External Injury Research Articles

Association between External Load and Injury Incidence in Professional and Elite-Youth Football Players

Association between External Load and Injury Incidence in Professional and Elite-Youth Football Players

Pattern and distribution of injuries associated with road traffic accident in Haldwani (Nainital) - An autopsy based study

Indiais one of the fastest growing economies. There is a rapid inflation of vehicles on the road that range from motorcycles to heavy vehicles which also shows an active surge in the fatal road accidents. This study is focussed to find out the pattern and distribution of injuries in fatal road traffic accident cases in Kumaon region of Uttarakhand as to plan at the time of policy making and traffic law implementation.: The present study was conducted in the department of Forensic Medicine & Toxicology of Government Medical College, Haldwani from January 1 2019 to December 31 2019, on total 110 cases of RTA brought to mortuary for medico-legal post mortem examination.: Maximum number of cases sustained head and neck injuries (42 out of 110 externally) followed by extremities injury (28 out of 110). Total 38 cases out of 110 sustained head and neck injuries internally, followed by abdominal injuries (28 cases). Abrasions (30 cases) and laceration (29 cases) were commonest type of external injury noted in RTA cases followed by contusion (22 cases) and fracture (19 cases). Most common cause of death among RTA victims was head injury (40 out of 110 cases) followed by shock and haemorrhage (37 out of 110 cases).

Current Status of Wound Dressing Research in Biomaterials

Skin is the body's first defense against external injuries, in daily production life, skin as an organ is easily injured, forming surface trauma. Wound dressings play a pivotal role in the process of skin wound repair. In order to meet the clinical demand for wound dressings, functional wound dressings with excellent biocompatibility, excellent antimicrobial activity, absorption of wound exudate and promotion of wound tissue repair have been developed. We categorize wound dressings into traditional medical dressings and novel medical wound dressings, and review the wound dressings included in the latter in terms of types, preparation methods, and effects. In future treatments for chronic wounds, researchers will integrate and utilize the antimicrobial activity, biocompatibility, and mechanical properties of wound dressings to investigate advanced wound dressings with multiple functions.

To investigate the pattern of neck injuries and the role of toxicology in cases of hanging and manual/homicidal ligature strangulation in Ireland between 2016 – 2020: A retrospective review and analysis

The pattern of neck injuries sustained in fatal cases of external compression to the neck is recorded during Post Mortem Examinations (PME), to assist in the interpretation of the circumstances that led to death. In this study, the PMEs performed for 298 cases of hanging and strangulation occurring between 2016 and 2020 in Ireland were retrospectively reviewed for the purpose of recording and collating the external and internal neck injuries observed during each PME, as well as the toxicology results for each decedent. Statistical analysis was performed to investigate potential novel associations between anthropometric variables pertaining to the decedents and the PME findings in cases of hanging and strangulation, serving to add further data to the existing body of research in this area and to assist in the resolution of future cases of hanging or strangulation where there are conflicting findings. In completing statistical analysis, it was found that there was no discernible association between the occurrences of cartilaginous neck fractures (CNFs) with increasing ligature width. Positive associations between increasing weight and BMI of the decedents were identified, and a significantly positive association between the increasing height of the decedent and the incidence of CNFs were identified. Analysis of the toxicology demonstrated that antipsychotics were implicated most frequently in cases of incomplete and complete hanging associated with CNFs and that opioids were implicated most frequently in cases of manual and ligature strangulation associated with CNFs. ObjectiveTo record the pattern of neck injuries sustained in retrospective cases of hanging and manual/ligature strangulation and to collate these findings so as to provide scientific evidence to support the interpretation of the findings in future cases of suicidal hanging and homicidal manual/ligature strangulation for the purpose of medicolegal investigation. To analyse the associations between the occurrence of neck fractures and anthropometric variables pertaining to the victims in cases of complete hanging. Study designThe reports of 298 Post Mortem Examinations (PMEs) performed for cases of hanging and manual/homicidal ligature strangulation between 2016 and 2020 in Ireland were retrospectively reviewed. Pseudoanonymised data sets were recorded for each report, which included the following parameters: neck injuries (soft tissue and cartilaginous), weight, height, BMI and ligature width, toxicology, noose position, ligature material, tongue protrusion, sex and age. Permission for the use of this data was sought from the pathologists and coroners involved in these cases. The data was analysed according to descriptive statistical methods and logistic regression analysis. ResultsLogistic regression analysis was undertaken to examine the associations between unit increases in ligature width and increases in a set of physical characteristics of the decedents (weight, BMI and height) with the occurrence of CNFs. Increasing ligature width was not found to increase the likelihood of a CNF occurring, where the Odds Ratio (OR) for this event occurring was 0.9596. Unit increases in body weight and BMI were found to increase the likelihood of the occurrence of a CNF with ORs of 1.0166 and 1.0607 respectively. Increasing height of the decedent yielded an OR = 4.64, demonstrating that CNFs are significantly more likely to occur with increasing height (CI 95 %: 0.2915, 73.9559). ConclusionsAccording to the statistical analysis performed for this study, increasing weight, height and BMI are parameters of the decedents which increase the likelihood of the occurrence of CNFs in cases of complete hanging.

