RESUMO
BACKGROUND: There are clear standards for when to operate on both distal epiphyseal and diaphyseal forearm fractures in children. However, paediatric surgeons are often faced with fractures in the transition zone between metaphysis and diaphysis. This aim of the study is to compare different treatment approaches for diametaphyseal forearm fractures, to classify different types of these fractures, and to define further assessment parameters and treatment recommendations. METHODS: This retrospective study included all patients with diametaphyseal radial fractures who were seen at a paediatric surgery clinic between 01.01.2010 and 31.12.2013. Patients were treated either non-surgically (C) or surgically using bicortical Kirschner wire (BC-KW), intramedullary K-wire (IM-KW), elastic stable intramedullary nailing (ESIN), or combined bicortical and intramedullary K-wire (BCIM-KW). RESULTS: During the study period, 547 patients presented with forearm fractures of which 88 patients (16%) had a fracture in the diametaphyseal region. The majority of diametaphyseal fractures were greenstick fractures (54.4%) followed by transverse fractures (44.3%). Distal fractures were predominantly treated with bicortical K-wiring (BC-KW, 40.5%) or non-surgically (C, 26.2%). Proximal fractures were treated by ESIN osteosynthesis (50%), followed by IM-KW (30%). Intermediate fractures were just as likely to be treated with one out of the 5 above-mentioned techniques. The ulna was involved in 64 of 88 cases. Depending on the type of fracture, it was treated either by ESIN osteosynthesis or non-surgically. No superior operative technique was identified. CONCLUSIONS: The description of diametaphyseal fractures as a separate entity is important, because the therapy of these fractures is heterogeneous and challenging. A classification into proximal, intermediate, and distal may be useful in clinical decision-making. Despite the retrospective nature of this study, our data suggest that the use of a K-wire or combined technique BCIM-KW-technique, whenever technically feasible, achieves better radiological results without secondary dislocation. Further prospective studies are needed to provide better guidance to trauma surgeons.
Assuntos
Traumatismos do Antebraço , Fixação Intramedular de Fraturas , Fraturas do Rádio , Criança , Humanos , Estudos Retrospectivos , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Rádio (Anatomia) , Traumatismos do Antebraço/complicações , Traumatismos do Antebraço/cirurgia , Fixação Interna de Fraturas , Fixação Intramedular de Fraturas/efeitos adversos , Resultado do Tratamento , Pinos OrtopédicosRESUMO
BACKGROUND: The large number of biobanks within Germany results in a high degree of heterogeneity with regard to the IT components used at the respective locations. Within the German Biobank Alliance (GBA), 13 biobanks implement harmonized processes for the provision of biomaterial and accompanying data. OBJECTIVES: The networking of the individual biobanks and the associated harmonisation of the IT infrastructure should facilitate access to biomaterial and related clinical data. METHODS: For this purpose, the relevant target groups were first identified in order to determine their requirements for IT solutions to be developed in a workshop. RESULTS: Of the seven identified interest groups, three were initially invited to a first round of discussions. The stakeholder input expressed resulted in a catalogue of requirements with regard to IT support for (i) a sample and data request, (ii) the handling of patient consent and inclusion, and (iii) the subsequent evaluation of the sample and data request. CONCLUSIONS: The next step is to design the IT solutions as prototypes based on these requirements. In parallel, further user groups are being surveyed in order to be able to further concretise the specifications for development.
Assuntos
Bancos de Espécimes Biológicos , Alemanha , Humanos , Inquéritos e QuestionáriosRESUMO
Soot generated from diesel fuel in a combustion tube is characterized by microanalysis, x-ray diffraction, chemical reactivity, and nuclear magnetic resonance to address the recent proposal of the significance of carbon clusters in soot. The data support a traditional model of soot as polynuclear aromatic compounds rather than as clusters of carbon atoms with minimal edge site density. The amounts of noncarbon atoms in the soot (hydrogen, oxygen, nitrogen, and sulfur) are commensurate with the edge density of the crystallites (2 by 2 nanometers) inferred from diffraction. The chemistry of soot, in being reduced by potassium metal and alkylated by alkyl iodides, is that known for aromatic compounds and not that anticipated for materials such as graphite, with a small fraction of carbon atoms on edges.
RESUMO
PURPOSE: The purpose of this study was to report the feasibility of computed modelization and reconstitution of the paranasal sinuses, before and after trauma, from CT data. MATERIALS AND METHODS: We modeled and reconstructed the paranasal sinuses of two patients (A and B), before and after trauma, using two different softwares (3DSlicer® and Blender®). Both patients had different numbers and locations of fractures. The 3DSlicer® software was used to create a 3D model from CT data. We then imported the 3D data into the Blender® software, to reconstruct and compare the dimensions of the paranasal sinuses before and after trauma. RESULTS: The 3 fragments of patient A and the 7 fragments of patient B could be repositioned in the pre-traumatic configuration. Distance measurements proved to be similar between pre- and post-traumatic 3D volumes. CONCLUSION: After simple trauma, bone facial anatomy reconstruction is manually feasible. The whole procedure could benefit from automatization through machine learning. However, this feasibility must be confirmed on more severely fractured paranasal sinuses, to consider an application in forensic identification.
