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1.
PLoS One ; 15(3): e0229735, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150551

RESUMO

Keel bone fractures in laying hens have been described with increasing prevalence from several countries over the last twenty years and are considered one of the greatest welfare problems to the layer industry. In Denmark we have observed fracture prevalence in the range of 53% to 100% in flocks from cage-free systems whereas flock prevalences in birds from enriched cages ranged between 50-98%. Previous research have speculated that the underlying reason for the development of keel bone fractures is trauma in relation to impact of the bird with furniture, other equipment etc. However, little evidence of this theory has been provided. Predisposing factors have also been suggested including genetics of the bird, lack of specific feedstuff components, high egg production, management factors and layer fatigue. This study has addressed the possible pathogenesis of these fractures by pathological characterization of fractures in birds from different production systems. More than 60 keel bones with fractures have been characterized histo-pathologically and by CT scan. This included an assessment of damage to muscles and soft tissues, the bone and the healing process including callus formation. This investigation has shown that high energy collisions cannot be responsible for the majority of fractures, located at the caudal tip of the keel bone, observed in laying birds as markers associated trauma were not observed in the majority of the cases just as few recognized healing processes were observed. These results suggest an alternative pathogenesis to trauma.


Assuntos
Galinhas/fisiologia , Fraturas Ósseas/patologia , Ferimentos e Lesões/patologia , Envelhecimento/patologia , Animais , Feminino , Consolidação da Fratura , Fraturas Ósseas/diagnóstico por imagem , Imageamento Tridimensional , Inflamação/patologia , Masculino , Tomografia Computadorizada por Raios X
2.
PLoS One ; 15(3): e0230641, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32210472

RESUMO

AIM: The aim of this study was to determine prognostic factors for medical and productivity costs, and return to work (RTW) during the first two years after trauma in a clinical trauma population. METHODS: This prospective multicentre observational study followed all adult trauma patients (≥18 years) admitted to a hospital in Noord-Brabant, the Netherlands from August 2015 through November 2016. Health care consumption, productivity loss and return to work were measured in questionnaires at 1 week, 1, 3, 6, 12 and 24 months after injury. Data was linked with hospital registries. Prognostic factors for medical costs and productivity costs were analysed with log-linked gamma generalized linear models. Prognostic factors for RTW were assessed with Cox proportional hazards model. The predictive ability of the models was assessed with McFadden R2 (explained variance) and c-statistics (discrimination). RESULTS: A total of 3785 trauma patients (39% of total study population) responded to at least one follow-up questionnaire. Mean medical costs per patient (€9,710) and mean productivity costs per patient (€9,000) varied widely. Prognostic factors for high medical costs were higher age, female gender, spine injury, lower extremity injury, severe head injury, high injury severity, comorbidities, and pre-injury health status. Productivity costs were highest in males, and in patients with spinal cord injury, high injury severity, longer length of stay at the hospital and patients admitted to the ICU. Prognostic factors for RTW were high educational level, male gender, low injury severity, shorter length of stay at the hospital and absence of comorbidity. CONCLUSIONS: Productivity costs and RTW should be considered when assessing the economic impact of injury in addition to medical costs. Prognostic factors may assist in identifying high cost groups with potentially modifiable factors for targeted preventive interventions, hence reducing costs and increasing RTW rates.


Assuntos
Efeitos Psicossociais da Doença , Retorno ao Trabalho/economia , Ferimentos e Lesões/patologia , Adolescente , Adulto , Idoso , Feminino , Nível de Saúde , Humanos , Tempo de Internação , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Traumatismos da Medula Espinal/economia , Traumatismos da Medula Espinal/patologia , Inquéritos e Questionários , Ferimentos e Lesões/economia , Adulto Jovem
3.
J Zoo Wildl Med ; 50(4): 966-971, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926529

RESUMO

Determining the causes of mortality in endangered species is essential to understanding the possible reasons behind their decline and to facilitating the implementation of mitigating steps. The southern bent-winged bat (Miniopterus orianae bassanii) is a critically endangered Australian bat whose population numbers have decreased over the past 50 years. As part of a larger investigation to determine if disease could be a contributing factor to the decline, 27 southern bent-winged bats and one closely related eastern bent-winged bat (Miniopterus orianae oceanensis) that died during the study were necropsied and examined histologically. Trauma was the most common cause of death in the southern bent-winged bats, which mostly occurred at one site where fencing and other infrastructure was positioned around a key breeding cave. In response to these findings, management actions have been implemented to reduce this infrastructure-associated mortality of southern bent-winged bats. The single eastern bent-winged bat examined had a severe dermatitis caused by the mite Notoedres muris.


