Severe infections of the head and neck resulting from gas-forming organisms: report of case.

A case of severe infection of the head and neck associated with gas-forming organisms in a patient with fractures of the mandible is presented. Selected aspects of antibiotic therapy are discussed.

Post-traumatic first metatarsal reconstruction using coralline hydroxyapatite.

Autogenous bone grafting has been the standard approach to reconstruction of trauma-induced metatarsal defects. However, this treatment has well-known disadvantages related to the harvesting, size, shape, and availability of autografts. The authors used a synthetic hydroxyapatite bone-graft substitute manufactured from a marine coral with a morphology similar to that of cancellous bone in the reconstruction of a large, post-traumatic first metatarsal defect. The authors found grafting with coralline hydroxyapatite to be a safe and effective substitute for autogenous bone grafting in the post-traumatic setting.

Self-instructional posters: one way to save time and money.

Getting staff to continuing education programs can be difficult due to time, staffing, and cost restraints. A self-instructional module combined with a teaching poster format has had a favorable response from participants. This format has the capability of reaching a higher number of participants and is both time- and cost-effective.

Treatment of open fractures.

This article reviews current concepts in treating open fractures along with case studies to illustrate specific treatment procedures. It should be used as a basis for care and provide the fundamentals to successfully treat patients in a trauma setting. The practitioner will find this a challenging and exciting area for professional practice.

Chest pain and hypoxemia from inhalation of a trichloroethane aerosol product.

A 25-year-old man developed severe shortness of breath, constricting chest pressure, chest pain, cough and myalgia following acute exposure to a waterproofing aerosol that contained trichloroethane. He became febrile and developed a small area of atetectasis with significant hypoxemia. Recovery was complete within 36 hours. This experience suggests that casual use of a trichloroethane aerosol with a surface active agent can cause acute pulmonary toxicity. The mechanism of this injury is unknown.

Interferon beta1a treatment modulates TH1 expression in gammadelta + T cells from relapsing-remitting multiple sclerosis patients.

A paradigm exists that multiple sclerosis is causally related to dysregulation of TH1 inflammatory cytokines and TH2 antiinflammatory cytokines. The cytokine source(s) that initiate the imbalances are unknown. In this study, gammadelta, CD4, and CD8 T cell receptor-positive (TCR+) cells were isolated from the blood of 26 definitive relapsing-remitting multiple sclerosis patients prior to interferon beta-1a (IFNbeta1a) therapy and following 8-10 weeks of this therapy. The bioactivities of interferon gamma (IFNgamma), interleukin 10 (IL10), and interleukin 12 (IL12) were determined. The concentrations of IFN-gamma, IL10, and IL12 from each cell type did not change significantly with IFNbeta1a treatment. The IL10 secreted by gammadelta TCR+ cells strongly correlated with the IL12 secreted by the same gammadelta TCR+ cells, supporting the paradigm. Furthermore, IFNbeta1a therapy decreased the gammadelta TCR+ cell secretion of TH1 cytokines after 8-10 weeks of therapy.