Site Of Trauma Research Articles

“Home out of home”: South Africa, Central Europe, and “dark nostography”

The essay provides a comprehensive discussion of South African nostographies which are concerned with the nostographers’ return to their Central European father/motherland. The paper not only explores the poetics of nostographic writing but also attempts to identify specific generic signposts that characterise South African nostos narratives about Central European homecoming. Having analysed – with the support of archival records – several notable examples of second-generation nostographies by South African writers of Central European descent (Gordimer, Zwi, Jacobson), the essay focuses on the first nostos narrative by a second generation South African Pole, i.e. Blood and Silver by Jan Glazewski (2022). The proposed reading of Glazewski’s book pays special attention to the way in which the Polish/Ukrainian “home” to which the author returns partakes in negotiating the “anachronoid” identity of the auto/biographical (homecoming) subject – especially in the context of the subject’s multiple dislocations; and in revealing a new, essentially transnational geography of historical and ideological connections between Central Europe and South Africa. Additionally, the essay argues that Glazewski’s book should be recognised as a specimen of “dark nostography,” i.e. a homecoming narrative in which one’s double home (South African and Central Europe) is acknowledged as a site of trauma, while the homecomer is considered the subject implicated in the past and present forms of injustice and violence.

Epidemiological analysis of 2106 geriatric trauma patients in a level I trauma center in Lanzhou City, Gansu Province, China.

As the global population ages, geriatric trauma gains attention. Limited studies on geriatric trauma in developing countries necessitate comprehensive investigation. This study aims to delineate the epidemiological characteristics of geriatric trauma, providing insights for prevention and enhanced elderly trauma care. Clinical data of 2106 geriatric trauma patients (age ≥ 60) treated from November 1, 2020, to October 31, 2023, at the trauma center of the First Hospital of Lanzhou University were retrospectively analyzed. Descriptive statistics covered temporal and monthly distribution, trauma sites, causes, and length of stay. Inclusive were 2106 geriatric patients (941 males, 1165 females; male-to-female ratio 1:1.24). Trauma incidence was higher in summer and autumn (May-October) than winter (November-December). Peak incidents occurred between 14:00-16:00, with concentrations at 12:00-16:00 and 20:00-22:00. Falls (59.35%), road traffic accidents (16.62%), other traumas (14.10%), cutting/stabbing (4.56%), violence (3.42%), mechanical injuries (1.61%), winter sports injuries (0.14%), burns (0.14%), and animal bites (0.06%) were major causes. Extremity and skin injuries prevailed, with significant site distribution differences (P < .001). Average length of stay at the trauma center was 78.35 ± 48.32 minutes. The gender distribution, timing, causes, and sites of trauma in the elderly differ significantly from other age groups. Unlike the higher occurrence of trauma in young men compared to women, among the elderly, it is more prevalent in women than men, mainly attributed to falls. It is crucial to implement specific measures to prevent trauma in the elderly, and the advancement of information technology in the trauma care system could additionally improve the quality of care.

‘Your story matters’: the affective and relational work of teachers in sites of poverty and trauma

AbstractWhile teachers work is increasingly constrained by a focus on quantifiable measures and accountability, the persistent underachievement of students from disadvantaged backgrounds is an ongoing and unsolved problem. There is increasing expectation for schools to take responsibility for the social-emotional as well as intellectual capabilities of students. However there has been little exploration into the complexities of teaching in low socio-economic and vulnerable communities. In this paper, I explore the experiences, thoughts and perceptions of teachers who work with complex student cohorts in disadvantaged settings. My interest extends to the affective and relational dimensions of their work. Drawing from two research projects conducted in areas marked by poverty, the paper utilises segments of interviews to illustrate the deeply embodied and sensory and aspects of teachers’ relational practice. In presenting their perspectives and experiences I tell the story of their complex work as well as what ‘comes to matter’ in schools and classrooms where trauma and adversity are ever-present.