Assuntos
Quirópteros , Espécies em Perigo de Extinção , Ferimentos e Lesões/veterinária , Animais , Austrália , Causas de Morte , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/patologia
4.
Sci Rep ; 10(1): 1208, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31988287

RESUMO

PURPOSE: To investigate the clinical characteristics and visual outcomes of patients with work-related open globe injuries (OGIs) and compare them with patients with non-work-related OGIs. DESIGN: Retrospective, observational, multicentre, case-control study. METHODS: A total of 374 patients with work-related OGIs and 170 patients with non-work-related OGIs who presented to hospitals that belong to the Japan-Clinical Research of Study group from 2005 to 2015 were included in this study. Clinical data including age, sex, initial and final visual acuity, type of open globe injury, lens status, zone of injury, wound length, and presence of proliferative vitreoretinopathy, retinal detachment, expulsive haemorrhage, and endophthalmitis were recorded. MAIN OUTCOME MEASURES: Visual acuity. Results Work-related OGIs were associated with younger age, male sex, better initial and final visual acuity, more laceration, smaller wounds, presence of retinal detachment, and expulsive haemorrhage, compared with non-work-related OGIs. Multiple regression analysis revealed that final visual acuity is significantly associated with initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy in work-related OGIs. CONCLUSIONS: Work-related OGIs showed better visual outcomes than other OGIs. Initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy are predictors of visual outcomes in patients with work-related OGIs.


Assuntos
Lesões Acidentais/patologia , Ferimentos Oculares Penetrantes/patologia , Traumatismos Ocupacionais/patologia , Lesões Acidentais/complicações , Lesões Acidentais/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/terapia , Feminino , Seguimentos , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/complicações , Traumatismos Ocupacionais/terapia , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual , Vitreorretinopatia Proliferativa/etiologia , Ferimentos e Lesões/patologia , Adulto Jovem
5.
PLoS One ; 15(1): e0227565, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935266

RESUMO

BACKGROUND: Because of the rapid increase of non-communicable diseases (NCDs) and high burden of healthcare-related financial issues in Bangladesh, there is a concern that out-of-pocket (OOP) payments related to illnesses may become a major burden on household. It is crucial to understand what are the major illnesses responsible for high OPP at the household level to help policymakers prioritize key areas of actions to protect the household from 100% financial hardship for seeking health care as part of universal health coverage. OBJECTIVES: We first estimated the costs of illnesses among a population in urban Bangladesh, and then assessed the household financial burden associated with these illnesses. METHOD: A cross-sectional survey of 1593 randomly selected households was carried out in Bangladesh (urban area of Rajshahi city), in 2011. Catastrophic expenditure was estimated at 40% threshold of household capacity to pay. We employed the Bayesian two-stage hurdle model and Bayesian logistic regression model to estimate age-adjusted average cost and the incidence of household financial catastrophe for each illness, respectively. RESULTS: Overall, approximately 45% of the population of Bangladesh had at least one episode of illness. The age-sex-adjusted average medical expenses and catastrophic health care expenditure among the households were TK 621 and 8%, respectively. Households spent the highest amount of money 7676.9 on paralysis followed by liver disease (TK 2695.4), injury (TK 2440.0), mental disease (TK 2258.0), and tumor (TK 2231.2). These diseases were also responsible for higher incidence of financial catastrophe. Our study showed that 24% of individuals who suffered typhoid incurred catastrophic expenditure followed by liver disease (12.3%), tumor (12.1%), heart disease (8.4%), injury (7.9%), mental disease (7.9%), cataract (7.1%), and paralysis (6.5%). CONCLUSION: The study findings suggest that chronic illnesses were responsible for high costs and high catastrophic expenditures in Bangladesh. Effective risk pooling mechanism might reduce household financial burden related to illnesses. Chronic illness related to NCDs is the major cause of OOP. It is also important to consider prioritizing vulnerable population by subsidizing the high health care cost for some of the chronic illnesses.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Hepatopatias/economia , Transtornos Mentais/economia , Ferimentos e Lesões/economia , Adulto , Bangladesh , Teorema de Bayes , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Hepatopatias/patologia , Masculino , Transtornos Mentais/patologia , Pessoa de Meia-Idade , População Urbana , Ferimentos e Lesões/patologia
6.
Plast Reconstr Surg ; 145(2): 348e-359e, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985636

