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BACKGROUND: Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings. METHOD: We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare. RESULTS: Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases. DISCUSSION: Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.
Assuntos
Injúria Renal Aguda , Transtornos de Estresse por Calor , Saccharum , Humanos , Nicarágua/epidemiologia , Injúria Renal Aguda/epidemiologia , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Transtornos de Estresse por Calor/epidemiologia , Temperatura Alta/efeitos adversos , Exposição Ocupacional/efeitos adversosRESUMO
BACKGROUND: The San Diego-Mexico border wall height extension is associated with increased traumatic injuries and related costs after wall falls. We report previous trends and a neurological injury type not previously associated with border falls: blunt cerebrovascular injuries (BCVIs). METHODS: In this retrospective cohort study, patients who presented to the UC San Diego Health Trauma Center for injuries from border wall falls from 2016 to 2021 were considered. Patients were included if they were admitted before (January 2016 to May 2018) or after (January 2020 to December 2021) the height extension period. Patient demographics, clinical data, and hospital stay data were compared. RESULTS: We identified 383 patients, 51 (68.6% male; mean age, 33.5 years) in the pre-height extension cohort and 332 (77.1% male; mean age, 31.5 years) in the post-height extension cohort. There were 0 and 5 BCVIs in the pre- and post-height extension groups, respectively. BCVIs were associated with increased injury severity scores (9.16 vs. 31.33; P < 0.001), longer intensive care unit lengths of stay (median, 0 days; [interquartile range (IQR), 0-3 days]; vs. median, 5 days [IQR, 2-21 days]; P = 0.022), and increased total hospital charges (median, $163,490 [IQR, $86,578-$282,036]; vs. median, $835,260 [IQR, $171,049-$1,933,996]; P = 0.048). Poisson modeling found BCVI admissions were 0.21 (95% confidence interval, 0.07-0.41; P = 0.042) per month higher after the height extension. CONCLUSIONS: We review the injuries correlating with the border wall extension and reveal an association with rare, potentially devastating BCVIs that were not seen before the border wall modifications. These BCVIs and associated morbidity shed light on the trauma increasingly found at the southern U.S. border, which could be informative for future infrastructure policy decisions.
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Pseudoaneurysms of a pulmonary artery branch are a rare complication in cases of penetrating chest trauma. Other more frequent causes are secondary to infections or iatrogenesis. We present the case of a 16-year-old male patient who returns weeks after having sustained a stab wound to the chest, complaining of hemoptysis and chest pain. Imaging studies help detect and characterize a partially thrombosed pseudoaneurysm arising from the artery that supplies the anterior segment of the right upper lobe, with an associated post-traumatic pulmonary arteriovenous fistula. The patient was successfully treated with endovascular arterial embolization. Identifying this entity opportunely has an impact on the survival of this patient, avoiding risk secondary to massive bleeding by making an adequate treatment.
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OBJECTIVE: To identify the epidemiological profile and prognostic factors of open globe injuries that require emergency surgical treatment. DESIGN: Retrospective cohort study. SUBJECTS: Patients with OGI who underwent publicly funded emergency surgical treatment in the Federal District from 2014 to 2018. METHODS: Data were collected by reviewing electronic medical records through a questionnaire and tabulated. The statistical analysis was performed in SPSS Statistics 26.0.0.0 (p ≤ 0.05). RESULTS: A total of 359 records were included, corresponding to 336 eyes of 334 patients (294 males and 40 females). The average age was 32.7 years. The affected eye was the right eye in 165 cases, the left eye in 166 cases, and both eyes in 3 cases. The average time between injury and hospitalization was 75.7 h, and the time between injury and surgery averaged 173.7 h. The injury types were as follows: 197 penetrating; 109 rupture; 19 IOFB; 11 perforating. The injuries were in the following zones: 181 zone I; 82 zone II; 70 zone III. The OTS grades were as follows: 57 were classified as grade 1; 101 were grade 2; 142 were grade 3; 28 were grade 4; and 8 were 5. The most commonly performed surgeries were corneal suture, corneoscleral suture, and evisceration. The most common clinical features were traumatic cataract, herniated iris and hyphema. The following were risk factors for poor prognosis: zone III, time between trauma and surgery > 72 h, rupture injury, retinal detachment, disorganization of the eyeball, endophthalmitis, uveal prolapse, OTS classification 1 or 2, and low initial visual acuity. The following factors predicted a good prognosis: initial VA > 1/200, penetrating injury, OTS 4 and zone II. CONCLUSIONS: The high frequency of many of these factors may explain the high rate of severe visual loss found. Injury localization in zone II was identified as a previously unrecognized protective factor against severe visual loss.