Pediatric safety profile of low titer O whole blood with increasing Anti-A and Anti-B titers

Abstract Objectives To add additional evidence to the safety of using low-titer O whole blood (LTOWB) in the massively hemorrhaging pediatric population, even with increasing allowance of anti-A and anti-B titers, up to 200. Methods A retrospective review from December 2021 to March 2023 of the blood bank and surgical massive transfusion protocols was performed with IRB approval to identify patients less than 18 years old who had received LTOWB as part of trauma resuscitation. In addition to patient characteristics, volume of LTOWB and other components were assessed, as well as Day 1-3 of serum potassium, creatinine, and total bilirubin. Wilcoxon rank-sum tests were performed to compare continuous variables and Fisher’s exact tests were performed to compare categorical variables between group O blood groups patients and non-O blood group patients. Results Only ten patients were identified under 18 years of age who had received LTOWB during trauma resuscitation, with five being blood group O and five non-O. Patient characteristics were similar between the two groups; however, only 10% were female and 10% self-reported as Black or African American. Age in the non-O group was 15 +/- 3.0 and 16.2 +/- 1.3 in the O group, p=0.75. Weight was 56.16 kg +/- 7.17 in the non-O group and 64.02+/- 14.23 in the O group, p=0.35. LTOWB transfused was 10.46 mL/kg +/- 2.42 in the non-O group and 10.32 +/- 6.53 in the O group, p=0.25. Potassium, creatinine, and total bilirubin were similar on Days 1-3 in both groups, except a single high total bilirubin in the non-O group, and this value normalized on Day 3. Conclusion A small data set was extracted from the available massive transfusion protocol data, reflecting the small amount of pediatric patients requiring massive transfusion for trauma compared to adults. Moreover, the predominance of males requiring massive transfusion for trauma corresponds with general trauma trends in the United States. These data reflect and are similar to previous safety reviews of pediatric trauma patients receiving LTOWB. This retrospective review records, however, a time period when the titer of anti-A and anti-B had been relaxed to 200 (rather than 50 in previous studies). This study, although small, reflects an additional Level I trauma site delivering LTOWB at potentially higher titers without negative sequelae in potassium, creatinine, or total bilirubin. With upcoming randomized controlled trials, such as Massive Transfusion in Children (MATIC-2), these data continue to reassure that the practice of using LTOWB is likely safe during the resuscitation period.

High-energy blunt pelvic ring injuries and pre-hospital pelvic binder applications – A retrospective assessment based on a prospective registry

IntroductionApplication of a pelvic binder in the pre-hospital settings is a crucial step of high-energy blunt pelvic ring injury (PRI) management protocols. The aim of this retrospective cohort study was to evaluate the percentage of pre-hospital pelvic binder's applications in high-energy blunt type B or C PRI patients managed at a single level I trauma center, and to assess its impact on the medical resource requirements and patients' outcomes. MethodsThe institutional Severely Injured Patients’ Registry was screened for patients meeting the following inclusion criteria: (1) high-energy blunt PRI; (2) admission between 2014.01.01 and 2022.12.31; (3) age ≥16 years; and (4) available computed tomography of the pelvis. Exclusion criteria were: (1) death before admission; (2) low-energy injury; (3) penetrating, blast and electrical injuries; and (4) secondary transfers. Study variables, including pre-hospital application of a pelvic binder and demographic, clinical, management and outcome data were extracted from the registry. Additionally, AO/OTA classifications were determined. ResultsA consecutive series of 262 patients was included into the final analysis. Of these, 58.8 % received a pre-hospital pelvic binder (PPB), increasing from type A (45.1 %) to type B (57.8 %) and type C (73.7 %). Pre-hospital hemodynamic instability was a major factor triggering the use of PPB in high-energy blunt type B PRI patients with PPB in 76.9 % of the cases with hemodynamic instability vs. 51.3 % of the cases without hemodynamic instability (p = 0.009). This difference was not statistically significant for high-energy blunt type C PRI patients (82.8 % vs. 64.3 %, p = 0.200). The presence of a physician on the trauma site contributed to the increased percentage of PRI managed with PPB from 43.5 % to 67.3 % in type B PRI (p = 0.011), and from 50 % to 77.1 % in type C PRI (p = 0.257).This study showed an increased need for packed red blood cells (PRBC) transfusions in subgroups treated with PPB and no statistically significant differences in term of intensive care unit (ICU) and total hospital length of stay and complications between high-energy blunt type B or C PRI patients with or without PPB.Comparison of mortality rates in patients with and without PPB showed a trend towards lower mortality rates with PPB in patients with AIS extremity participating in at least 50 % of the total ISS. ConclusionIn the ideal pre-hospital scenario, every high-energy blunt type B or C PRI patient should be managed with a PPB. Continuous pre-hospital team training and information is crucial to achieve this goal. The preparation of Emergency Department and ICU who admit a patient with PPB should include a sufficient number of PRBC ready for transfusion. Mortality rates did not seem to be affected by PPB, except for a trend towards lower mortality rates in patients in whom their PRI was the major component of the global severity of their injury. This might point out the critical and positive effect of PPB in high-energy blunt PRI patients.

