Traumatic Origin Research Articles

Outcome Following Decompressive Craniectomy in a Tertiary Care Center in Nepal

Introduction: Decompressive Craniectomy (DC) is a common neurosurgical procedure performed to reduce the intractable intracranial pressure in various neurosurgical diseases (infarction, hemorrhage, traumatic brain injury). The main aim of the study was to describe the demographic, clinical and operative characteristics of patients who underwent DC for different conditions and to correlate the outcome with various preoperative and intraoperative factors in our center. Methods: This was a retrospective study of patients who underwent DC for various neurosurgical diseases from January 2019 to January 2021 in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The chart of the patients were retrieved from the medical records and additional information obtained via telephone. Results: A total of 55 patients were enrolled in the study with a mean age of 43.0 + 17.3 years and male:female ratio of 1.5:1. There were 20 (36.4%) patients who presented with trauma and 35 (63.6%) patients with non traumatic origin. Among them, 28 (51%) patients presented with GCS<8 and 27 (49%) patients with GCS>8 and 37 (67.3%) patients with unequal pupil. At the end of six months follow up, the favorable outcome was seen in 23 (41.8%) patients. The only factor significantly associated with favorable outcome was the preoperative pupillary status. Conclusion: In our cohort the preoperative pupillary status (bilateral equal and reactive pupil) was the variable significant for favourable outcome in patients undergoing DC.

USE OF ARTHROCENTESIS FOR СOMPLEX TREATMENT OF POST-TRAUMATIC TEMPOROMANDIBULAR DISORDERS, WHICH ARE NOT CAUSED BY MANDIBULAR FRACTURES

Introduction. Injury to the temporomandibular joint (TMJ) in patients without condylar fractures may cause more damage to the joint tissues than a fracture. Intra-articular changes are more often caused by intraarticular localization of the fracture, but extra-articular fractures of the mandible can also cause damage to the structural elements of the joint. Unfortunately, the use of conservative therapy after TMJ traumatic injuries is of little effectiveness, therefore, the next step in the treatment of TMJ post-traumatic disorders implies the use of minimally invasive surgery, including arthrocentesis. The aim of this work is to investigate the effectiveness of arthrocentesis in the treatment of post-traumatic internal temporomandibular disorders. Materials and methods. The study included 24 patients who had a history of head injury without bone fractures, namely TMJ contusions. Arthrocentesis was performed according to a modified method of D. Nitzan (1991) under local anesthesia. Results. According to clinical and radiological findings obtained after TMJ traumatic disorders, patients were divided into two groups according to the Wilkes classification (1989): 13 patients with stage II (early-medium) derangement and 11 patients with stage III (medium) derangement. Control radiological studies performed in 3-6 months after arthrocentesis did not show signs of hemarthrosis in 11 (84.61%) patients with intra-articular disorders of II degree and in 8 (72.72%) patients with internal disorders of III degree, position and function articular disc restored. Conclusions. Arthrocentesis with TMJ lavage is a minimally invasive surgical manipulation that has been proven as an effective mote to treat TMJ disorders of traumatic origin, and in particular, after TMJ contusion.

Hermeneutics of Lázaro in The Labyrinth by Buero Vallejo

This play contributes to a better understanding of the psychological mechanism of behavior with respect to recurrent auditory hallucinations and the traumatic origin that can cause it, such as experiencing a violent event. This causes an emotional blockage of fear in the actor, due to the defense mechanism of denial, with repercussions on memory and negative feelings of guilt and shame. The author proposes an adequate emotional management for the protagonist, Lázaro. The solution is aimed at making him dare to know the truth and accept it following current clinical psychological praxis, without taking refuge in the protection of others. In this way, he will improve and may even reduce the emotional state and the hallucination. In the analysis of the work, various contents are decoded. First, the planes of reality: the physical world, the fantasy world and the inner world of the characters. Second, the trauma lodged in the subconscious and auditory hallucination. Third, relationship of defense mechanisms, emotional intelligence and memory. Fourth, plot about love relationships. Fifth, the psychological mechanisms in favor of justice and truth. It is proposed how this drama could have contributed to the social imaginary to raise awareness about the emotional management of individuals. The results indicate that this symbolic and complex work of form and content also contributes to solving other human dilemmas such as the limitation to know reality, in addition to the feelings and emotions in the subconscious, as well as to accept them. It is discovered how to cope with an ethical sense of justice in a society in democratic transition, with still open wounds that derive from a war. Also, there is the aspiration to a humane society on the part of the author.

