8. No neurochemical evidence for brain injury caused by heading in soccer.

    Zetterberg, Henrik; Jonsson, Michael; Rasulzada, Abdullah; Popa, Cornel; Styrud, Ewa; Hietala, Max Albert; Rosengren, Lars; Wallin, Anders; Blennow, Kaj


    The possible injurious effect to the brain of heading in soccer is a matter of discussion. To determine whether standardised headings in soccer are associated with increased levels of biochemical markers for neuronal injury in cerebrospinal fluid (CSF) and serum. 23 male amateur soccer players took part in a heading training session involving heading a ball kicked from a distance of 30 m at least 10 m forward. Ten players performed 10 and 13 players performed 20 approved headings. The players underwent lumbar puncture and serum sampling 7-10 days after the headings. The study also included 10 healthy male non-athletic control subjects. CSF was analysed for neurofilament light protein, total tau, glial fibrillary acidic protein, S-100B and albumin concentrations. Serum was analysed for S-100B and albumin. None of the biomarker levels were abnormal and there were no significant differences between any of the three groups, except for a slightly increased CSF S-100B concentration in controls compared with headers. Biomarker levels did not correlate with the number of headings performed. Repeated low-severity head impacts due to heading in soccer are not associated with any neurochemical signs of injury to the brain.

  9. Edaravone inhibits apoptosis caused by ischemia/reperfusion injury in a porcine hepatectomy model

    Mitsugi Shimoda; Yoshimi Iwasaki; Toshie Okada; Keiichi Kubota


    AIM:To investigate the effect of E3-methyl-1-phenyl-2-pyrazolin-5-one (Edr) on hepatic ischemia-reperfusion (I/R) injury and liver regeneration in a porcine hepatectomy model.METHODS:One hour ischemia was induced by occluding the vessels and the bile duct of the right and median lobes.A 40% left hepatectomy was performed after reperfusion.Six animals received Edr (3 mg/kg per hour)intravenously and six control animals received saline just before reperfusion.Remnant liver volume,hemodynamics,aspartate aminotransferase (AST),alanine aminotransferase,lactate dehydrogenase and lactic acid,were compared between the groups.The expression of transforming growth factor-β (TGF-β1) and toll-like receptor (TRL) mRNA in hepatic tissues was examined using reverse transcription polymerase chain reaction.Apoptosis was demonstrated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining,respectively.RESULTS:Serum AST (P =0.029),and toll like receptor 4 level (P =0.043) were significantly lower after 3 hin animals receiving Edr.In addition,TUNEL staining in Edr-treated pigs showed significantly fewer hepatocytes undergoing apoptosis compared with control pigs.After mo,all factors were non-significantly different between the two groups.CONCLUSION:Edr is considered to reduce hepatic injury in the early stage of I/R injury in a porcine model.

  10. Understanding the causes and consequences of injuries to adolescents growing up in poverty in Ethiopia, Andhra Pradesh (India), Vietnam and Peru: a mixed method study.

    Morrow, Virginia; Barnett, Inka; Vujcich, Daniel


    The World Health Organization estimates that almost half of all premature deaths among 15- to 19-year olds can be attributed to injuries with most (95%) fatal injuries occurring in low- and middle-income countries. Yet the evidence base for adolescent injuries in low-income countries is poor. This article uses a mixed method approach to gain an understanding of patterns, causes and consequences of unintentional injuries among adolescents aged between 14 and 16 years in four low-income country settings. Survey data collected in 2009 in Ethiopia, India (Andhra Pradesh), Peru and Vietnam (from ~900 adolescents in each country) were integrated with qualitative research (conducted between 2007 and 2011) with a nested sample of older cohort children in Ethiopia (n = 25) and India (n = 25) using an iterative process. Logistic regression models were fitted to examine potential risk factors for injuries. Injuries were a concern for adolescents in all countries and occurred during work, recreation and sports or transportation. Being male was associated with an increased risk for all types of injuries, whereas being poor was only significantly associated with work injuries. Area of residence (urban vs rural) made a difference in some countries and for some kinds of injuries as did perceived health status. Qualitative findings highlight the consequences of injuries not only for the adolescents but also for the social and economic status of the entire household. Injury prevention programmes need to be specific to cultural and environmental settings, expectations of adolescent's responsibilities and responsive to the context of poverty.

  11. Clinical Effects of Lianbai Liquid in Prevention and Treatment of Dermal Injury Caused by Radiotherapy


    Objective: To observe the effect of Lianbai liquid (连柏液) in prevention and treatment of acute radiation dermal injury. Method: From May 2000 to December 2005, 126 cancer patients were randomly divided into a prevention group of 75 cases given externally topical application of Lianbai liquid since the first radiotherapy, and a control group Ⅰ of 51 cases given only advice after radiotherapy; while the other 92 cancer patients who had already had grade Ⅲ acute radiation-induced dermal injury were randomly divided into a treatment group of 54 cases treated by externally topical use of Lianbai liquid, and a control group Ⅱ of 38 cases treated by topical use of norfloxacin. Clinical evaluation was carried out according to the CTC.V2.0 standard stipulated by NCI for classifying acute radiation dermal injury. Results: The incidence of skin reaction was 32.0% in the prevention group and 92.2% in the control group Ⅰ, with an obvious difference between the two groups (χ2=54.163, P<0.01). Mild radioactive reaction (grade Ⅰ and Ⅱ) was 28.0% (21/75) in the prevention group and 70.6% (36/51) in the control group Ⅰ, with a remarkable difference between the two groups (χ2=22.226, P<0.01). The effective rate for grade Ⅲ dermal injury was 92.6% (50/54) in the treatment group and 65.9% (25/38) in the control group Ⅱ, with a remarkable difference between the two groups (χ2=6.018, P=0.024). The wound-healing time was 11.07±2.21 days in the treatment group and 18.08±1.76 days in the control group Ⅱ, with a remarkable difference between the two groups (u=16.932, P<0.01). Conclusion: Lianbai liquid can effectively prevent the radiation dermatitis, and treat grade Ⅲ acute radiation dermal injury with obvious curative effect.

  12. Comparison of the incidence, nature and cause of injuries sustained on dirt field and artificial turf field by amateur football players

    Kordi Ramin


    Full Text Available Abstract Background Data on the incidence, nature, severity and cause of match football injuries sustained on dirt field are scarce. The objectives of this study was to compare the incidence, nature, severity and cause of match injuries sustained on dirt field and artificial turf field by amateur male football players. Methods A prospective two-cohort design was employed. Participants were 252 male football players (mean age 27 years, range 18-43 in 14 teams who participated in a local championship carried on a dirt field and 216 male football players (mean age 28 years, range 17-40 in 12 teams who participated in a local championship carried on a artificial turf field in the same zone of the city. Injury definitions and recording procedures were compliant with the international consensus statement for epidemiological studies of injuries in football. Results The overall incidence of match injuries for men was 36.9 injuries/1000 player hours on dirt field and 19.5 on artificial turf (incidence rate ratio 1.88; 95% CI 1.19-3.05. Most common injured part on dirt field was ankle (26.7% and on artificial turf was knee (24.3%. The most common injury type in the dirt field was skin injuries (abrasion and laceration and in the artificial turf was sprain and ligament injury followed by haematoma/contusion/bruise. Most injuries were acute (artificial turf 89%, dirt field 91% and resulted from player-to-player contact (artificial turf 59.2%, dirt field 51.4%. Most injuries were slight and minimal in dirt field cohort but in artificial turf cohort the most injuries were mild. Conclusions There were differences in the incidence and type of football match injuries sustained on dirt field and artificial turf.


    杨敏; 泮葵芬; 郭云萍; 叶媛媛


    目的 观察免手技术在外科器械运用中减少锐器损伤的效果,评估免手技术预防锐器损伤的实用价值.方法 通过手术因素与锐器伤发生风险分析方法,结合实际手术过程分析和评价了免手技术对降低锐器损伤效果.结果 经观察233例使用免手技术的手术过程,发生5例锐器损伤,发生率为2.1%;观察274例未使用免手技术的手术过程,发生14例锐器损伤,发生率为5.1%.两组手术过程锐器损伤发生率比较,具有显著统计学意义.结论 免手技术的使用可降低锐器伤发生率59%,效果明显,值得推广.%Objective To observe the hands - free technology in surgical instruments to reduce the effect of sharp instrument injury, assess the practical value of hands - free technology in prevention of sharp injuries.Methods The surgical operation and the risk of sharp injuries, combined with the actual process of analysis and evaluation of surgical hands - free technology to reduce the effect of sharp instrument injuries.Results 233 patients observed using hands - free technology in surgical procedures, sharp injuries occurred in 5 cases, the occurrence rate of 2.1%.274 patients not using hands free technology in surgical procedures, the occurrence of 14 cases of sharp injuries, the rate was 5.1%.Two surgical procedures incidence of sharp injuries have significant statistical difference.Conclusion Hands - free technology can reduce the incidence of sharp injuries by 59%, the effect was worthy of promotion.

  14. [The diagnosis of the types of automobile-caused trauma by the nature of the injuries to the internal abdominal organs].

    Solokhin, A A; Tkhakakhov, A A


    A total of 307 cases of fatal car injuries with traumas of the abdominal organs are analyzed. There were three types of injuries: those caused by collision of a pedestrian with a moving car (96 cases) injuries inflicted inside a car cabin (n = 157), and inflicted by a car wheel crossing the body (n = 54). Differences in the injuries inflicted in different types of car traumas are described. The authors demonstrate the possibility of differential diagnosis of these types of traumas in cases when the circumstances of the accident are unknown. They offer a differential diagnostic table for practical use, based on their findings.

  15. Hand infections: a retrospective analysis

    Tolga Türker


    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  16. 眼外伤致眶蜂窝组织炎的护理%Nursing of Oribital Cellulitis Caused by Eye Injury

    林丽萍; 胡淑英; 陈少娜


    To sum up 20 cases of nursing Oribital cellulitis caused by eye injury and suggest that it is important fornursing to pay close attention to patient's condition, to prevent cross infection and psychological nursing and to publicizehygiene element knowledge.

  17. 职业训练模式在手外伤康复治疗的应用%Application of Occupation Training Mode in Hand Injury Rehabilitation

    王志军; 严文


      目的:观察职业训练模式治疗手外伤患者的职业康复效果。方法:将60例患者随机分为治疗组及对照组,治疗组采用职业训练模式治疗,对照组采用常规治疗,12周后进行职业康复评估及职业技能鉴定。结果:治疗组通过率为93.33%,高于对照组的46.67%(P<0.05)。结论:职业训练促进了手外伤患者再就业能力,明显优于常规临床康复治疗。%Objective:To observe rehabilitation efficacy of the treament of occupation training mode on hand trauma patients. Meth-ods: 60 patients were randomly divided into treatment group and control group, treatment group treated by occupation training mode, control group with conventional therapy. After 12 weeks there are occupation rehabilitation assessment and occupation skill appraisal. Results:In treatment group, the rate is 93.33%, higher than 46.67%in the control group (P<0.05). Conclusion:The occu-pation training has promoted the employment ability of patients with hand injury, is superior than conventional clinical rehabilitation.

  18. Indoxyl Sulfate as a Mediator Involved in Dysregulation of Pulmonary Aquaporin-5 in Acute Lung Injury Caused by Acute Kidney Injury

    Nozomi Yabuuchi


    Full Text Available High mortality of acute kidney injury (AKI is associated with acute lung injury (ALI, which is a typical complication of AKI. Although it is suggested that dysregulation of lung salt and water channels following AKI plays a pivotal role in ALI, the mechanism of its dysregulation has not been elucidated. Here, we examined the involvement of a typical oxidative stress-inducing uremic toxin, indoxyl sulfate (IS, in the dysregulation of the pulmonary predominant water channel, aquaporin 5 (AQP-5, in bilateral nephrectomy (BNx-induced AKI model rats. BNx evoked AKI with the increases in serum creatinine (SCr, blood urea nitrogen (BUN and serum IS levels and exhibited thickening of interstitial tissue in the lung. Administration of AST-120, clinically-used oral spherical adsorptive carbon beads, resulted in a significant decrease in serum IS level and thickening of interstitial tissue, which was accompanied with the decreases in IS accumulation in various tissues, especially lung. Interestingly, a significant decrease in AQP-5 expression of lung was observed in BNx rats. Moreover, the BNx-induced decrease in pulmonary AQP-5 protein expression was markedly restored by oral administration of AST-120. These results suggest that BNx-induced AKI causes dysregulation of pulmonary AQP-5 expression, in which IS could play a toxico-physiological role as a mediator involved in renopulmonary crosstalk.

  19. Old drug new trick: levamisole-adulterated cocaine causing acute kidney injury.

    Ammar, Abeer T; Livak, Mark; Witsil, Joanne C


    Levamisole is an agent previously used in humans and later withdrawn from the US drug market due to concerns of agranulocytosis.It is currently used as an adulterating agent in cocaine, bringing to light toxicities typically manifested by vasculitis and skin necrosis.We report a case of a 36-year-old crack cocaine user who presented with a purpuric rash on her face and limbs. Levamisole-induced vasculitis was suspected, and she therefore underwent an extensive work-up. In addition to these findings, she also presented with acute kidney injury of unknown etiology, which was later attributed to levamisoleadulterated cocaine.

  20. [Successful treatment of people with severe body injuries caused rabid animal bites].

    Golubović, S


    Seven patients were presented with severe injuries seeking medical help 3-10 days after being bitten by rabid animals. Just one of those subjects underwent timely and correct surgical management. Three patients were with complete, and four with incomplete antirabic prophylaxis. Two patients did not receive human rabies immunoglobulin, and another two did not receive HDC-RV vaccine. At least 3 patients were expected to develop rabies, but it did not happen. The course of these cases could be explained by the existence of less pathogenic strains of virus in Banja Luka region.

  1. Oro-facial thermal injury caused by food heated in a microwave oven.

    Wakefield, Yasha; Pemberton, Michael N


    Burns to the oral mucosa usually result from the accidental ingestion of hot food or beverages. The burns are usually of short duration and little consequence. The widespread use of microwave ovens, however, has added a new dimension to the problem. Microwave ovens heat food much quicker than a conventional oven, but they produce uneven heating within the food and extremely high temperatures can be reached. We describe two cases of patients who suffered inadvertent injury to the oral mucosa from the ingestion of microwave-heated food.

  2. Diaphragmatic injury caused by an endo-retractor during laparoscopic cholecystectomy

    Chih-Yang Hsiao


    Full Text Available Endo-retractors are convenient devices for exposure and traction during minimally invasive surgery and are widely used in laparoscopic cholecystectomy (LC. Complications associated with the use of this device are rare. We present a patient with symptomatic gallstones who underwent LC and developed a diaphragmatic laceration as a result of the inappropriate use of an endo retractor. Although the incidence of complications with endo retractors is low, this report indicates the potential risk of diaphragmatic injury while using the retractors for exposure and traction during minimally invasive surgery.

  3. Rehabilitative potential of Ayurveda for neurological deficits caused by traumatic spinal cord injury

    Sanjeev Rastogi


    Full Text Available Spinal cord injury (SCI is associated with worst outcomes and requires a prolonged rehabilitation. Ayurvedic indigenous methods of rehabilitation are often utilized to treat such conditions. A case of SCI was followed up for 3 months upon an Ayurvedic composite intervention and subsequently reported. The composite treatment plan involved Ayurvedic oral medications as well as a few selected external and internal pancha karma procedures. A substantial clinical and patient centered outcome improvement in existing neurological deficits and quality of life was observed after 3 months of the Ayurvedic treatment given to this case.

  4. Assistance of inhalation injury victims caused by fire in confined spaces: what we learned from the tragedy at Santa Maria.