“Can Corpses Undie?” Traces of Rothberg’s Trauma Model in Faridah Àbíké-Íyímídé’s Ace of Spades

Interdisciplinary studies in memory have become more relevant since the turn of the twentieth century with scholars giving their divergent views. That way, personal and collective memories have been explored vis-à-vis communal identities. How tragic/traumatic events affect personal and collective memories remains the concern of trauma theory which has critically investigated both the personal and intergenerational traumas of victims of injustice. One major contribution of Michael Rothberg to collective memory is his advancement of solidarity between group victims of diverse cultures, nationalities, races, and identities in order to create a more peaceful world to live in. This paper purports that Rothberg’s multidirectional memory and theory of implication are useful theoretical tools for analysing Faridah Àbíké-Íyímídé’s Young Adult novel, Ace of Spades (2021). The paper, therefore, indicates how diverse sites of trauma in the author’s world synergise with those of the protagonists. Also, the paper notably identifies some white characters in Ace of Spades as implicated subjects of racism and white supremacy. On the whole, the premise of this paper is that the new media can serve as a convenient site of thoughtful convergence for different victim groups to devise a means of dismantling long-existing regimes of oppression and injustice.

Prevalence and Associated Factors Affecting Outcomes of Adult Patients with Cardiac Arrest Who Receive Cardiopulmonary Resuscitation in Emergency Department of a Tertiary Hospital

Background Cardiopulmonary resuscitation (CPR) aims at restoring spontaneous circulation in a victim of cardiac arrest. This study intends to find out the demographic information of cardiac arrest patients, their outcomes and the possible factors that could affect the outcomes.MethodsA hospital-based cross-sectional study was conducted at Dhulikhel Hospital to investigate cardiac arrest outcomes among patients aged over 14 years who either presented with or developed cardiac arrest in the Emergency Department. Data were documented and, then entered into Microsoft Excel and analyzed using SPSS. Descriptive statistics were used to summarize categorical and continuous variables, while a Chi-square test (p &lt; 0.05) assessed associations between selected variables and CPR outcomes.ResultsThe majority of patients were over 65 years old (31.9%), with the smallest group under 25 years (10.1%). Regarding gender distribution 34.8% were female. Trauma was present in 24.6% of cases, while 48.9% were witnessed by bystanders but none of them received CPR. Initial rhythm was predominantly asystole (87%). CPR lasted for 20-40 minutes in 47.8% of cases and over 40 minutes in 14.5%, averaging 24.1 minutes. 40.6% patients had ROSC after CPR while 59.4% had no Return of Spontaneous Circulation (ROSC). Statistically significant associations with CPR outcomes were found for sex, site of cardiac arrest, trauma, witnessed events, CPR duration, and intubation (p-value &lt;0.05).Conclusions Our hospital experiences a high prevalence of cardiac arrest and has comparable ROSC rate. Statistically significant variables associated with outcomes of CPR were, sex, site of cardiac arrest, Trauma, Witnessed event, Duration of CPR and Intubation.

