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Journal of Cardiothoracic Surgery Feb 2024Penetrating cardiac injuries are rare but often fatal, with 16-55% mortality. We report a patient who suffered a non-fatal occupational cardiac injury.
BACKGROUND
Penetrating cardiac injuries are rare but often fatal, with 16-55% mortality. We report a patient who suffered a non-fatal occupational cardiac injury.
CASE PRESENTATION
A 47-year-old man was operating an ironworker machine. A thin 3-cm metal fragment catapulted from the machine piercing the chest wall and the right ventricular outflow tract (RVOT), burrowing into the interventricular septum (IVS). The patient remained hemodynamically stable and walked to the nearest hospital. ECG-gated computed tomography revealed the exact location of the fragment within the IVS, allowing for detailed preoperative planning. The fragment was removed through a sternotomy and an incision through the RVOT. The postoperative course was uneventful.
CONCLUSIONS
This case underscores the value of detailed preoperative imaging and the wide spectrum of clinical scenarios of penetrating cardiac injuries.
Topics: Male; Humans; Middle Aged; Ventricular Septum; Wounds, Penetrating; Heart Ventricles; Heart Injuries; Foreign Bodies
PubMed: 38310275
DOI: 10.1186/s13019-024-02512-5 -
Open Veterinary Journal Dec 2023Traumatic reticulitis (TR) and abomasal obstruction are common digestive diseases in beef cattle. In clinical practice, these two conditions are often detected alone and...
BACKGROUND
Traumatic reticulitis (TR) and abomasal obstruction are common digestive diseases in beef cattle. In clinical practice, these two conditions are often detected alone and rarely occur at the same time. Surgical therapy is an effective approach to treat both of these diseases. However, there are no reports on the treatment of abomasal obstruction in cattle induced by TR.
CASE DESCRIPTION
We here report a rare case of the diagnosis and treatment of TR associated with abomasal obstruction in a beef cow during late pregnancy. The affected cattle had an iron wire that was piercing the wall of the reticulum, but did not penetrate the wall; the abomasum was blocked and appeared solid; and the fetus survived well (268 days gestation). To save the lives of the cow and fetus on the same day, a cesarean section was first performed, followed by rumenotomy, the foreign body (wire) was removed, and abomasotomy was finally performed. The fetus removed by cesarean section grew well, and the beef cow recovered and successfully became pregnant again.
CONCLUSION
This case thus offers guidance for the timely diagnosis, effective treatment, and postoperative management of these digestive diseases in cattle to prevent progression and further complications.
Topics: Cattle; Animals; Pregnancy; Female; Cattle Diseases; Abomasum; Cesarean Section; Foreign Bodies
PubMed: 38292727
DOI: 10.5455/OVJ.2023.v13.i12.27 -
Journal of Surgical Case Reports Jan 2024Appendicitis is the most common general surgery condition encountered in pregnant patients. Its presentation and diagnosis can be confounded by physiological changes of...
Appendicitis is the most common general surgery condition encountered in pregnant patients. Its presentation and diagnosis can be confounded by physiological changes of pregnancy causing atypical symptoms and overlap between pregnancy symptoms and appendicitis. Diagnosis of appendicitis in pregnancy is important, as pregnant persons have a much higher rate of complication from appendicitis. In this case report, we describe a patient with a history of right lower quadrant pain thought to be related to round ligament pain. Her previously undiagnosed appendicitis was discovered during routine inspection during caesarian section. The patient's final pathology revealed a metallic foreign body, one of the rarest causes of appendicitis.
PubMed: 38283409
DOI: 10.1093/jscr/rjae021 -
Frontiers in Psychiatry 2023Tattoos and piercings are associated with impulsive and risk-taking personality traits, which are also common along the ADHD continuum. However, studies on ADHD and body...
INTRODUCTION
Tattoos and piercings are associated with impulsive and risk-taking personality traits, which are also common along the ADHD continuum. However, studies on ADHD and body modification are lacking. Thus, this study aimed to assess the association between body modification and subclinical ADHD symptom severity and to investigate if body modification can serve as an indication for ADHD examination.
METHODS
A total of 762 adults (529 women and 233 men) without a diagnosis of ADHD completed the adult ADHD Self-Report Scale (ASRS) and answered questions concerning body modification. Two different ASRS versions were utilized: the 18-item ASRS Symptom Checklist and the 6-item ASRS Screener. Three categorizations of body modifications were analyzed: (i) having at least one tattoo, (ii) having at least one piercing other than ear piercing, and (iii) the combination of simultaneously having at least one tattoo and one piercing. Mean 18-item ASRS total and subscale scores and the proportion of positive results on the 6-item ASRS Screener were compared between those with and those without body modifications while adjusting for covariates age and sex. Additional analyses were performed for ≥2 and ≥3 body modifications.