Результати застосування артроцентезу при лікуванні скронево-нижньощелепних розладів, асоційованих з переломами виросткового відростка нижньої щелепи

The purpose of the work was to study the effectiveness of arthrocentesis in the complex treatment of post-traumatic temporomandibular disorders. Materials and methods. The clinical part of the study included 24 patients, who had a history of fractures of the mandibular articular process. Patients underwent radiological examination – orthopantomography, computer tomography, ultrasound and magnetic resonance. Patients with titanium mini-plates after osteosynthesis were subjected to ultrasound, and since the reposition and fixation of fragments was performed using intermaxillary fixation they were subjected to magnetic resonance imaging. Pain assessment was performed according to visual analogue scale. Temporomandibular joint arthrocentesis was performed according to a modified method of D. Nitzan (1991) under local anesthesia. Results and discussion. All patients complained of the temporomandibular joint pain, which was rated from 1 to 6 points. All patients noted pain on palpation of the temporomandibular joint. Limited mouth opening ranging from 30 to 38 mm was found in 11 patients. Lower jaw deviation was observed in 18 patients. All patients had articulatory noises – clicking, and 11 had blocked movement of the joint head. Orthopantomograms or computer tomography revealed satisfactory restoration of the anatomical shape of the mandible after fractures and complete consolidation of the fracture. Ultrasound and magnetic resonance revealed signs of unabsorbed hematoma as consequences of hemarthrosis; in 18 patients – deformity of the capsule, in 17 – a slight thickening of the posterior edge of the articular disc, in 18 patients – disc adhesion, in 13 people – forward disc displacement with reduction, in 11 patients – disc protrusion without reduction. According to clinical and radiological signs after traumatic temporomandibular disorders, patients were divided into two groups according to Wilkes classification: 13 patients with stage II (early-middle) and 11 – with stage III (middle). We also found that after surgical treatment – osteosynthesis, the number of patients with stage III according to Wilkes makes up 58.33% (7 people), while those after splinting – 33.33% (4 people). The control ultrasound and MRI carried out 3-6 months after arthrocentesis showed no signs of hemarthrosis in 11 (84.61%) patients with intra-articular disorders of the second degree, and in 8 (72.72%) patients with internal disorders of the third degree, the position and function of the articular disc were restored. Conclusion. Arthrocentesis with temporomandibular joint lavage is a minimally invasive surgical manipulation that has proven itself in temporomandibular disorders of traumatic origin, in particular after fractures of the articular process of the mandible. Arthrocentesis is recommended to be used after ineffective conservative treatment, as well as to prevent post-traumatic intra-articular disorders in the early post-treatment fractures (intermaxillary fixation or osteosynthesis) with the attenuation of acute post-traumatic events, which is our goal of further work

Traumatic Spigelian hernia in a child

Spigelian hernia is an uncommon surgical condition in children and accounts for only 1% of all abdominal hernias. Its traumatic origin has been described sporadically in the literature. We report a case of a 9-year-old boy, brought to the emergency department 2 hours after abdominal trauma caused by a bicycle's handlebar grip at the lower abdomen, complaining of abdominal pain. Apart from edema, bruising and tenderness of the right of lower abdomen, physical examination showed a 1.5 * 2 cm reducible swelling lateral to the rectus muscle and a 1-cm facial defect of the anterior abdominal wall at the same site. Ultrasonography concluded to diastasis between the rectus abdominis muscle and the broad abdominal muscles with evidence of a hernia sac. The diagnosis of traumatic Spigelian hernia was retained and the patient was operated on. He had primary repair of the defect in layers using interrupted sutures. He was discharged in the same day and the aftermath of surgery was uneventful. In conclusion, traumatic Spigelian hernias are rare entities in children which diagnosis should be considered following blunt abdominal trauma. We recommend careful abdominal examination after trauma to highlight swelling and/or aponeurotic defect.