Combined biomaterial scaffold and neuromodulation strategy to promote tissue repair and corticospinal connectivity after spinal cord injury in a rodent model

Spinal cord injury (SCI) damages the trauma site, leading to progressive and secondary structural defects rostral and caudal to the injury. Interruption of ascending and descending pathways produce motor, sensory, and autonomic impairments, driving the need for effective therapies. In this study, we address lesion site repair and promoting descending projections using a combined biomaterial-neuromodulation strategy in a rat model of cervical contusion SCI. To promote tissue repair, we used Chitosan fragmented physical hydrogel suspension (Cfphs), a biomaterial formulation optimized to mitigate inflammation and support tissue remodeling. To promote descending projections, we targeted the corticospinal motor system with dual motor cortex–trans-spinal direct current neuromodulation to promote spared corticospinal tract (CST) axon sprouting rostral and caudal to SCI. Cfphs, injected into the lesion site acutely, was followed by 10 days of daily neuromodulation. Analysis was made at the chronic phase, 8-weeks post-SCI. Compared with SCI only, Cfphs alone or in combination with neuromodulation prevented cavity formation, by promoting tissue remodeling at the injury site, abrogated astrogliosis surrounding the newly formed tissue, and enabled limited CST axon growth into the remodeled injury site. Cfphs alone significantly reduced CST axon dieback and was accompanied by preserving more CST axon gray matter projections rostral to SCI. Cfphs + neuromodulation produced sprouting rostral and caudal to injury. Our findings show that our novel biomaterial-neuromodulation combinatorial strategy achieves significant injury site tissue remodeling and promoted CST projections rostral and caudal to SCI.

Amorphous zinc phosphate nanoclusters loaded polycarbonate thermosensitive hydrogel: An innovative strategy for promoting wound healing

Skin trauma is a matter of great concern for public health, emphasizing the importance of reconstructing the microenvironment at the trauma site to facilitate tissue regeneration. Therefore, the investigation of innovative wound dressings has significant research and clinical implications. In this study, we prepared a thermosensitive hydrogel based on a hydrophilic-hydrophobic-hydrophilic triblock polycarbonate polymer (PTP), and created a composite hydrogel, PTPH-AZP, by incorporating amorphous zinc phosphate (AZP) nanoclusters. We evaluated the effects of PTPH-AZP on human umbilical vein endothelial cells (HUVECs) and the ability to promote skin wound healing. According to the results, PTPH-AZP was found to promote the proliferation, migration, and tube formation of HUVECs through the sustained release of Zn2+ at appropriate concentrations. In vivo experiments demonstrated that in the early-mid stages of wound healing, PTPH-AZP promotes increases in Platelet Endothelial Cell Adhesion Molecule-1 (CD31) and α-Smooth Muscle Actin (α-SMA) content within the wound area, facilitating accelerated re-epithelialization and enhanced collagen deposition. In later healing stages, epidermal thickness in the PTPH-AZP treated group was significantly improved, aligning with surrounding intact skin with no instances of attenuated or hypertrophic scarring observed. The findings from the in vivo study suggested that PTPH-AZP may have a positive impact on vascularization and wound healing. In conclusion, this study presents a promising strategy for skin wound healing, highlighting the potential of PTPH-AZP as an effective therapeutic approach.