Assuntos
Ferimentos Oculares Penetrantes , Traumatismos Oculares , Adulto , Brasil/epidemiologia , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/epidemiologia , Ferimentos Oculares Penetrantes/cirurgia , Feminino , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Acuidade VisualRESUMO
Introduction: Decision making in determining management of post-trauma patient is very important, especially for traumatic in the small bones, fingers and toes. The global predictor to determine the management of retaining or amputating the limb is using the Mangled Extrimity Severity Score (MESS) scoring system, values above 7 are the indication for amputation. The decision maker have to pay attention for the end result of the actions which were performed in the initial management. Material and Methods: One case is reported from Orthopaedic emergency department Hospital in Makassar, South Sulawesi, Indonesia. A 39-year old male with motor vehicle accident trauma at left foot region since 6 hours before admitted to hospital, later was diagnosed with open comminutive fracture shaft proximal phalang of left 5th toe, the Mangled Extrimity Severity Score (MESS) was 8. Patient underwent emergency debridement and retained the toe by performed Open Reduction Internal Fixation (ORIF) K-Wire. Results: This patient has a good clinical outcome by following up 2 weeks and 8 months after surgery by retain the affected side with debridement and Open Reduction Internal Fixation (ORIF) K-Wire. Patient can ambulate normally with full weight bearing, and there is no difficulty to wearing shoe or sandal. Conclusions: Determination of action by retaining the traumatized limb needs to be considered for the good of the patient, but it is necessary to provide informed consent to the patient and family that there will be a possibility of tissue death with the worst possibility of limb amputation
Assuntos
Humanos , Masculino , Adulto , Articulação do Dedo do Pé/cirurgia , Fios Ortopédicos , Escala de Gravidade do Ferimento , Fraturas Cominutivas/cirurgia , Traumatismos do Pé/terapia , Desbridamento , Fixação Interna de FraturasRESUMO
In his review article John W. Verano covered trauma, warfare, trophy taking, and human sacrifice, but his discussion mostly focused on the results of studies of museum or private collections and the recent discovery of the mass human sacrifice from Huaca de la Luna. Due to the renewed interest in the paleopathology of South America, a trend which Verano observed, these types of investigations have grown exponentially in the past twenty years since his initial publication. Here we synthesize the published data on the study and interpretation of traumatic injuries across time and space and we tease out some of the themes that have emerged in the twenty odd years since the seminal paper written by Verano. We searched and analyzed publications from 1997 to 2017 that pertained specifically to Andean South America through the review of library databases and then narrowed our search to trauma-related topics. In our literature review and meta-analysis of published studies on traumatic injuries, we found that nearly one-third of publications related to the field of paleopathology in Andean South America dealt with subjects we classified under trauma (Nâ¯=â¯116/378), such as trephination, violence, sacrifice, warfare, etc. Large sample sizes, population-focused research, advances in methods of analysis, and hypothesis driven investigations have led to sophisticated and nuanced interpretations along a wide range of themes so that we understand a great deal more about violence, sacrifice, trephination, warfare and their sociopolitical and environmental contexts in prehistoric and early colonial Andean South America.