Is Fibular Fixation Necessary with Increasing Proximity in Ankle Fractures: A Survey of OTA and AOFAS Surgeons

Introduction/Purpose: Ankle fractures are one of the most common fractures encountered in orthopedics. The Maisonneuve fracture pattern is described as a pronation, external rotation injury involving the medial ankle structures, the syndesmosis, and the proximal third of the fibula. However, the actual distance from the proximal fibula has not been defined in what distinguishes a Maisonneuve fracture. With Weber C fractures, most surgeons tend to provide fixation to the fibula and reassess the syndesmosis afterwards. When dealing with the proximal fibula “Maisonneuve” fracture pattern, most surgeons would tend to ignore the fibula fracture and focus on syndesmotic reduction. Orthopaedic Trauma Association and American Orthopaedic Foot & Ankle Society provided their opinion via survey in treating increasing proximity of fibula fractures associated with unstable ankle fracture patterns. Methods: A survey was provided to eight OTA and AOFAS orthopedic surgeons. A powerpoint was provided to the surgeons that contained non-weightbearing injury films of eighteen patients. A questionnaire was provided giving two answer choices, address the fibular or syndesmosis primarily. The eighteen ankle fractures were selected based on increasing proximity of the fibula fracture, which ranged from 4.5cm to 32.3cm. The ankle fractures were grouped into four categories to include the Maisonneuve variant based on distance. These fracture radiographs were randomized in order to not influence the surgeon’s opinion during the study. The four groups were as follows: 1. 4.5cm – 7.4cm to include six ankle fracture radiographs 2. 8cm – 10.4cm to include four ankle fracture radiographs 3. 14.6cm to 23.3cm to include five ankle fracture radiographs 4. 30.7cm to 32.3 cm to include three Maisonneuve variant ankle fracture radiographs Results: Regarding section 1, the majority of surgeons responded with open reduction, internal fixation of the fibula as their initial reduction. Section 2, the responses remained consistent with a majority of surgeons choosing to address fibular fixation followed by syndesmotic evaluation. The total number of responses in this section scored 43 answer A selections to 5 answer B selections. Section 3 (14.6-23.3cm) provided the most variability in the responses provided. With 60 possible answer choices, the polled surgeons responded with answer choice A seventeen times and answer choice B 43 times. Section 4 (30.7-32.2cm) or the Maisonneuve produced a steady response of answer choice B. Syndesmotic reduction was performed 34 times compared to only two fibular fixation choices – or answer choice A. Conclusion: The purpose of this study was to evaluate expert opinion on differing treatment as the proximity of the fibular fracture increased in connection with an unstable ankle fracture pattern. General consensus under 10,4cm was to address fibular fixation. However, once the fibular fracture exceeded 14cm, significant variability was noted. These results prove that further biomechanical studies are needed to determine the effect fibular stability in increasing proximity has on the syndesmosis. Chart 1 shows answer selections across the four categories. Chart 2 shows answer selections across the highest variability group 3.