A retrospective, single-center 4-year review of synthetic polyurethane matrix use in burns and other complex wounds

Here we describe the use of a synthetic polyurethane matrix in the setting of burns and other complex wounds in the largest United States case series to date. A retrospective review was conducted at a verified, regional burn center. All patients greater than 18 years of age who received this matrix between January 2019 and July 2023 were included. A total of 182 patients with 250 wounds were included in this study. Thirty-seven percent were smokers, 23.6 % had diabetes and 5.5 % had peripheral vascular disease. The majority were acute burn wounds (60 %), followed by trauma (24.4 %), chronic wounds (5.6 %), infection (4 %) and donor sites (2 %). Exposed structures included fat (54 %), muscle (30 %), bone (16 %) and tendon (14.4 %). Microbial colonization was present in 143 (57.2 %) of cases: 98 (39.2 %) pre-application and 89 (35.6 %) post application. The incidence of new microbial colonisation post-application was 25.6 %. Infection was present in 117 (46.8 %) cases, 49 (19.6 %) pre-matrix application, 44 (17.6 %) post-matrix application and 24 (9.6 %) pre and post application. Eighteen patients (10 %) died. Median length of stay was 27 days. Median time to matrix implantation was 10 days. Median time from matrix placement to skin grafting was 35 days. Where documented, there were 162 wounds (83.5 %) with > 95 % matrix survival and 136 wounds (82.4 %) with > 95 % skin graft survival even in the setting of adverse factors such as infection, diabetes, or nicotine use. This study demonstrates the robustness of this skin substitute to achieve successful reconstruction even in the setting of adverse patient or wound characteristics.

Related factors of severe osteoporotic vertebral compression fracture and clinical outcomes of percutaneous kyphoplasty: A retrospective study.

Osteoporosis is the most common disease in postmenopausal women and the elderly, which can lead to vertebral compression fracture. To investigate the related factors of severe osteoporotic vertebral compression fracture (SOVCF) and evaluate the long-term outcomes of percutaneous kyphoplasty (PKP) for treating SOVCF through comparison with mild OVCF (MOVCF). From September 2015 to March 2019, 294 osteoporotic vertebral compression fracture (OVCF) patients treated with PKP were analyzed. Compression of the anterior margin of the fractured vertebral body beyond 2/3 of the original height was defined as SOVCF. Baseline data, clinical and imaging findings before and after surgery and at the last follow-up were recorded. Numerical Rating Scale (NRS) was used to evaluate low back pain, the Oswestry Disability Index (ODI) was used to evaluate activity of daily life. Anterior vertebral height (AVH) and local kyphosis angle (LKA) was used to evaluate radiographic outcomes. During the follow-up, patients with recurrent back pain were examined by MRI to identify new fractures and the incidence of adjacent vertebral fracture (AVF) was recorded. Age, sex, body mass index (BMI), dual energy X-ray absorptiometry based T value, duration of symptom, history of trauma, steroid use, and fracture site were collected for univariate logistic regression analysis Variables with a P-value of less than 0.05 were then included in multivariate analysis to determine the related factors for SOVCF. Logistic regression analysis indicated that longer duration of symptom (OR = 1.109, 95%CI: 1.038-1.185, P= 0.002), lower T value (OR = 0.332, 95%CI: 0.139-0.763, P= 0.001), and steroid use (OR = 31.294, 95%CI: 1.020-960.449, P= 0.049) were related factors of SOVCF. Compared with the MOVCF group, the SOVCF group had longer operation time (57.3 ± 13.51 minutes vs 44.9 ± 8.13 minutes, P< 0.001), more radiation exposure (39.9 ± 7.98 times vs 25.5 ± 4.01 times, P< 0.001), and higher cement leakage rate (55.81% vs 18.73%, P< 0.001). At the last follow-up, the SOVCF group had higher NRS (2.28 ± 0.85 vs 1.30 ± 0.71, P< 0.001), and ODI (16.23 ± 4.43 vs 12.88 ± 3.34, P< 0.001). After operation and at the last follow-up, the SOVCF group had higher LKA and lower AVH (all P< 0.05). The AVF rate at the last follow-up was higher in the SOVCF group at the last follow-up (4.78% vs 18.60%, P< 0.001). Lower T value, longer duration of disease, and steroid use were related factors of SOVCF. Compared with MOVCF, PKP for SOVCF had longer operation time, more radiation exposure, and higher cement leakage rate, and the long-term outcomes were worsen.

