Impact of cranioskeletal trauma on the development of endogenous intoxication syndrome in rats of different ages.

OBJECTIVE: Aim: The aim of the study was to determine the impact of cranioskeletal trauma (CST) on the development of endogenous intoxication syndrome in rats of different ages. PATIENTS AND METHODS: Materials and Methods: The experiments involved 147 white male Wistar rats of different age groups. The first experimental group included sexual immature rats aged 100-120 days. The second group includes sexually mature rats aged 6-8 months. The third group included old rats aged 19-23 months. In all experimental groups, CST was modelled under thiopentalonatrium anaesthesia. The control rats were only injected with thiopentalonatrium anaesthesia. The animals were withdrawn from the experiments under anaesthesia after 1, 3, 7, 14, 21 and 28 days by total bleeding from the heart. In blood serum, the content of fractions of molecules of middle mass was determined at a wavelength of 254 and 280 nm (MMM254, MMM280). RESULTS: Results: As a result application of CST in rats of different age groups, an increase in the serum content of MMM254 and MMM280 was observed with a maximum after 14 days and a subsequent decrease by 28 days. At all times of the experiment, the indicators were statistically significantly higher compared to the control groups. The degree of growth of the MMM254 fraction after 1, 7 and 14 days was statistically significantly higher in sexual immature rats, and after 21 and 28 days - in old rats. In old rats after 21 and 28 days of the post-traumatic period, the content and degree of growth of the MMM280 fraction in the blood serum were also significantly higher. CONCLUSION: Conclusions: Modelling of CST in rats of different age groups is accompanied by the development of endogenous intoxication syndrome, which is manifested by the accumulation of MMM254 and MMM280 fractions in the blood serum with a maximum after 14 days of the experiment. The content of the serum fraction of MMM254 in sexual immature rats in the dynamics of experimental CST exceeds other age groups after 1, 7 and 14 days, in old rats the content of the studied MMM fractions is significantly higher after 21-28 days.

Pediatric skeletal injuries in emergency department; an alarm of child maltreatment in Egypt: A cross-sectional study.

BACKGROUND: Child physical abuse, a type of child maltreatment (CM), poses a significant global public health concern. Nonaccidental fractures and soft tissue injuries, which encompass any action that directly or indirectly harms a child, are the primary indicators of physical abuse in children. OBJECTIVE: This study aimed to investigate the prevalence, risk factors, and outcomes of accidental and nonaccidental skeletal fractures in a sample of Egyptian children. METHODS: A cross-sectional analytical study was conducted between March 2022 and August 2022. A total of 156 children who presented with skeletal injuries and attended Mobarak Central Hospital were enrolled. Patients were subjected to full history taking, complete examination, and investigations. A structured questionnaire was administered to all the legal guardians. RESULTS: Physical abuse was reported in 22.4 % of cases, while medical neglect was reported in 19.9 % of cases. The incidence of physical abuse was notably higher among children whose fathers were smokers and/or drug addicts (p ≤ 0.05). The most common form of physical abuse was hitting (94.3 %). Among skeletal injuries, fractures were predominant (94.3 %), primarily closed fractures associated with contusions. Fractures of the upper limb accounted for the highest incidence (94.3 %) of skeletal injuries, and 60 % of physically abused children experienced moderate-severity injuries. CONCLUSION: The most common fracture observed in abused children is the upper limb fracture, typically involving a single bone. Clinicians should be more vigilant in suspecting abuse, even in cases where there is an isolated fracture, and advocate for the development of parental training programs.

ANTIOXIDANT-PROOXIDANT BALANCE OF THE KIDNEYS IN RATS OF DIFFERENT AGES UNDER CONDITIONS OF EXPERIMENTAL CRANIOSKELETAL TRAUMA.

OBJECTIVE: The aim: To determine the peculiarities of the antioxidant-prooxidant balance in the kidney of rats of different ages under conditions of experimental cranioskeletal trauma (CST). PATIENTS AND METHODS: Materials and methods: The experiments involved 147 male white Wistar rats of different age groups. The first experimental group included immature animals aged 100-120 days. The second group included sexually mature animals aged 6-8 months. The third group included old animals aged 19-23 months. In all experimental groups, CST was modelled under thiopental-sodium anaesthesia. The control groups of rats was only injected with thiopental-sodium anaesthesia. The animals were withdrawn from the experiments under anaesthesia after 1, 3, 7, 14, 21 and 28 days by total bleeding from the heart. The content of reagents to thiobarbituric acid and catalase activity was determined in a 10 % kidney homogenate extract, and the antioxidant-prooxidant index (API) was calculated from the ratio of these two parameters. RESULTS: Results: As a result of the application of CST in rats of different age groups, a decrease in the value of renal API was observed with a maximum in immature rats - after 7 days, in mature and old rats - after 14 days. By day 28, the index increased in all experimental groups, but did not reach the control level. The degree of decrease in renal API in old rats under the influence of CCT was significantly higher than in other experimental groups. In immature rats, the impairment of renal API after the application of CST was less, indicating higher reserve capacity of the renal antioxidant defence system in this age group of rats. CONCLUSION: Conclusions: Simulation of CST in rats of different age groups is accompanied by a decrease in the value of API, which by day 28 does not reach the control level in any of the experimental groups. The degree of decrease in renal API value statistically significantly increases with increasing age of rats at all times of the post-traumatic period.