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Paleopatologia , Projetos de Pesquisa , Ferimentos e Lesões/história , Comportamento Ritualístico , Características Culturais , Difusão de Inovações , Previsões , História Antiga , Humanos , Paleopatologia/tendências , Projetos de Pesquisa/tendências , América do Sul , Violência/história , Guerra/história , Ferimentos e Lesões/etnologia , Ferimentos e Lesões/patologiaRESUMO
Abstract We present the first recent reported case of traumatic injury caused by catfish in the Americas. Although 66.2% of fish-related injuries occur in the Amazon Region, they are scarcely reported. We report a traumatic injury in a 2-year-old boy who entered Madeira River. The use of traditional methods to treat the injury and his incomplete vaccination history reflect the weakness of the health system. Further, the fact that it was the second time that such an incident had occurred in the locality in 3 weeks during the dry season suggests that this could be a frequent occurrence during this period.
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Humanos , Animais , Masculino , Mordeduras e Picadas/terapia , Peixes-Gato/classificação , RiosRESUMO
Traumatic head injury is a leading cause of mortality and morbidity. As a result of head trauma occurring in the retina of the various biochemical, histological and immunohistochemical effects were investigated. SpragueDawley rats were subjected to traumatic brain injury with a weight-drop device using 300 g-1 m weightheight impact. Twenty one rats were divided into three groups, as group 1 (vehicle-treated control), group 2 (vehicle-treated trauma) group 3 trauma + Potentilla fulgens ( P. Fulgens) 400 mg/kg/day, i.p.). Distilled water was used as vehicle. All rats were decapitated 5 days after the induction of trauma, and the protective effects of P. Fulgens were evaluated by histological, immunohistochemical and biochemical analyses. Although further studies are necessary to evaluate the time-and dose-dependent neuroprotective effects of P. Fulgens. Depending on whether trauma inhibits apoptosis of photoreceptor cells, ganglion cells, it is thought that the the support against the degeneration of neural connections can be considered. This study indicates that P.Fulgens is potentially useful for the treatment of eye disorders induced by traumatic brain injury.
El trauma de cráneo es una de las principales causas de morbilidad y mortalidad. Como resultado de un traumatismo craneal, la retina puede sufrir diversos efectos bioquímicos, histológicos e inmunohistoquímicos. Veintiún ratas Sprague-Dawley fueron sometidas a lesión craneal traumática con un dispositivo, de caída de peso, usando un impacto de 300 g-1 m de peso-altura. Las ratas fueron divididas en tres grupos: grupo 1 (control), grupo 2 (traumatismo) y grupo 3 trauma + Potentilla fulgens (400 mg / kg / día, i. p.). Se usó agua destilada como vehículo en todos los grupos. Las ratas fueron decapitadas 5 días después de la inducción del trauma, y se evaluaron los efectos protectores de P. Fulgens mediante análisis histológicos, inmunohistoquímicos y bioquímicos. Es necesario realizar más estudios para evaluar los efectos neuroprotectores, dependientes del tiempo y la dosis, de P. Fulgens. Dependiendo si el trauma inhibe la apoptosis de las células fotorreceptoras, se estima que la disposición de las células ganglionares ayuda contra la degeneración de las conexiones neuronales. P. Fulgens ha demostrado ser efectivo para el tratamiento de los trastornos oculares inducidos por lesión cerebral traumática.
Assuntos
Animais , Ratos , Traumatismos Craniocerebrais/complicações , Traumatismos Oculares/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Potentilla/química , Retina/patologia , Traumatismos Oculares/etiologia , Ratos Sprague-Dawley , Retina/efeitos dos fármacosRESUMO
Las lesiones del árbol traqueobronquial (aTB) es un evento no frecuente, pero con un alto riesgo de vida. La causa puede ser iatrogénica, secundaria a procedimientos médico y traumática por trauma cerrado o penetrante. Su incidencia no se conoce exactamente. La dificultad para establecer la incidencia de la lesión traumática se debe a que un 30 a 80% de las víctimas de trauma fallecen en el lugar del accidente por las lesiones asociadas. El pronóstico de los pacientes que logran llegar al hospital va a depender esencialmente de las características de la lesión en la vía aérea (VA) y las lesiones asociadas.