RESUMO

BACKGROUND: The authors developed a noncontact low-frequency ultrasound device that delivers high-intensity mechanical force based on phased-array technology. It may aid wound healing because it is likely to be associated with lower risks of infection and heat-induced pain compared with conventional ultrasound methods. The authors hypothesized that the microdeformation it induces accelerates wound epithelialization. Its effects on key wound-healing processes (angiogenesis, collagen accumulation, and angiogenesis-related gene transcription) were also examined. METHODS: Immediately after wounding, bilateral acute wounds in C57BL/6J mice were noncontact low-frequency ultrasound- and sham-stimulated for 1 hour/day for 3 consecutive days (10 Hz/90.6 Pa). Wound closure (epithelialization) was recorded every 2 days as the percentage change in wound area relative to baseline. Wound tissue was procured on days 2, 5, 7, and 14 (five to six per time point) and subjected to histopathology with hematoxylin and eosin and Masson trichrome staining, CD31 immunohistochemistry, and quantitative polymerase-chain reaction analysis. RESULTS: Compared to sham-treated wounds, ultrasound/phased-array-treated wounds exhibited significantly accelerated epithelialization (65 ± 27 percent versus 30 ± 33 percent closure), angiogenesis (4.6 ± 1.7 percent versus 2.2 ± 1.0 percent CD31 area), and collagen deposition (44 ± 14 percent versus 28 ± 13 percent collagen density) on days 5, 2, and 5, respectively (all p < 0.05). The expression of Notch ligand delta-like 1 protein (Dll1) and Notch1, which participate in angiogenesis, was transiently enhanced by treatment on days 2 and 5, respectively. CONCLUSIONS: The authors' noncontact low-frequency ultrasound phased-array device improved the wound-healing rate. It was associated with increased early neovascularization that was followed by high levels of collagen-matrix production and epithelialization. The device may expand the mechanotherapeutic proangiogenesis field, thereby helping stimulate a revolution in infected wound care.


Assuntos
Pele/lesões , Terapia por Ultrassom/métodos , Cicatrização/fisiologia , Ferimentos e Lesões/terapia , Animais , Colágeno/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neovascularização Fisiológica/fisiologia , Pele/metabolismo , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia
7.
J Forensic Sci ; 65(2): 627-635, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31577378

RESUMO

Noncontact three-dimensional (3D) surface scanning methods are used within forensic medicine to record traumas and other related findings. A structured light scanning technique is one of these methods and the most suitable for the forensic field. An assessment of the efficiency of different structured light scanners with forensic injuries is essential to validate this technique for wound documentation. The purpose of this study was to evaluate the capability of the HP structured light scanner Pro S3 for digitizing open injuries having complicated areas and depths. Fifteen simulated injuries on mannequins were scanned and assessed. Comparisons between 3D and direct wound measurements were made. The results showed that the technique was able to create detailed 3D results of the extensive injuries. Statistical significance tests revealed no difference between the two measurement methods. Because the scanner is applicable for routine work, it should be considered to confirm the same results on real cadavers and actual wounds.