RESULTS
In our cohort, 26% had a tattoo, 14% had a piercing other than ear piercing, and 8% had a combination of tattoo and piercing. Having any kind of body modification was associated with more pronounced symptoms of ADHD and with a cutoff score on the ASRS screener indicating ADHD. Whereas, the effect sizes were small for tattoos, medium to large effect sizes were seen for ≥2 piercings in the ASRS. Moreover, moderately strong associations emerged for ≥1 piercing and a positive ASRS screening result.
CONCLUSION
Our results suggest that acquiring a body modification, especially a tattoo, is entering the mainstream in Sweden. Correspondingly, differences in subclinical ADHD symptomatology between non-clinical adults with and without body modifications are subtle. Having ≥2 piercings other than ear piercings, on the other hand, is associated with clinically relevant differences in ADHD symptoms. Moreover, piercing status may serve as an indicator, among others, for further ADHD assessments. However, more research is needed to ascertain the possible signaling functions of body modifications in clinical settings.
PubMed: 38234366
DOI: 10.3389/fpsyt.2023.1224811 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Jan 2024To investigate the clinical application of high-frequency color Doppler ultrasound (HFCDU) in detecting perforators in the deep adipose layers for harvesting super-thin...
[A prospective study of super-thin anterolateral thigh flap harvesting assisted by high-frequency color Doppler ultrasound in detecting perforators in deep adipose layers].
OBJECTIVE
To investigate the clinical application of high-frequency color Doppler ultrasound (HFCDU) in detecting perforators in the deep adipose layers for harvesting super-thin anterolateral thigh flap (ALTF).
METHODS
Between August 2019 and January 2023, 45 patients (46 sides) with skin and soft tissue defects in the foot and ankle were treated, including 29 males and 16 females, aged from 22 to 62 years, with an average of 46.7 years. The body mass index ranged from 19.6 to 36.2 kg/m , with an average of 23.62 kg/m . The causes of injury included traffic accident injury in 15 cases, heavy object crush injury in 20 cases, mechanical injury in 8 cases, heat crush injury in 1 case, and chronic infection in 1 case. There were 20 cases on the left side, 24 cases on the right side, and 1 case on both sides. After thorough debridement, the wound size ranged from 5 cm×4 cm to 17 cm×11 cm. All patients underwent free super-thin ALTF transplantation repair. HFCDU was used to detect the location of the perforators piercing the deep and superficial fascia, as well as the direction and branches of the perforators within the deep adipose layers before operation. According to the preoperative HFCDU findings, the dimensions of the super-thin ALTF ranged from 6 cm×4 cm to 18 cm×12 cm. The donor sites of the flaps were directly sutured.
RESULTS
A total of 55 perforators were detected by HFCDU before operation, but 1 was not found during operation. During operation, a total of 56 perforators were found, and 2 perforators were not detected by HFCDU. The positive predictive value of HFCDU for identifying perforator vessels was 98.2%, and the sensitivity was 96.4%. Among the 54 perforators accurately located by HFCDU, the orientation of the perforators in the deep adipose layers was confirmed during operation. There were 21 perforators (38.9%) traveled laterally and inferiorly, 12 (22.2%) traveled medially and inferiorly, 14 (25.9%) traveled laterally and superiorly, 5 (9.3%) traveled medially and superiorly, and 2 (3.7%) ran almost vertically to the body surface. Among the 54 perforators accurately located by HFCDU, 35 were identified as type 1 perforators and 12 as type 2 perforators (HFCDU misidentified 7 type 2 perforators as type 1 perforators). The sensitivity of HFCDU in identifying type 1 perforators was 100%, with a positive predictive value of 83.3%. For type 2 perforators, the sensitivity was 63.2%, and the positive predictive value was 100%. The surgeries were successfully completed. The super-thin ALTF had a thickness ranging from 2 to 6 mm, with an average of 3.56 mm. All super-thin ALTF survived, however, 1 flap experienced a venous crisis at 1 day after operation, but it survived after emergency exploration and re-anastomosis of the veins; 1 flap developed venous crisis at 3 days after operation but survived after bleeding with several small incisions; 3 flaps had necrosis at the distal edge of the epidermis, which healed after undergoing dressing changes. All 45 patients were followed up 6-18 months (mean, 13.6 months). Three flaps required secondary defatting procedures, while the rest had the appropriate thickness, and the overall appearance was satisfactory.
CONCLUSION
Preoperative application of HFCDU to detect the perforator in the deep adipose layers can improve the success and safety of the procedure by facilitating the harvest of super-thin ALTF.