    Bassi, Estevão; Miranda, Leandro Costa; Tierno, Paulo Fernando Guimarães Morando Marzocchi; Ferreira, César Biselli; Cadamuro, Filipe Matheus; Figueiredo, Viviane Rossi; Damasceno, Maria Cecilia de Toledo; Malbouisson, Luiz Marcelo Sá


    On January 2013, a disaster at Santa Maria (RS) due to a fire in a confined space caused 242 deaths, most of them by inhalation injury. On November 2013, four individuals required intensive care following smoke inhalation from a fire at the Memorial da América Latina in São Paulo (SP). The present article reports the clinical progression and management of disaster victims presenting with inhalation injury. Patients ERL and OC exhibited early respiratory failure, bronchial aspiration of carbonaceous material, and carbon monoxide poisoning. Ventilation support was performed with 100% oxygen, the aspirated material was removed by bronchoscopy, and cyanide poisoning was empirically treated with sodium nitrite and sodium thiosulfate. Patient RP initially exhibited cough and retrosternal burning and subsequently progressed to respiratory failure due to upper airway swelling and early-onset pulmonary infection, which were treated with protective ventilation and antimicrobial agents. This patient was extubated following improvement of edema on bronchoscopy. Patient MA, an asthmatic, exhibited carbon monoxide poisoning and bronchospasm and was treated with normobaric hyperoxia,bronchodilators, and corticosteroids. The length of stay in the intensive care unit varied from four to 10 days, and all four patients exhibited satisfactory functional recovery. To conclude, inhalation injury has a preponderant role in fires in confined spaces. Invasive ventilation should not be delayed in cases with significant airway swelling. Hyperoxia should be induced early asa therapeutic means against carbon monoxide poisoning, in addition to empiric pharmacological treatment in suspected cases of cyanide poisoning.

  5. The complexity of biomechanics causing primary blast-induced traumatic brain injury: a review of potential mechanisms.

    Amy eCourtney


    Full Text Available Primary blast induced traumatic brain injury (bTBI is a prevalent battlefield injury in recent conflicts, yet biomechanical mechanisms of bTBI remain unclear. Elucidating specific biomechanical mechanisms is essential to developing animal models for testing candidate therapies and for improving protective equipment. Three hypothetical mechanisms of primary bTBI have received the most attention. Because translational and rotational head accelerations are primary contributors to TBI from non-penetrating blunt force head trauma, the acceleration hypothesis suggests that blast-induced head accelerations may cause bTBI. The hypothesis of direct cranial transmission suggests that a pressure transient traverses the skull into the brain and directly injures brain tissue. The thoracic hypothesis of bTBI suggests that some combination of a pressure transient reaching the brain via the thorax and a vagally mediated reflex result in bTBI. These three mechanisms may not be mutually exclusive, and quantifying exposure thresholds (for blasts of a given duration is essential for determining which mechanisms may be contributing for a level of blast exposure. Progress has been hindered by experimental designs which do not effectively expose animal models to a single mechanism and by over-reliance on poorly validated computational models. The path forward should be predictive validation of computational models by quantitative confirmation with blast experiments in animal models, human cadavers, and biofidelic human surrogates over a range of relevant blast magnitudes and durations coupled with experimental designs which isolate a single injury mechanism.

  6. Initiation of resuscitation with high tidal volumes causes cerebral hemodynamic disturbance, brain inflammation and injury in preterm lambs.

    Graeme R Polglase

    Full Text Available AIMS: Preterm infants can be inadvertently exposed to high tidal volumes (V(T in the delivery room, causing lung inflammation and injury, but little is known about their effects on the brain. The aim of this study was to compare an initial 15 min of high V(T resuscitation strategy to a less injurious resuscitation strategy on cerebral haemodynamics, inflammation and injury. METHODS: Preterm lambs at 126 d gestation were surgically instrumented prior to receiving resuscitation with either: 1 High V(T targeting 10-12 mL/kg for the first 15 min (n = 6 or 2 a protective resuscitation strategy (Prot V(T, consisting of prophylactic surfactant, a 20 s sustained inflation and a lower initial V(T (7 mL/kg; n = 6. Both groups were subsequently ventilated with a V(T 7 mL/kg. Blood gases, arterial pressures and carotid blood flows were recorded. Cerebral blood volume and oxygenation were assessed using near infrared spectroscopy. The brain was collected for biochemical and histologic assessment of inflammation, injury, vascular extravasation, hemorrhage and oxidative injury. Unventilated controls (UVC; n = 6 were used for comparison. RESULTS: High V(T lambs had worse oxygenation and required greater ventilatory support than Prot V(T lambs. High V(T resulted in cerebral haemodynamic instability during the initial 15 min, adverse cerebral tissue oxygenation index and cerebral vasoparalysis. While both resuscitation strategies increased lung and brain inflammation and oxidative stress, High V(T resuscitation significantly amplified the effect (p = 0.014 and p<0.001. Vascular extravasation was evident in the brains of 60% of High V(T lambs, but not in UVC or Prot V(T lambs. CONCLUSION: High V(T resulted in greater cerebral haemodynamic instability, increased brain inflammation, oxidative stress and vascular extravasation than a Prot V(T strategy. The initiation of resuscitation targeting Prot V(T may reduce the severity of brain injury in preterm neonates.

  7. Antiplatelet antibody may cause delayed transfusion-related acute lung injury

    Torii Y


    Full Text Available Yoshitaro Torii1, Toshiki Shimizu1, Takashi Yokoi1, Hiroyuki Sugimoto1, Yuichi Katashiba1, Ryotaro Ozasa1, Shinya Fujita1, Yasushi Adachi2, Masahiko Maki3, Shosaku Nomura11The First Department of Internal Medicine, Kansai Medical University, Osaka, 2Department of Clinical Pathology, Toyooka Hospital, Hyogo, 3First Department of Pathology, Kansai Medical University, Osaka, JapanAbstract: A 61-year-old woman with lung cancer developed delayed transfusion-related acute lung injury (TRALI syndrome after transfusion of plasma- and leukoreduced red blood cells (RBCs for gastrointestinal bleeding due to intestinal metastasis. Acute lung injury (ALI recurred 31 days after the first ALI episode. Both ALI episodes occurred 48 hours after transfusion. Laboratory examinations revealed the presence of various antileukocyte antibodies including antiplatelet antibody in the recipient's serum but not in the donors' serum. The authors speculate that antiplatelet antibodies can have an inhibitory effect in the recipient, which can modulate the bona fide procedure of ALI and lead to a delay in the onset of ALI. This case illustrates the crucial role of a recipient's platelets in the development of TRALI.Keywords: delayed TRALI syndrome, recurrence, anti-platelet antibody

  8. A case of abdominal aortic injury caused by a traffic accident.

    Kutsukata, Noriyoshi; Mashiko, Kunihiro; Matsumoto, Hisashi; Hara, Yoshiaki; Sakamoto, Yuichiro; Takei, Kenkichi; Saito, Nobuyuki


    A 30-year-old man was injured when the large motorcycle he was riding crashed into a power pole. Upon arrival at our institution, the patient complained of abdominal pain; blood pressure at admission was 160/70 mmHg, and the heart rate was 112 bpm. Abdominal ultrasonography showed a small collection of fluid in Morrison's pouch. A chest X-ray film showed a right rib fracture. Multidetector computed tomography (MD-CT) revealed pleural effusion, a hepatic lesion, and a dissection of the abdominal aorta distal to the renal artery. Because of the complicated intraluminal injuries, the insertion of a stent graft was difficult. On the 34th day after injury, elective surgery was performed. Because dissection of the lumen was observed, the vessel was replaced with an artificial graft. Medial degeneration of the aorta wall was not observed upon pathological examination, and no degenerative disorders have occurred. The postoperative progress was favorable, and the patient was discharged from hospital.

  9. 150 bicycle injuries in children: a comparison with accidents due to other causes.

    Illingworth, C M; Noble, D; Bell, D; Kemn, I; Roche, C; Pascoe, J


    One hundred and fifty bicycle accidents seen at the Children's Hospital Sheffield over a 6-month period from mid-August 1979 were analysed and 9.3 per cent of the cases were admitted. Twenty-two per cent had fractures, 20 per cent had soft tissue injuries of face or scalp, 8 children having damaged their teeth. Of the accidents 17.3 per cent were due to hitting an obstruction, 30.7 per cent were due to loss of control on a hill or corner and 8 per cent were of mechanical origin. Eighty-eight per cent had cycling experience of a year or more, and 32.7 per cent had had previous cycling accidents. Comparison with other types of accidents previously studied at the hospital, involving skateboards, playground equipment or road traffic accidents affecting child pedestrians, showed that by far the most serious were those involving child pedestrians. The injuries from bicycle accidents were similar in severity to those involving skateboards.

  10. Untethering an unusual cause of kidney injury in a teenager with Down syndrome.

    Yen, Elizabeth; Miele, Niel F; Barone, Joseph G; Tyagi, Rachana; Weiss, Lynne S


    Acute kidney injury (AKI) is characterized by the acute nature and the inability of kidneys to maintain fluid homeostasis as well as adequate electrolyte and acid-base balance, resulting in an accumulation of nitrogenous waste and elevation of serum blood urea nitrogen and creatinine values. Acute kidney injury may be a single isolated event, yet oftentimes, it results from an acute chronic kidney disease. It is critical to seek out the etiology of AKI and to promptly manage the underlying chronic kidney disease to prevent comorbidities and mortality that may ensue. We described a case of a 16-year-old adolescent girl with Down syndrome who presented with AKI and electrolyte aberrance.Abdominal and renal ultrasounds demonstrated a significantly dilated bladder as well as frank hydronephrosis and hydroureter bilaterally. Foley catheter was successful in relieving the obstruction and improving her renal function. However, a magnetic resonance imaging was pursued in light of her chronic constipation and back pain, and it revealed a structural defect (tethered cord) that underlies a chronic process that was highly likely contributory to her AKI. She was managed accordingly with a guarded result and required long-term and close monitoring.

  11. Gunshot-like wound caused by sling shot injury – a case report

    Vinuthinee N


    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia; 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Abstract: We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic. Keywords: preseptal cellulitis, orbital roof fracture, pediatric trauma

  12. 手足口病的医院感染控制%Control of nosocomial infections caused by hand foot and mouth disease

    李星; 蔡水仙; 林慧卿


    目的 预防和控制手足口病(HFMD)引起的医院感染或感染的暴发流行.方法 严格执行消毒隔离制度,医护人员实行标准预防,加强手卫生管理,对手足口病患儿和陪护人员进行积极的健康教育.结果 2010年4-10月共收治手足口病患儿217例,均治愈出院,无医院感染病例发生.结论 采取有效的消毒隔离措施,是控制手足口病医院感染的关键.%OBJECTIVE To prevent and control the outbreak and prevalence of nosocomial infections caused by hand foot and mouth disease ( HFMD). METHODS Strict disinfection and isolation system was implemented, the medical staffs were required for standard prevention, the management of hand hygiene was strengthened, health education was actively conducted for HFMD children and the accompanying staffs. RESULTS All the 217 children with HFMD enrolled for treatment from Apr. to Oct. 2010 were cured and discharged, no nosocomial infections occurred. CONCLUSION Adopting effective disinfection and isolation measures is a key to control nosocomial infections due to HFMD.

  13. Liver manipulation causes hepatocyte injury and precedes systemic inflammation in patients undergoing liver resection.

    Poll, M.C. van de; Derikx, J.P.M.; Buurman, W.A.; Peters, W.H.M.; Roelofs, H.M.J.; Wigmore, S.J.; Dejong, C.H.


    BACKGROUND: Liver failure following liver surgery is caused by an insufficient functioning remnant cell mass. This can be due to insufficient liver volume and can be aggravated by additional cell death during or after surgery. The aim of this study was to elucidate the causes of hepatocellular injur

  14. The epidemiological study on industrial hand injuries in Qinpu area of Shanghai%上海市青浦区工业性手外伤流行病学研究

    傅阳; 潘福根; 叶作舟; 吴晓天


    目的 调查上海市青浦区工业性手外伤流行病学特征.方法 对2 152例工业性手外伤病例进行回顾性统计和分析.结果 工业性手外伤发生的高危人群是20~50岁的青壮年,男性为主.每年3,4月份及7,8月份为事故高发期,而每天12-18时为事故好发时间.切割伤和轧砸伤是主要损伤类型,食、拇指较易受伤.设备条件差、缺少防护装置和人为因素是致伤的主因,个体私营企业是事故高发单位.结论 人为因素、安全培训和保护及事故好发单位是手外伤发生的三要素,针对其发病特征,制定预防措施,可降低发病率.%Objective To illustrate the possible risk factors of industrial hand injuries through analyzing the epidemiological characteristics in 2009~2010 in Qinpu Area of Shanghai. Methods A questionnaire investigation was carried out on 2 152 cases of industrial hand injuries. Results Males of 20~50 years old were in critical danger of industrial hand injury. In March, April, July and August of every year as well as on 12 to 18 o'clock of every day, the industrial hand injury significandy increases. Cutting and extruding were main injury type, index and thumb fingers were easy to be wounded. Majority of hand injuries resulted from the bad equipments condition and the lack of protection device and artificial factors. The incidence in private -owned enterprises was higher. Conclusion It is the three factors of hand injury, induding artificial factor, safety training and protection and the accident occurred unit. So drawing up synthesized preventive measures can reduce the morbidity.

  15. The influence of hand positions on biomechanical injury risk factors at the wrist joint during the round-off skills in female gymnastics.

    Farana, Roman; Jandacka, Daniel; Uchytil, Jaroslav; Zahradnik, David; Irwin, Gareth


    The aim of this study was to examine the biomechanical injury risk factors at the wrist, including joint kinetics, kinematics and stiffness in the first and second contact limb for parallel and T-shape round-off (RO) techniques. Seven international-level female gymnasts performed 10 trials of the RO to back handspring with parallel and T-shape hand positions. Synchronised kinematic (3D motion analysis system; 247 Hz) and kinetic (two force plates; 1235 Hz) data were collected for each trial. A two-way repeated measure analysis of variance (ANOVA) assessed differences in the kinematic and kinetic parameters between the techniques for each contact limb. The main findings highlighted that in both the RO techniques, the second contact limb wrist joint is exposed to higher mechanical loads than the first contact limb demonstrated by increased axial compression force and loading rate. In the parallel technique, the second contact limb wrist joint is exposed to higher axial compression load. Differences between wrist joint kinetics highlight that the T-shape technique may potentially lead to reducing these bio-physical loads and consequently protect the second contact limb wrist joint from overload and biological failure. Highlighting the biomechanical risk factors facilitates the process of technique selection making more objective and safe.

  16. Minister's shaky hands cause uproar


    Läti Sõltumatu Televisioon ja ajakiri Latvijas Avize on arvustanud Läti kaitseministri Atis Slakterise kohmakust ja närvilisust Iraagist naasnud sõdurite autasustamisel, kahtlustades ministril alkohoolset joovet

  17. Minister's shaky hands cause uproar


    Läti Sõltumatu Televisioon ja ajakiri Latvijas Avize on arvustanud Läti kaitseministri Atis Slakterise kohmakust ja närvilisust Iraagist naasnud sõdurite autasustamisel, kahtlustades ministril alkohoolset joovet

  18. Mechanical eye injuries in children aged 0-15 years treated at the Clinic of Eye Diseases in Belgrade: Frequency, causes and preventive measures

    Jovanović Miloš


    Full Text Available Introduction. Eye injuries represent a significant problem in children. Objective. The aim of the study was to determine the incidence and causes of the eye injury and to propose measures of the eye injury prevention in children up to 15 years of age. Methods. This was a retrospective study of 552 children with the eye injuries treated at the Clinic of Eye Diseases in Belgrade during the period March 1999 to February 2010. Gender and age of the children, time of injury, the type and site of injuries, visual acuity upon admission and at discharge, as well as the time of surgery in relation to time of injury were analyzed. Results. The ratio between the injured boys and girls was 3.6:1. The highest percentage of injured children was in the group 6-10 years old (39.7%; the injuries were almost evenly distributed according to months during the year and days during the week. The percentages of severe closed and open injuries of the eyeball were almost equal. Visual acuity upon discharge and subsequent follow-up examinations were significantly improved after the applied treatment in comparison with the visual acuity upon admission. Conclusion. Eye injuries in children still represent a severe health problem. Regarding the youngest age group of children, adults are mainly responsible for these injuries due to their lack of attention, while in older children these injuries are the result of the production and distribution of inappropriate toys and a failure to implement the legal traffic regulations applicable to children. The prevention of eye injuries is essential.