Paradoxical clinical presentation in ocular trauma following road traffic accident – A case report

Ocular trauma following road traffic accident is one of the main causes of preventable monocular blindness in young adult men and a significant contributor to severe vision impairment in people of all ages. Though helmet protects the riders from severe brain injury and also protects the face, still ocular injuries are possible even wearing a helmet. We are presenting here a case of ocular trauma following road traffic accident in a 34-year-old male wearing helmet, in whom there were anterior segment injuries in one eye without any defect in vision, whereas without any external ocular injury, the other eye had sever retinal edema, hemorrhage, and vitreous hemorrhage, grossly affecting the vison in that eye. Any patient even with mid-facial injuries should be evaluated for suspected ocular impairment and rule out the potential need for early intervention to prevent blindness.

Diagnostic approach to penetrating neck trauma: What you need to know.

Diagnostic evaluation of penetrating neck trauma has evolved considerably over the last several decades. The contemporary approach to these injuries is based primarily on clinical signs of injury and multidetector computed tomographic angiography. The neck is evaluated as a unit, rather than relying on the surface anatomy zones in which external injuries are seen to guide the workup of internal injuries. This "no-zone" approach safely spares many patients from negative explorations and unnecessary invasive tests. The purpose of this review is to describe an evidence-based approach to the diagnostic evaluation of penetrating neck trauma, including indications for adjunctive testing beyond physical examination and multidetector computed tomographic angiography. Literature Synthesis and Expert Opinion; Level V.

Electrochemical Monitoring in Anticoagulation Therapy.

The process of blood coagulation, wherein circulating blood transforms into a clot in response to an internal or external injury, is a critical physiological mechanism. Monitoring this coagulation process is vital to ensure that blood clotting neither occurs too rapidly nor too slowly. Anticoagulants, a category of medications designed to prevent and treat blood clots, require meticulous monitoring to optimise dosage, enhance clinical outcomes, and minimise adverse effects. This review article delves into the various stages of blood coagulation, explores commonly used anticoagulants and their targets within the coagulation enzyme system, and emphasises the electrochemical methods employed in anticoagulant testing. Electrochemical sensors for anticoagulant monitoring are categorised into two types. The first type focuses on assays measuring thrombin activity via electrochemical techniques. The second type involves modified electrode surfaces that either directly measure the redox behaviours of anticoagulants or monitor the responses of standard redox probes in the presence of these drugs. This review comprehensively lists different electrode compositions and their detection and quantification limits. Additionally, it discusses the potential of employing a universal calibration plot to replace individual drug-specific calibrations. The presented insights are anticipated to significantly contribute to the sensor community's efforts in this field.

Temporary Cast Application in Dislocated Ankle Fractures Leads to High Rates of Secondary Loss of Reduction: Does the Lauge-Hansen Injury Type Matter?

For the temporary treatment of ankle fracture dislocations (AFDs), previous studies indicate higher rates of secondary loss of reduction (LOR) with splint immobilization, prompting consideration for expanding indications for external fixation (ExFix). However, these studies did not investigate the influence of fracture morphology to further improve patient selection. The aim of this study was to investigate the influence of Lauge-Hansen injury type on the LOR rate in bimalleolar or trimalleolar AFDs for temporary cast vs ExFix immobilization. In this retrospective cohort study, patients with isolated AFD cases treated at our institution from 2011 to 2020 were reviewed. Inclusion criteria required radiographs depicting initial dislocation and appropriate reduction after Cast or ExFix immobilization. Exclusion criteria encompassed concomitant injuries, open fractures, conservative management as well as surgery performed within 48 hours or at a different facility. Patients were grouped by temporary treatment (Cast or ExFix). The primary endpoint was LOR prior to definitive surgery across various Lauge-Hansen types. The LOR rate was significantly higher in the cast group (40/152, 26.3%) compared to the ExFix group (5/191, 2.6%; P < .0001). In the cast group, LOR was associated with an increase in time to definitive surgery by a mean of 3 days (P < .002). During cast treatment, LOR was significantly more likely for pronation abduction (P = .001) and supination external rotation injuries (P < .0001), whereas no significant differences were observed for pronation external rotation (P = .006), supination adduction (P > .99), and fractures not classifiable (P > .99). In cases of AFDs resulting from supination external rotation or pronation abduction trauma according to the Lauge-Hansen classification, especially in the setting of an additional posterior malleolar fracture, primary application of external fixation should be considered to reduce the risk for secondary loss of reduction. Level III, retrospective cohort study.