Childhood musculoskeletal impairment in Malawi from traumatic and non-traumatic causes: a population- based assessment using the key informant method

BackgroundMusculoskeletal impairment (MSI) in children is an under-recognised public health challenge. Although preventable, road injuries and other traumas continue to cause significant impairments to children worldwide. The study aimed to use the Key Informant Method (KIM) to assess prevalence and causes of MSI in children in two districts in Malawi, estimating the associated need for services provision, with a focus on traumatic aetiology.MethodsThe KIM was conducted in the districts of Thyolo (Southern Malawi) and Ntcheu (Central Malawi) in 2013. Five hundred key informants were trained to identify children who may have one of a range of MSI. The identified children were referred to a screening camp where they were examined by medical experts with standardised assessment protocols for diagnosing each form of impairment.Results15,000 children were referred to screening camps. 7220 children were assessed (response rate 48%) for an impairment of whom 15.2% (1094) had an MSI. 13% of children developed MSI from trauma, while 54% had a neurological aetiology. For MSI of traumatic origin the most common body part affected was the elbow. Less than half of children with MSI (44.4%) were enrolled in school and none of these children attended schools with resources for disability. More than half of children with MSI (60%) had not received required services and 64% required further physical therapy.ConclusionsThe KIM method was used to identify a high prevalence of MSI among children in two districts of Malawi and estimates an unmet need for dedicated MSI services.

Surgical treatment of post-traumatic luxation of rib heads with spinal cord compression in a cat

BackgroundLuxation of the rib head with intrusion into the intervertebral foramen seems to be rare in cats. Only one report has been published describing a cat with non-ambulatory paraparesis, which was managed conservatively. Here we report a case of rib head luxation that was managed surgically.Case presentationA 4-year-old, female domestic shorthair cat with a two-week history of non-ambulatory paraparesis was presented at our clinic. Based on history and neurological examination, a diagnosis of thoracolumbar spinal cord lesion of traumatic origin was made. Computed tomography scanning revealed mild scoliosis, a luxation of the 3rd and 4th right rib heads and penetration into the spinal canal through intervertbral foramina. Surgical management using right dorsal approach to the spine was performed. The spinal cord was decompressed by cutting and removing of proximal ribs’ fragments by rotation and pulling out from the intervertebral foramina. The cat was ambulatory and paraparetic four weeks after surgery. Two years after surgery the cat regained functional gait, but ataxia remained.ConclusionsWe report the first case of a surgical treatment of rib head luxation and intrusion into the spinal canal in a cat. The applied procedure resulted in an improvement of neurological signs.

Pathological and epidemiological investigation of skin lesions in belugas (Delphinapterus leucas) from the St. Lawrence Estuary, Quebec, Canada

AbstractFollowing the evaluation of 26,020 photographs collected from 2003 to 2014 as part of a photo‐identification program in St. Lawrence Estuary belugas, an atlas of cutaneous anomalies, composed of 18 skin lesions categories (SLCs), is proposed. At least one SLC was present in 51%, 97%, and 94% of neonates, gray, and white belugas, respectively. The most common SLC observed were “single linear fissure” (22%), “single linear scar” (19%), and “ulcer‐like lesion” (17%) in neonates, and “rake mark” (77%; 70%), “single linear fissure” (31%; 24%) and “circular depression” (40%; 35%) in gray and white belugas, respectively. Logistic regression modeling revealed significant correlations between temporal and individual variables for most SLCs. Histological evaluation of cutaneous lesions from 111 belugas stranded between 1983 and 2017 were also performed. “Single linear fissure,” “single linear scar,” “crater‐like scar,” “rake mark,” and “Morse code lesions” appear to be of traumatic origin. Results from pathological and epidemiological analyses suggest that some of these SLCs, such as “yellow patch,” “circular depression,” and “map depression” are associated with molting. Postnatal molting could account for “ulcer‐like lesions” and “single linear fissures” in neonates. Urchin spines were found within “pinhole erosions” and a gamma‐herpesvirus was detected by PCR in a wound.

Should proximal ruptures of the anterior rectus femoris muscle be treated surgically?