Injuries to the tracheobronchial tree (aTB) is an uncommon event, but with a high risk of life. The cause can be iatrogenic, secondary to medical and traumatic procedures by closed or penetrating trauma. Its incidence is not exactly known. The difficulty in establishing the incidence of the traumatic injury is due to the fact that 30 to 80% of trauma victims die at the scene of the accident due to the associated injuries. The prognosis of patients who reach the hospital will depend essentially on the characteristics of the airway (VA) lesion and associated lesions.
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Ferimentos e Lesões , Endoscopia , Manuseio das Vias AéreasRESUMO
OBJECTIVE: To assess clinical and nonclinical characteristics associated with the use of pediatric inpatient rehabilitation services among children with traumatic injuries. We hypothesized there would be no nonclinical variations in the use of pediatric inpatient rehabilitation services. STUDY DESIGN: Retrospective analysis of 1139 patients who were injured seriously (0-18 years of age) from our institutional trauma registry (2004-2014). Patients' nonclinical and clinical characteristics were analyzed. We used a full matching technique to compare characteristics between those admitted to rehabilitation (cases) to those discharged home (controls). We matched patients by age category, sex, maximum Abbreviated Injury Scale, and body region of maximum Abbreviated Injury Scale. We used survey-based multivariate logistic regression to identify characteristics associated with inpatient rehabilitation services, controlling for multiple injuries, distance from home to rehabilitation center, year of service, hospital length of stay, and clinically relevant interactions. RESULTS: Ninety-eight patients (8.6%) were admitted to inpatient rehabilitation and 968 (85.0%) were discharged home. Black and other minority patients had increased odds of receiving inpatient rehabilitation compared with white patients (OR, 7.6 [P< .001] and OR, 1.6 [P= .03], respectively). Patients with private compared with public insurance had increased odds of receiving inpatient rehabilitation (OR, 2.4; P< .001). CONCLUSIONS: Pediatric inpatient rehabilitation beds are a scarce resource that should be available to those with the greatest clinical need. The mechanism creating differences in the use of inpatient rehabilitation based on nonclinical characteristics such as race/ethnicity or insurance status must be understood to prevent disparities in access to inpatient rehabilitation services.
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Pacientes Internados/estatística & dados numéricos , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/reabilitação , Escala Resumida de Ferimentos , Adolescente , Fatores Etários , California , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Escala de Gravidade do Ferimento , Tempo de Internação , Modelos Logísticos , Masculino , Análise Multivariada , Seleção de Pacientes , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Taxa de Sobrevida , Centros de Traumatologia , Resultado do Tratamento , Ferimentos e Lesões/mortalidadeRESUMO
Resumo Este estudo objetivou avaliar o conhecimento e as atitudes de estudantes de Educação Física de Universidades públicas do Estado do Rio de Janeiro, Brasil, em relação ao traumatismo dentário e uso de protetor bucal. Foram entrevistados 373 graduandos de três universidades públicas do Rio de Janeiro, através de questionário semiestruturado e padronizado. Os dados foram tabulados e analisados (SPSS 16.0), sendo obtida a frequência (%) e a relação dos mesmos (Teste qui-quadrado, p < 0,05). Apenas 3,21% dos entrevistados haviam recebido informação sobre traumatismo dentário e utilização do protetor bucal durante a graduação. Com relação à atitude dos graduandos, responderam corretamente apenas 19,83% a conduta frente a uma avulsão; 54,69% ao manuseio do dente avulsionado e 7,77% ao transporte do dente avulsionado. Ao se comparar essas atitudes em razão do período de graduação (< 5º período ou ≥ 5º período), informações prévias de trauma e experiências prévias de trauma, não se observou diferença significativa (p > 0,05). Tratando de prevenção, 89,81% conheciam o protetor bucal, embora apenas 17,96% o utilizavam durante atividades esportivas. Conclui-se que os alunos não recebem tais informações durante a graduação, mesmo possuindo em sua grade curricular a disciplina de primeiros socorros. Cabe aos cirurgiões dentistas desenvolver ações para que este conhecimento supra as necessidades dos futuros profissionais de educação física.(AU)