  19. Blunt abdominal trauma with handlebar injury: A rare cause of traumatic amputation of the appendix associated with acute appendicitis

    Amanda Jensen


    Full Text Available We describe traumatic appendicitis in a 7-year-old boy who presented after sustaining blunt abdominal trauma to his right lower abdomen secondary to bicycle handlebar injury. With diffuse abdominal pain following injury, he was admitted for observation. Computed axial tomography (CT obtained at an outside hospital demonstrated moderate stranding of the abdomen in the right lower quadrant. The CT was non-contrasted and therefore significant appendiceal distention could not be confirmed. However, there was a calcified structure in the right pelvis with trace amount of free fluid. Patient was observed with conservative management and over the course of 15 h his abdominal pain continued to intensify. With his worsening symptoms, we elected to take him for diagnostic laparoscopy. In the operating room we found an inflamed traumatically amputated appendix with the mesoappendix intact. We therefore proceeded with laparoscopic appendectomy. Pathology demonstrated acute appendicitis with fecalith. It was unclear as to whether the patient's appendicitis and perforation were secondary to fecalith obstruction, his blunt abdominal trauma or if they concurrently caused his appendicitis. Acute appendicitis is a common acute surgical condition in the pediatric population and continues to be a rare and unique cause of operative intervention in the trauma population.

  20. Pre-existing interleukin 10 in cerebral arteries attenuates subsequent brain injury caused by ischemia/reperfusion.

    Liang, Qiu-Juan; Jiang, Mei; Wang, Xin-Hong; Le, Li-Li; Xiang, Meng; Sun, Ning; Meng, Dan; Chen, Si-Feng


    Recurrent stroke is difficult to treat and life threatening. Transfer of anti-inflammatory gene is a potential gene therapy strategy for ischemic stroke. Using recombinant adeno-associated viral vector 1 (rAAV1)-mediated interleukin 10 (IL-10), we investigated whether transfer of beneficial gene into the rat cerebral vessels during interventional treatment for initial stroke could attenuate brain injury caused by recurrent stroke. Male Wistar rats were administered rAAV1-IL-10, rAAV1-YFP, or saline into the left cerebral artery. Three weeks after gene transfer, rats were subjected to occlusion of the left middle cerebral artery (MCAO) for 45 min followed by reperfusion for 24 h. IL-10 levels in serum were significantly elevated 3 weeks after rAAV1-IL-10 injection, and virus in the cerebral vessels was confirmed by in situ hybridization. Pre-existing IL-10 but not YFP decreased the neurological dysfunction scores, brain infarction volume, and the number of injured neuronal cells. AAV1-IL-10 transduction increased heme oxygenase (HO-1) mRNA and protein levels in the infarct boundary zone of the brain. Thus, transduction of the IL-10 gene in the cerebral artery prior to ischemia attenuates brain injury caused by ischemia/reperfusion in rats. This preventive approach for recurrent stroke can be achieved during interventional treatment for initial stroke.

  1. Analysis of sports related mTBI injuries caused by elastic wave propagation through brain tissue

    D Case


    Full Text Available Repetitive concussions and sub-concussions suffered by athletes have been linked to a series of sequelae ranging from traumatic encephalopathy to dementia pugilistica. A detailed finite element model of the human head was developed based on standard libraries of medical imaging. The model includes realistic material properties for the brain tissue, bone, soft tissue, and CSF, as well as the structure and properties of a protective helmet. Various impact scenarios were studied, with a focus on the strains/stresses and pressure gradients and concentrations created in the brain tissue due to propagation of waves produced by the impact through the complex internal structure of the human head. This approach has the potential to expand our understanding of the mechanism of brain injury, and to better assess the risk of delayed neurological disorders for tens of thousands of young athletes throughout the world.

  2. Involvement of Oxidative Stress and Inflammation in Liver Injury Caused by Perfluorooctanoic Acid Exposure in Mice

    Bei Yang


    Full Text Available Perfluorooctanoic acid (PFOA is widely present in the environment and has been reported to induce hepatic toxicity in animals and humans. In this study, mice were orally administered different concentrations of PFOA (2.5, 5, or 10 mg/kg/day. Histological examination showed that the exposure to PFOA for 14 consecutive days led to serious hepatocellular injury and obvious inflammatory cell infiltration. In addition, malondialdehyde formation and hydrogen peroxide generation, indicators of oxidative stress, were significantly induced by PFOA treatment in the liver of mice. Furthermore, hepatic levels of interleukin-6, cyclooxygenase-2, and C-reactive protein, markers of inflammatory response, were markedly increased by exposure to PFOA in mice. These results demonstrated that PFOA-induced hepatic toxicity may be involved in oxidative stress and inflammatory response in mice.

  3. Hantavirus: an infectious cause of acute kidney injury in the UK.

    Adams, Kate; Jameson, Lisa; Meigh, Rolf; Brooks, Tim


    We present a case of an undifferentiated febrile illness in a 59-year-old man from East Yorkshire. He was initially treated for leptospirosis due to the fact that he had farm exposure and the findings of acute kidney injury (AKI), thrombocytopenia and a raised alanine transferase (ALT) on his initial blood results. Serology tests later proved him to have had another rodent-borne illness: hantavirus. An investigation by Public Health England (formerly known as Health Protection Agency) (PHE) went on to prove the presence of the same serotype of hantavirus in rats caught on the patient's property. After an initial deterioration, the patient made a relatively uneventful recovery and all his blood tests returned to normal levels.

  4. Alternative causes of hypopituitarism: traumatic brain injury, cranial irradiation, and infections.

    Pekic, Sandra; Popovic, Vera


    Hypopituitarism often remains unrecognized due to subtle clinical manifestations. Anterior pituitary hormone deficiencies may present as isolated or multiple and may be transient or permanent. Traumatic brain injury (TBI) is recognized as a risk factor for hypopituitarism, most frequently presenting with isolated growth hormone deficiency (GHD). Data analysis shows that about 15% of patients with TBI have some degree of hypopituitarism which if not recognized may be mistakenly ascribed to persistent neurologic injury and cognitive impairment. Identification of predictors for hypopituitarism after TBI is important, one of them being the severity of TBI. The mechanisms involve lesions in the hypothalamic-pituitary axis and inflammatory changes in the central nervous system (CNS). With time, hypopituitarism after TBI may progress or reverse. Cranial irradiation is another important risk factor for hypopituitarism. Deficiencies in anterior pituitary hormone secretion (partial or complete) occur following radiation damage to the hypothalamic-pituitary region, the severity and frequency of which correlate with the total radiation dose delivered to the region and the length of follow-up. These radiation-induced hormone deficiencies are irreversible and progressive. Despite numerous case reports, the incidence of hypothalamic-pituitary dysfunction following infectious diseases of the CNS has been underestimated. Hypopituitarism usually relates to the severity of the disease, type of causative agent (bacterial, TBC, fungal, or viral) and primary localization of the infection. Unrecognized hypopituitarism may be misdiagnosed as postencephalitic syndrome, while the presence of a sellar mass with suprasellar extension may be misdiagnosed as pituitary macroadenoma in a patient with pituitary abscess which is potentially a life-threatening disease.

  5. Inflammatory responses are not sufficient to cause delayed neuronal death in ATP-induced acute brain injury.

    Hey-Kyeong Jeong

    Full Text Available BACKGROUND: Brain inflammation is accompanied by brain injury. However, it is controversial whether inflammatory responses are harmful or beneficial to neurons. Because many studies have been performed using cultured microglia and neurons, it has not been possible to assess the influence of multiple cell types and diverse factors that dynamically and continuously change in vivo. Furthermore, behavior of microglia and other inflammatory cells could have been overlooked since most studies have focused on neuronal death. Therefore, it is essential to analyze the precise roles of microglia and brain inflammation in the injured brain, and determine their contribution to neuronal damage in vivo from the onset of injury. METHODS AND FINDINGS: Acute neuronal damage was induced by stereotaxic injection of ATP into the substantia nigra pars compacta (SNpc and the cortex of the rat brain. Inflammatory responses and their effects on neuronal damage were investigated by immunohistochemistry, electron microscopy, quantitative RT-PCR, and stereological counting, etc. ATP acutely caused death of microglia as well as neurons in a similar area within 3 h. We defined as the core region the area where both TH(+ and Iba-1(+ cells acutely died, and as the penumbra the area surrounding the core where Iba-1(+ cells showed activated morphology. In the penumbra region, morphologically activated microglia arranged around the injury sites. Monocytes filled the damaged core after neurons and microglia died. Interestingly, neither activated microglia nor monocytes expressed iNOS, a major neurotoxic inflammatory mediator. Monocytes rather expressed CD68, a marker of phagocytic activity. Importantly, the total number of dopaminergic neurons in the SNpc at 3 h (∼80% of that in the contralateral side did not decrease further at 7 d. Similarly, in the cortex, ATP-induced neuron-damage area detected at 3 h did not increase for up to 7 d. CONCLUSIONS: Different cellular

  6. Clinical analysis of ocular injuries caused by bee sting%蜂螫伤眼病例临床分析

    徐海萍; 於水清; 张志勇


    Objective To investigate the clinical feature,treatment and pathogenesis of ocular injuries caused by bee sting.Methods Retrospective study on the 25 eyes of 20 patients harmed by bee sting.Results The clinical feature of the patients suffered from bee sting included tissue edema,corneal epithelium defect,iridocyclitis,secondary glaucoma,cataract and optic neuritis.The vision was recovered after immediate removal of the stinger,and the application of corticosteroids,antihistamines and neurotrophic drugs.Nonenzymatic polypeptide toxins and enzymes in bee venom caused severe toxic effect and hypersensitivity reaction might be the main pathogenesis of ocular injuries caused by bee sting.Conclusion Bee stings can cause the injury of ocular tissues.Removal of the stinger,and application of steroids,antihistamines,and neurotrophic drugs are effective treatments for bee stings.%目的 探讨蜂螫伤的临床表现、治疗方法以及致病机制.方法 回顾性分析我院就诊的蜂螫伤21例(25眼)的临床资料.结果 患者的临床表现主要为组织水肿,角膜上皮缺损,虹膜睫状体炎,继发性青光眼,白内障,视神经炎.通过去除蜂螫刺,应用糖皮质激素、抗组胺药及神经营养药,大部分患者的视力基本恢复.蜂毒中的非酶多肽类毒素产生的直接毒性作用和酶类引起的超敏变态反应可能是致病的主要因素.结论 蜂螫伤可以产生明显的眼组织损伤,去除蜂的螫刺以及应用糖皮质激素,抗组胺药,神经营养药是有效治疗方法.

  7. Eye injury caused by dendrolimus poisonous hair%松毛虫毒毛致眼外伤

    田敏; 吕红彬


    Objective To investigate the clinical characteristics,diagnosis and treatment for eye injury caused by dendmlimus poisonous hair.Methods One case of eye injury caused by dendrolimus poisonous hair was analyzed,and the literature was reviewed.Results The dendrolimus poisonous hairs were removed from the patient' s cornea and anterior chamber.The antiallergic drugs,corticosteroid,antibiotics and corneal epithelial healing medication were applied.After treatment,the vision recovered to normal and the cornea epithelium was repaired.There was no poisonous hair deposited in anterior chamber.The aqueous flare was negative and papillary light reaction was prompt.Conclusion Eye injuries caused by dendrolimus poisonous hair has been featured with severe corneal edema and chemosis,complicated with iritis,endophthalmitis,which would cause vision impairment.The dendrolimus poisonous hair is very fine,which is difficult to be removed.Early removal and timely treatment is crucial for visual recovery.%目的 探讨松毛虫毒毛刺伤眼部的临床特点、诊断及规范化治疗.方法 结合1例松毛虫毒毛致眼外伤的临床资料复习相关文献.结果 患者行右眼角膜、前房毒毛摘出术后,予以抗过敏药物、糖皮质激素、抗生素及促进角膜上皮修复类药物治疗.患者右眼视力恢复正常,角膜上皮修复,前房内无毒毛,房水闪光(-),瞳孔对光反应灵敏.结论 松毛虫毒毛引起的角结膜病变水肿较重,毛刺短小难以被检查出,且毒毛有引起虹膜炎、眼内炎,严重者失明的可能.因此应及早诊断,适时及使用正确的方法摘出异物,以保护眼球,保持和恢复视力.

  8. Patterns of Pediatric Maxillofacial Injuries.

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha


    Facial trauma in children and adolescents is reported to range from 1% to 30%. Because of many anatomical, physiological, and psychological characteristics of the pediatric population, maxillofacial injuries in children should be treated with special consideration that is attributable to certain features inherent in facial growth patterns of children. This study evaluated maxillofacial injuries in 726 children in terms of incidence, patterns of injury, causes, and treatment modalities and compared these parameters among 3 pediatric age groups. Intergroup differences were analyzed using Z test for 2 populations' proportion. The results showed that the incidence of pediatric maxillofacial injuries and fractures is higher than that reported elsewhere with male predominance. Soft tissue injuries are more frequently encountered in younger individuals, whereas the incidence of skeletal injuries increases with age. This study also revealed that certain etiologies, namely road traffic accidents, violence, bicycle, missiles, and industrial injures, increase with age; on the other hand, falls and puncture wounds are more common in younger children.

  9. The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.

    D'Angelo, Kevin; Sutton, Deborah; Côté, Pierre; Dion, Sarah; Wong, Jessica J; Yu, Hainan; Randhawa, Kristi; Southerst, Danielle; Varatharajan, Sharanya; Cox Dresser, Jocelyn; Brown, Courtney; Menta, Roger; Nordin, Margareta; Shearer, Heather M; Ameis, Arthur; Stupar, Maja; Carroll, Linda J; Taylor-Vaisey, Anne


    The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand. We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles. We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the

  10. High fluid shear strain causes injury in silver shark: Preliminary implications for Mekong hydropower turbine design

    Baumgartner, L. J. [New South Wales Department of Primary Industries, Narrandera Fisheries Centre, Narrandera NSW Australia; Institute of Land, Water and Society, Charles Sturt University, Albury NSW Australia; Thorncraft, G. [Faculty of Agriculture, Forestry and Fisheries, National University of Laos, Vientiane Lao People’s Democratic Republic; Phonekhampheng, O. [Faculty of Agriculture, Forestry and Fisheries, National University of Laos, Vientiane Lao People’s Democratic Republic; Boys, C. [New South Wales Department of Primary Industries, Port Stephens Fisheries Institute, Nelson Bay NSW Australia; Navarro, A. [Institute of Land, Water and Society, Charles Sturt University, Albury NSW Australia; Robinson, W. [Institute of Land, Water and Society, Charles Sturt University, Albury NSW Australia; Brown, R. [Pacific Northwest National Laboratory, Richland WA USA; Deng, Z. D. [Pacific Northwest National Laboratory, Richland WA USA


    Fluid shear arises when two bodies of water, travelling at different velocities, intersect. Fish entrained at the interface of these two water masses will experience shear stress; which can be harmful. The stress magnitude is dependent on waterbody mass and velocity; with the fish impact largely related to body size. Elevated shear stress occurs where rapidly flowing water passes near spillways, across screens, within turbine draft tubes or other passage routes. A flume was used to determine critical tolerances of silver shark (Balantiocheilos melanopterus) to different shear stress rates generated by a high velocity jet. Fish experienced higher levels of injury and mortality as shear stress was increased. Excessive shear forces had damaging impacts on fish. Mortality occurred at shear levels higher that 600/s. It is important that developers should attempt to model potential shear profiles expected during turbine passage in selected designs. These data will be critical to determine potential impacts on fish. If the likelihood of adverse impact is high, then alternative designs which have lower shear stress could be explored.