PurposeNo therapeutic consensus has been established about proximal ruptures of the rectus femoris muscle. The objective of this literature review is to determine a therapeutic course of action. MethodsWe conducted a literature review on the PubMed database using the following keywords (in French and English, respectively): "quadriceps/quadriceps", "droit antérieur/rectus femoris", "proximal/proximal", "chirurgie/surgical", "avulsion/avulsion". We collected 266 articles, 36 of them were selected, which were related to our topic: proximal rupture of the anterior rectus femoris. Patients with a proximal rupture of the rectus femoris, minor or major patient of traumatic origin were included in this study. Patients injured at another lesion level, or non-traumatic lesions of the proximal rectus femoris (tendinitis without ruptures, tumor or others) were excluded. For each patient, the indications, the type of treatment and the functional result were analyzed, with the time to recovery and the level of recovery from sports and professional activities (same sport/profession or not, same level or not) as the main criterion of judgment. Fisher exact test was used for statistical comparison. ResultsThe aims of conservative treatment are to be pain free for the patient, to fight hematoma and to rehabilitate the injury as quickly as possible. The surgical techniques are varied, with most consisting of either a reinsertion of the musculo-tendon stump or a resection of the scar tissue with myo-tendino-aponeurotic suture in place. The functional results are good for the majority of the treatments proposed, but the conservative treatment has a shorter recovery time (3 months vs. 4 months for the best surgical results). Highly displaced bone avulsion is the only indication for first-line surgical treatment. ConslusionThe main disadvantage of conservative treatment is the risk of residual pain beyond 3 months (10%), justifying an MRI to guide secondary surgical treatment. We propose a treatment plan for proximal rupture of the proximal rectus femoris rupture.

Abstract 13678: Validation of the Termination of Resuscitation Rules in Detroit

Introduction: 326,000 patients suffer from an out of hospital cardiac arrest (OHCA) each year. The Termination of Resuscitation (TOR) criteria, which recommends termination when the arrest is unwitnessed by EMS, no shocks are administered, and no ROSC occurs, guides physicians in determining the futility of continuing CPR and transporting patients to the hospital. We examined compliance with current BLS TOR rules as well as assessed an alternate set of rules, with the goal of retrospectively deriving improved TOR guidelines for OHCAs in Detroit. Methods: This is a retrospective study utilizing non-traumatic OHCA cases in Detroit from January 1, 2017 to December 31, 2019, which includes time before and after BLS TOR guidelines were officially implemented (June 1, 2018). Data is extracted from the Detroit Cardiac Arrest Registry (DCAR). Patients younger than 18 years of age and arrests of traumatic origin or those with no resuscitation attempted were excluded. Results: BLS TOR criteria was applied to the pre-TOR implementation data with resulting specificity of 79% (95% CI: 50.7-80.8) and PPV of 97.3% (95% CI: 95.5-98.6). Survival to hospital discharge when termination was recommended was projected at 2.9% (13/444). Overall transportation rate was 85% (559/656). Post-TOR implementation, specificity was 88.9% (95% CI: 78.6-99.1) and PPV was 99.1% (95% CI: 98.3-99.9). Survival to hospital discharge was 0.88% (4/453) with a 69% (451/650) overall transportation rate. Post-hoc addition of age or EMS time to patient side increased transportation rates to 81% (529/650) and 88% (571/650), respectively, and decreased false positive terminations to 0.84% (2/237) and 0% (0/148), respectively. Conclusion: Overall survival when TOR was recommended as well as futile transportation rates decreased since the implementation of the BLS TOR guidelines in Detroit. Addition of EMS time to patient side or patient age to the current TOR guidelines suggested improved performance. Although the additional criteria resulted in higher transportation rates, these factors may be useful for physicians to consider when deciding to transport patients who meet the current TOR criteria. However, further derivation and validation are needed to create optimal TOR guidelines.