Abstract To evaluate the knowledge and attitudes in a group of Brazilian physical education undergraduate students, relative to dental trauma and use of mouthguard. A total of 373 undergraduates from three public universities of Rio de Janeiro were interviewed by means of a semi-structured standardised questionnaire. The data were tabulated and analyzed using the statistical program SPSS, 17.0. Frequency was performed and it was also applied the qui-quadrado (p < 0.05) test, to establish a relation between variables of interest. Only 3.21% of the interviewees had been given information on dental trauma and use of mouth protector during their undergraduate course. With regard to their attitudes, only 19.83% responded correctly about how to act towards a tooth avulsion; 54.69% about how to manage the avulsed tooth, and 7.77% about how to transport the avulsed tooth. By comparing these attitudes in relation to the undergraduate period (before or after the 5th semester), previous information and experience on dental trauma, it was observed no significant difference (p > 0.05). With regard to prevention, 89.81% knew mouthguard although only 17.96% wore it during sport activities. The students were given no information during their undergraduation course, even though the curriculum has the discipline of first aid. The dentist are supposed to develop actions so that such knowledge meets the needs of the future physical education practitioners.(AU)
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Humanos , Masculino , Feminino , Adulto , Educação Física e Treinamento , Esportes , Avulsão Dentária , TutoriaRESUMO
Antecedentes: las lesiones en el hueso temporal ocurren en el 30 a 70% de los casos de traumatismo de cráneo cerrado, siendo los accidentes automovilísticos causa del 31%. En general, las líneas de fractura corren paralelas a la línea del golpe entregado y se extienden a través de los agujeros de la base del cráneo, puntos débiles del hueso temporal. Estas se denominan como longitudinal o transversal, a pesar de que la mayoría son en realidad mixtas. Las fracturas bilaterales tienen una incidencia menor de 8-29%. Objetivo: Analizar los tipos de fracturas temporales más frecuentes y las modificaciones de éstas sobre su anatomía en correlación con la clínica del paciente y los exámenes de TAC. Diseño: Retrospectivo de corte transversal. Población: Niños y adultos jóvenes de ambos sexos. Método: Es un trabajo retrospectivo transversal con revisión de historias clínicas de niños y adultos jóvenes, más disecciones microanatómicas en cadáveres adultos de ambos sexos, fijados en formol al 10%. Resultados: Se recolectaron 10 pacientes; 8 de sexo masculino y 2 femeninos, del total 2 son niños. Todos con procedencia de Córdoba, consultan por zumbido, hipoacusia y mareo o desequilibrio postraumático. Uno de ellos niño de 13 años con hipoacusia bilateral y supuración de oído. Al grupo se suma una parálisis facial recuperada con tratamiento clínico. Conclusiones: El conocimiento de la anatomía, con el apoyo de la tomografía computada de oído, y los estudios audiológicos son fundamentales para el diagnóstico clínico y topográfico de la lesión.
Background: lesions occur in the temporal bone in the 30 to 70% of cases of closed skull trauma. Being car accidents cause 31%. In general, the fracture lines run parallel to the line of blow delivered and extend through the holes to the skull base, temporal bone weak points. These are denominate as longitudinal or transverseal, though most are actually mixed. The bilateral fractures have a lower incidence of 8-29%. Objetive: analize the types of temporal fractures the most frequent and modifications of these on their anatomy correlated with the patients clinical and computed tomography exams. Design: transversal cut retrospective. Population: children and young adults of both sexes. Method: it is a transversal retrospective study with review of clinical records of children and young adults more microanatomic dissections in adult cadavers of both sexes, fixed in 10% formalin. Results: 10 patients were collected; 8 male and 2 female, total 2 are children. All of them are from Córdoba, complaining of tinnitus, hearing loss and dizziness or post traumatic imbalance. The age average is to 22 years old. The 50% is given by automobile accidents, also presented cases of labor accident, drop height and flattening. One of them, a child to 13 years old with bilateral hearing loss and ear drainage. The group adds a facial paralysis recovered with clinical treatment. Conclusions: knowledge of anatomy, with supported by computed tomography ear, and audiological studies are essential for clinical diagnosis and topographic of the lesion.
