Update on hypertrophic scar treatment

Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. .

Abdominal compartment syndrome

The term abdominal compartment syndrome [ACS] describes the clinical manifestations of the pathologic elevation of the intra-abdominal pressure [IAP]. When the IAP exceeds 12 mm Hg it is referred to as intra-abdominal hypertension [IAH] while ACS generally sets in at an IAP in excess of 20 mm Hg. This syndrome is most commonly observed in the setting of severe abdominal trauma and in the aftermath of major abdominal operations. ACS affects mainly the respiratory, cardiovascular, renal, gastrointestinal and the central nervous systems. Fundamental to the development of ACS are the obstruction of venous return to the heart via the inferior vena cava and the splinting of the diaphragm due to elevated IAP. Preventing ACS by the identification of patients at risk and early diagnosis is paramount to its successful management. To this end a high index of suspicion is sine qua non. The management of established ACS requires clinical astuteness and decisiveness with a readily available and generous team support. The purpose of this review is to enhance awareness among clinicians about a subtle condition with a devastating impact on morbidity and mortality if undiagnosed

The protection effect of a new combined anti-G measure / 中国应用生理学杂志

<p><b>AIM</b>To observe the protection effect of a new combined anti-G measure which was composed of KH-x anti-G suit, unassisted PBG (positive pressure breathing for G, PBG) and PHP maneuver. The problem of fatigue and pain when using this measure was also discussed.</p><p><b>METHODS</b>Five fully qualified centrifuge subjects were exposed to 5 groups of +Gz exposure: (1) relaxed tolerance, (2) KH-x and KT-x, (3) PBG, (4) 6.5 G 45 s, (5) 9.0 G 15 s. The subjective feeling of fatigue and pain induced by +Gz exposure was evaluated by the questionnaire after runs.</p><p><b>RESULTS</b>There was no incidents of G-induced lose of consciousness in this study. The protective effect of KH-x and KT-x was 2.3 G while it was 1.7 G for PBG. All the subjects have accomplished the 4th and 5th runs. The pain has developed on neck, waist, arm and hands. The problem of waist pain was very significant.</p><p><b>CONCLUSION</b>The new combined anti-G measure could meet the requirement of +9.0 Gz protection for high performance plane. How to prevent the occurrence of neck injury and alleviate the pain induced by G when using this measure should be studied further.</p>

Relative study for +Gz protection of an advanced bladder anti-G system and that of capstan anti-G system / 中国应用生理学杂志

<p><b>AIM</b>To assess the +Gz protection afforded by an advanced bladder anti-G system in the centrifuge against a capstan anti-G system.</p><p><b>METHODS</b>Tow centrifuge experiments were completed, respectively, by two groups of six male subjects. In the first experiment, subjects using advanced bladder anti-G system, the +Gz protection afforded by this anti-G system was determined. Then they were exposed to simulated air combat maneuver (SACM)I with leg straining, the +Gz-time tolerance was determined. In the second experiment, subjects using capstan anti-G system, the +Gz protection afforded by this anti-G system was determined. Then they were exposed to SACMII with anti-G straining maneuver, the +Gz-time tolerance was determined.</p><p><b>RESULTS</b>The anti-G effectiveness of the advanced bladder system was 5.33 G, which was significantly higher than that of the capstan system by 1.35 G (P < 0.01). All subjects of the two groups passed themselves SACM, but the effort, fatigue, and heart rates of the first group subjects were lower than those of the second group subjects.</p><p><b>CONCLUSION</b>The results demonstrate that the +Gz protection afforded by the advanced bladder anti-G system is significantly higher than that by the capstan system.</p>

+Gz protection provided by tilt-back seat and GZ-2 anti-G suit / 中国应用生理学杂志

<p><b>AIM</b>To investigate the +Gz protection provided by tilt-back seat and GZ-2 anti-G suit.</p><p><b>METHODS</b>6 subjects were exposed to centrifuge and onset rate is 3 G/s. First, their relaxed +Gz tolerances were determined while using tilt-back seat of 13 degrees. Secondly, it was their +Gz tolerance provided by pressurized GZ-2 anti-G suit and tilt-back seat of 13 degrees. Finally, their +Gz tolerances while using pressurized GZ-2 anti-G suit and tilt-back seat of 45 degrees were determined. The difference between the first and the third result was the +Gz protection that pressurized GZ-2 anti-G suit and tilt-back seat of 45 degrees offered.</p><p><b>RESULTS</b>+Gz protection of pressurized GZ-2 anti-G suit and tilt-back seat of 13 degrees was 3.06 G, and +Gz protection of pressurized GZ-2 anti-G suit and tilt-back seat of 45 degrees was 4.13 G, which had an increase of 1.06 G.</p><p><b>CONCLUSION</b>Tilt-back seat of 45 degrees can greatly enhance +Gz tolerances of human.</p>

Evaluation of sequential intermittent pneumatic compression for filarial lymphoedema.