Identification of the marks of psychic trauma in spoken language: Definition of the “SPLIT-10” diagnostic scale

Identification of the marks of psychic trauma in spoken language: Definition of the “SPLIT-10” diagnostic scale

TO DEVELOP FORENSIC CRITERIA FOR THE DIFFERENTIAL DIAGNOSIS OF INTRACEREBRAL HEMORRHAGE OF TRAUMATIC AND NON-TRAUMATIC ORIGIN USING MUELLER-MATRIX MICROSCOPY OF LINEAR DICHROISM

Differential diagnosis of intracerebral hemorrhage due to traumatic and non-traumatic origin is a challenging issue, especially in the absence of visible body injuries and other signs of violence. For a forensic expert-practitioner, the main thing is objectivity, accuracy, and speed of obtaining the result, which could fully satisfy the methods of laser polarimetry in the case of differential diagnosis of hemorrhages of traumatic and non-traumatic origin in the human brain matter.
 The purpose: To develop forensic criteria for the differential diagnosis of intracerebral hemorrhage of traumatic and non-traumatic origin using Mueller-matrix microscopy of linear dichroism.
 Materials and methods: The object of the study was brain matter samples, collected in 115 corpses of both sexes aged 22 to 86 years with accurately known causes of death. The causes of death included coronary artery disease, traumatic brain hemorrhage, ischemic brain infarction, and non-traumatic brain hemorrhages. Brain matter samples have been frozen rapidly, and histological sections have been made using a freezing microtome. The slices have been evaluated using the method of azimuthal-invariant Mueller-matrix microscopy, followed by mathematical and statistical processing of the results. 
 Results: significant topographic heterogeneity of Mueller-matrix invariants of brain matter samples linear dichroism maps among all research groups have been found. Individual and significant variations of dispersion, asymmetry, and kurtosis magnitude have confirmed the heterogeneity of Mueller-matrix invariants. The difference of images and histograms among groups is explained by the presence of necrotic changes in the case of ischemic brain necrosis and blood cells in the brain matter samples. For the set of central statistical moments of the 1st, 3rd, and 4th orders, which characterize the distributions of circular dichroism, the method of MM-microscopy in the differentiation of samples of non-hemorrhage and hemorrhage groups reaches a satisfactory level - 78% - 84%.
 Conclusions: Brain matter samples Muller-matrix microscopy of linear dichroism is effective for solving diagnostic problems of forensic medicine related to evaluating the cause of death from intracerebral hemorrhage of various origins. Diagnostic efficiency of Mueller-matrix mapping of polarization manifestations of linear dichroism method for intergroup differentiation of samples of deaths from traumatic hemorrhage (Group 2) and ischemic cerebral infarction (Group 3) reaches a satisfactory level of 79 - 84%.

Contribution of Tomodensitometry in the Management of Cranio-Encephalic Trauma in Chme Luxembourg

Goal: We initiated this work with the aim of evaluating the cost and benefit of computed tomography in the management of craniocerebral trauma. Patients and Methods: This was a prospective study of 340 head trauma patients who underwent a brain scan at Luxembourg Hospital during the study period from April 1 to December 1, 2019. Result: During this study we collected 340 cases of cerebral CT scans for cranio-encephalic trauma, ie 10.36%. The average age of our patients was 22.14 years. Male dominated the study with a sex ratio of 2H / 1F. Pupils and students were the most affected socio-professional layer, ie 44.4% of cases. The most frequent aetiology was road accidents, ie 83.8% of cases. The symptoms that prompted the request for the CT scan were dominated by headache, ie 93.2% of cases. The time to complete the CT scan was between the 2nd and 6th hour after their admission to the ward. The cost of the brain scan of these patients amounted to 15, 300,000 FCFA (45,000F per person). On CT, a predominance of bone fractures was noted, ie 37.6% of cases. Intracerebral lesions were dominated by edema-hemorrhagic contusions (6.5%). Conclusion: The CT scan is the primary examination of an emergency head trauma patient. It provides a better understanding of the different types of cranio-encephalic injuries of traumatic origin, their topography and their importance. But the high cost of the scanner in our health facilities and the lack of an emergency aid service are factors that delay the urgent care of trauma patients.