Antecedentes: as lesões no osso temporal ocorrem em 30% a 70% dos casos de traumatismo de crânio fechado, sendo os acidentes automobilísticos causa de 31%. Em geral, as linhas de fratura correm paralelas à linha do golpe e se estendem através dos orifícios da base do crânio, pontos frágeis do osso temporal. Estas são denominadas como longitudinal ou transversal, a pesar de, na verdade, a maioria ser mista. As fraturas bilaterais tem uma incidência menor de 8-29%. Objetivo: Analisar os tipos de fraturas temporais mais frequentes e as modificações destas sobre a sua anatomia em correlação com a clínica do paciente e os exames de TAC. Desenho: Retrospectivo de corte transversal População: Crianças e jovens adultos em ambos os sexos. Método: É um trabalho retrospectivo transversal com revisão de histórias clínicas de crianças e jovens adultos mais dissecações microanatômicas em cadáveres adultos de ambos os sexos, conservados em formol a 10%. Resultados: Foram coletados 10 pacientes: 8 do sexo masculino e 2 femininos, dos quais 2 são crianças. Todos oriundos de Córdoba, consultam por zumbido, hipoacusia e tontura ou desequilíbrio póstraumático. Um desses pacientes, um adolescente de 13 anos com hipoacusia bilateral e supuração do ouvido. Ao grupo, soma-se uma paralisia facial recuperada com tratamento clínico. Conclusões: O conhecimento da anatomia, com o apoio da tomografia computadorizada de ouvido e os estudos audiológicos, é fundamental para o diagnóstico clínico e topográfico da lesão.
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Masculino , Feminino , Humanos , Adolescente , Criança , Adulto Jovem , Osso Temporal/anatomia & histologia , Osso Temporal/lesões , Fraturas Cranianas/classificação , Fraturas Cranianas/diagnósticoRESUMO
This paper reports multidisciplinary treatment of a dental trauma case to achieve a favorable prognosis. A healthy 14-year-old girl reported avulsion of teeth 11 and 21 which had occurred three months earlier. The initial treatment consisting of replantation with a semi-rigid splint was performed in hospital. At presentation, the patient was still using the semi-rigid splint. The clinical examination revealed the presence of increased mobility in teeth 11 and 21, and absence of vitality in both. Radiographic examination showed the presence of inflammatory external root resorption in both teeth. The treatment proposed consisted of teeth extraction, a temporary prosthesis followed by adhesive prosthesis, and finally, implant surgery associated with porcelain crowns.