Topics: Male; Female; Humans; Thigh; Plastic Surgery Procedures; Prospective Studies; Skin Transplantation; Free Tissue Flaps; Burns; Soft Tissue Injuries; Ultrasonography, Doppler, Color; Crush Injuries; Perforator Flap; Treatment Outcome
PubMed: 38225843
DOI: 10.7507/1002-1892.202310091 -
Cureus Dec 2023Introduction Tattooing and piercing, which were uncommon in affluent countries, have recently spread throughout societies. Over the past two decades, young people have...
Introduction Tattooing and piercing, which were uncommon in affluent countries, have recently spread throughout societies. Over the past two decades, young people have shown considerable excitement for the practice. This reported growth creates more difficulties because of the numerous operations performed without awareness of health and hygiene requirements. This study aims to assess the knowledge and attitudes of the general population toward the cutaneous complications of tattoos and piercings in Saudi Arabia. Methods This was a web-based descriptive cross-sectional study. An online questionnaire was developed by the study researchers, which included participants' demographic data, their knowledge of tattoos and piercings with associated health effects and possible infections, their attitude towards tattoos and piercings, and their practice and experienced complications regarding tattooing and body piercing. The final validated questionnaire was made publicly available via social media until no more new responses were obtained. Results Eight hundred and forty-eight individuals completed the study questionnaire. The ages of the participants varied from 18 to more than 55 years old, with a mean age of 25.2 ± 13.9 years, and (589 [69.5%]) were female. The most reported health effects and infections were bacterial infections in place of body modification (479 [56.5%]), purpura (380 [44.9%]), cutaneous abscesses (380 [44%]), melanoma (338 [39.9%]), hepatitis B virus (321 [37.9%]), HIV (311 [36.7%]), sepsis (306 [36.2%]), allergic contact dermatitis (296 [35%]), and hepatitis C virus (279 [33.1%]). In total, 336 (39.6%) had an overall good knowledge of tattooing and body piercing hazards, with higher knowledge among females with high education (p< 0.05). Conclusion This study revealed that one in three individuals knew about the health risks and infections associated with tattooing and body piercing. Higher awareness was found among females with high education levels. Of all the associated complications, procedure-related infections were the most common among participants.
PubMed: 38174194
DOI: 10.7759/cureus.49912 -
Canadian Liver Journal Dec 2023The estimated prevalence of hepatitis C virus (HCV) in Canada is approximately 1.0%. However, the number of individuals living with HCV but unaware of it is estimated to...
BACKGROUND
The estimated prevalence of hepatitis C virus (HCV) in Canada is approximately 1.0%. However, the number of individuals living with HCV but unaware of it is estimated to be 30%-44%. Increased screening programs that are accessible, effective, and feasible are important to ensure treatment and meet WHO elimination goals. We implemented an HCV point of care test (POCT) program in community pharmacies to examine the effectiveness and feasibility in screening.
METHODS
Twenty two London Drugs pharmacies in British Columbia and Alberta implemented an HCV POC screening program using OraQuick rapid antibody tests. Consenting patients filled out a 10-question screening questionnaire to examine risk factors. The participants then were tested using the POCT. While waiting for the test (20 minutes), patients were educated on HCV and treatment options.
RESULTS
Three hundred seventy-one participants underwent HCV screening. The most common HCV risk factor was being born between 1945 and 1975 (baby boomer) (93% of cohort), while the second most common was having a tattoo or body piercing (22%). Seven people (2%) tested positive; four were HCV-RNA PCR-positive and were treated, whereas the PCR status of three was unknown as they were lost to follow-up or not tested.
CONCLUSIONS
Pharmacy-based POCT was shown to be effective and feasible in the western Canadian context, especially for baby boomers. Sustainable funding for pharmacy screening programs may be considered nationwide to identify HCV-infected persons and help meet elimination goals.
PubMed: 38152322
DOI: 10.3138/canlivj-2023-0005 -
Medicina (Kaunas, Lithuania) Dec 2023Although acupuncture is listed as a beneficial treatment for neck/shoulder stiffness, which has increased with the spread of information technology, to date, evidence... (Randomized Controlled Trial)
Randomized Controlled Trial
Although acupuncture is listed as a beneficial treatment for neck/shoulder stiffness, which has increased with the spread of information technology, to date, evidence of its efficacy under double-blind conditions has not been shown. This study aimed to assess whether acupuncture treatment with superficial skin piercing is superior to placebo treatment. A randomized, double-blind (practitioner-patient) placebo-controlled trial was performed at a single center with four arms (ISRCTN76896018). Four hundred patients with essential neck/shoulder stiffness were randomly assigned to penetrating needle treatment (acupuncture ritual and skin penetration), skin-touch needle treatment (acupuncture ritual and skin touch), no-touch needle treatment (acupuncture ritual alone), and no-treatment control. Each of the six acupuncturists applied a needle to each of the four acupoints in the neck/shoulder of 50 patients. Each of the three treatments significantly ( = 0.01) improved neck/shoulder stiffness compared with the no-treatment control immediately and 24 h after treatment. There was a significant improvement in penetrating needle treatment over no-touch needle treatment 24 h later. However, there was no significant difference between the penetrating and skin-touch and skin-touch vs. no-touch. All treatments that received the ritual of acupuncture were better than the no-treatment control. Only genuine acupuncture involves the specific effects of needle insertion into the body. The acupuncture ritual had a significant impact on the subjective improvement of neck/shoulder stiffness; however, improvement with ritual alone versions of placebo acupuncture was not maintained as with superficial skin piercing. Our study provides important evidence of acupuncture efficacy and information regarding inert no-touch placebo control in acupuncture research.