Traumatic cubitus valgus consequent of distal humeral fracture: Two case studies from the Holocene Later Stone Age in southern Africa.

OBJECTIVES: Distal fractures of the humerus and their complications have rarely been described or analysed in the palaeopathological literature. The objective of this study was to evaluate two cases of distal humeral fracture with associated cubitus valgus observed in two individuals from the context of the Later Stone Age (LSA) in southern Africa. MATERIALS: Skeletal remains of two individuals. A middle-aged female radiocarbon dated to c.160 BP and a middle-aged male radiocarbon dated to c.2 300 BP. METHODS: Remains were macroscopically and radiographically assessed for injury. RESULTS: Both cases presented with healed antemortem injury to the right elbow attributed to possible falls. Distal humeral fracture resulted in non-union of the lateral epicondyle with extensive morphological changes to the elbow joint including an increased carrying angle. Morphological and osteoarthritic changes suggest a survival period of several years post-injury. SIGNIFICANCE: Cubitus valgus following traumatic injury has rarely been reported amongst historic or prehistoric populations. The described injuries would have had physical and functional consequences, raising questions relating to probable care received during the healing process. The elbow injuries would have resulted in restricted motion and instability of the elbow joint, with a high likelihood of ulnar neuropathy. LIMITATIONS: The contextual information for these individuals is limited and do not permit broader population level study. SUGGESTIONS FOR FURTHER RESEARCH: Formal biomechanical analysis including cross-sectional geometry analysis will provide further information regarding complications and strengthen the diagnosis of ulnar neuropathy. Further research is necessary on the prevalence and complications of humeral fracture.

Research progress of fluoride on non-skeletal injury in multiple systems of the body / 中华地方病学杂志

Fluorine is an essential trace element for human body. Appropriate amount of fluorine can have a certain positive impact on the body, but long-term intake of excessive fluorine will cause damage to the body, which is an important cause of endemic fluorosis. The main feature of fluorosis is skeletal injury to the bones and teeth of the body. In recent years, the research of non-skeletal injury has been increasingly paid attention by research scholars. This paper summarized the non-skeletal injury of fluorine to urinary, digestive, nervous, circulatory, reproductive, immune systems and other systems, providing a reference for fluorosis-related studies other than skeletal injury.

Radiation-Induced Rib Fractures on Magnetic Resonance Imaging Following Proton Therapy for Breast Cancer With Pencil Beam Scanning.

Radiation-induced rib fractures (RIRF) are long-term complications associated with irradiation of the chest/chest wall. RIRFs are commonly seen in lung- or breast-cancer patients treated with stereotactic body radiotherapy (SBRT) or conventional external beam radiation therapy (EBRT), respectively. We report a case of a 31-year-old female presenting with pathological fractures of the third, fourth, and fifth ribs discovered on magnetic resonance imaging (MRI) as a complication from pencil beam scanning (PBS) proton therapy (PT), of the whole left breast and regional lymph nodes. To our knowledge, this presentation is the first to be initially reported on MRI in radiological literature.

Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children.

Background: Timely diagnosis of child physical abuse is of paramount importance. The added value of bone scintigraphy (BS) after a negative radiological skeletal survey (RSS) in children with suspected physical abuse has never been evaluated. Objective: The objective of this study was to assess the extent to which BS could improve the detection rate of skeletal injury in children with suspected physical abuse with an initial negative RSS. Methods: We used discharge codes to retrospectively identify children evaluated for suspected physical abuse in a university hospital (Nantes, France). We included all consecutive children younger than 3 years old who underwent both RSS and BS, with an interval of ≤96 h between tests, from 2013 to 2019. BS and RSS results were interpreted independently during the study period. We specifically analyzed BS results for children with a negative RSS to assess the value of BS as an add-on test. Results: Among the 268 children ≤3 years old with suspected physical abuse who underwent RSS, 140 (52%) also underwent BS within 96 h and were included in the analysis. The median age was 6 months old (interquartile range: 3-8). The detection rate of ≥1 skeletal injury with RSS alone was 49% (n = 69/140, 95% CI: 41-58%) vs. 58% (n = 81/140, 50-66%) with RSS followed by add-on BS, for an absolute increase in the detection rate of 9% points (95% CI: 4-14%). The number of children with a negative RSS who would need to undergo BS to detect one additional child with ≥1 skeletal injury was 6 (95% CI: 4-11). Conclusion: In young children with suspected physical abuse with a negative RSS, add-on BS would allow for a clinically significant improvement in the detection rate of skeletal injuries for a limited number of BS procedures required. Prospective multicenter studies are needed to confirm these findings.