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Os pseudotumores inflamatórios são lesões benignas que se assemelham a neoplasias malignas comrelação aos aspectos clínicos, radiológicos e histológicos, e representam uma reação a uma variedadede injúrias que são bem caracterizadas em seres humanos. Avaliação clínica seguida de examehistopatológico criterioso é fundamental para diferenciação dos pseudotumores inflamatórios de neoplasiasmesenquimais, como os sarcomas. O objetivo do presente relato é descrever um caso depseudotumor inflamatório subcutâneo em um cão com histórico prévio de lesão cutânea causadapor agressão de outro cão há um ano antes do surgimento da massa de aspecto tumoral. Os achadosclínicos, anátomo-patológicos e imunoistoquímicos permitiram concluir se tratar de um pseudotumorinflamatório, pouco relatado na espécie canina.(AU)
The Inflammatory pseudotumors are benign lesions that resemble malignancies in relation to clinical,radiological and histological features, and represent a reaction to a variety of injuries that are wellcharacterized in humans. A clinical evaluation followed by a thorough histological examination is essentialfor differentiation of inflammatory pseudotumors and mesenchymal neoplasms such as sarcomas.The purpose of this report is to describe a case of subcutaneous inflammatory pseudotumor in adog with a previous history of skin damage caused by the aggression of another dog a year before theadvent of mass of tumor appearence. The clinical, pathological and immunohistochemical allowedthe conclusion of an inflammatory pseudotumor, that are few reports in dogs.(AU)
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Animais , Cães , Granuloma de Células Plasmáticas/veterinária , Cães , LinfócitosRESUMO
Os pseudotumores inflamatórios são lesões benignas que se assemelham a neoplasias malignas comrelação aos aspectos clínicos, radiológicos e histológicos, e representam uma reação a uma variedadede injúrias que são bem caracterizadas em seres humanos. Avaliação clínica seguida de examehistopatológico criterioso é fundamental para diferenciação dos pseudotumores inflamatórios de neoplasiasmesenquimais, como os sarcomas. O objetivo do presente relato é descrever um caso depseudotumor inflamatório subcutâneo em um cão com histórico prévio de lesão cutânea causadapor agressão de outro cão há um ano antes do surgimento da massa de aspecto tumoral. Os achadosclínicos, anátomo-patológicos e imunoistoquímicos permitiram concluir se tratar de um pseudotumorinflamatório, pouco relatado na espécie canina.
The Inflammatory pseudotumors are benign lesions that resemble malignancies in relation to clinical,radiological and histological features, and represent a reaction to a variety of injuries that are wellcharacterized in humans. A clinical evaluation followed by a thorough histological examination is essentialfor differentiation of inflammatory pseudotumors and mesenchymal neoplasms such as sarcomas.The purpose of this report is to describe a case of subcutaneous inflammatory pseudotumor in adog with a previous history of skin damage caused by the aggression of another dog a year before theadvent of mass of tumor appearence. The clinical, pathological and immunohistochemical allowedthe conclusion of an inflammatory pseudotumor, that are few reports in dogs.
Assuntos
Animais , Cães , Cães , Granuloma de Células Plasmáticas/veterinária , LinfócitosRESUMO
La muerte celular programada es un evento fisiológico durante el desarrollo. En el encéfalo y la médula espinal, este proceso determina el número y la localización de los diferentes tipos celulares. En el sistema nervioso del adulto, la muerte celular programada o apoptosis está más restringida, pero puede jugar un papel determinante en enfermedades crónicas o agudas. Al contrario de otros tejidos en los cuales la apoptosis está documentada ampliamente desde el punto de vista morfológico, en el sistema nervioso central la evidencia en este sentido es escasa. A pesar de esto, existe consenso acerca de la activación de diferentes sistemas de señalización apoptótica. En el presente artículo se intenta resumir las principales vías de señalización apoptótica identificadas en el tejido nervioso. Considerando que las vías apoptóticas son múltiples, los tipos neuronales diversos y especializados y que la respuesta neuronal a la lesión y la supervivencia dependen del contexto de la célula en el tejido (preservación de la conectividad, integridad glial y matriz extracelular, flujo sanguíneo y disponibilidad de factores tróficos), lo que es relevante en el proceso apoptótico en un sector del cerebro puede no serlo en otro.
Programmed cell death occurs as a physiological process during development. In the brain and spinal cord this event determines the number and location of the different cell types. In adulthood, programmed cell death or apoptosis is more restricted but it may play a major role in different acute and chronic pathological entities. However, in contrast to other tissues where apoptosis has been widely documented from a morphological point of view, in the central nervous system complete anatomical evidence of apoptosis is scanty. In spite of this there is consensus about the activation of different signal systems associated to programmed cell death. In the present article we attempt to summarize the main apoptotic pathways so far identified in nervous tissue. Considering that apoptotic pathways are multiple, the neuronal cell types are highly diverse and specialized and that neuronal response to injury and survival depends upon tissue context, (i.e., preservation of connectivity, glial integrity and cell matrix, blood supply and trophic factors availability) what is relevant for the apoptotic process in a sector of the brain may not be important in another.