First Report of Organochlorine Pesticides and Heavy Metals in a Stranded Bottlenose Dolphin Off the Central Coast of Veracruz State: A Warning to Assess Pollution in a Reef Marine Ecosystem from the Gulf of Mexico

Live-strandings of cetaceans are uncommon in the southwestern Gulf of Mexico. However, an adult female bottlenose dolphin (Tursiops truncatus) with normal body condition was recorded at Pelicano’s Beach on the coast of Veracruz State. Health assessment showed multiple external injuries, possibly caused by the stranding event, as well as potential bacterial infection, and, thus, the individual was held in temporary facilities for rehabilitation. Blood samples were taken to assess the health status of the individual and were also analyzed for concentrations of 20 pollutants (14 organochlorine pesticides [OCPs] and six heavy metals [HMs]). The animal was released and found dead within a few days. The concentration of OCPs and HMs were close or above the government limits. Although these were lower than those reported in other living, free-ranging bottlenose dolphins, there are well-known negative effects for health. Low OCP values were attributed to an offloading process through lactation or mobility of the lipophilic OCPs that pass from blood to fat. Whereas HM concentrations (mainly non-essential metals: mercury [Hg], lead [Pb], and cadmium [Cd]—2.73, 21.13, and 12.67 µg L-1, respectively) were probably linked to the diet and the possible distribution of the specimen (possibly offshore). This is the first report on pollutants from anthropogenic origin in the area where uncontrolled activities are of major concern within a protected national reef park. Since marine ecosystems are under continuous pressure, several health issues for top predators are being noticed; therefore, this study underlines the relevance of studying health status of marine mammals in the Mexican waters of the Gulf of Mexico.

Mapping knowledge of the stem cell in traumatic brain injury: a bibliometric and visualized analysis.

Traumatic brain injury (TBI) is a brain function injury caused by external mechanical injury. Primary and secondary injuries cause neurological deficits that mature brain tissue cannot repair itself. Stem cells can self-renewal and differentiate, the research of stem cells in the pathogenesis and treatment of TBI has made significant progress in recent years. However, numerous articles must be summarized to analyze hot spots and predict trends. This study aims to provide a panorama of knowledge and research hotspots through bibliometrics. We searched in the Web of Science Core Collection (WoSCC) database to identify articles pertaining to TBI and stem cells published between 2000 and 2022. Visualization knowledge maps, including co-authorship, co-citation, and co-occurrence analysis were generated by VOSviewer, CiteSpace, and the R package "bibliometrix." We retrieved a total of 459 articles from 45 countries. The United States and China contributed the majority of publications. The number of publications related to TBI and stem cells is increasing yearly. Tianjin Medical University was the most prolific institution, and Professor Charles S. Cox, Jr. from the University of Texas Health Science Center at Houston was the most influential author. The Journal of Neurotrauma has published the most research articles on TBI and stem cells. Based on the burst references, "immunomodulation," "TBI," and "cellular therapy" have been regarded as research hotspots in the field. The keywords co-occurrence analysis revealed that "exosomes," "neuroinflammation," and "microglia" were essential research directions in the future. Research on TBI and stem cells has shown a rapid growth trend in recent years. Existing studies mainly focus on the activation mechanism of endogenous neural stem cells and how to make exogenous stem cell therapy more effective. The combination with bioengineering technology is the trend in this field. Topics related to exosomes and immune regulation may be the future focus of TBI and stem cell research.

Posttraumatic glaucoma in southern China: A ten-year retrospective study.

To analyze posttraumatic glaucoma regarding its demographics, presentations, different causes, surgical modalities, and hospitalization burden among patients in southern China. This retrospective study investigated all individuals with posttraumatic glaucoma admitted to the Zhongshan Ophthalmic Center of Sun Yat-Sen University from January 2012 through December 2021. Out of 2211 cases, 64.82% had closed globe injury (CGI), 28.22% had open globe injury (OGI), and 6.96% had chemical injury (CI). The mean age of all patients was 44.45 ± 19.45 years old. Males (83.36%), rural patients (56.17%), and farmers (27.14%) predominantly had posttraumatic glaucoma. The most common external injury mechanism was blunt objects (37.82%). Compared with the other two groups, the majority of surgical modalities were cataract extraction (27.12%) in the CGI group, combined anterior-posterior surgery (34.79%) in the OGI group, and cyclocryotherapy/cyclophotoagulation (49.1%) in the CI group. The CI group had higher times of hospitalization (3.542 ± 0.242) and hospitalization duration (8.373 ± 0.743 days), whereas the OGI group had more operation expense ($ 1476.729 ± 11.047) and medical consumables expense per head ($ 962.578 ± 25.801). Blunt injury, males, adults, farmers, and rural patients were high-risk factors for posttraumatic glaucoma. Chemical-induced glaucoma management requires a longer hospitalization period, while OGI requires more medical expenditure. This knowledge provides a new reference for clinicians to accurately diagnose and intervene in posttraumatic glaucoma. It also suggests that more education and long-term surveillance are needed regarding the presence of glaucoma after ocular trauma.