Memorial museums and burial sites: Rwanda’s unfinished memory work

Memorialisation of those who died during the 1994 genocide against the Tutsi has been an ongoing concern for both the Rwandan and non-Rwandan communities. The majority of the existing memorials were initially constructed by survivors supported by the local community, administration and other partners in response to the urgent need to bury the bodies of genocide victims. These sites have transformed over the years as memorial policies have codified and evolved. Memorial museums reflect the growing tendency of viewing trauma sites as artistic, interactive spaces that engage with those who visit them. This article examines the aesthetics of memory in three memorial museums situated in Rwanda’s western province: Bisesero, Gatwaro and Ngoma. It reflects on the work of the Rwandan architect Vedaste Ngarambe and his contribution as a local voice by considering how the architect’s aesthetic design choices reflect not only stories of the massacres that unfolded at the three sites but also the mourning culture of the community in which they are located.

A challenging decision for emergency physicians: Routine repeat computed brain tomography of the brain in head trauma in infants and neonates.

Head trauma is a leading cause of death and disability. While standard treatment protocols exist for severe head trauma, no clear follow-up standards are available for mild head trauma with positive imaging findings in infants and newborns. Although routine follow-up brain computed tomography (CT) imaging is not recommended for children with moderate and mild head trauma, the necessity for follow-up imaging in infants and newborns remains uncertain. Our study is a retrospective, observational, and descriptive study. Infants under 1 year old presenting to the emergency department with isolated head trauma were reviewed with the approval of the Ethics Committee of Ankara Etlik City Hospital. Inclusion criteria included presentation to the emergency department, undergoing more than one brain CT scan, and sustaining mild head trauma (Glasgow Coma Scale [GCS] >13). Patients with incomplete follow-up data or multiple traumas were excluded. Age, gender, mechanism of trauma, initial and follow-up brain CT findings, hospital admission, and surgical procedures were recorded and analyzed using the SPSS statistical package. Out of 238 screened patients, 154 were included in the study. Of these, 66.9% were male and the average age was 5.99 months. The most common presenting symptom was swelling at the trauma site, observed in 79.2% of cases. The most common mechanism of injury was falling from a height of less than 90 cm, accounting for 85.1% of cases. Pathological progression on follow-up CT was observed in 5.2% of the patients, and only 1.9% required surgical treatment. A total of 34.4% of the patients required hospitalization. Patients with parenchymal brain pathology had a higher rate of pathological progression on follow-up CT and a longer hospital stay. Follow-up CT scans in infants with mild head trauma do not alter patient outcomes except in cases with brain parenchymal pathology. Study data indicated that repeat imaging is not beneficial for isolated skull fractures. Imaging artifacts often necessitated repeated scans, contributing to increased radiation exposure. Unnecessary repeat imaging escalates radiation exposure and healthcare costs. Only a small percentage of patients exhibited progression of intracranial pathology, justifying follow-up imaging solely in the presence of brain parenchymal injury. Larger prospective studies are necessary to confirm these findings.

A case of lymphocutaneous sporotrichosis (S braziliensis)

We report the case of a 59-year-old Brazilian woman who sustained an injury to her right index finger when the cat she was caring for scratched her. She developed a tender, ulcerating, scaly lesion with a pustular component and surrounding erythema at the site of trauma.

Laser-Induced Koebner-Related Skin Reactions: A Clinical Overview.