  11. O2 free radicals: cause of ischemia-reperfusion injury to cardiac Na+-K+-ATPase

    Kim, M.S.; Akera, T.


    The role of O2 free radicals in the reduction of sarcolemmal Na+-K+-ATPase, which occurs during reperfusion of ischemic heart, was examined in isolated guinea pig heart using exogenous scavengers of O2 radicals and an inhibitor of xanthine oxidase. Ischemia and reperfusion reduced Na+-K+-ATPase activity and specific (3H)ouabain binding to the enzyme in ventricular muscle homogenates and also markedly lowered sodium pump activity estimated from ouabain-sensitive 86Rb+ uptake by ventricular muscle slices. These effects of ischemia and reperfusion were prevented to various degrees by O2-radical scavengers, such as superoxide dismutase, catalase, dimethyl-sulfoxide, histidine, or vitamin E or by the xanthine oxidase inhibitor, allopurinol. The degree of protection afforded by these agents paralleled that of reduction in enhanced lipid peroxidation of myocardial tissue as estimated from malondialdehyde production. These results strongly suggest that O2 radicals play a crucial role in the injury to sarcolemmal Na+-K+-ATPase during reperfusion of ischemic heart.

  12. Drug-Induced Liver Injury Caused by Adalimumab: A Case Report and Review of the Bibliography

    Bernardo Frider


    Full Text Available The most serious adverse drug reaction of adalimumab (ADR is tuberculosis reactivation. We describe a case of a 35-year-old man, with rheumatoid arthritis (RA and hepatitis C virus genotype 1a with a liver biopsy in 2001 with a METAVIR score pattern A1 F0; he received interferon alpha 2b for six months, but treatment was suspended because of reactivation of RA. Liver function tests after treatment were similar to previous ones showing a minimal cholestatic pattern. In 2008, methotrexate was prescribed, but the drug was withdrawn at the third month because of the appearance of pruritus and Ggt rise. Viral load at that moment was 9300000 UI/mL, log 6,9. The liver biopsy showed a Metavir Score A2 F1. Adalimumab was started in 2010, and at the third month of treatment, Ggt showed a rise of 23 times normal value (NV, alkaline phosphatase 2,5 times NV with AST and ALT with no change. A new liver biopsy showed portal inflammation with eosinophils and a METAVIR A1 F2. We think that adalimumab appears to be responsible for the liver injury, because of temporal relationship, liver biopsy findings, other clinical conditions being discarded, and the improvement of clinical symptoms and biochemical abnormalities when adalimumab was suspended.

  13. The Acute Liver Injury in Mice Caused by Nano-Anatase TiO2

    Ma, Linglan; Zhao, Jinfang; Wang, Jue; Liu, Jie; Duan, Yanmei; Liu, Huiting; Li, Na; Yan, Jingying; Ruan, Jie; Wang, Han; Hong, Fashui


    Although it is known that nano-TiO2 or other nanoparticles can induce liver toxicities, the mechanisms and the molecular pathogenesis are still unclear. In this study, nano-anatase TiO2 (5 nm) was injected into the abdominal cavity of ICR mice for consecutive 14 days, and the inflammatory responses of liver of mice was investigated. The results showed the obvious titanium accumulation in liver DNA, histopathological changes and hepatocytes apoptosis of mice liver, and the liver function damaged by higher doses nano-anatase TiO2. The real-time quantitative RT-PCR and ELISA analyses showed that nano-anatase TiO2 can significantly alter the mRNA and protein expressions of several inflammatory cytokines, including nucleic factor-κB, macrophage migration inhibitory factor, tumor necrosis factor-α, interleukin-6, interleukin-1β, cross-reaction protein, interleukin-4, and interleukin-10. Our results also implied that the inflammatory responses and liver injury may be involved in nano-anatase TiO2-induced liver toxicity.

  14. Metabolomic Characterizations of Liver Injury Caused by Acute Arsenic Toxicity in Zebrafish.

    Caixia Li

    Full Text Available Arsenic is one of the most common metalloid contaminants in groundwater and it has both acute and chronic toxicity affecting multiple organs. Details of the mechanism of arsenic toxicity are still lacking and profile studies at metabolic level are very limited. Using gas chromatography coupled with mass spectroscopy (GC/MS, we first generated metabolomic profiles from the livers of arsenic-treated zebrafish and identified 34 significantly altered metabolite peaks as potential markers, including four prominent ones: cholic acid, glycylglycine, glycine and hypotaurine. Combined results from GC/MS, histological examination and pathway analyses suggested a series of alterations, including apoptosis, glycogenolysis, changes in amino acid metabolism and fatty acid composition, accumulation of bile acids and fats, and disturbance in glycolysis related energy metabolism. The alterations in glycolysis partially resemble Warburg effect commonly observed in many cancer cells. However, cellular damages were not reflected in two conventional liver function tests performed, Bilirubin assay and alanine aminotransferase (ALT assay, probably because the short arsenate exposure was insufficient to induce detectable damage. This study demonstrated that metabolic changes could reflect mild liver impairments induced by arsenic exposure, which underscored their potential in reporting early liver injury.

  15. Rare causes of closed rupture of the flexor tendon

    Stenekes, Martin W.; Ruttermann, Mike; Werker, Paul M. N.

    Closed injuries to the flexor tendon are relatively rare. We present three rare causes of closed injury to the flexor tendon. Early recognition and adequate treatment by a specialised hand surgeon are crucial for the prognosis of such cases. Delayed diagnosis and treatment often require secondary

  16. Rare causes of closed rupture of the flexor tendon

    Stenekes, Martin W.; Ruttermann, Mike; Werker, Paul M. N.


    Closed injuries to the flexor tendon are relatively rare. We present three rare causes of closed injury to the flexor tendon. Early recognition and adequate treatment by a specialised hand surgeon are crucial for the prognosis of such cases. Delayed diagnosis and treatment often require secondary re

  17. Mechanism of blood-brain barrier impairment after mild traumatic brain injury caused by blast shock waves and its relationship with delayed nerve dysfunction

    Zhao-xi XU


    Full Text Available Mild traumatic brain injury (mTBI caused by blast shock waves (BSWs is one of the most common injuries among soldiers in the war. Such mTBI can also happen in civilians if exposed to shock waves of accidental explosion disasters, bomb attacks by terrorists and so on. This injury often results in cognitive problems, memory dysfunction and emotional disorder, and these neurological deficits are closely related to the dysfunction or disruption of the blood-brain barrier (BBB. The present paper discusses mainly the relationship between dysfunction or disruption of BBB and inflammatory reaction in mild brain injury associated with explosive shock wave and effects of early intervention of oxidative stress injury, repairing the BBB and blocking inflammation on relieving delayed neurological deficits. DOI: 10.11855/j.issn.0577-7402.2016.05.15

  18. The Macrophage Is a Key Factor in Renal Injuries Caused by Glomerular Hyperfiltration



    Full Text Available Glomerular hyperfiltration is a common pathway leading to glomerulosclerosis in various kinds of kidney diseases. The 5/6 renal ablation is an established experimental animal model for glomerular hyperfiltration. On the other hand, low-grade inflammation is also a common mechanism for the progression of kidney diseases including diabetic nephropathy and atherosclerosis. Here we analyzed the gene expression profile in the remnant kidney tissues of 5/6 nephrectomized mice using a DNA microarray system and compared it with that of sham-operated control mice. The 5/6 nephrectomized mice showed glomerular hypertrophy and an increase in the extracellular matrix in the glomeruli. DNA microarray analysis indicated the up-regulated expression of various kinds of genes related to the inflammatory process in remnant kidneys. We confirmed the up-regulated expression of platelet factor-4, and monocyte chemoattractant protein-1, 2, and 5 in remnant kidneys by RT-PCR. The current results suggest that the inflammatory process is involved in the progression of glomerulosclerosis and is a common pathway of the pathogenesis of kidney disease.

  19. Advanced fiber tracking in early acquired brain injury causing cerebral palsy.

    Lennartsson, F; Holmström, L; Eliasson, A-C; Flodmark, O; Forssberg, H; Tournier, J-D; Vollmer, B


    Diffusion-weighted MR imaging and fiber tractography can be used to investigate alterations in white matter tracts in patients with early acquired brain lesions and cerebral palsy. Most existing studies have used diffusion tensor tractography, which is limited in areas of complex fiber structures or pathologic processes. We explored a combined normalization and probabilistic fiber-tracking method for more realistic fiber tractography in this patient group. This cross-sectional study included 17 children with unilateral cerebral palsy and 24 typically developing controls. DWI data were collected at 1.5T (45 directions, b=1000 s/mm(2)). Regions of interest were defined on a study-specific fractional anisotropy template and mapped onto subjects for fiber tracking. Probabilistic fiber tracking of the corticospinal tract and thalamic projections to the somatosensory cortex was performed by using constrained spherical deconvolution. Tracts were qualitatively assessed, and DTI parameters were extracted close to and distant from lesions and compared between groups. The corticospinal tract and thalamic projections to the somatosensory cortex were realistically reconstructed in both groups. Structural changes to tracts were seen in the cerebral palsy group and included splits, dislocations, compaction of the tracts, or failure to delineate the tract and were associated with underlying pathology seen on conventional MR imaging. Comparisons of DTI parameters indicated primary and secondary neurodegeneration along the corticospinal tract. Corticospinal tract and thalamic projections to the somatosensory cortex showed dissimilarities in both structural changes and DTI parameters. Our proposed method offers a sensitive means to explore alterations in WM tracts to further understand pathophysiologic changes following early acquired brain injury. © 2015 by American Journal of Neuroradiology.

  20. Heme oxygenase-1 expression protects the heart from acute injury caused by inducible Cre recombinase.

    Hull, Travis D; Bolisetty, Subhashini; DeAlmeida, Angela C; Litovsky, Silvio H; Prabhu, Sumanth D; Agarwal, Anupam; George, James F


    The protective effect of heme oxygenase-1 (HO-1) expression in cardiovascular disease has been previously demonstrated using transgenic animal models in which HO-1 is constitutively overexpressed in the heart. However, the temporal requirements for protection by HO-1 induction relative to injury have not been investigated, but are essential to employ HO-1 as a therapeutic strategy in human cardiovascular disease states. Therefore, we generated mice with cardiac-specific, tamoxifen (TAM)-inducible overexpression of a human HO-1 (hHO-1) transgene (myosin heavy chain (MHC)-HO-1 mice) by breeding mice with cardiac-specific expression of a TAM-inducible Cre recombinase (MHC-Cre mice), with mice containing an hHO-1 transgene preceded by a floxed-stop signal. MHC-HO-1 mice overexpress HO-1 mRNA and the enzymatically active protein following TAM administration (40 mg/kg body weight on 2 consecutive days). In MHC-Cre controls, TAM administration leads to severe, acute cardiac toxicity, cardiomyocyte necrosis, and 80% mortality by day 3. This cardiac toxicity is accompanied by a significant increase in inflammatory cells in the heart that are predominantly neutrophils. In MHC-HO-1 mice, HO-1 overexpression ameliorates the depression of cardiac function and high mortality rate observed in MHC-Cre mice following TAM administration and attenuates cardiomyocyte necrosis and neutrophil infiltration. These results highlight that HO-1 induction is sufficient to prevent the depression of cardiac function observed in mice with TAM-inducible Cre recombinase expression by protecting the heart from necrosis and neutrophil infiltration. These findings are important because MHC-Cre mice are widely used in cardiovascular research despite the limitations imposed by Cre-induced cardiac toxicity, and also because inflammation is an important pathological component of many human cardiovascular diseases.

  1. Microparticles generated by decompression stress cause central nervous system injury manifested as neurohypophysial terminal action potential broadening.

    Yang, Ming; Kosterin, Paul; Salzberg, Brian M; Milovanova, Tatyana N; Bhopale, Veena M; Thom, Stephen R


    The study goal was to use membrane voltage changes during neurohypophysial action potential (AP) propagation as an index of nerve function to evaluate the role that circulating microparticles (MPs) play in causing central nervous system injury in response to decompression stress in a murine model. Mice studied 1 h following decompression from 790 kPa air pressure for 2 h exhibit a 45% broadening of the neurohypophysial AP. Broadening did not occur if mice were injected with the MP lytic agent polyethylene glycol telomere B immediately after decompression, were rendered thrombocytopenic, or were treated with an inhibitor of nitric oxide synthase-2 (iNOS) prior to decompression, or in knockout (KO) mice lacking myeloperoxidase or iNOS. If MPs were harvested from control (no decompression) mice and injected into naive mice, no AP broadening occurred, but AP broadening was observed with injections of equal numbers of MPs from either wild-type or iNOS KO mice subjected to decompression stress. Although not required for AP broadening, MPs from decompressed mice, but not control mice, exhibit NADPH oxidase activation. We conclude that inherent differences in MPs from decompressed mice, rather than elevated MPs numbers, mediate neurological injury and that a component of the perivascular response to MPs involves iNOS. Additional study is needed to determine the mechanism of AP broadening and also mechanisms for MP generation associated with exposure to elevated gas pressure.

  2. [Spinal cord injuries caused by extraspinal gunshot. A historical, experimental and therapeutic approach].

    Jourdan, P; Breteau, J P; Volff, P


    A careful study of all clinical observations reported by various authors during one century teaches us that spinal cord wounds caused by a missile path away from the spine have always had vague and mysterious mechanisms. We have simulate shots near the cervical spine included in gelatin and we have shot at pigs weighing 100 kilograms, previously anaesthetized and bio-instrumented according to J. Breteau methodology. So, we have been able to reproduce medullary wounds by shooting in the nape of the neck, away from the cervical spine. The knowledge of all mechanisms of balistic wounds, the analysis of the results obtained and a histological examination of wounded medulla leads us to the conclusion that this type of medullary wound distance from the spinal cord, is not specific and that, in fact, the missile causes an ordinary medullary contusion. While waiting for forthcoming medicinal progress, a management of treatment is suggested.

  3. [Early functional passive mobilization of flexor tendon injuries of the hand (zone 2) : Exercise with an exoskeleton compared to physical therapy].

    Gülke, Joachim; Mentzel, Martin; Krischak, Gert; Gulkin, David; Dornacher, Daniel; Wachter, Nikolaus


    These days there are different types of aftercare following flexor tendon injury. Patients in this study received a dynamic Kleinert protocol and additionally two different postoperative treatments. Both treatment groups were compared to each other and results were put into perspective when compared to other treatment options. Sixty-two patients presenting with clean lesions of the two flexor tendons in zone 2 received postoperative treatment with a dynamic Kleinert protocol. Patients were randomly divided into either Group I (physical therapy) or Group II (exoskeleton). Range of motion was assessed after 6, 12 and 18 weeks. In addition, we measured the Strickland score and grip strength at the 18-week follow-up. DASH scores were obtained at weeks 12 and 18. Regardless of the received postoperative treatment, range of motion was predominantly limited in the proximal interphalangeal and distal interphalangeal joints after 6 weeks. This deficit decreased with time and almost full range of motion was achieved after 18 weeks. Grip strength measured 75% (Group I) and 78% (Group II) of the healthy hand's level. Good functional outcome was observed in the DASH scores after 12 weeks, which improved further, measuring 7.5 (Group I) and 6.8 (Group II) at the 18-week follow-up. We did not see any clinically relevant differences between the two patient groups. Regarding possible reruptures, the Kleinert protocol delivers a safe treatment regime. The possible disadvantage of flexion contractures with the Kleinert protocol was not seen in our measurements. Additional motion exercises using an exoskeleton delivered comparable results to classic physical therapy.