Role of Uttarabasti in Neurogenic Urinary Incontinence

Neurogenic bladder refers to dysfunction of the urinary bladder arising from internal or external trauma, disease, or injury of the central, autonomic or somatic nervous system in the control of micturition. Depending on the nerves involved and the nature of the damage, bladder becomes either overactive or underactive and this usually presents clinically as urinary incontinence or retention of urine. Urinary Incontinence (UI) is a hygienic problem and is one of the troublesome, important cause of morbidity and impairment of quality of life, in both men and women. It may lead to recurrent UTI and ascending infections which affect the functioning of kidney. Deranged function of Vatadosha especially Apanavata along with Pranavata and Vyanavata are the main culprits of neurogenic bladder. Vitiated Doshas cause Mootravahasrotodushti and Atipravritti of mootra. This case study discusses the effect of Mootramarga uttarabasti in reducing the signs and symptoms of neurogenic urinary incontinence and thereby improving the quality of life. A 66 year old male patient was admitted with weakness in left upper and lower limbs, slurred speech, and difficulty in controlling micturition since 5 months. He was a diagnosed case of stroke on the basis of a brain computed tomography scan. During the course of management, Uttarabasti was administered for 8 days with Dhanwantarataila and Balamoolakashaya alternatively. The intervention resulted in reducing the symptoms of neurogenic urinary incontinence as evidenced by the reduction in ICIQ-UI -SF score. It was observed that the overall impact of the disease was reduced and quality of life improved with the help of King’s Health Questionnaire (KHQ).

Child Violence in the Household Sphere in Kasu Village, Belakang Padang District, Batam City

This research aims to determine child violence in the household sphere in Kasu Village, Rear Padang District, Batam City. Where currently there is an increase in the rate of violence against children in Indonesia, this research also aims to determine the impact that occurs due to violence and is analyzed using sociological theory, namely social control theory. This research uses qualitative research methods by means of interviews and collecting data from the internet. Acts of violence committed against children can cause pain, both internal and external injuries to the child. Violence against children can also hinder children's growth and development. Emotional, physical violence or chronic neglect can inhibit the growth of a child's brain and organs, increase the risk of diseases triggered by stress and hinder cognitive and social development which will ultimately lead to anxiety disorders, depression, behavioral disorders and poor academic achievement.

Blunt chest trauma-induced myocardial infarction: a case of sudden death by homicide

BackgroundBlunt cardiac injuries, which are typically the result of blunt chest trauma, are not particularly significant clinically. It is vital never to underestimate blunt chest injuries, especially when they occur in the anterior thoracic area. Blunt trauma to the chest is one of the rarest causative factors of myocardial infarction (MI). Blunt cardiac injury encompasses different medical emergency conditions such as gradual damage to the myocardium leading to myocardial ischemia, injuries to the great vessels of the heart, pericardial tamponade, septum or wall ruptures, pump failure, conduction abnormalities, and atrial and ventricular fibrillations. The most common cause of blunt chest trauma is a road traffic accident (RTA), followed by a sports injury. Mostly blunt trauma chest injuries occur below the age group of 45 years.Case presentationA 45-year-old male with a history of physical assault was brought to the emergency department by his neighbor. He was allegedly kicked by his relative over the chest during an altercation sustained blunt-force trauma to the chest and collapsed immediately. On admission, he was given cardiopulmonary resuscitation and declared dead. On autopsy, there were no signs suggestive of external injury or any shoeprints/footprints on the chest. On histopathological examination, a diffuse area of discoloration consistent with an extensive myocardial infarction was noted. Old healed infarcts were seen in the free wall of the left ventricle, left posterior papillary muscle, and left apex. The coronaries showed atheromatous plaque with lumen narrowing and focal calcification.ConclusionsIt is the task of the forensic pathologist to ascertain and record evidence as to whether the myocardial infarction was caused by the alleged blunt trauma to the chest during the autopsy. This is important as it will determine the type of prosecution the accused is likely to be charged with and the extent of the punishment that he will likely receive under the Indian Penal Code.