Assuntos
Caspases , Isquemia , Doenças Neurodegenerativas , Proteínas , Ferimentos e LesõesRESUMO
OBJECTIVE: To identify which pediatric patients with mild head trauma are candidates for skull radiographs or cranial computed tomography (CCT) scans. METHOD: Patients with mild head trauma aged from 0 to 19 years presenting to the Emergency Department of a trauma centre from Salvador City, Brazil, between May 2007 and May 2008. RESULTS: A total of 1888 mild head trauma patients were admitted; mean age was 7.4 (±5.5) years. A total of 1956 skull radiographs and 734 CCT scans were performed. About 44.4 percent patients with Glasgow coma score (GCS) 13 and 55.4 percent with GCS 14 had abnormal CCT scans. In patients with multiple traumas, 16 percent had abnormal findings on CCT scans. CONCLUSION: We strongly recommend routine CCT studies to patients with GCS of 13 and 14 or to multiple trauma victims, independently of score. Routine screening skull radiographs were not useful in the evaluation of mild head trauma patients in this study.
OBJETIVO: Identificar quais os pacientes na faixa pediátrica com trauma craniencefálico leve são candidatos para a realização de radiografia simples ou tomografia computadorizada do crânio (TCC). MÉTODO: Pacientes com trauma craniano leve, entre 0 e 19 anos, admitidos em um centro de referência em traumatologia, na cidade do Salvador, Brasil, entre maio 2007 e maio 2008. RESULTADOS: Foram atendidos 1888 pacientes com trauma craniano leve, com idade média de 7,4 (±5,5) anos. Um total de 1956 radiografias simples e 734 TCC foram realizadas. Em 44,4 por cento dos pacientes com escala de coma de Glasgow (GCS) 13 e 55.4 por cento com GCS 14, tiveram TCC com achados anormais. Em pacientes com múltiplos traumas, 16 por cento possuíam alterações na TCC. CONCLUSÃO: Recomendamos TCC em pacientes com GCS 13 e 14 ou naqueles com traumas múltiplos, independente do GCS. Radiografias simples do crânio como rotina, não foram identificadas como úteis, no presente estudo.
Assuntos
Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Adulto Jovem , Traumatismos Craniocerebrais , Crânio , Escala de Coma de Glasgow , Inquéritos e Questionários , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Injuries to the temporal bone are caused by high energy mechanisms. Fractures, longitudinal or transverse, are the most frequent lesions and they need to be specifically searched. If the fracture is not visible, its presence is suspected by means of indirect signs, such as soft tissue occupation within mastoid cells, or in the tympanic cavity, and air in an abnormal situation. The ossicular chain can undergo luxations, being the most frequent the incudomallear joint, and fractures. For the study of traumatic injuries of the temporal bone, the CT scan should be the method of choice, especially by means of multislice technology, since the speed of acquisition, and the good quality of multiplanar reconstructions, facilitates the diagnosis.
: Los traumatismos del hueso temporal ocurren por mecanismos de alta energía. Las fracturas, longitudinales o transversales, son las lesiones más frecuentes y deben buscarse dirigidamente. Si el rasgo de fractura no es visualizado, signos indirectos como ocupación de partes blandas en celdillas mastoideas o en la caja timpánica y aire en lugares no habituales, deberían aumentar la sospecha. La cadena de huesecillos puede lesionarse por luxaciones, la incudomaleolar es la más frecuente, o por fracturas. Para el estudio de las lesiones traumáticas del hueso temporal, la tomografía computada debe ser el método de elección, sobretodo si se realiza con tecnología multicorte ya que, la rapidez en la adquisición y la gran calidad en reconstrucciones multiplanares facilita el diagnóstico.