Assuntos
Imageamento Tridimensional , Ferimentos e Lesões/diagnóstico por imagem , Ferimentos e Lesões/patologia , Simulação por Computador , Medicina Legal/métodos , Humanos , Luz , Manequins , Software
8.
N Z Vet J ; 68(2): 84-91, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31607211

RESUMO

Aims: To characterise and classify wounds in sheep suspected to have been caused by attacks by kea (Nestor notabilis) (kea strike), and to report the prevalence of these wounds on five high country farms in the South Island of New Zealand.Methods: Data were collected from farms between 28 August 2012 and 20 September 2013. Sheep were examined opportunistically immediately after shearing for signs of wounds caused by kea. The age and sex of sheep were also recorded. Wounds were measured and characterised as recent, healing, or healed, and the estimated true prevalence was calculated for each farm.Results: Injuries consistent with kea strike wounds were identified in 70/13,978 (0.5%) sheep examined. The estimated true prevalence varied between farms, from 0 (95% CI = 0-0.16) to 1.25 (95% CI = 0.97-1.61)%. Of the 76 wounds identified, 61 (80%) were located in the lumbar region, and 74 (97%) consisted of full-thickness ulceration of the skin, one showed evidence of injury to muscle and one to bone. The median length of the 63 wounds measured was 6 (min 1, max 23.5) cm, and 10/63 (13%) were categorised as recently healed, 47/63 (62%) as healing, and 17/63 (22%) as recent wounds.Conclusions: The results of this study show that kea strike on sheep was occurring at a low prevalence on the high country farms surveyed. The wounds identified were survivable, but the welfare impact of kea strike on sheep should be considered in balance with the conservation status of kea. There was clear variation in the prevalence of wounds attributed to kea strike between the farms but we were not able to identify the risk factors contributing to these differences. Future studies of kea strike should examine variables such as altitude, local kea density and distribution, and differences in kea strike management and husbandry practices, and should include high country farms without a history of kea strike.


Assuntos
Mordeduras e Picadas , Papagaios/fisiologia , Ovinos/lesões , Ferimentos e Lesões/veterinária , Animais , Nova Zelândia/epidemiologia , Prevalência , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/patologia
9.
Forensic Sci Int ; 306: 110059, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31780351

RESUMO

In traffic accidents, the differentiation of run-over and other injuries is crucial because questions about the origin of fatal injuries often arise. It is sometimes difficult for forensic pathologists to answer them due to the superimposition of injuries or competing, potentially fatal findings. Therefore, using morphometric three-dimensional (3D) reconstructions offers new perspectives based on an interdisciplinary evaluation of all findings and traces. The morphometric 3D reconstruction includes the allocation of patterned injuries or transferred material, the determination of the origin of injuries as well as the reconstruction of the incident. The generated 3D models of persons, clothes, vehicles, incident sites and relevant objects resulting from forensic imaging, photogrammetry, 3D structured-light and laser scanning are included, as are all detected traces and damages. Three case studies are presented to illustrate the possibilities and results of morphometric 3D reconstruction. Run-over accidents have received less attention than the topic of pedestrian, bicycle and motorbike accident analysis for which there is a large body of literature. Our goal is to add to the understanding of run-over accidents using morphometric reconstruction in order to improve their analysis in the future. The possibilities of morphometric reconstructions by means of 3D techniques in run-over accidents are wide-ranging and can provide new, unexpected and significant insights.


Assuntos
Acidentes de Trânsito , Simulação por Computador , Medicina Legal/métodos , Imageamento Tridimensional , Pedestres , Humanos , Lasers , Imagem por Ressonância Magnética , Masculino , Fotogrametria , Software , Tomografia Computadorizada por Raios X , Ferimentos e Lesões/patologia
11.
Forensic Sci Int ; 305: 110029, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31726327

RESUMO

The question whether an injury was sustained during life or not is one of the most important subjects in forensic medicine. Therefore, vital reactions have been a main research topic in forensic medicine for a long period and many renowned forensic pathologists have devoted important papers to this field. The research area ranges from macroscopically visible organ reactions, over tissue alterations (enzyme histochemistry, later on immunohistochemistry with a wide range of enzymes and other analytes, molecular pathology) to biochemical responses to injury. Especially in the field of immunohistochemistry and molecular pathology much progress has been achieved in the last years (e.g. heat-shock-proteins or positive aquaporine3-staining in mechanical skin trauma). Furthermore, 20 years after its implementation postmortem imaging also contributes to the detection and visualization of vital signs. The aim of the present review is to provide an update on forensically relevant vital signs/vital reactions. Systemic vital reactions especially of the circulatory and respiratory system as well as local vital reactions will be addressed. Vital reactions of different organ systems will be discussed in detail regarding pathogenesis and possible postmortem evolution. Current research on immunohistochemically detectable vital reactions (heat-shock-protein expression, aquaporine3-staining in mechanical trauma of the skin) will be addressed as well as biochemical vital reactions (agonochemical stress reaction, myoglobine in electrocution death, hypoxanthine as marker of hypoxia).