RETROSPECTIVE ANALYSIS OF BLOOD CULTURES AND THEIR ASSOCIATION WITH CLINICAL FINDINGS AND OUTCOME IN GREEN SEA TURTLES (CHELONIA MYDAS) AT A FLORIDA SEA TURTLE REHABILITATION FACILITY, 2017-2020.

Septicemia is commonly suspected of sea turtles entering rehabilitation. However, blood culture results of green sea turtles (Chelonia mydas) are infrequently reported in the literature. Aerobic blood cultures were performed for intake examinations of 167 green sea turtles undergoing rehabilitation at Brevard Zoo's Sea Turtle Healing Center, Melbourne, Florida, USA from 2017 to 2020. The incidence of positive cultures during intake examinations was 24% (40/167). The most common bacterial isolates identified were Vibrio alginolyticus, Shewanella algae, Achromobacter xylosoxidans, Photobacterium damselae, Sphingomonas paucimobilis, and Vibrio parahaemolyticus. There was a statistically significant association (P < 0.05) between culture status and evidence of external injury. There was no significant association between culture status and Caryospora-like coccidia infection, or fibropapillomatosis. Culture-positive turtles had significantly lower (P < 0.05) total white blood cell, lymphocyte, monocyte, total protein, albumin, and calculated globulin values compared to turtles with negative blood cultures. Significantly more culture-positive turtles died in rehabilitation compared to culture-negative (P = 0.042). Positive blood cultures suggestive of septicemia are commonly found during intake examinations at a Florida sea turtle rehabilitation facility.

Anterior Intercondylar Notch Geometry in Relation to the Native Anterior Cruciate Ligament Size.

The intercondylar notch (ICN) and the anterior cruciate ligament (ACL) are important structures in knee morphometry, with key roles in stabilizing the knee. To determine the associations between the specific shape of the ICN (A-, W-, or U-shape) and the ACL size in patients with intact ACLs. Magnetic resonance imaging (MRI) scans were independently analyzed by two experts: one orthopedic surgeon and one imaging physician. In all cases, the following measurements were taken based on the existing definitions: ACL area, anterior ICN (aICN) area, ICN width, lateral trochlear inclination (LTI), and Insall-Salvati index. A total of 65 cases (50.8% male; 33.8 ± 10.2 years mean age at inclusion) were included in the study. The ACL and aICN areas were significantly larger in patients with U-shaped compared with A-shaped and W-shaped ICNs: 0.50 (0.20-0.80) vs. 0.40 (0.20-0.80) vs. 0.40 (0.30-0.80), p = 0.011 and 1.16 (0.57-3.60) vs. 0.47 (0.15-0.95) vs. 0.37 (0.15-0.81), p < 0.001, respectively. Internal meniscal lesions were more common in cases with U-shaped ICNs (64.0%), while external ones were more common in W-shaped ICN cases (35.3%). None of the A-shaped cases had external chondral or meniscal lesions. The ACL area was significantly larger in males and internal meniscal injuries, with no differences between chondral lesions, external meniscal injuries, patellar chondral lesions, patella alta, or trochlear dysplasia. The specific shape of the intercondylar notch was associated with the anterior cruciate ligament-anterior intercondylar notch (ACL-aICN) area size correlation, with a strong correlation between ACL and aICN area when the intercondylar notch was A-shaped or W-shaped, and a low correlation when the notch was U- shaped. The specific shape of the intercondylar notch (A-, W-, or U-shape) was associated with the occurrence of both internal and external meniscal injuries, with the U-shaped intercondylar notch morphometry being more frequent in cases with internal meniscal injuries and the W-shape being more common in cases with external meniscal injuries.

Advances in reparative materials for infectious bone defects and their applications in maxillofacial regions.