  4. Traumatic endophthalmitis caused by Nocardia kruczakiae in a patient with traumatic eye injury

    Compte, Rafael Barraquer; Martínez-Osorio, Hernán; Carrasco, Gema; Lorente, Betty; Elizalde, Javier; Valdezate, Sylvia; Lorente, Ramón; Iglesias, Emilio; Saez-Nieto, Juan Antonio


    Background We describe a case of traumatic ocular endophthalmitis caused by Nocardia kruczakiae after vegetable trauma in an immunocompetent child. Findings A 5-year-old boy suffered from a trauma with a palm tree leaflet. Two months later, he was diagnosed with traumatic infectious uveitis and intumescent cataract with anterior capsule rupture. Intensive treatment with systemic and topical vancomycin, ceftazidime and methylprednisolone began. After 1 month, he underwent phacoemulsification w...

  5. 手卫生导致医院感染的预防及控制探讨%Study on Prevention and Control of Hospital Infection Caused by Hand hy-giene



    The main influence factors of hospital infection caused by hand hygiene include the insufficient fund, misun-derstanding, low compliance and work factor, in order to prevent and control the hospital infection caused by hand hy-giene, we should improve the hand hygiene facilities, correctly understand hand hygiene, improve compliance and stan-dardize the hand cleanness and disinfection, the hand hygiene control is the major content of the hospital overall manage-ment. The paper analyzes the influence factors of hospital infection caused by hand hygiene and puts forwards strategies aiming at the prevention and control.%手卫生导致医院感染影响因素主要包括经费不足、认识误区、依从性差、工作因素;手卫生导致医院感染预防及控制应注重改善手卫生设施、正确认识手卫生、提高依从性、规范手清洁与消毒。手卫生控制是医院整体管理的重要内容,该文分析手卫生导致医院感染影响因素,并针对预防及控制提出对策。

  6. A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic

    Roxana Jurubita


    Full Text Available Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis, but also in the situations when a hypercoagulable state is presumed. The unspecific presenting symptoms often mask the true etiology of the patient’s complaints. We present here a rare case of renal infarction that occurred in the setting of a hypercoagulable state, in a female patient with a history of breast cancer and documented hepatic metastases.

  7. Necrotizing fasciitis of lower extremity caused by Haemophilus influenzae in a healthy adult with a closed lisfranc injury.

    Gonzalez, R Wesley; Casillas, Mark M; Almaguer, Enrique C


    Necrotizing fasciitis is a rare bacterial infection with an incidence of approximately 0.4 cases per 100,000 population. Although the majority of cases of necrotizing fasciitis are polymicrobial, a systematic review of the literature found only 7 reports of Haemophilus influenzae as the causal agent, and only 1 incidence of H influenzae causing the infection in a healthy adult. This report documents the unusual case of necrotizing fasciitis in a healthy adult with a history of smoking as her only risk factor. The patient presented with a seemingly innocuous low-grade Lisfranc injury. Our case illustrates the importance of early diagnosis and aggressive surgical management and medical treatment of necrotizing fasciitis.

  8. Numerical Analysis of the Risk of Neck Injuries Caused By IED Explosion under the Vehicle in Military Environments

    Mackiewicz Agnieszka


    Full Text Available As a result of an explosion under a military vehicle, the risk of threat to life and health of the crew increases. Examination of this event in terms of the security of soldiers comes down to a complex analysis of the mutual interaction of the body of a soldier, seating and structural elements of the vehicle. As a result, shock wave impacts can cause tremor resulting from the construction of the vehicle and acceleration of the passenger's body. This study attempts to analyze the impact of an explosion of an improvised explosive device (IED under the military vehicle with the risk of cervical spine injuries of soldiers. The analysis was carried out using numerical methods in the LS-DYNA program and was carried out taking into account the variable displacement values and acceleration recorded during the\\ explosion. The study used a model of the body of a soldier in the form of a Hybrid III 50th Male Dummy.

  9. Meralgia paresthetica-like syndrome may be caused by transient lumbar nerve root injury without definite compression: a case report.

    Dharmasaroja, Pornpatr; Dharmasaroja, Permphan


    Meralgia paresthetica is a well-known sensory syndrome describing paresthesia and/or anesthesia in the anterolateral aspect of the thigh that is supplied by the lateral femoral cutaneous nerve. Compression of the nerve usually occurs at the point where it passes between the anterior superior iliac spine and the inguinal ligament. Proximal lesions such as lumbar radiculopathy, lumbar disc herniation, and spinal stenosis have been reported to cause meralgia paresthetica-like syndrome. These proximal lesions directly injure L2 and L3 spinal nerve roots and cause a constant compression of the nerve roots. The presented paper introduces a hypothesis that this syndrome can be caused by transient injury to the L2 and L3 nerve roots by the upper adjacent disc bulge without definite compression. This hypothesis is supported by lumbar spine magnetic resonance imaging of a patient presenting with a meralgia paresthetica-like symptom during bending forward and twisting of the body, showing no L2/L3 herniated disc but mildly posterior bulging of T12/L1 disc. This hypothesis emphasizes an importance of appropriate postures in patients with meralgia paresthetica-like symptoms in order to prevent long-term morbidity.

  10. Hand Anatomy

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Bones Joints Muscles Nerves Vessels Tendons Anatomy The upper extremity is ...

  11. Android Hands

    Vlachos, Evgenios; Schärfe, Henrik


    . On such occasions, android and humanoid hand models should have similar structure, functions, and performance as the human hand. In this paper we present the anatomy, and the key functionalities of the human hand followed by a literature review on android/humanoid hands for grasping and manipulating objects...

  12. An ultrastructural study on indirect injury of dental pulp caused by high-speed missile projectile to mandible in dogs.

    Ren, Changqun; Liu, Ruifeng; Tian, Lei; Chen, Peng; Zhou, Shuxia


    The aim of this study was to evaluate the characteristics of indirect injury of dental pulp caused by high-speed missile projectile to mandible in dogs. Eighteen dogs aged 12-13 months were divided equally into six groups (n = 3 in each group) with random allocation, then a high-speed missile projectile (a ball bearing of stainless steel, phi6.0 mm, 0.88 g) was shot at right mandible body (the wound tract was below the fourth premolar, 1 cm or so to the root tips) of each dog, but the teeth were not wounded directly. The dogs were killed 6 h (n = 3), 24 h (n = 3), 3 days (n = 3), 7 days (n = 3), 2 weeks (n = 3) and 4 weeks (n = 3) after the wound, respectively; then ultrastructural change of dental pulp of the fourth premolar and the second premolar of right mandible, and the second premolar of left mandible was observed through transmission electron microscope. The results showed that mean initial velocity of projectiles was 778.0 +/- 33.2 m s(-1) and mean projection energy was 266.1 +/- 19.1 J, which were in conformity with parameters of gunshot wound. On the wound side, dental pulp of the fourth mandibular premolar was injured seriously and irreversible necrosis happened in the end; yet, dental pulp of the second mandibular premolar was injured less seriously, reversibly; on the opposite side, dental pulp of the second mandibular premolar was injured slightly and temporarily. It may be concluded that there are several characteristics in indirect injury of dental pulp caused by high-speed missile projectile to dogs' mandible: the injured area is relatively extensive; traumatic degree decreases progressively and sharply with the distance to the wound tract increasing; ultrastructural change of nerval damage takes place in early stage after wound, etc.

  13. Chronic subhepatotoxic exposure to arsenic enhances hepatic injury caused by high fat diet in mice

    Tan, Min; Schmidt, Robin H.; Beier, Juliane I. [Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); Department of Medicine, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); Watson, Walter H. [Department of Medicine, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); University of Louisville Alcohol Research Center, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); Zhong, Hai [Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); University of Louisville Alcohol Research Center, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); States, J. Christopher [Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); Arteel, Gavin E., E-mail: [Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States); University of Louisville Alcohol Research Center, University of Louisville Health Sciences Center, Louisville, KY 40292 (United States)


    Arsenic is a ubiquitous contaminant in drinking water. Whereas arsenic can be directly hepatotoxic, the concentrations/doses required are generally higher than present in the US water supply. However, physiological/biochemical changes that are alone pathologically inert can enhance the hepatotoxic response to a subsequent stimulus. Such a '2-hit' paradigm is best exemplified in chronic fatty liver diseases. Here, the hypothesis that low arsenic exposure sensitizes liver to hepatotoxicity in a mouse model of non-alcoholic fatty liver disease was tested. Accordingly, male C57Bl/6J mice were exposed to low fat diet (LFD; 13% calories as fat) or high fat diet (HFD; 42% calories as fat) and tap water or arsenic (4.9 ppm as sodium arsenite) for ten weeks. Biochemical and histologic indices of liver damage were determined. High fat diet ({+-} arsenic) significantly increased body weight gain in mice compared with low-fat controls. HFD significantly increased liver to body weight ratios; this variable was unaffected by arsenic exposure. HFD caused steatohepatitis, as indicated by histological assessment and by increases in plasma ALT and AST. Although arsenic exposure had no effect on indices of liver damage in LFD-fed animals, it significantly increased the liver damage caused by HFD. This effect of arsenic correlated with enhanced inflammation and fibrin extracellular matrix (ECM) deposition. These data indicate that subhepatotoxic arsenic exposure enhances the toxicity of HFD. These results also suggest that arsenic exposure might be a risk factor for the development of fatty liver disease in human populations. -- Highlights: Black-Right-Pointing-Pointer Characterizes a mouse model of arsenic enhanced NAFLD. Black-Right-Pointing-Pointer Arsenic synergistically enhances experimental fatty liver disease at concentrations that cause no overt hepatotoxicity alone. Black-Right-Pointing-Pointer This effect is associated with increased inflammation.

  14. Lesão do colo do cafeeiro, causada pelo calor Collar injury- young coffe plants caused by heat

    Coaracy M. Franco


    Full Text Available Tem sido observada ocasionalmente uma lesão no colo de cafeeiros novos ao nível do solo. .Estudos dc laboratório mostraram que o caule de cafeeiros novos foram danificados quando ao redor dêle se fêz circular água aquecida às temperaturas de 45 o 50ºC. O aquecimento da superfície do solo, compreendendo o colo de cafeeiro vegetando em laminados, com o auxílio de uma lâmpada de raios infravermelhos, resultou em lesão semelhante àquela observada nas culturas. Essa lesão apareceu em tratamentos cujas temperaturas estiveram entre 44 e 51°C. O fato dessas temperaturas serem freqüentemente observadas em solos expostos ao sol, sugere que a lesão do caule do cafeeiro, observada freqüentemente em cafèzais novos, seja conseqüência do aquecimento excessivo da superfície do solo pelos raios solares.A collar injury of young, field coffee plants at the soil level has been observed occasionally in the summer. The location of the abnormality and the season when it appears .suggested that excessive heating of the soil surface by the sun rays could be its cause. Two experiments were then conducted in the laboratory to investigate this bypothesis. The first experiment consisted in circulating water at the desired temperature around the stem ofyoung coffee plants, using the same apparatus described in a previous paper. In a second experiment the base of the stem and the soil around it was heated by means of a G. E. 250 watts infrared industrial reflector. By changing the distance between the heat source and the plant, different temperatures at the soil surface could be obtained. The results of the first experiment showed that 4 plants out of o that were treated at 45ºC showed injury; the other 2 plants survived without damage. From 5 plants that were treated at 50ºC, 2 showed injury and 3 died shortly after the treatment. All plants subjected to the temperature treatments at 35°C and 40ºC survived without damage, while those treated at 55º

  15. Injury of cortical neurons is caused by the advanced glycation end products-mediated pathway

    Ying Xing; Xu Zhang; Xiangfu Song; Zhongwen Lv; Lingling Hou; Fei Li


    Advanced glycation end products lead to cell apoptosis, and cause cell death by increasing endoplasmic reticulum stress. Advanced glycation end products alone may also directly cause damage to tissues and cells, but the precise mechanism remains unknown. This study used primary cultures of rat cerebral cortex neurons, and treated cells with different concentrations of glycation end products (50, 100, 200, 400 mg/L), and with an antibody for the receptor of advanced glycation end products before and after treatment with advanced glycation end products. The results showed that with increasing concentrations of glycation end products, free radical content increased in neurons, and the number of apoptotic cells increased in a dose-dependent manner. Before and after treatment of advanced glycation end products, the addition of the antibody against advanced glycation end-products markedly reduced hydroxyl free radicals, malondialdehyde levels, and inhibited cell apoptosis. This result indicated that the antibody for receptor of advanced glycation end-products in neurons from the rat cerebral cortex can reduce glycation end product-induced oxidative stress damage by suppressing glycation end product receptors. Overall, our study confirms that the advanced glycation end products-advanced glycation end products receptor pathway may be the main signaling pathway leading to neuronal damage.

  16. Serotonin syndrome caused by fentanyl and methadone in a burn injury.

    Hillman, Ashley D; Witenko, Corey J; Sultan, Said M; Gala, Gary


    Serotonin syndrome is a syndrome identified by a triad of altered mental status, neuromuscular overactivity, and autonomic instability caused by the overstimulation of serotonin in the central nervous system and periphery. Serotonin syndrome may be provoked with the addition or increase in serotonergic agents such as selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors as well as other agents with serotonergic properties. Some narcotics, including fentanyl and methadone, have these properties and may be associated with the development of serotonin syndrome when used in conjunction with other agents. Currently, there are no identified case reports of narcotics as the sole agent causing serotonin syndrome. This report provides a brief overview of serotonin syndrome, particularly with cases involving administration of narcotics such as fentanyl and methadone. The case described is the first report associated with fentanyl and methadone without the coadministration of other serotonergic agents, and a possible drug interaction with voriconazole is discussed. This raises awareness of using multiple serotonergic narcotics and the potential precipitation of serotonin syndrome.

  17. Critical progressive small-graft injury caused by intrasinusoidal pressure elevation following living donor liver transplantation.

    Sugimoto, H; Kaneko, T; Hirota, M; Nagasaka, T; Kobayashi, T; Inoue, S; Takeda, S; Kiuchi, T; Nakao, A


    In adult-to-adult living liver transplantation, small-for-size graft syndrome sometimes occurs. The relationship between the hemodynamic changes and histologic findings has not been studied in patients with failure of small-for-size grafts. We analyzed the relationship between the postoperative hemodynamic changes and pathologic findings in patients with small-for-size grafts that ended in graft failure. From March 1999 to December 2002, adult-to-adult living-donor liver transplantation with small-size grafts (graft volume/standard liver volume less than 40%) was performed in eight patients. Three patients died from graft failure caused by overperfusion, which was diagnosed from pathologic findings. We analyzed the relation between hepatic hemodynamic parameters, such as portal venous blood velocity or splenic arterial pulsatility index, and histologic changes in patients with graft failure. Severe portal hyperperfusion (90 cm/sec at the umbilical portion) was observed on postoperative day 1. Among patients with graft failure, critical hemodynamic changes, such as sudden onset of extremely deteriorated portal venous blood flow, occurred during the early postoperative period (postoperative day 5, 3, 6, respectively). Histologic examination revealed vacuolar changes in the cytoplasm of hepatocytes, and submassive necrosis indicated intrasinusoidal pressure elevation. These changes were not observed in the biopsy obtained soon after reperfusion. In conclusion, critically decreased vascular beds may cause intrasinusoidal pressure elevation and sinusoidal circulatory disturbances.