Assuntos
Medicina Legal/métodos , Ferimentos e Lesões/patologia , Catecolaminas/sangue , Tosse , Deglutição , Embolia/patologia , Exsanguinação/patologia , Hemorragia/patologia , Humanos , Imuno-Histoquímica , Insulina/sangue , Absorção Intestinal , Isquemia/patologia , Pneumotórax/patologia , Proteínas/metabolismo , Enfisema Pulmonar/patologia , Ventilação Pulmonar , Púrpura/patologia , Aspiração Respiratória/patologia , Salivação
12.
Nat Commun ; 10(1): 5166, 2019 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727891

RESUMO

Immune cells congregate at specific loci to fight infections during inflammatory responses, a process that must be transient and self-resolving. Cell dispersal promotes resolution, but it remains unclear how transition from clustering to dispersal is regulated. Here we show, using quantitative live imaging in zebrafish, that differential ligand-induced trafficking of chemokine receptors such as Cxcr1 and Cxcr2 orchestrates the state of neutrophil congregation at sites of tissue damage. Through receptor mutagenesis and biosensors, we show that Cxcr1 promotes clustering at wound sites, but is promptly desensitized and internalized, which prevents excess congregation. By contrast, Cxcr2 promotes bidirectional motility and is sustained at the plasma membrane. Persistent plasma membrane residence of Cxcr2 prolongs downstream signaling and is required for sustained exploratory motion conducive to dispersal. Thus, differential trafficking of two chemokine receptors allows coordination of antagonistic cell behaviors, promoting a self-resolving migratory response.


Assuntos
Neutrófilos/metabolismo , Receptores de Interleucina-8A/metabolismo , Receptores de Interleucina-8B/metabolismo , Ferimentos e Lesões/patologia , Proteínas de Peixe-Zebra/metabolismo , Peixe-Zebra/metabolismo , Sequência de Aminoácidos , Animais , Membrana Celular/metabolismo , Movimento Celular , Regulação para Baixo , Endocitose , Modelos Biológicos , Mutagênese/genética , Mutação/genética , Transporte Proteico , Receptores de Interleucina-8A/química , Receptores de Interleucina-8A/genética , Receptores de Interleucina-8B/química , Receptores de Interleucina-8B/genética , Fatores de Tempo , Proteínas de Peixe-Zebra/química , Proteínas de Peixe-Zebra/genética
13.
Int J Mol Sci ; 20(21)2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31731459

RESUMO

Noise exposure affects the organ of Corti and the lateral wall of the cochlea, including the stria vascularis and spiral ligament. Although the inner ear vasculature and spiral ligament fibrocytes in the lateral wall consist of a significant proportion of cells in the cochlea, relatively little is known regarding their functional significance. In this study, 6-week-old male C57BL/6 mice were exposed to noise trauma to induce transient hearing threshold shift (TTS) or permanent hearing threshold shift (PTS). Compared to mice with TTS, mice with PTS exhibited lower cochlear blood flow and lower vessel diameter in the stria vascularis, accompanied by reduced expression levels of genes involved in vasodilation and increased expression levels of genes related to vasoconstriction. Ultrastructural analyses by transmission electron microscopy revealed that the stria vascularis and spiral ligament fibrocytes were more damaged by PTS than by TTS. Moreover, mice with PTS expressed significantly higher levels of proinflammatory cytokines in the cochlea (e.g., IL-1ß, IL-6, and TNF-α). Overall, our findings suggest that cochlear microcirculation and lateral wall pathologies are differentially modulated by the severity of acoustic trauma and are associated with changes in vasoactive factors and inflammatory responses in the cochlea.