The Koebner phenomenon (KP), also known as the isomorphic response, describes the process by which new lesions that are clinically and histologically identical to a patient's existing skin disease develop following trauma. Many skin diseases exhibit this characteristic, with variations that include possible, questionable, and pseudo-Koebner reactions, with the latter category occurring due to infectious agents seeding at a trauma site. Laser application, a type of controlled skin injury used for improving cutaneous lesions and skin rejuvenation, is also considered a form of trauma. This raises the question of whether controlled thermal injury can be regarded as a type of mechanical trauma capable of producing Koebner-related reactions. We conducted a literature review of cases or studies to identify laser-induced dermatoses that correspond to Koebner-related or pathergy reaction categories. As a whole, we identified nine case reports on true KPs, two cases on possible KPs, seventeen cases on laser-induced questionable KPs comprising cases of vasculitis, eczema or Meyerson reactions, and eruptive squamous atypia cases (ESA) as well as two pseudo-Koebner cases involving wart occurrences at laser application sites. Laser-induced Koebner reactions highlight several aspects of the KP. Firstly, the type of mechanical damage influences disease promotion, as different lasers are associated with different KPs. For example, hair removal lasers are linked with true and questionable KPs such as vasculitis while resurfacing lasers were found to be more connected with ESA occurrence. Secondly, the laser target is significant, with vascular laser application for port-wine stains tending to result in eczematous reactions, while hair follicle destruction can frequently lead to true KPs. Thirdly, the number of sessions matters; true KPs and eruptive squamous atypia questionable KPs typically appear after one to two sessions, whereas eczematous reactions require more sessions (at least four). Additionally, skin phototype is crucial, with darker phototypes showing a higher KP frequency as laser treatment for hypertrichosis relies on melanin absorption in the hair bulge or bulb for follicle destruction, as chromophore competes with the abundant melanin in the epidermis. Further research with larger-scale studies into trauma-specific Koebner reactions is vital for refining treatment protocols, minimizing post-laser adverse effects, and improving dermatological care outcomes.

The Maternal Psychophysical Knot

ABSTRACT The idea of birth trauma places a psychophysical knot at the center of the constitution of the psyche tied to maternal space. What does it mean that the maternal is seen as a site of trauma and regressive desire? How do women experience being this place? While Freud’s neglect of the importance of the mother and hyper-emphasis on the father has been visited and re-visited, from the angle of birth trauma, an idea he fought against fearsomely, we begin to witness something important concerning his efforts to move away from this battleground. Not to erase the mother, but to leave something Real there intact. Revisiting three wild speculations on the psychoanalytic meaning of birth, I ask about this maternal knot.

ON THE QUESTION OF THE EFFECT OF REGENERATION STIMULATION DRUGS ON THE RESTORATION OF THE SKIN IN CASE OF INJURY

Background. The study of the reaction of tissue (epidermis and dermis) to the medication of regeneration stimulants (МSR) in injuries is relevant both for the development of wound coatings and treatment regimens for the traumatic process. In this study, special attention is paid to the process of stimulation of stem cells in the hair papilla, which play an important role in the restoration of skin structures. The aim of the study was also to study the morphological changes of the epidermis and dermis in the dynamics of trauma. Materials and methods. To conduct the experiment, experimental groups were formed: a burn model without treatment; a burn model with a МSR preparation (oral administration and wound coating); an experimental group with a linear wound with МSR treatment, an experimental group similar reproduction of a wound without suturing with МSR, a control group similar reproduction of a wound without treatment with suturing, a control group - similar reproduction of the wound without treatment and without suturing. Animals were removed from the experiment by inhalation of ether vapors in accordance with the "Rules for carrying out work using experimental animals" and in accordance with the principles of the Helsinki Declaration of the World Medical Association (Declaration of Helsinki, and approved by the Institutional Review Board). Tissue fragments were taken from the site of thermal trauma and healthy tissue for the preparation of histological preparations. The production of paraffin histological sections with a thickness of 5-7 microns was carried out according to generally accepted standard methods. The sections were stained with hematoxylin and eosin. The photos were taken using the Vision Bio system (Epi 2014) and stained with hematoxylin-eosin, which were examined under x100 magnification. The obtained data were processed using MS Excel and Statgraphics software packages using generally accepted methods of statistics. Results. When reproducing thermal trauma In the control group on day 14, there is no epidermis in part of the visual fields within the studied material, the layers are replaced by connective tissue strands, scar tissue is visualized. The dermis is moderately edematous, with neutrophilic and lymphocytic infiltration is weakly expressed, in the papillary and reticular layer it is evenly represented, there are single apoptotic corpuscles. No areas of hemorrhage were detected, but the blood vessels were dilated. While in the experimental group there are signs of restoration of microcirculation with a large number of vessels and a more pronounced layer of the epidermis. When examining scars after a linear wound, it was found that animals who did not receive therapy have a thin scar, and in animals who received МSR, the consequences of surgical intervention are not visualized. Conclusion. The dynamics of the wound process was studied when using a prototype ointment containing a regeneration complex in the treatment of burn and linear wounds in an experiment. The effectiveness of the regenerative complex of a prototype ointment for the treatment of experimental burn and linear wounds in laboratory animals in comparison with the control group was revealed. It has been established that in the treatment of burn and linear wounds with experimental ointment, the healing period of burn wounds is reduced due to more active formation of the microcirculatory bed and the early onset of epithelization.