  18. Emerging neuromodulatory molecules for the treatment of neurogenic erectile dysfunction caused by cavernous nerve injury

    Anthony J. Bella; Guiting Lin; Ilias Cagiannos; Tom F. Lue


    Advances in the neurobiology of growth factors, neural development, and prevention of cell death have resulted in a heightened clinical interest for the development of protective and regenerative neuromodulatory strategies for the cavernous nerves (CNs), as therapies for prostate cancer and other pelvic malignancies often result in neuronal damage and debilitating loss of sexual function. Nitric oxide released from the axonal end plates of these nerves within the corpora cavernosa causes relaxation of smooth muscle, initiating the haemodynamic changes of penile erection as well as contributing to maintained tumescence; the loss of CN function is primarily responsible for the development of erectile dysfunction (ED) after pelvic surgery and serves as the primary target for potential neuroprotective or regenerative strategies. Evidence from pre-clinical studies for select neuromodulatory approaches is reviewed, including neurotrophins, glial cell line-derived neurotrophic factors (GDNF), bone morphogenic proteins, immunophilin ligands,erythropoetin (EPO), and stem cells.

  19. Pattern of injury in those dying from traumatic amputation caused by bomb blast.

    Hull, J B; Bowyer, G W; Cooper, G J; Crane, J


    Traumatic amputation of limbs caused by bomb blast carries a high risk of mortality. This paper describes 73 amputations in 34 deaths from bomb blast in Northern Ireland. The principal aim was to determine the sites of traumatic amputation to provide a biophysical basis for the development of protective measures. Few amputations were through joints; nearly all were through the bone shafts. The most common site in the tibia was the upper third. The distribution of femoral sites resulting from car bombs differed from that characterizing other types of explosion. For car bombs the principal site of amputation was the upper third; for other types of device it was the lower third. It is concluded that flailing is not a notable contributor to limb avulsion. The pattern of amputation is consistent with direct local pressure loads leading to bone fracture; the amputation itself is a secondary event arising from the flow of combustion products.

  20. Sports injuries in Plus League volleyball players.

    Cieśla, E; Dutkiewicz, R; Mgłosiek, M; Nowak-Starz, G; Markowska, M; Jasiński, P; Dudek, J


    Although physical activity brings a range of lifelong health benefits, it may also lead to injuries that pose a significant threat to health. It is particularly noticeable in people involved in professional sports where sport-related injuries commonly occur and are associated with intense exercise which aims to improve physical fitness. The article attempts to determine incidence of sports injuries reported by Plus League volleyball players, as well as to identify their most common types and causes. The research project involved 90 Plus League volleyball players aged 18-37 with the average age of 25.11 (SD±5.378). A method of diagnostic survey was applied to collect empirical data by means of questionnaire developed by the authors (researchers). The results were statistically analysed and verified with the analysis of variance (ANOVA) and χ2 test at the significance level (or critical P-value) of P≤0.05. Over 87% of the respondents suffered from at least one sport-related injury. In total, 362 injuries occurred, on average 4.02 injuries per one volleyball player. The most common sports injuries involved ankle or talocrural joint (46 injuries), knee and lower leg muscles (30), interphalangeal articulations of fingers (30) as well as shoulder joint. More than half of the injuries (57%) occurred twice or three times. Volleyball players commonly sustain injuries through contact with an opposing player in competition. Sport-specific injuries may also occur due to exhaustion, lack of rest and undertreated injuries. The most common volleyball-related injuries are primarily talocrural joint, hand and shoulder injuries. Common types of injuries that can affect volleyball players include muscles, joints and ligaments injuries, sprains and strains as well as bruises. Most of these injuries are caused by exhaustion, contact with an opposing player during competition and fatigue. The incidence of sport-related injuries seems to be influenced by such factors as somatic

  1. Thumb injuries in downhill skiing.

    Engkvist, O; Balkfors, B; Lindsjö, U


    Thumb injuries are next to knee injuries the most common injury in downhill skiing today. In this material they constituted 17% of all skiing injuries. Three-fourths of the thumb injuries were lesions of the ulnar collateral ligament of the metacarpophalangeal joint. Compared to a control population consisting of 1619 randomly chosen uninjured skiers, we found that no type of ski pole handle in common use today eliminated the risk of thumb injury, but the injury frequency was higher when using a ski pole with a big plate on the top of the handle. It was, however, of no importance how the skier gripped the ski pole in relation to the strap. It is suggested that the skier during a fall holds on to the ski pole until the very last moment before the hand hits the ground. The ski pole handle then remains in the hand and constitutes the hypomochlium that forces the thumb into abduction and extension, which causes the typical ulnar collateral ligament injury.

  2. Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

    Shih Hao Wang


    Full Text Available A case of choroidal rupture caused by airbag-associated blunt eye trauma and complicated with massive subretinal hemorrhage and vitreous hemorrhage that was successfully treated with intravitreal injection of expansile gas and bevacizumab is presented. A 53-year-old man suffered from loss of vision in his right eye due to blunt eye trauma by a safety airbag after a traffic accident. On initial examination, the patient had no light perception in his right eye. Dilated ophthalmoscopy revealed massive subretinal hemorrhage with macular invasion and faint vitreous hemorrhage. We performed intravitreal injection of pure sulfur hexafluoride twice for displacement, after which visual acuity improved to 0.03. For persistent subretinal hemorrhage and suspicion of choroidal neovascularization (CNV, intravitreal bevacizumab (1.25 mg/0.05 mL injection was administered. After 3 weeks, the visual acuity of his right eye recovered to 0.4. For early-stage choroidal rupture-induced subretinal hemorrhage and complications of suspected CNV, intravitreal injection of expandable gas and intraocular injection of antiangiogenesis drugs seem to be an effective treatment.

  3. Inhalation Injuries

    ... you can inhale that can cause acute internal injuries. Particles in the air from fires and toxic ... and lung diseases worse. Symptoms of acute inhalation injuries may include Coughing and phlegm A scratchy throat ...

  4. Effect of Toll-Like Receptor 4 on Synovial Injury of Temporomandibular Joint in Rats Caused by Occlusal Interference

    Jingjing Kong


    Full Text Available Synovitis is an important disease that causes intractable pain in TMJ. Some investigations suggested that the increasing expression of IL-1β secreted by synovial lining cells plays an important role in synovial inflammation and cartilage destruction in TMJ. In our previous research, the results demonstrated that TLR4 is involved in the expression of IL-1β in SFs from TMJ with lipopolysaccharide stimulation. However, the inflammatory response that occurred in synovial membrane is not caused by bacterial infection. In the current study, we investigated whether or not TLR4 participates in the inflammatory responses and the expression of IL-1β in synovial membrane of rats induced by occlusal interference. The results showed that obvious inflammation changes were observed in the synovial membranes and the expression of TLR4 and IL-1β was increased at both mRNA and protein levels in the occlusal interference rats. In addition, the inflammation reactions and the increased expression of IL-1β could be restrained by treatment with TAK-242, a blocker of TLR4 signaling. The results prompted us that the activation of TLR4 may be involved in the inflammatory reactions and increased expression of IL-1β in patients with synovitis and participate in the mechanisms of the initiation and development of synovial injury by regulating the expression of inflammatory mediators like IL-1β in synovial membranes.


    Albuquerque, Polianna L.M.M.; Jacinto, Camilla N.; Silva, Geraldo B.; Lima, Juliana B.; Veras, Maria do Socorro B.; Daher, Elizabeth F.


    SUMMARY Ophidic accidents are an important public health problem due to their incidence, morbidity and mortality. An increasing number of cases have been registered in Brazil in the last few years. Several studies point to the importance of knowing the clinical complications and adequate approach in these accidents. However, knowledge about the risk factors is not enough and there are an increasing number of deaths due to these accidents in Brazil. In this context, acute kidney injury (AKI) appears as one of the main causes of death and consequences for these victims, which are mainly young males working in rural areas. Snakes of the Bothrops and Crotalus genera are the main responsible for renal involvement in ophidic accidents in South America. The present study is a literature review of AKI caused by Bothrops and Crotalus snake venom regarding diverse characteristics, emphasizing the most appropriate therapeutic approach for these cases. Recent studies have been carried out searching for complementary therapies for the treatment of ophidic accidents, including the use of lipoic acid, simvastatin and allopurinol. Some plants, such as Apocynaceae, Lamiaceae and Rubiaceae seem to have a beneficial role in the treatment of this type of envenomation. Future studies will certainly find new therapeutic measures for ophidic accidents. PMID:24037282

  6. 氟中毒致机体损伤及其机制%Injuries caused by fluorosis and its mechanisms

    李薛燕; 黄文丽


    地方性氟中毒简称地氟病,是由氟导致的全身慢性蓄积性中毒。地氟病不仅给患者带来精神和肉体上的痛苦,而且加重家庭经济负担,同时严重影响病区的经济发展。本文将主要从氟对机体各器官系统的损伤作用及其发病机制加以阐述,以期为氟中毒相关研究提供参考。%Endemic fluorosis is a systemic chronic chemical poisoning caused by fluorine . Fluorosis not only imposes mental and physical harm to patients ,but also increases their financial burdens while adversely affecting the economical developments in the area .This article summarizes the injuries on various body organs caused by fluorosis and its pathogenesis ,in hopes of providing references for future fluorosis‐related studies .

  7. Subcutis calcinosis caused by injection of calcium-containing heparin in a chronic kidney injury patient

    Lilia Ben Fatma


    Full Text Available Subcutis calcinosis, characterized by abnormal calcium deposits in the skin, is a rare complication of using calcium-containing heparin occurring in patients with advanced renal failure. We report the case of an 83-year-old female, a known case of chronic kidney disease (CKD for four years with recent worsening of renal failure requiring hospitalization and hemodialysis. She developed subcutis calcinosis following injection of calcium-containing heparin. Biochemical tests showed serum parathormone level at 400 pg/dL, hypercalcemia, elevated calcium-phosphate product and monoclonal gammopathy related to multiple myeloma. She developed firm subcu-taneous nodules in the abdomen and the thighs, the injection sites of Calciparin ® (calcium nadroparin that was given as a preventive measure against deep vein thrombosis. The diagnosis of subcutis calcinosis was confirmed by the histological examination showing calcium deposit in the dermis and hypodermis. These lesions completely disappeared after discontinuing calcium nadro-parin injections. Subcutis calcinosis caused by injections of calcium-containing heparin is rare, and, to the best our knowledge, not more than 12 cases have been reported in the literature. Pathogenesis is not well established but is attributed to the calcium disorders usually seen in advanced renal failure. Diagnosis is confirmed by histological tests. Outcome is mostly favorable. The main differential diagnosis is calciphylaxis, which has a poor prognosis. Even though rarely reported, we should be aware that CKD patients with elevated calcium-phosphorus product can develop subcutis calcinosis induced by calcium-containing heparin. When it occurs, fortunately and unlike calci-phylaxis, outcome is favorable.

  8. Subcutis calcinosis caused by injection of calcium-containing heparin in a chronic kidney injury patient.

    Fatma, Lilia Ben; El Ati, Zohra; Azzouz, Haifa; Rais, Lamia; Krid, Madiha; Smaoui, Wided; Maiz, Hédi Ben; Béji, Soumaya; Zouaghi, Karim; Zitouna, Moncef; Moussa, Fatma Ben


    Subcutis calcinosis, characterized by abnormal calcium deposits in the skin, is a rare complication of using calcium-containing heparin occurring in patients with advanced renal failure. We report the case of an 83-year-old female, a known case of chronic kidney disease (CKD) for four years with recent worsening of renal failure requiring hospitalization and hemodialysis. She developed subcutis calcinosis following injection of calcium-containing heparin. Biochemical tests showed serum parathormone level at 400 pg/dL, hypercalcemia, elevated calcium-phosphate product and monoclonal gammopathy related to multiple myeloma. She developed firm subcutaneous nodules in the abdomen and the thighs, the injection sites of Calciparin ® (calcium nadroparin) that was given as a preventive measure against deep vein thrombosis. The diagnosis of subcutis calcinosis was confirmed by the histological examination showing calcium deposit in the dermis and hypodermis. These lesions completely disappeared after discontinuing calcium nadroparin injections. Subcutis calcinosis caused by injections of calcium-containing heparin is rare, and, to the best our knowledge, not more than 12 cases have been reported in the literature. Pathogenesis is not well established but is attributed to the calcium disorders usually seen in advanced renal failure. Diagnosis is confirmed by histological tests. Outcome is mostly favorable. The main differential diagnosis is calciphylaxis, which has a poor prognosis. Even though rarely reported, we should be aware that CKD patients with elevated calcium-phosphorus product can develop subcutis calcinosis induced by calcium-containing heparin. When it occurs, fortunately and unlike calciphylaxis, outcome is favorable.

  9. Star fruit toxicity: a cause of both acute kidney injury and chronic kidney disease: a report of two cases.

    Abeysekera, R A; Wijetunge, S; Nanayakkara, N; Wazil, A W M; Ratnatunga, N V I; Jayalath, T; Medagama, A


    Star fruit (Averrhoa carambola) is commonly consumed as a herbal remedy for various ailments in tropical countries. However, the dangers associated with consumption of star fruit are not commonly known. Although star fruit induced oxalate nephrotoxicity in those with existing renal impairment is well documented, reports on its effect on those with normal renal function are infrequent. We report two unique clinical presentation patterns of star fruit nephrotoxicity following consumption of the fruit as a remedy for diabetes mellitus-the first, in a patient with normal renal function and the second case which we believe is the first reported case of chronic kidney disease (CKD) due to prolonged and excessive consumption of star fruits. The first patient is a 56-year-old female diabetic patient who had normal renal function prior to developing acute kidney injury (AKI) after consuming large amount of star fruit juice at once. The second patient, a 60-year-old male, also diabetic presented with acute on chronic renal failure following ingestion of a significant number of star fruits in a short duration with a background history of regular star fruit consumption over the past 2-3 years. Both had histologically confirmed oxalate induced renal injury. The former had histological features of acute tubulo-interstitial disease whilst the latter had acute-on-chronic interstitial disease; neither had histological evidence of diabetic nephropathy. Both recovered over 2 weeks without the need for haemodialysis. These cases illustrate the importance of obtaining the patient's detailed history with respect to ingestion of herbs, traditional medication and health foods such as star fruits especially in AKI or CKD of unknown cause.

  10. Quantitative relationships between different injury factors and development of brown rot caused by Monilinia fructigena in integrated and organic apple orchards.