Assuntos
Cóclea , Citocinas/metabolismo , Perda Auditiva Provocada por Ruído , Ferimentos e Lesões , Animais , Velocidade do Fluxo Sanguíneo , Cóclea/irrigação sanguínea , Cóclea/metabolismo , Cóclea/ultraestrutura , Modelos Animais de Doenças , Perda Auditiva Provocada por Ruído/metabolismo , Perda Auditiva Provocada por Ruído/patologia , Perda Auditiva Provocada por Ruído/fisiopatologia , Masculino , Camundongos , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia , Ferimentos e Lesões/fisiopatologia
14.
Acta Histochem ; 121(8): 151450, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31672390

RESUMO

INTRODUCTION: Traumatic Ulcerative Granuloma with Stromal Eosinophilia (TUGSE) is a rare oral ulcerated lesion of uncertain etiology, showing eosinophil-rich granulation tissue, with occasional large atypical CD30 positive mononuclear cells. It had been suggested that it may represent an oral counterpart of cutaneous lymphomatoid papulosis, with a potential to evolve into CD30 + T cell lymphoma OBJECTIVES: To compare TUGSE and non-specific oral ulcers (NSU) clinically, histopathologically and by clonality analysis for T-cell receptor re-arrangement, aiming to determine whether TGUSE with atypical cells is a lymphomatous premalignant condition, and whether therapeutic approach should be radical or conservative. MATERIALS AND METHODS: Retrospective archival analysis included 17 TUGSE and 8 NSU cases. Histopathological parameters included mean eosinophil number per high power field (HPF), presence of infiltration of deep soft tissues and presence of atypical cells. Immuno-morphometry comprised of the mean number of CD30+ atypical cells per HPF. T-cell receptor (TCR) gene rearrangement by polymerase chain reaction (PCR) was performed in all cases showing atypical cells. Clinical and follow up data were retrieved from files. RESULTS: TUGSE showed a significantly higher mean eosinophil number/HPF in comparison to NSU (7.0 + 4.2 cells and 2.3 + 1.72, respectively; p < 0.001). Atypical cells were found in 9 (53%) cases of TUGSE and in only 1 (11%) case of NSU. CD30+ atypical cells were found in 7 (41%) cases of TUGSE and only in 1 (11%) case of NSU. Mean number of CD30+ cells/HPF was 0.23 + 0.19 (range 0 - 0.54 cells/HPF) for TUGSE. In the only NSU case with CD30+ cells, their density was 0.52/HPF. All lesions with atypical cells were polyclonal for TCR. All cases were self-limiting, with no recurrences, after 3-9 years (mean 4.6 years) follow up. CONCLUSIONS: Analysis found no support to the suggestion that TUGSE with atypical cells represents the oral counterpart of lymphomatoid papulosis or predisposes the lesions for a hematolymphoid malignancy. Suggestions for radical therapeutic approach and long-term follow-up are probably unjustified, with no recurrences or malignancy recorded following conservative treatment alone for a period of up to 9 years of follow-up. Staining for CD30 and PCR for TCR gene rearrangement should be reserved only for rare cases with abundant large atypical cells and/or unusual clinical behavior.


Assuntos
Rearranjo Gênico do Linfócito T , Granuloma , Antígeno Ki-1 , Granulomatose Linfomatoide , Neoplasias Bucais , Proteínas de Neoplasias , Úlceras Orais , Ferimentos e Lesões , Idoso , Idoso de 80 Anos ou mais , Criança , Eosinofilia/genética , Eosinofilia/metabolismo , Eosinofilia/patologia , Feminino , Seguimentos , Granuloma/genética , Granuloma/metabolismo , Granuloma/patologia , Humanos , Antígeno Ki-1/genética , Antígeno Ki-1/metabolismo , Granulomatose Linfomatoide/genética , Granulomatose Linfomatoide/metabolismo , Granulomatose Linfomatoide/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/genética , Neoplasias Bucais/metabolismo , Neoplasias Bucais/patologia , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Úlceras Orais/genética , Úlceras Orais/metabolismo , Úlceras Orais/patologia , Estudos Retrospectivos , Ferimentos e Lesões/genética , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia
15.
Wilderness Environ Med ; 30(4): 362-368, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31668938