Infectious bone defects are characterized by the partial loss or destruction of bone tissue resulting from bacterial contaminations subsequent to diseases or external injuries. Traditional bone transplantation and clinical methods are insufficient in meeting the treatment demands for such diseases. As a result, researchers have increasingly focused on the development of more sophisticated biomaterials for improved therapeutic outcomes in recent years. This review endeavors to investigate specific reparative materials utilized for the treatment of infectious bone defects, particularly those present in the maxillofacial region, with a focus on biomaterials capable of releasing therapeutic substances, functional contact biomaterials, and novel physical therapy materials. These biomaterials operate via heightened antibacterial or osteogenic properties in order to eliminate bacteria and/or stimulate bone cells regeneration in the defect, ultimately fostering the reconstitution of maxillofacial bone tissue. Based upon some successful applications of new concept materials in bone repair of other parts, we also explore their future prospects and potential uses in maxillofacial bone repair later in this review. We highlight that the exploration of advanced biomaterials holds promise in establishing a solid foundation for the development of more biocompatible, effective, and personalized treatments for reconstructing infectious maxillofacial defects.

Cutaneous manifestations of endocrine diseases and their assessment in reconstructive surgery

The skin is the largest organ of the human body, and its main function is protection from external injuries and infectious influences. It is a metabolically active organ that works mainly by self-renewal of the squamous epithelium through continuous differentiation. The surface layer of the skin “epidermis” is updated every four weeks. It is also the body’s largest sensory organ, which can respond to external stimuli such as heat, cold, touch and pressure, which is necessary to maintain the body’s thermostat. Being the largest organ of the body, the skin is an active immune organ and an important peripheral neuro-endocrine organ. It is closely related to the endocrine system and, therefore, contributes to the homeostasis of peripheral hormones. A complex pathophysiology occurs when thyroid hormones are exposed to the skin, especially in the case of a continuing apparent violation of the regulation of thyroid hormones. Thyroid hormone is considered one of the key hormones regulating skin homeostasis. The release of peripheral thyroid hormones (T4 and T3) affects many organs, additionally regulating various functions at the cellular level. In particular, the skin is considered an important target organ, on which the thyroid hormone has a significant effect. Numerous skin diseases are associated with a violation of the regulation of thyroid hormones. Rough skin manifestations are usually the first sign of an imbalance of thyroid hormones, in which they play an integral role in maintaining natural function. This article reviews the pathology of thyroid hormones, as well as skin diseases associated with diseases of the pancreas. The interaction of thyroid gland diseases with the skin, manifested in the form of various skin pathologies, will be considered. It is known that endocrine disorders affect all organ systems of the body, including the skin.

Pathological study of a traumatic anthropogenic injury in the skeleton of a spiny butterfly ray (Gymnura altavela).

External injuries in elasmobranchs are frequent findings, either due to inter- or intraspecific interactions or as a result of interaction with human activities. However, the resilience of these species to traumatic injury remains poorly understood. This work provides an insight into the clinical presentation, diagnostic imaging, and pathological features of a severe traumatic injury to the cartilaginous skeleton of a spiny butterfly ray (Gymnura altavela). An adult female was found lethargic in the bottom of the coast of Gran Canaria, with an external incised-contused traumatic lesion of 2 cm diameter in the scapulocoracoid cartilage. It was captured and transferred to the Poema del Mar Aquarium for its clinical evaluation and treatment. Despite these efforts, the animal eventually died and was transfer to the Institute of Animal Health and Food Safety (IUSA) for its pathological diagnosis, including a Computed Tomography (CT) study and necropsy. The animal presented a marked reduction in hematocrit and hepatosomatic index due a chronic debilitation process. The CT scan revealed a destructive lesion with irregular margins at the level of the right scapulocoracoid cartilage. The main pathological findings were the disorganization of the tesserae layer, appearing as whitish square to rectangular geometric pieces separated from the cartilaginous core. Histologically, these pieces of tesserae were separated from the unmineralized cartilage core and displaced from the adjacent perichondrium, where inflammatory cells infiltrate. Edema and hemorrhages were also observed. This study reports the first comprehensive description of skeleton trauma in a spiny butterfly ray, including the clinical presentation, diagnostic imaging and the anatomopathological features.