    Holb, I J; Scherm, H


    In a 4-year study, the incidence of various types of injuries (caused by insects, birds, growth cracks, mechanical wounding, and other, unidentified factors) was assessed in relation to brown rot development (caused by Monilinia fructigena) on fruit of three apple cultivars (Prima, Jonathan, and Mutsu) in integrated and organic blocks of two apple orchards in Hungary. In addition, populations of male codling moths (Cydia pomonella) were monitored with pheromone traps season-long in both management systems. On average, injury incidence on fruit at harvest was 6.1 and 19.2% in the integrated and organic treatments, respectively. Insect injury, which was caused primarily by C. pomonella, had the highest incidence among the five injury types, accounting for 79.4% of the total injury by harvest in the organic blocks and 36.6% in the integrated blocks. Levels of all other injury types remained close to zero during most of the season, but the incidence of bird injury and growth cracks increased markedly in the final 3 to 5 weeks before harvest in both production systems. Brown rot developed more slowly and reached a lower incidence in the integrated (6.4% final incidence on average) compared with the organic blocks (20.1% average incidence). In addition, the disease developed later but attained higher levels as the cultivar ripening season increased from early-maturing Prima to late-maturing Mutsu. Overall, 94.3 to 98.7% of all injured fruit were also infected by M. fructigena, whereas the incidence of brown-rotted fruit without visible injury was very low (0.8 to 1.6%). Correlation coefficients (on a per plot basis) and association indices (on a per-fruit basis) were calculated between brown rot and the various injury types for two selected assessment dates 4 weeks preharvest and at harvest. At both dates, the strongest significant (P integrated blocks. Although it is well established that brown rot in pome fruits is closely associated with fruit injuries, this is the

  11. 规范化职业康复护理对手外伤患者重返工作的影响%Effects of normalized vocational rehabilitation nursing on returning to work after hand injury



    目的 探讨规范化职业康复护理对手外伤患者重返工作的影响.方法 选择2009年1~12月本院收治的136例手外伤患者,术后进行规范化的职业康复护理,观察患者手功能的恢复情况及其重返工作岗位的情况.结果 术后随访6个月~2年,中位随访时间1.1年,103例患者随访成功,33例失访.其中获得随访的103例患者手功能恢复优36例、良57例、可7例、差3例,优良率为90.3%:重返工作岗位92例,重返工作率89.3%.结论 手外伤患者术后存在手功能障碍的问题,对重返工作带来影响,而规范化的职业康复护理能有效促进患者按步骤进行康复锻炼,提高患者的治疗效果,有利于患者早日恢复工作.%Objective To investigate the effects of normalized vocational rehabilitation nursing on returning to work after hand injury. Methods A total of 136 patients with hand injury from our hospital involved in the study from January to December 2009. After surgery they were treated with normalized vocational rehabilitation nursing, their hands' working conditions and their resumption to work recorded. Results Follow-up ranged from 6 months to 2 years, averaged 1.1 years after surgery. 103 patients had their hand functions recovered, among whom 36 reached excellent recovery in their hand function, 57 good, 7 fairly good and 3 poor, with a good rate of 90.3%. 92 patients returned to work, taking up 89.3%. Conclusions The patients with hand injury usually suffer from a problem of hand dysfunction, which affects their returning to work. The normalized vocational rehabilitation nursing can effectively lead the patients to carry out rehabilitation exercise step by step, improve their therapeutic efficacy, and help them return to work as soon as possible.

  12. Hand Fractures

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is ... serve as a framework. This framework supports the muscles that make the wrist ... When one of these hand bones is broken (fractured), it can prevent you ...

  13. Protective effect of liquiritin on oxidative stress injury of SH-EP1 cell lines caused by hydrogen peroxide

    Ning Shi; Hong-ju Guo; Huan Wang; Yu-Xin Fan; Yu-Min Zhang; Li-Rong Chang


    Objective:To study the protective effect of liquiritin on the oxidative stress injury of SH-EP1 cell lines caused by hydrogen peroxide.Methods: SH-EP1 cell lines were cultured and randomly divided into control group, H2O2 group and liquiritin group that were treated with the culture medium without serum, 200 μmol/L H2O2 as well as 100 μmol/L, 200 μmol/L and 400 μmol/L liquiritin combined with 200 μmol/L H2O2 respectively. After treatment, cell viability values as well as the content of mitochondrial apoptosis molecules and antioxidant molecules in cells were determined.Results:After 12 h, 24 h, 36 h and 48 h of treatment, the cell viability values of H2O2 group were significantly lower than those of control group, the cell viability values of 100 μmol/L, 200 μmol/L and 400 μmol/L liquiritin group were significantly higher than those of H2O2 group and the larger the liquiritin dosage, the higher the cell viability value; after 24 h of treatment, Bax, Caspase-3, Nrf2 and ARE content of H2O2 group were significantly higher than those of control group while Bcl-2, XIAP, SOD, GHS-Px and HO-1 content were significantly lower than those of control group; Bax and Caspase-3 content of 100 μmol/L, 200 μmol/L and 400 μmol/L liquiritin group were significantly lower than those of H2O2 group while Bcl-2, XIAP, Nrf2, ARE, SOD, GHS-Px and HO-1 content were significantly higher than those of H2O2group, and the larger the liquiritin dosage, the lower the Bax and Caspase-3 content while the higher the Bcl-2, XIAP, Nrf2, ARE, SOD, GHS-Px and HO-1 content.Conclusions:Liquiritin can inhibit the mitochondrial apoptosis and enhance the antioxidant system function to relieve the oxidative stress injury of SH-EP1 cell lines caused by hydrogen peroxide.

  14. Eye Injuries in Sports

    ... in Sports Which sports cause the most eye injuries?Sports cause more than 40,000 eye injuries each ... and racquet sports.When it comes to eye injuries, sports can be classified as low risk, high risk ...

  15. The probability of laser caused ocular injury to the aircrew of undetected aircraft violating the exclusion zone about the airborne aura LIDAR.

    Augustoni, Arnold L.


    The probability of a laser caused ocular injury, to the aircrew of an undetected aircraft entering the exclusion zone about the AURA LIDAR airborne platform with the possible violation of the Laser Hazard Zone boundary, was investigated and quantified for risk analysis and management.

  16. A rapid and non-destructive method to assess leaf injury caused by the cassava green mite, Mononychellus tanajoa (Bondar) (Acarina: Tetranychidae)

    Tomkiewicz, Jonna; Skovgård, Henrik; Nachman, Gösta;


    A relative scale of Leaf Damage Indices (LDI) from 0 to 5 describes the visible injury to leaves of cassava, Manihot esculenta Crantz caused by the cassava green mite, Mononychellus tanajoa (Bondar). As the scale is ordinal and thus not quantitative, the observed LDIs are converted individually...

  17. Visceral injuries.

    Wisner, D H; Blaisdell, F W


    Abdominal visceral injuries are encountered by every surgeon who deals with trauma. It is simple and useful to divide abdominal visceral injuries into those caused by penetrating mechanisms of injury and those due to blunt mechanisms. Determination of the need for operative intervention is generally easier after penetrating trauma. Gunshot wounds to the abdomen should be explored, as should stab wounds to the anterior abdomen that penetrate the fascia. A midline incision is the standard approach to abdominal visceral injuries because of its ease and versatility. Abdominal exploration should be consistent and systemic so as not to miss significant injuries. Hollow viscus injury is most common after penetrating injury, while blunt injury most often results in injury to solid viscera. Diagnostic and operative aspects of the treatment of specific visceral injuries are reviewed.

  18. RhoA-ROCK Inhibition Reverses Synaptic Remodeling and Motor and Cognitive Deficits Caused by Traumatic Brain Injury.

    Mulherkar, Shalaka; Firozi, Karen; Huang, Wei; Uddin, Mohammad Danish; Grill, Raymond J; Costa-Mattioli, Mauro; Robertson, Claudia; Tolias, Kimberley F


    Traumatic brain injury (TBI) causes extensive neural damage, often resulting in long-term cognitive impairments. Unfortunately, effective treatments for TBI remain elusive. The RhoA-ROCK signaling pathway is a potential therapeutic target since it is activated by TBI and can promote the retraction of dendritic spines/synapses, which are critical for information processing and memory storage. To test this hypothesis, RhoA-ROCK signaling was blocked by RhoA deletion from postnatal neurons or treatment with the ROCK inhibitor fasudil. We found that TBI impairs both motor and cognitive performance and inhibiting RhoA-ROCK signaling alleviates these deficits. Moreover, RhoA-ROCK inhibition prevents TBI-induced spine remodeling and mature spine loss. These data argue that TBI elicits pathological spine remodeling that contributes to behavioral deficits by altering synaptic connections, and RhoA-ROCK inhibition enhances functional recovery by blocking this detrimental effect. As fasudil has been safely used in humans, our results suggest that it could be repurposed to treat TBI.

  19. Early detection of injuries in leaves of Clusia hilariana Schltdl. (Clusiaceae caused by particulate deposition of iron

    Diego Ismael Rocha


    Full Text Available This study aims to evaluate the prognostic value of microscopic parameters of asymptomatic leaves of Clusia hilariana Schltdl. subjected to particulate deposition of iron (2.14 mg cm-2 day-1 for 45 consecutive days. Samples of young and expanded leaves without symptoms were collected and subjected to light and scanning electron microscopy techniques. The height of the epidermal cells on both surfaces of the leaf and the thickness of the hypodermis, the chlorophyll parenchyma, and the leaf blade were measured. Micromorphological injury occurred in the abaxial surface of young leaves and on both surfaces of expanded leaves. Erosion of the epicuticular wax and cuticle rupture were frequent on the adaxial surface, while on the abaxial surface of both leaves there was a loss of sinuosity on the anticlinal wall of the epidermal cells, stomatal deformity and obstruction. Micromorphometric alterations were seen in all leaf tissues except in the height of epidermic cells, probably due to the thick cuticle and prominent cuticular flanges. The highest difference in thickness of the leaf blade was seen in young leaves of plants subjected to SPMFe, indicating greater sensibility to particulate iron in comparison to the expanded leaves. The micromorphological and micromorphometric alterations in the leaf blade of Clusia hilariana Schltdl. showed the prognostic potential of these tools on the evaluation of impacts caused by the deposition of particulate matter, especially in the 'Restinga' natural vegetation, where the exposure is increasing due to the presence of iron ore industry in their surroundings.

  20. von Frey anesthesiometry to assess sensory impairment after acute spinal cord injury caused by thoracolumbar intervertebral disc extrusion in dogs.

    Song, R B; Basso, D M; da Costa, R C; Fisher, L C; Mo, X; Moore, S A


    Sensory threshold (ST) was measured using an electric von Frey anesthesiometer (VFA) in all limbs of 20 normal dogs and 29 dogs with acute thoracolumbar spinal cord injury (SCI) caused by spontaneous intervertebral disc extrusion. ST values were measured at three separate time points in normal dogs and on days 3, 10 and 30 following decompressive surgery in dogs with SCI. ST values were compared between groups and correlated with locomotor recovery in SCI-affected dogs. ST values were significantly higher (consistent with hypoalgesia) in the pelvic limbs of SCI-affected dogs at day 3, day 10 and day 30 when compared to normal dogs (P dogs over time, consistent with improvement toward normal sensation or development of allodynia. This finding correlated inversely with locomotor score at 3 and 10 days after surgery. A significant decline in ST values across testing sessions was observed for all limbs of normal and SCI-affected dogs and may be related to patient acclimation, operator training effect, or effect of analgesic medications. This study supports the feasibility of VFA to assess differences in ST between normal and SCI-affected dogs. However, future studies must focus on techniques to minimize or compensate for clinical, environmental and behavioral factors which may impact ST values in the clinical setting.

  1. Management of Hand Burns

    Fatih Irmak


    Full Text Available Objective: The hand is one of the most frequently affected body parts by burn injuries with a rate of 80% among all burn wounds. Early and effective treatment ensures the best chance of survival as well as a good functional prognosis. The aim of this study was to determine the epidemiology, variation, relationship between etiology and hospital stay, clinical features, and management of hand burns. Material and Methods: This retrospective study was conducted the University of Health Sciences; Şişli Hamidiye Etfal Application and Research Center, Departmant of Plastic, Reconstructive and Aesthetic Surgery and the Intensive Burn Care Unit between April 2009 and April 2014. Burns were assessed based on etiology, anatomical location, percentage of total body surface area affected, and depth of injury. Treatment was categorized as conservative, elective operative, or urgent operative. Results: In the study period, 788 patients were admitted to our Burn Unit. Of these, 240 were females (30.5% and 548 were males (69.5%. The most common type of burn injury in this study was thermal injury (695 cases; 88.2%, followed by electrical injury (67 cases; 8.5%, and chemical, frictional or unknown injuries (26 cases; 3.3%. Majority (more than 85% of the patients had second-degree burns, and some had third-degree burns. Conclusions: Burns commonly affect the hands, and many functional problems may develop if appropriate basic treatments are neglected. The best treatment for burns is prevention. Appropriate indoor arrangement and simple but effective measures that can be taken at home can significantly reduce burn trauma exposure.

  2. Hypercalcemia and acute kidney injury caused by abuse of a parenteral veterinary compound containing vitamins A, D, and E

    Paulo Novis Rocha


    Full Text Available A previously healthy 19 year-old male presented to the hospital with anorexia, nausea, and vomiting. Laboratory studies were significant for hypercalcemia (peak calcium value of 14.8 mg/dL and acute kidney injury (peak serum creatinine of 2.88 mg/dL. He admitted to using a parenteral formulation of vitamins A, D and E restricted for veterinary use containing 20,000,000 IU of vitamin A; 5,000,000 IU of vitamin D3; and 6,800 IU of vitamin E per 100 mL vial. The patient stated to have used close to 300 mL of the product over the preceding year. Interestingly, the young man was not interested in the massive amounts of vitamins that the product contained; he was only after the local effects of the oily vehicle. The swelling produced by the injection resulted in a silicone-like effect, which gave the impression of bigger muscles. Nevertheless, the product was absorbed and caused hypervitaminosis. The serum level of 25(OH vitamin D was clearly elevated at 150 ng/mL (reference range from 30 to 60 ng/mL, but in most published cases of vitamin D toxicity, serum levels have been well above 200 ng/mL. His PTH level was undetectable and other potential causes of hypercalcemia were excluded. Therefore, we posit that the severity of the hypercalcemia observed in this case was the result of a synergistic effect of vitamins A and D. The patient was treated with normal saline, furosemide and zolendronic acid, with rapid normalization of calcium levels and renal function.

  3. Physiological Expression of AMPKγ2RG Mutation Causes Wolff-Parkinson-White Syndrome and Induces Kidney Injury in Mice.

    Yang, Xiaodong; Mudgett, John; Bou-About, Ghina; Champy, Marie-France; Jacobs, Hugues; Monassier, Laurent; Pavlovic, Guillaume; Sorg, Tania; Herault, Yann; Petit-Demoulière, Benoit; Lu, Ku; Feng, Wen; Wang, Hongwu; Ma, Li-Jun; Askew, Roger; Erion, Mark D; Kelley, David E; Myers, Robert W; Li, Cai; Guan, Hong-Ping


    Mutations of the AMP-activated kinase gamma 2 subunit (AMPKγ2), N488I (AMPKγ2(NI)) and R531G (AMPKγ2(RG)), are associated with Wolff-Parkinson-White (WPW) syndrome, a cardiac disorder characterized by ventricular pre-excitation in humans. Cardiac-specific transgenic overexpression of human AMPKγ2(NI) or AMPKγ2(RG) leads to constitutive AMPK activation and the WPW phenotype in mice. However, overexpression of these mutant proteins also caused profound, non-physiological increase in cardiac glycogen, which might abnormally alter the true phenotype. To investigate whether physiological levels of AMPKγ2(NI) or AMPKγ2(RG) mutation cause WPW syndrome and metabolic changes in other organs, we generated two knock-in mouse lines on the C57BL/6N background harboring mutations of human AMPKγ2(NI) and AMPKγ2(RG), respectively. Similar to the reported phenotypes of mice overexpressing AMPKγ2(NI) or AMPKγ2(RG) in the heart, both lines developed WPW syndrome and cardiac hypertrophy; however, these effects were independent of cardiac glycogen accumulation. Compared with AMPKγ2(WT) mice, AMPKγ2(NI) and AMPKγ2(RG) mice exhibited reduced body weight, fat mass, and liver steatosis when fed with a high fat diet (HFD). Surprisingly, AMPKγ2(RG) but not AMPKγ2(NI) mice fed with an HFD exhibited severe kidney injury characterized by glycogen accumulation, inflammation, apoptosis, cyst formation, and impaired renal function. These results demonstrate that expression of AMPKγ2(NI) and AMPKγ2(RG) mutations at physiological levels can induce beneficial metabolic effects but that this is accompanied by WPW syndrome. Our data also reveal an unexpected effect of AMPKγ2(RG) in the kidney, linking lifelong constitutive activation of AMPK to a potential risk for kidney dysfunction in the context of an HFD. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  4. Evaluation of patients undergoing removal of glass fragments from injured hands: a retrospective study.