RESUMO

INTRODUCTION: With the growing enthusiasm from people of all ages about rock climbing and bouldering, adaptions and medical conditions of the older athlete have become increasingly important. We aimed to analyze injury demographics, distribution, and severity for the older rock-climbing athlete. METHODS: During a 3-y period, we performed a single-center injury surveillance in athletes ≥35 y of age presenting with rock climbing-related injuries or complaints. A standard questionnaire and examination protocol were conducted. RESULTS: A total of 198 patients (age 44.2±7.1 [35-77] y) (mean±SD, with range) with 275 independent injuries were recorded. Ninety percent of all injuries affected the upper extremity, 6% the lower extremity, and 4% other body regions. The Union Internationale des Associations d'Alpinisme injury scores were 2.0±0.3 (1-4), and no fatalities occurred. Acute injuries were observed in 32% and overuse injuries in 68% of all injuries. Among the overuse injuries, 47% were classified as degenerative overuse conditions. Athlete age did not significantly correlate with the development of overuse injuries and UIAA injury score, but subgroup analysis showed a weak correlation of the climber age with the development of degenerative conditions (P<0.05). The leading diagnosis of degenerative conditions was subacromial impingement syndrome of the shoulder. CONCLUSIONS: Compared to younger athletes, older rock climbers demonstrate a higher proportion of overuse injuries, especially degenerative conditions. Profound knowledge of climbing injuries patterns and conditions in older rock climbers is crucial to prevent injuries among all age groups and to decrease the number of degenerative injuries.


Assuntos
Traumatismos em Atletas/etiologia , Extremidade Inferior/lesões , Recreação , Extremidade Superior/lesões , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/patologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Pelve/lesões , Traumatismos da Coluna Vertebral/patologia
16.
Wilderness Environ Med ; 30(4): 425-430, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31694782

RESUMO

Massive hemorrhage is an immediate threat to life. The military developed the Tactical Combat Casualty Care guidelines to address the management of acute trauma, including administration of blood products. The guidelines have been expanded to include low titer O whole blood, which is in limited use by the military. This proposal describes how the transfusion of fresh whole blood might be applied to the remote civilian environment. In doing so, this life-saving intervention may be brought to the austere medical environment, allowing critically hemorrhaging patients to survive to reach definitive medical care.


Assuntos
Sistema ABO de Grupos Sanguíneos , Transfusão de Sangue , Hemorragia/terapia , Ferimentos e Lesões/patologia , Doadores de Sangue , Tipagem e Reações Cruzadas Sanguíneas , Preservação de Sangue , Medicina de Emergência/métodos , Acesso aos Serviços de Saúde , Hemorragia/etiologia , Humanos , Ressuscitação , Reação Transfusional , Medicina Selvagem
17.
Molecules ; 24(23)2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31766365

RESUMO

Skin wound healing, especially chronic wound healing, is a common challenging clinical problem. It is urgent to broaden the sources of bioactive substances that can safely and efficiently promote skin wound healing. This study aimed to observe the effects of small molecular peptides (SMPs) of the mantle of Pinctada martensii on wound healing. After physicochemical analysis of amino acids and mass spectrometry of SMPs, the effect of SMPs on promoting healing was studied through a whole cortex wound model on the back of mice for 18 consecutive days. The results showed that SMPs consisted of polypeptides with a molecular weight of 302.17-2936.43 Da. The content of polypeptides containing 2-15 amino acids accounted for 73.87%, and the hydrophobic amino acids accounted for 56.51%. Results of in vitro experimentation showed that SMPs possess a procoagulant effect, but no antibacterial activity. Results of in vivo experiments indicated that SMPs inhibit inflammatory response by secretion of anti-inflammatory factor IL-10 during the inflammatory phase; during the proliferative phase, SMPs promote the proliferation of fibroblasts and keratinocytes. The secretion of transforming growth factor-ß1 and cyclin D1 accelerates the epithelialization and contraction of wounds. In the proliferative phase, SMPs effectively promote collagen deposition and partially inhibit superficial scar hyperplasia. These results show that SMPs promotes dermal wound healing in mice and have a tremendous potential for development and utilization in skin wound healing.