Time since hemorrhages of traumatic and non-traumatic genesis into the substance of the human brain formation using distribution of linear dichroism fluctuations reconstruction

For a forensic expert-practitioner, it is especially important to objectively diagnose and time since the formation of hemorrhage (TSFH) in the substance of the human brain (SHB) of traumatic and non-traumatic origin, as there are cases when the external examination of the corpse at the scene are absent, and at internal research find hemorrhages in a brain. In forensic practice, to verify the cause of death, physical-optical methods are successfully used, which are based on laser irradiation of biological tissues with subsequent mathematical and statistical processing of the obtained data. Previous studies on the possibility of differentiating the cause of death by traditional polarization methods have yielded positive results, which suggests the possibility of their suitability for verification of the genesis of hemorrhage into the brain. For a forensic expert-practitioner, the main thing is objectivity, accuracy and speed of obtaining the result, which could fully satisfy the methods of laser polarimetry in the case of determining the TSFH of traumatic and non-traumatic origin in SHB. Therefore, it is necessary to continue the development and research of these methods for this purpose.
 Aim of the work. To substantiate the possibility of using the method of differential Mueller-matrix mapping of phase anisotropy to determine the temporal dynamics of maps of linear birefringence of histological sections of human brain in determining the age of hemorrhage in human brain substance and to develop forensic criteria for determining the age. death due to cerebral infarction of ischemic and hemorrhagic origin.
 Materials and methods. To achieve this goal, we studied native histological preparations SHB from 130 corpses with a known time of death. The cause of death was TBI (group II (n=35)), cerebral infarction of ischemic origin (group III (n=32)), hemorrhagic stroke (group IV (n=33)), acute coronary insufficiency (group I – comparison group (n=30)). The values of the distribution of the coordinates of the polarization parameters at the points of the microscopic images at the location of the standard Stokes polarimeter were measured. Experimental measurements of Stokes-parametric images of biological layers were performed according to the method presented in the sources. Subsequently, the obtained data were subjected to statistical processing and evaluation of the obtained results. Statistical moments (SM) of the 1st-4th orders (mean (SM1), variance (SM2), asymmetry (SM3) and excess (SM4)) of each map were determined.
 Results and discussion. Comparative analysis of polarization Mueller-matrix mapping images of SHB sections from all groups revealed the destruction of the polycrystalline structure formed by optically active protein complexes of the brain substance, which indicates a decrease in absolute values and range of their scatter with increasing hemorrhage time. This is indicated by the coordinate inhomogeneity of the Mueller-matrix invariant maps of histological sections of SHB of all groups. For histograms that characterize the distributions of the Mueller-matrix invariant samples from all (comparison groups 1 and experimental 2-4) groups, are characterized by individual and significant variations in the values of statistical moments. Due to this, with increasing hemorrhage time, the value of the mean (SM1) and variance (SM2) decreases. Asymmetry (SM3) and excess (SM4), on the contrary, increase. The analysis of the results of statistical processing of the topographic structure of LD tomograms of fibrillar networks of histological sections of SHB dead from all groups shows a greater temporal dynamics of necrotic destruction of nervous tissue. Accordingly, there is a faster time decrease in the absolute values and the range of scatter of the LD value with increasing TSFH. That is, the diagnostic sensitivity of the statistical moments of the 3rd and 4th orders for azimuthal-invariant Mueller-matrix differentiation of nerve tissue samples of the brain of the deceased of control group 1 and all experimental groups 2-4 (p<0,05) was revealed.
 Conclusions. A series of studies of the effectiveness of a new in forensic practice method of differential Mueller-matrix mapping of partially depolarizing histological sections of SHB and tomographic reproduction of optical anisotropy parameters of their polycrystalline structure revealed a high level of accuracy of differentiation and formation of genesis, even under conditions of small geometric thickness of experimental samples. The range of linear change of values of statistical moments of the 1st - 4th orders which characterize distributions of size of LD of fibrillar networks of histologic sections of SHB of the dead from all groups, makes 24 h. In the range of 6-24 hours, the accuracy of determining the TSFH using statistical processing of the topographic structure of LD tomograms of fibrillar networks of histological sections of TSFH is (30±5) minutes.

Trauma et symbolisation chez Edvard Munch. Art et psychanalyse

This article examines the evolution of the concept of trauma from a psychoanalytic perspective and the psychic elaboration of the consequences of trauma through painting, taking as an example the life and work of Norwegian Edvard Munch. The traumatic experiences of artist's childhood find their place in his art and in his vision of the world. Art allows us to “psychically work out” the effects of these catastrophic childhood experiences. The representations of childhood trauma through painting are an opportunity to give a “figurability”, a meaningful representation to the traumatic experience. Thus, visual art, as a work of symbolization and psychic treatment of trauma, is a kind of bulwark against unbinding and destructiveness. With the famous painting “The Scream” by Edvard Munch, which bears the motif of repetition, we want to show the artist's ability to choose a “positive destiny” for his traumatic experience, where the “repetition of the same” takes the form of a “working-off mechanism” aimed at gradually eliminating tension and overexcitations of traumatic origin.