Assuntos
Antropologia Forense/métodos , Medicina Legal/métodos , Processamento de Imagem Assistida por Computador/métodos , Seios Paranasais/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Interface Usuário-Computador , Estudos de Viabilidade , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Seios Paranasais/lesões , Design de SoftwareRESUMO
The influence of sexual victimization on the psychological and social adjustment of 177 pregnant and parenting African Americans was examined. Compared with those who had not been victimized, young women with a history of sexual victimization were more symptomatic, had lower self esteem, and had a more external locus of control than the non-victimized women. In addition, women who were sexually victimized at some time in their lives reported higher levels of economic strain. Victimized young women were less satisfied with their social support than their non-victimized peers. Taken together, these findings suggest that the link between sexual victimization and psychological distress in pregnant and parenting adolescents may be mediated through young women's interpersonal resources.
Assuntos
Negro ou Afro-Americano/psicologia , Poder Familiar/psicologia , Gravidez na Adolescência/psicologia , Estupro/psicologia , Ajustamento Social , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Controle Interno-Externo , Inventário de Personalidade , Gravidez , Fatores de Risco , Autoimagem , Apoio Social , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
The level of total Enterobacterial Enterotoxins of the blood serum, of beta-lysins, lysozyme activity, complement and normal antibodies were studied in 191 patients with acute Flexner dysentery and in 285 patients with acute Sonne dysentery, depending on the period of the disease, its severity, the treatment applied, and the species of the causative agent. The level of the nonspecific humoral immunity factors increased before the treatment and its normalization depended on the treatment applied.
Assuntos
Disenteria Bacilar/imunologia , Doença Aguda , Adolescente , Adulto , Anticorpos/análise , Atividade Bactericida do Sangue , Proteínas do Sistema Complemento/análise , Disenteria Bacilar/tratamento farmacológico , Feminino , Furazolidona/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Muramidase/sangue , Shigella flexneri , Shigella sonnei , Sulfatiazóis/uso terapêuticoRESUMO
A single vaccination of animals with diphtheria-tetanus vaccine caused changes in non-specific resistance of the organism to influenza of phasic character: a reduction of resistance to influenza was observed at the early periods after the vaccination, with its subsequent restoration to the initial level and increase at the remote periods after the immunization. Immunization of children with diphtheria-tetanus vaccine also led to a short-term reduction non-specific resistance to influenza and acute respiratory diseases during the second decade after the vaccination, and its subsequent increase at periods from the 40th to the 60th day.
Assuntos
Toxoide Diftérico , Infecções por Orthomyxoviridae/imunologia , Doenças Respiratórias/imunologia , Toxoide Tetânico , Vacinação , Animais , Difteria/prevenção & controle , Camundongos , Infecções por Orthomyxoviridae/etiologia , Doenças Respiratórias/etiologia , Tétano/prevenção & controleRESUMO
The planned immunization of children aged 11 years with adsorbed DT vaccine in the years of influenza epidemics produced changes in unspecific resistance, occurring in phases: a decrease at the early postvaccinal period and an increase at the late postvaccinal period. When immunization was carried out, on the average, 10 days before the outbreak of influenza, the increased susceptibility phase coincided with the outbreak of influenza; as a reuslt, morbidity rate among the vaccinated children was 3 times higher than among the nonvaccinated children (P < 0.05). In children vaccinated, on the average, 30 days before the epidemic rise of influenza morbidity the increased resistance phase coincided with the peak of the epidemic outbreak; such children showed morbidity rate 6 times lower than the children in the control group. Planned immunization with adsorbed DT vaccine at definite seasons is proposed.
Assuntos
Toxoide Diftérico/administração & dosagem , Influenza Humana/prevenção & controle , Infecções Respiratórias/prevenção & controle , Toxoide Tetânico/administração & dosagem , Criança , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Masculino , Fatores de Tempo , VacinaçãoRESUMO
The article analyzes post-surgery immunosuppression as judged by the data on the functional activity of peripheral blood monocytes in 34 patients with rheumatic heart disease following its surgical correction. It has been established that prolonged immunosuppression may serve as an additional criterion of myocarditis development in the early post-surgery period.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Doenças das Valvas Cardíacas/cirurgia , Síndromes de Imunodeficiência/sangue , Monócitos/imunologia , Miocardite/sangue , Cardiopatia Reumática/cirurgia , Circulação Extracorpórea , Humanos , Complicações Pós-Operatórias/sangue , Cardiopatia Reumática/imunologiaRESUMO
A new experimental rabbit model of acute purulent osteomyelitis is proposed. The model is reproduced by percutaneous introduction of 4 million St. aureus microorganisms into the medullary channel of the femoral bone after aseptic destruction of the bone marrow by ethyl alcohol and hot saline. The model satisfies the demands of good reproduction, reduces probability of contamination of periosteal tissues during intraosteal inoculation and provides reproduction of local inflammation without its generalization which results in reduced number of fatal outcomes among experimental animals.