BACKGROUND: Lymphoedema is a major cause of morbidity in patients with lymphatic filariasis. There is no effective medical treatment and the results of surgery are uncertain. There are very few published studies assessing the volumetric response to the use of sequential intermittent pneumatic compression (SIPC) in patients. METHODS: A 12-celled instrument capable of providing sequential compression from the distal to proximal direction was used in 28 patients with unilateral grades II (n=17) and III (n=11) filarial lymphoedema in a planned 4-week session. The patients were followed up for 6 months after compression therapy by water displacement volumetry. RESULTS: We found that 12 patients with grade II filarial lymphoedema had >26% reduction in oedema volume immediately after compression, but this reduction (>26%) was maintained in only 7 at 6 months. The corresponding figures for grade III filarial lymphoedema were 6 and 4, respectively. The effect in grade III was less sustained than grade II. No complications attributable to SIPC were seen. An added advantage of SIPC was a significant decrease in attacks of adenolymphangitis after compression when compared to pre-compression frequency. These observations were seen even with non-compliance to both foot care measures and use of bandages to maintain reduction in oedema volume. CONCLUSION: SIPC reduces morbidity in filarial lymphoedema though the effect is not sustained. It is simple, easy to use and could form part of the morbidity control programme for lymphatic filariasis.

La mujer embarazada agredida por trauma y su atención prehospitalaria / La pregnant woman who undergoes trauma: pre-hospital care and medical attention

El trauma en el embarazo se ha incrementado en los últimos años llegando hasta un 7 por ciento. Se le ha asociado con un alto riesgo de pérdida del feto. La causa principal son los accidentes automovilísticos y el tipo más frecuente es el trauma cerrado. Para una adecuada atención prehospitalaria es necesario considerar sus cambios fisiológicos tales como la presión arterial, el pulso, el volumen sanguíneo, los cambios de posición del útero, vejiga, corazón, etc. Los efectos del trauma se pueden presentar entre otros como shock, abruptio placenta, ruptura uterina, lesiones fetales directas y hemorragia maternofetal. El abordaje debe ser conducido con la misma agresividad que para una paciente no embarazada, tomando en cuenta sus cambios fisiológicos y como primera prioridad la reanimación materna. Toda vez que los signos aparentemente estables de la madre pueden no ser indicativo real, el transporte rápido al centro de trauma es esencial

Greyout, blackout e perda de consciência induzida pelas aceleraçöes na Força Aérea Brasileira: um estudo em 1991-92 / Greyout, blackout and loss of conciousness induced by acceleration in the Brazilian Air Force: a study in 1991-92

A national survey wiyh high and medium performance aircraft pilots on the incidence of symptoms duee to + Gz acceleration has been performed, in order to make up a human centrifuge physiological training profile directed to the needs of the Brazilian Air Force pilots. Anonymous questionnaires were sent to flight Squadrons of F-5, AMX, Mirage F-103, Xavante AT-26 and Tucano T-27. They consisted of inquiries about the ocurrence of visual symptoms and/or loss of consciouness during + Gz maneuvers, and post G-LOC symptoms, 23 pilots (11.92 per cent) reported greyout and/or loss of peripheral vision; 40 (20.72 per cent) blackout; 20 (10,36 per cent) G-LOC. Those who reported LOC also reported post G-LOC symptons (100 per cent), being 16 (80 per cent) gradual and 4 (20 per cent) instantaneous. Incidence of G-LOC was not found to depend upon the type pf aircraf flown (p>0.05). Considering the pilots who reported G-LOC, 80 per cent were preceded by blackout, which could allow them to relieve + Gz load before they would reach their endpoint for the ocurrence of G-LOC. For these reasons we recommend intensive human centrifuge training periodically, similar to the hypocia-recognition symptoms test in the low-pressure chamber, not only for high performance aircraft pilots but as well as for any pilot who can perform aerobatics (thus exposing himself to the adverse effects of "pulling G"), in order for each pilot to recognize his consciousness endpoint when undergoing + Gz maneuvers, in a controlled and safe environment.