Rapidly Growing Congenital Disseminated Pyogenic Granuloma in the Scalp Treated with Staged Embolization and Excision: A Case Report

Pyogenic granulomas are common, acquired vascular lesions that most often arise spontaneously or in sites of previous trauma. However, there are reports of a few cases that describe a rare condition, congenital disseminated pyogenic granuloma (CDPG), in which an infant either is born with or shortly after birth develops multiple pyogenic granulomas. A hallmark of CDPG is negative staining for glucose transporter 1 (GLUT-1) on immunohistochemistry, which helps distinguish it from the more common multifocal infantile hemangiomas. Because few case reports have described CDPG, much is unknown about its characteristics, clinical course, and most effective treatment options. Here, we present a case of an infant with a unique presentation of CDPG with lesions that are atypically large and growing at a rapid pace. We also describe a novel approach to treating large pyogenic granulomas in CDPG via staged glue embolization and surgical excision.

Island Detention and Seeking Asylum in the Asia-Pacific

Abstract Drawing on Bhasan Char and Manus Island as case studies, this article makes an argument for the concept of “grey sovereignty,” which is understood as the suspension and/or manipulation of established state norms and obligations in order to contain and punish irregular migrants. The operationalization of grey sovereignty is discussed through three paradigms that can help to understand its purpose and practice: As sites of sovereign decline, violence and trauma, and erasure. I argue that the practice of grey sovereignty is enabled by the entanglement of the humanitarian apparatus and/or discourses in these practices of the state. Further, such practices use dubious means to “shrink asylum” (through temporality, precarity, power inequities) and undermine the ideals of both sovereignty and humanitarianism.

Alleviating severity of limb trauma pain with coadministration of topical sesame oil and standard treatments: A GRADE-assessed systematic review and meta-analysis of randomised controlled trials.

Recent randomised controlled trials (RCTs) have investigated the analgesic activity of sesame oil among patients with limb trauma; nevertheless, their findings are inconsistent. Hence, this review aimed to clarify the impact of topical administration of sesame oil on acute pain of adult outpatients with minor limb trauma. The online databases (e.g., Scopus, PubMed, Web of Science) were searched up to 31 January 2024. The RCTs were included if they compared the effect of applying standard treatments plus topical sesame oil to administering standard treatments alone or with a placebo/sham treatment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and the Cochrane Collaboration's risk of bias tool were applied to address the evidence quality and the study's methodological rigour, respectively. Four RCTs had the inclusion criteria, and their findings were pooled in a meta-analysis employing a random-effects approach. According to the pooled analysis, the reduction in mean change of the pain score from baseline to the second/third intervention day was significantly higher in favour of clients who received standard care plus daily massage of the trauma site with sesame oil compared to those who received a control condition (weighted mean difference: -1.10; 95% confidence interval [-1.62, -0.57]; p < 0.001). However, the evidence quality was moderate, and only two studies had good methodological rigour. Hence, more high-quality studies are needed to make a solid evidence-based conclusion about the favourable consequence of topical sesame oil on alleviating acute traumatic limb pain.