On the issue of birth injuries of the urinary tract of a woman

With minor exceptions, urinary incontinence after childbirth has a traumatic origin. It can be the result of two different reasons, namely, the result of a long standing of the fetal head in the cavity or, more often, in the entrance of the small pelvis and the associated prolonged pressing of the underlying tissues, of which the anterior wall of the vagina with the posterior wall of the bladder and the urethra suffers or re as a result of surgical interventions undertaken for the purpose of delivery without the necessary conditions, more often with an empty bladder and with an unprepared birth canal.

About dry pleurisy of traumatic origin

The issue of dry pleurisy of traumatic origin has not yet undergone a comprehensive and thorough study, while this type of pleurisy has in its clinical course a number of characteristic and specific features that sharply distinguish them from dry pleurisy of another, non-traumatic etiology.

Identification des marques du traumatisme psychique dans le langage parlé : définition de l’échelle diagnostique « SPLIT-10 »

Identification des marques du traumatisme psychique dans le langage parlé : définition de l’échelle diagnostique « SPLIT-10 »

Prevalence of anophthalmia etiological factors in patients treated in a reference center: A retrospective study

BackgroundOcular prosthesis rehabilitation has an important social, psychological, esthetic, and functional role. Congenital factors, trauma, and tumors, among others, can cause anophthalmia, and it is essential to identify the etiology to guide its prevention and treatment. MethodsThe aim of this study was to retrospectively investigate the records of patients treated from 2013 to 2020 by the Oral and Maxillofacial Prosthesis Group, aiming to identify the prevalence of patients with anophthalmia and the etiology of their anophthalmia. After approval by the Human Research Ethics Committee, two calibrated researchers evaluated 520 records, identifying those from patients with anophthalmia. The inclusion criteria were records with complete and legible information from patients with anophthalmia and a description of their etiology. Descriptive statistics were performed, and etiological factors were categorized into trauma, congenital cause, end-stage eye disease, and tumor. Spearman's correlation was performed to verify the relation between gender and anophthalmia etiology, with a 5% significance level. Seventy-two records were included in the study. ResultsIt was observed that 33.4% of patients were women and 66.6% were men. The etiologies were physical trauma (52.4%), tumor (21.8%), end-stage eye disease (16.6%), and congenital cause (9.2%), and there was no correlation between gender and these etiologies (p = .301). ConclusionMost of the cases identified were of traumatic origin, which allows the establishment of preventive and educational measures to avoid new cases of anophthalmia.

Forensic medical evaluation of hemorrhages into the brain of traumatic and non-traumatic genesis by the Mueller matrix microscopy of circular dichroism

The aim of the work is to develop forensic criteria for differentiation of hemorrhages of traumatic and non-traumatic genesis by digital Mueller matrix (MM) polarization microscopy of histological sections of human brain substance (HBS).Material and methods. Native histological preparations of HBS from 32 corpses with ischemic stroke (1 group), 35 corpses with hemorrhages of traumatic origin (2 groups), 33 corpses with hemorrhages in HBS of non-traumatic genesis (3 group) and 30 corpses caused by acute coronary insufficiency (4 control group). The method of research is azimuthal-invariant MM microscopy of circular dichroism (CD) of histological sections of the brain.Results. The results of studies of the coordinate and statistical structure of maps of the size of values at the points of digital microscopic images of histological sections of HBS of the dead of all groups revealed a coordinate-inhomogeneous structure of all distributions of the size of the CD of microscopic images of histological sections of the dead of all groups. Probable distributions that characterize MM invariants CD maps of histological sections of brain samples from all groups have a small scatter of values of the statistical moment of the 2nd order, as well as significant values of statistical moments of the 3rd and 4th orders.Conclusion. The efficiency of using the Mueller-matrix mapping method in diagnosing of hemorrhage genesis in the brain substance in the differentiation of the set of samples of control and experimental groups reaches a satisfactory level - 77% - 78%.