Topics: Humans; Neck Pain; Double-Blind Method; Japan; Acupuncture Therapy; Skin
PubMed: 38138244
DOI: 10.3390/medicina59122141 -
Journal of Cranio-maxillo-facial... Jan 2024The aim of this study was to introduce and report on a 3D-printed perforator navigator and its clinical application. Integrated imaging and 3D printing techniques were...
The aim of this study was to introduce and report on a 3D-printed perforator navigator and its clinical application. Integrated imaging and 3D printing techniques were employed for the design and manufacture of a perforator navigator. Key techniques included establishing a digital image coordinate system, localizing perforator fascia piercing points, creating a reference plane for the perforator course, and projecting the perforator course onto the body surface. All cases of maxillofacial defect repaired with free fibular myocutaneous flaps, from January 2019 to January 2022, were reinvestigated. Patients treated using traditional perforator localization methods were assigned into group Ⅰ, while those who had a navigator used during treatment were allocated to group Ⅱ. Outcome measurements included perforator positioning accuracy, perforator preparation time (PT), and flap growth score. Capillary refilling time and degree of flap swelling were recorded on the 1st, 3rd, and 7th days after surgery. On the 10th day after surgery, the flap survival situation was graded. In total, 25 patients were included in the study. Perforator preparation time for group Ⅱ was significantly less (p = 0.04) than for group Ⅰ (1038.6 ± 195.4 s versus 1271.4 ± 295.1 s. In group Ⅱ, the mean positioning deviation for the perforator navigator was 2.12 cm less than that for the high-frequency color Doppler (p = 0.001). Group Ⅱ also had a higher score than group Ⅰ for overall flap growth evaluation (nonparametric rank sum test, p = 0.04). Within the scale of the study, it seems that perforator localization and navigation using a 3D-printed navigator is technically feasible, and helps to improve the clinical outcome of free fibular flaps. The perforator navigator will play a useful role in displaying the perforator course, improving the accuracy of perforator localization, reducing surgical injury, and ultimately enhancing flap success rate.
Topics: Humans; Plastic Surgery Procedures; Skin Transplantation; Perforator Flap; Myocutaneous Flap; Free Tissue Flaps; Soft Tissue Injuries; Treatment Outcome
PubMed: 38129182
DOI: 10.1016/j.jcms.2023.11.004 -
International Journal of Surgery Case... Oct 2023Penetrating cardiac injuries are a significant challenge for surgeons and can have varying outcomes depending on factors such as initial care, characteristics of the...
INTRODUCTION
Penetrating cardiac injuries are a significant challenge for surgeons and can have varying outcomes depending on factors such as initial care, characteristics of the wounds, and surgical management. These injuries can result from both stab wounds and gunshot wounds, with different mortality rates associated with each. Life-threatening illnesses include penetrating injuries to the heart.
CASE PRESENTATION
We present here A 4-year-old child who was injured by a pencil while running and falling on the ground presented to our emergency room with a piercing injury in the right third ICS. She was awake but had trouble breathing when they got there.
DISCUSSION
Penetrating cardiac injuries can also occur as a result of intentional penetration or accidental direct penetration of foreign bodies into the heart. The main pathophysiological determinant for most survivors is acute pericardial tamponade, which can lead to shock and hemodynamic instability. This case report contributes to the current literature when any patient has a penetrating injury in the cardiac box and is highly suspect of a cardiac injury, regardless of the material of the injury. To increase health education among people, never try to remove any material stuck in the body until the patient has a suitable place and equipment.
CONCLUSION
Penetrating cardiac injuries are severe and life-threatening conditions that require prompt diagnosis and management, which in most cases need surgical treatment is required. To improve outcomes for patients with penetrating heart injuries, further research and improvements in diagnostic and treatment methods are required.
PubMed: 37729822
DOI: 10.1016/j.ijscr.2023.108792