    Tuncer, Serdar; Ozcelik, Ismail Bulent; Mersa, Berkan; Kabakas, Fatih; Ozkan, Turker


    The hand is the body part most frequently injured by broken glass. Glass fragments lodged in soft tissues may result in numerous complications, such as infection, delayed healing, persistent pain, and late injury as a result of migration. Between 2005 and 2010, we removed 46 glass particles from the hands of 26 patients. The injuries were caused by the following: car windows broken during motor vehicle accidents in 11 patients (42%); fragments from broken glasses, dishes, or bottles in 9 (35%); the hand passing through glass in 5 (19%); and a fragment from a broken fluorescent lamp in 1 (4%) patient. Despite the efficacy of plain radiographs in detecting glass fragments, these are sometimes not obtained. Given the relatively low cost, accessibility, and efficacy of radiographs, and the adverse consequences of retained foreign bodies, the objections to obtaining radiographs should be few in diagnosing glass-related injuries of the hand.

  5. Humidifier Disinfectants Are a Cause of Lung Injury among Adults in South Korea: A Community-Based Case-Control Study.

    Ji-Hyuk Park

    Full Text Available An outbreak of lung injury among South Korean adults was examined in a hospital-based case-control study, and the suspected cause was exposure to humidifier disinfectant (HD. However, a case-control study with community-dwelling controls was needed to validate the previous study's findings, and to confirm the exposure-response relationship between HD and lung injury.Each case of lung injury was matched with four community-dwelling controls, according to age (±3 years, sex, residence, and history of childbirth since 2006 (for women. Environmental risk factors, which included type and use of humidifier and HD, were investigated using a structured questionnaire during August 2011. The exposure to HD was calculated for both cases and controls, and the corresponding risks of lung injury were compared.Among 28 eligible cases, 16 patients agreed to participate, and 60 matched controls were considered eligible for this study. The cases were more likely to have been exposed to HD (odds ratio: 116.1, 95% confidence interval: 6.5-2,063.7. All cases were exposed to HDs containing polyhexamethyleneguanidine phosphate, and the risk of lung injury increased with the cumulative exposure, duration of exposure, and exposure per day.This study revealed a statistically significant exposure-response relationship between HD and lung injury. Therefore, continuous monitoring and stricter evaluation of environmental chemicals' safety should be conducted.

  6. Criminal Law Judgment on Conducts Causing Injuries or Death to the Fetus%致胎儿死伤的刑法评价



    国内关于胎儿性致死伤的讨论,往往忽略中外刑法在是否规定堕胎罪问题上的明显差异性;自愿堕胎可谓一种自伤行为不构成犯罪,计生部门依法强制堕胎因存在违法性阻却事由而不构成犯罪;凡是违背孕妇意愿伤害胎儿(未导致孕妇死亡),致胎儿在母体内死亡的,或者在母体内受到重大伤害但经过治疗而没有留下后遗症的,以及在母体内受到严重伤害留下后遗症以致出生后不久死亡或者形成严重残疾的,都是对母体健康生育机能的侵害,故意为之的构成故意伤害罪,过失为之的构成过失致人重伤罪。%In our country, discussions on conducts causing injuries or death to the fetus often neglect the apparent differences that whether abortion is forbidden by criminal laws in different countries. This paper holds that in our country, voluntary abortion is no crime but self - injury. Compulsory abortion which is required by the family planning department is a justifiable defense for illegal violation of criminal law. However, those who, against the pregnant woman' s will cause injuries to the fetus and lead to its death within the womb of the pregnant woman ( without causing the woman' s death) ; or cause severe injury to the fetus within the pregnant woman' s womb but leave no sequela upon treatment; or cause severe injury to the fetus within the pregnant woman's womb and the sequel result in death soon after being born or severe disability, shall constitute the crime of intentional injury or the crime of negligent injury causing severe harm, since such conducts have damaged the healthy fertility of a pregnant woman.

  7. Principles of Hand Fracture Management

    Haughton, DN; Jordan, D; Malahias, M; Hindocha, S; Khan, W


    The hand is essential in humans for physical manipulation of their surrounding environment. Allowing the ability to grasp, and differentiated from other animals by an opposing thumb, the main functions include both fine and gross motor skills as well as being a key tool for sensing and understanding the immediate surroundings of their owner. Hand fractures are the most common fractures presenting at both accident and emergency and within orthopaedic clinics. Appropriate evaluation at first presentation, as well as during their management, can significantly prevent both morbidity and disability to a patient. These decisions are dependant on a wide range of factors including age, hand dominance, occupation and co-morbidities. A fracture is best described as a soft tissue injury with an associated bony injury. Despite this being the case, this paper intends to deal mainly with the bone injury and aims to discuss both the timing, as well as the methods available, of hand fracture management. PMID:22423303

  8. Extensor Tendon Injuries

    ... Media Find a Hand Surgeon Home Anatomy Extensor Tendon Injuries Email to a friend * required fields From * ... to straighten one or more joints. Common Extensor Tendon Injuries Mallet Finger refers to a drooping end- ...

  9. Brachial Plexus Injuries

    ... sensation in the arm or hand Brachial plexus injuries can happen because of shoulder trauma, tumors, or ... the nerves stretch or tear. Some brachial plexus injuries may heal without treatment. Many children who are ...

  10. Eye Injuries (For Parents)

    ... Habits for TV, Video Games, and the Internet Eye Injuries KidsHealth > For Parents > Eye Injuries Print A ... sand, dirt, and other foreign bodies on the eye surface) Wash your hands thoroughly before touching the ...

  11. [Hand surgery training].

    Moutet, F; Haloua, J P


    ). Unfortunately it is non-sufficient to train the necessary number of hand surgeons needed in France today. So we try to obtain from the authority the formal recognition of a training period in private practice. Eleven out of the 28 hand units listed as formative by the French College of Hand Surgeons are in private practice and may be recognized as formative in the hand surgeon training. That needs to create an official agreement between university and private Units. This part of the training is yet accepted by the Right to the Title commission for a 6-month training period. But this needs a legal modification or adaptation of the private units legal status so they will be able to offer a quite equivalent conditions of training. Now a days 233 surgeons in France passed the Right to the Title. Among them, the oldest do not have emergency practice any more. So unfortunately, out of 1,400,000 hand injuries a year in France, only few are actually cared by hand surgeons. The emergency training needs at least a three to four senior surgeons team, operating and caring emergencies, 24 h a day, 365 days a year. They need to be surrounded by high-level technical facilities for this type of surgery. Only this type of unit may have a frequent severe hand traumatology practice, especially regarding microsurgery. But on the other hand a less complex hand unit operating only planed surgery and less complicated emergencies, may also be definitively formative. This only depends on the hand surgeon's qualification. It is only with a very demanding and high-level training program that our credibility as hand surgeon may be definitively established. The mainstay of this training is the combined action of the FESUM, the French College of Hand Surgeons and the DIU diploma. The Right to the Title formally confirms that training. For university or private unit, to be a member of the FESUM, must continue to guarantee a high level training regarding emergencies as in number as in complexity. We proposed

  12. Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological-pathological correlation

    Twomey, Eilish L.; Iemsawatdikul, Kriengkrai; Stephens, Boyd G.; Gooding, Charles A. [Department of Radiology, University of California at San Francisco, 505 Parnassus Avenue, Box 0628, 94143-0628, San Francisco, CA (United States)


    We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented. (orig.)

  13. Hand Eczema

    Coenraads, Pieter-Jan


    A 33-year-old woman presents with redness of the hands and reports the intermittent occurrence of tiny vesicles, scaling, and fissuring, accompanied by itching on the palms, fingers, and dorsal sides of the hands. She has two young children and works as a nurse in a nearby hospital. She has a histor

  14. FY13 High Performance EVA Glove (HPEG) Collaboration: Glove Injury Data Mining Effort - Training Data Overview

    Reid, Christopher; Benson, Elizabeth; England, Scott; Charvat, Jacqueline; Norcross, Jason; McFarland, Shane; Rajulu, Sudhakar


    From the time hand-intensive tasks were first created for EVAs, discomforts and injuries have been noted.. There have been numerous versions of EVA gloves for US crew over the past 50 years, yet pain and injuries persist. The investigation team was tasked with assisting in a glove injury assessment for the High Performance EVA Glove (HPEG) dot To aid in this assessment, the team was asked to complete the following objectives: - First, to develop the best current understanding of what glove-related injuries have occurred to date, and when possible, identify the specific mechanisms that caused those injuries - Second, to create a standardized method for comparison of glove injury potential from one glove to another. center dot The overall goal of the gloved hand injury assessment is to utilize ergonomics in understanding how these glove injuries are occurring, and to propose mitigations to current designs or design changes in the next generation of EVA gloves.

  15. Rebamipide protects small intestinal mucosal injuries caused by indomethacin by modulating intestinal microbiota and the gene expression in intestinal mucosa in a rat model.

    Kurata, Satoshi; Nakashima, Takako; Osaki, Takako; Uematsu, Naoya; Shibamori, Masafumi; Sakurai, Kazushi; Kamiya, Shigeru


    The effect of rebamipide, a mucosal protective drug, on small intestinal mucosal injury caused by indomethacin was examined using a rat model. Indomethacin administration (10 mg/kg, p.o.) induced intestinal mucosal injury was accompanied by an increase in the numbers of intestinal bacteria particularly Enterobacteriaceae in the jejunum and ileum. Rebamipide (30 and 100 mg/kg, p.o., given 5 times) was shown to inhibit the indomethacin-induced small intestinal mucosal injury and decreased the number of Enterococcaceae and Enterobacteriaceae in the jejunal mucosa to normal levels. It was also shown that the detection rate of segmented filamentous bacteria was increased by rebamipide. PCR array analysis of genes related to inflammation, oxidative stress and wound healing showed that indomethacin induced upregulation and downregulation of 14 and 3 genes, respectively in the rat jejunal mucosa by more than 5-fold compared to that of normal rats. Rebamipide suppressed the upregulated gene expression of TNFα and Duox2 in a dose-dependent manner. In conclusion, our study confirmed that disturbance of intestinal microbiota plays a crucial role in indomethacin-induced small intestinal mucosal injury, and suggests that rebamipide could be used as prophylaxis against non-steroidal anti-inflammatory drugs -induced gastrointestinal mucosal injury, by modulating microbiota and suppressing mucosal inflammation in the small intestine.

  16. Surgical management of cutaneous infection caused by atypical mycobacteria after penetrating injury: the hidden dangers of horticulture.

    Holland, J; Smith, C; Childs, P A; Holland, A J


    We identified two patients in a 12-month period who presented with cutaneous infection and secondary lymph node involvement from atypical mycobacterial infection after minor gardening injuries. One patient had a coinfection with Nocardia asteroides. Both patients required multiple surgical interventions, despite appropriate antibiotic therapy, before resolution of the disease. The course of the infection was characterized by chronic relapses with complete healing at 12 to 18 months after the original injury. The identification and management of this clinical problem are reviewed.

  17. Mountain biking injuries in children and adolescents.

    Aleman, Kylee B; Meyers, Michael C


    Over the last decade, the sport of mountain biking has experienced extensive growth in youth participation. Due to the unpredictable nature of outdoor sport, a lack of rider awareness and increased participation, the number of injuries has unnecessarily increased. Many believe that the actual incidence of trauma in this sport is underestimated and is just the 'tip of the iceberg'. The most common mechanism of injury is usually attributed to downhill riding and forward falling. Although rare, this type of fall can result in serious cranial and thoraco-abdominal trauma. Head and neck trauma continue to be documented, often resulting in concussions and the possibility of permanent neurological sequelae. Upper limb injuries range from minor dermal abrasions, contusions and muscular strains to complex particular fracture dislocations. These are caused by attempting to arrest the face with an outstretched hand, leading to additional direct injury. Common overuse injuries include repeated compression from the handlebars and vibration leading to neurovascular complications in the hands. Along with reports of blunt abdominal trauma and lumbar muscle strains, lower extremity injuries may include various hip/pelvic/groin contusions, patellofemoral inflammation, and various muscle strains. The primary causes of mountain biking injuries in children and adolescents include overuse, excessive fatigue, age, level of experience, and inappropriate or improperly adjusted equipment. Additional factors contributing to trauma among this age group involve musculoskeletal immaturity, collisions and falls, excessive speed, environmental conditions, conditioning and fitness status of the rider, nonconservative behavioural patterns, and inadequate medical care. The limited available data restrict the identification and understanding of specific paediatric mountain biking injuries and injury mechanisms. Education about unnecessary risk of injury, use of protective equipment, suitable bikes

  18. Wheelchair skills performance between discharge and one year after inpatient rehabilitation in hand-rim wheelchair users with spinal cord injury

    Fliess-Douer, Osnat; Vanlandewijck, Yves C.; Post, Marcel W. M.; Van Der Woude, Lucas H. V.; De Groot, Sonja


    Objective: To study possible changes in wheelchair skills in participants with spinal cord injury between discharge and 1 year after rehabilitation, and to determine whether changes in wheelchair skills performance are related to lesion and personal characteristics, self-efficacy, and wheelchair sat

  19. Application of active kinesitherapy for psychosomatic functions to patients with hand dysfunction after surgery for hand injury%心身机能活性运动疗法在术后手功能障碍患者中的应用



    目的:探讨心身机能活性运动疗法在手外伤术后手功能障碍患者中的应用方法及效果.方法:将196例手外伤术后手功能障碍患者按照入院顺序随机分为观察组和对照组各98例,观察组采用心身机能活性运动疗法,对照组采用单纯运动疗法.随访3个月,评价两组患者康复效果.结果:观察组患者手功能恢复总有效率明显高于对照组(P<0.05).结论:心身机能活性运动疗法能有效提高患者术后手功能恢复效果,提高患者术后生活质量.%Objective:To explore the methods and effect of active kinesitherapy for psychosomatic functions to patients with hand dysfunction after surgery for hand injury.Methods:196 patients with hand dysfunction after surgery were randomly divided into the observation group and the control group (98 cases in each group) according to the order of admission.The active kinesitherapy for psychosomatic functions was adopted in the observation group and the simple exercise therapy was used in the control group.The rehabilitation effect of the patients was evaluated in the two groups after 3-month follow-up.Results:The total effective rate of hand function recovery of the patients was higher in the observation group than the control group (P < 0.05).Conclusion:The active kinesitherapy for psychosomatic functions can effectively improve the rehabilitation effect of hand function and the quality of life of the patients after surgery for hand injury.

  20. Metallothionein (MT -I and MT-II expression are induced and cause zinc sequestration in the liver after brain injury.

    Michael W Pankhurst

    Full Text Available UNLABELLED: Experiments with transgenic over-expressing, and null mutant mice have determined that metallothionein-I and -II (MT-I/II are protective after brain injury. MT-I/II is primarily a zinc-binding protein and it is not known how it provides neuroprotection to the injured brain or where MT-I/II acts to have its effects. MT-I/II is often expressed in the liver under stressful conditions but to date, measurement of MT-I/II expression after brain injury has focused primarily on the injured brain itself. In the present study we measured MT-I/II expression in the liver of mice after cryolesion brain injury by quantitative reverse-transcriptase PCR (RT-PCR and enzyme-linked immunosorbent assay (ELISA with the UC1MT antibody. Displacement curves constructed using MT-I/II knockout (MT-I/II(-/- mouse tissues were used to validate the ELISA. Hepatic MT-I and MT-II mRNA levels were significantly increased within 24 hours of brain injury but hepatic MT-I/II protein levels were not significantly increased until 3 days post injury (DPI and were maximal at the end of the experimental period, 7 DPI. Hepatic zinc content was measured by atomic absorption spectroscopy and was found to decrease at 1 and 3 DPI but returned to normal by 7DPI. Zinc in the livers of MT-I/II(-/- mice did not show a return to normal at 7 DPI which suggests that after brain injury, MT-I/II is responsible for sequestering elevated levels of zinc to the liver. CONCLUSION: MT-I/II is up-regulated in the liver after brain injury and modulates the amount of zinc that is sequestered to the liver.