[Relationship between geratic frailty and cognitive dysfunction in the eldly].

OBJECTIVE: To analyze the current situation and correlation between frailty and cognitive dysfunction in the old patients of orthopedic emergency. METHODS: Enrolling 248 elderly people( ≥65 years old) in orthopedic emergency department of Beijing Jishuitan Hospital from September to December 2018, the cognitive function of the subjects was assessed by Mini-mental State Examination( MMSE). The frailty situation was assessed by FRAIL Scale. In addition, ADL, exercise tolerance assessment, gripping power and geriatric nutritional risk index( GNRI) were also tested in this study. RESULTS: In this research, 58( 23. 4%) were the elderly with normal cognitive function, 69( 27. 8%) were MCI, and 86( 34. 7%) were dementia and 35( 14. 1%) were severe dementia. The prevalence of seniors over 76 years old was significantly higher than that of the younger age group( χ~2= 39. 300, P < 0. 001), the prevalence of seniors below primary school was significantly higher than that of junior middle school and above( χ~2= 117. 082, P<0. 001), and the prevalence of dementia in patients with chronic obstructive pulmonary disease( COPD) was higher( χ~2= 11. 685, P = 0. 009). The study subjects were strong elderly, accounting for 69( 27. 8%), 114( 46. 0%) and 65( 26. 2%)were in prefrailty and frailty. The prevalence of prefrailty in 75-85 years old people was significantly higher than that in other groups, and the prevalence of prefrailty and frailty in85 years old people was both higher( χ~2= 45. 247, P<0. 001). In addition, education level( χ~2= 13. 909, P = 0. 008), hypertension( χ~2= 6. 892, P = 0. 032), COPD( χ~2= 8. 411, P =0. 015), cerebral infarction( χ~2= 7. 477, P = 0. 024) and GNRI( χ~2= 22. 942, P = 0. 001)were all the influencing factors of frailty. There were also significant differences in ADL, exercise tolerance and gripping power among the above factors. There were significant differences in cognitive function among subjects with different levels of frailty( χ~2=61. 259, P = 0. 000), ADL( χ~2= 54. 652, P<0. 001), exercise tolerance( χ~2= 77. 001, P =0. 000) and grip strength( χ~2= 54. 778, P < 0. 001). After adjusting for demographic characteristics and chronic diseases such as age, sex, education, BMI, coronary heart disease, hypertension and et al. Logistic regression analysis showed that the OR values of prefrailty, frailty, ADL and exercise tolerance affect cognition are 1. 918( 95% CI 0. 990-3. 716), 2. 732( 95%CI 1. 063-7. 023), 3. 217( 95% CI 1. 421-7. 285), 6. 440( 95% CI1. 803-22. 997). CONCLUSION: Prefrailty and frailty are closely related to cognitive dysfunction in the elderly.

Hox11 Function Is Required for Region-Specific Fracture Repair.

The processes that govern fracture repair rely on many mechanisms that recapitulate embryonic skeletal development. Hox genes are transcription factors that perform critical patterning functions in regional domains along the axial and limb skeleton during development. Much less is known about roles for these genes in the adult skeleton. We recently reported that Hox11 genes, which function in zeugopod development (radius/ulna and tibia/fibula), are also expressed in the adult zeugopod skeleton exclusively in PDGFRα+/CD51+/LepR+ mesenchymal stem/stromal cells (MSCs). In this study, we use a Hoxa11eGFP reporter allele and loss-of-function Hox11 alleles, and we show that Hox11 expression expands after zeugopod fracture injury, and that loss of Hox11 function results in defects in endochondral ossification and in the bone remodeling phase of repair. In Hox11 compound mutant fractures, early chondrocytes are specified but show defects in differentiation, leading to an overall deficit in the cartilage production. In the later stages of the repair process, the hard callus remains incompletely remodeled in mutants due, at least in part, to abnormal bone matrix organization. Overall, our data supports multiple roles for Hox11 genes following fracture injury in the adult skeleton. © 2017 American Society for Bone and Mineral Research.