Assuntos
Queratinócitos/fisiologia , Peptídeos/farmacologia , Pinctada/metabolismo , Pele/citologia , Bibliotecas de Moléculas Pequenas/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Bactérias/efeitos dos fármacos , Coagulação Sanguínea/efeitos dos fármacos , Proliferação de Células , Células Cultivadas , Citocinas/metabolismo , Queratinócitos/citologia , Queratinócitos/efeitos dos fármacos , Masculino , Camundongos , Pele/efeitos dos fármacos , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia
18.
ACS Appl Mater Interfaces ; 11(38): 34736-34743, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31518114

RESUMO

Wound dressings are important materials for the successful recovery of skin trauma. Traditional wound dressings such as gauzes are not efficient in wound healing. Here we show that silk fibroin, spun from a wild silkworm Antheraea pernyi (A. pernyi) and rich in Arg-Gly-Asp (RGD) sequences, can be developed into a wound dressing after proper modification for improving the cell adhesion to accelerate the skin repair. Specifically, polydopamine (PDA) was coated on an A. pernyi silk fibroin (AF) film to form the PAF film to achieve enhanced cell adhesion and would healing. The PDA coating significantly increased the roughness and hydrophilicity of the AF film and thus its protein absorption capability. Furthermore, the PAF films promoted the adhesion and migration of mesenchymal stem cells (MSCs) in the in vitro wound healing assay. In vivo testing confirmed that wound covered with the PAF film was completely healed with the formation of the new skin and hair within 14 days post trauma. Histological examination indicated that, compared to the AF film and gauze control, the PAF film did not cause significant inflammation in the wound but promoted the epithelialization and well-organized collagen deposition in the dermis. This work indicates that AF films coated with PDA are promising wound dressings for skin tissue repair.


Assuntos
Materiais Revestidos Biocompatíveis/química , Indóis/química , Membranas Artificiais , Células-Tronco Mesenquimais , Polímeros/química , Cicatrização , Ferimentos e Lesões , Animais , Bombyx , Adesão Celular , Movimento Celular , Fibroínas , Masculino , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Oligopeptídeos/química , Ratos , Ratos Sprague-Dawley , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia , Ferimentos e Lesões/terapia
19.
Mater Sci Eng C Mater Biol Appl ; 105: 110083, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31546466

RESUMO

Cutaneous wounds, especially chronic wounds, remain clinical challenges, and this is partially due to the complex healing process composed of four overlapping but distinct stages including hemostasis, inflammation, proliferation and remodeling. Therefore, wound dressings with spatially designed structures which can temporally regulate certain bioactive components to function at specific healing stages might be able to accelerate the healing process. In this study, nanobioglass incorporated chitosan-PVA (polyvinyl alcohol) trilayer nanofibrous membrane (nBG-TFM) was fabricated via sequential electrospinning. This membrane exhibited excellent biocompatibility, antibacterial activity and regeneration promotion effect. Furthermore, spatially designed structure optimized functions of each component and provided more suitable microenvironment as compared with uniform membrane. Rat full-thickness skin defects model and mice diabetic chronic wound model showed that nBG-TFM could achieve significantly accelerated and enhanced healing, in terms of complete re-epithelialization, improved collagen alignment and formation of skin appendages. It was revealed that nBG-TFM functioned through upregulating growth factors including VEGF and TGF-ß. Meanwhile inflammatory cytokines such as TNF-α and IL-1ß were downregulated. The technology presented in this study shed new light on designing functional wound dressings which can promote healing of chronic wounds.


Assuntos
Bandagens , Cerâmica , Quitosana , Membranas Artificiais , Nanofibras , Álcool de Polivinil , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões , Animais , Linhagem Celular , Cerâmica/química , Cerâmica/farmacologia , Quitosana/química , Quitosana/farmacologia , Doença Crônica , Complicações do Diabetes/metabolismo , Complicações do Diabetes/patologia , Complicações do Diabetes/terapia , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Experimental/terapia , Masculino , Camundongos , Nanofibras/química , Nanofibras/uso terapêutico , Álcool de Polivinil/química , Álcool de Polivinil/farmacologia , Ratos , Ratos Sprague-Dawley , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia , Ferimentos e Lesões/terapia
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