Bioarchaeological investigation of ancient Maya violence and warfare in inland Northwest Yucatan, Mexico.

This study investigates evidence of changes and continuities in ancient Maya violence and warfare in inland northwest Yucatan, Mexico from the Middle Preclassic (600-300 BC) to the Postclassic (AD 1050-1542) through bioarchaeological analysis of cranial and projectile trauma. It is hypothesized that the frequency of violence increases before the Classic Maya collapse and remains high during the Postclassic period. It is also hypothesized that the flat, open terrain was conducive to warfare and resulted in higher trauma frequencies than in other parts of the Maya area. Results show that the frequency of cranial trauma decreases before the Classic collapse and increases in the Postclassic, partially matching the expected chronological trends. The frequency of cranial trauma does not differ significantly from other Maya regions but the pattern does: for all periods, males have more healed injuries than females and they are concentrated on the left side of the anterior of the skull. Some injuries appear to be from small points hafted in wooden clubs. In addition, projectile trauma is evident in a scapula with an embedded arrowhead tip, the first such case reported in a Maya skeleton. Overall, these results suggest greater reliance on open combat and less on raids in this region compared with other parts of the Maya area, possibly due to the flat, open terrain, though the identification of perimortem trauma in both women and men indicates surprise raids on settlements were also practiced.

MUSCLE INJURY - PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT AND CLINICAL PRESENTATION.

Skeletal muscle tissue has the largest mass in the human body, accounting for 45% of the total weight. Muscle injuries can be caused by bruising, stretching or laceration. The current classification divides such injuries into mild, moderate and severe. The signs and symptoms of grade I lesions are edema and discomfort; grade II, loss of function, gaps and possible ecchymosis; and grade III, complete rupture, severe pain and extensive hematoma. The diagnosis can be confirmed by: ultrasound, which is dynamic and cheap, but examiner dependent; and tomography or magnetic resonance, which gives better anatomical definition, but is static. Initial phase of the treatment can be summarized as the "PRICE" protocol. NSAIDs, ultrasound therapy, strengthening and stretching after the initial phase and range of motion without pain are used in clinical treatment. On the other hand, surgery has precise indications: hematoma drainage and muscle-tendon reinsertion and reinforcement.

Effects of Ginsenoside Rg1 on Structure and Function of Rat Skeletal Muscle with Exercise-induced Fatigue / 广州中医药大学学报

Objective To observe the effects of ginsenoside Rg1 group on the structure and function of rat skeletal muscle with exercise-induced fatigue.Methods SD rats were randomized into blank control group,model group and ginsenoside Rg1 group.The rats in the model group and ginsenoside Rg1 group received medium-intensity treadmill running to induce exercise-induced fatigue.Ginsenoside Rg1 group was given ginsenoside Rg1 50 mg?kg-1?d-1 for 2 continuous weeks during the modeling.After treatment,malondialdehyde(MDA)content,superoxide dismustase(SOD) activity,mitochondrial membrane potential and free calcium content in the rat skeletal muscle were measured.Meanwhile,ultrastructure of the skeletal muscle was observed under the electron microscope.Results In the model group,SOD activity,mitochondrial membrane potential,and free calcium content were decreased,MDA content was increased,and the difference was significant as compared with the blank control group(P

Orthopaedic Injuries in Patients with Traumatic Brain Injury / 대한정형외과학회잡지

PURPOSE: To evaluate the incidence of orthopaedic injuries and develop guidelines for routine radiologic examinations in patients with traumatic brain injury in order to reduce the incidence of delayed diagnosis. MATERIALS AND METHODS: For this study, 175 out of 720 traumatic brain injury patients, who were treated at Sun General Hospital from May 1994 through December 1997, were analyzed. The incidences of musculoskeletal injury and delayed diagnosis were checked. RESULTS: Clavicle fracture occurred most frequently, followed by tibia-fibular fracture, femur fracture, pelvic fracture or hip fracture-dislocation, axial spine fracture, radius-ulnar fracture, knee ligament injury, fracture of the hand and humerus. The overall incidence of delayed diagnosis was 14 percent (24 patients) . And multiple (more than 2) injuries occurred in 43 patients (24%) . CONCLUSION: The data of this study suggest that a radiologic survey, including X-rays of chest, long bones of the lower extremites, pelvis (both hips) and entire axial spine, should be obtained in patients with traumatic brain injury. Also careful examination of the knee should be included.