Homogeneity of Different Functional mRNA Indicators for Wound Age Estimation / 法医学杂志

OBJECTIVES@#To explore the homogeneity level of four different functional mRNA （PUM2, TAB2, Cx45 and CHRNA1） expressions in rats with skeletal muscle contusion.@*METHODS@#The relative expressions of PUM2, TAB2, Cx45 and CHRNA1 mRNAs were detected by quantitative real-time reverse transcription-polymerase chain reaction （RT-qPCR）. The coefficient of variation （CV） of the relative expressions for different individuals in each injury group was calculated. The extreme value of CV, cumulative variability, and CVCV were compared.@*RESULTS@#A high CV of PUM2 and TAB2 mRNAs appeared on several different time points. However, the CV of Cx45 and CHRNA1 mRNAs was relatively low. The cumulative variability from high to low was PUM2, CHRNA1, TAB2 and Cx45 mRNAs. The relative expression of PUM2 mRNA was significantly higher than that of TAB2, Cx45 and CHRNA1 mRNAs （ P<0.05）. There was no statistical significance （P>0.05） in the CVCV of the relative expression of TAB2, CHRNA1 and Cx45 mRNAs.@*CONCLUSIONS@#As the mRNAs involving in biological process regulation, PUM2 and CHRNA1 mRNAs show a lowest individual homogeneity of the relative expression followed by TAB2 mRNA. As the mRNAs participating in the composition of cellular structure, Cx45 and CHRNA1 mRNAs show a high individual homogeneity of the relative expressions. The functional classification should be considered for the screening of the mRNA indicators used for wound age estimation.

Violência contra a criança: indicadores dermatológicos e diagnósticos diferenciais / Child abuse: skin markers and differential diagnosis

As denúncias de abuso contra a criança têm sido frequentes e configuram grave problema de saúde pública. O tema é desconfortável para muitos médicos, seja pelo treinamento insuficiente, seja pelo desconhecimento das dimensões do problema. Uma das formas mais comuns de violência contra a criança é o abuso físico. Como órgão mais exposto e extenso, a pele é o alvo mais sujeito aos maustratos. Equimoses e queimaduras são os sinais mais visíveis. Médicos (pediatras, clínicos-gerais e dermatologistas) costumam ser os primeiros profissionais a observar e reconhecer sinais de lesões não acidentais ou intencionais. Os dermatologistas podem auxiliar na distinção entre lesões traumáticas intencionais, acidentais e doenças cutâneas que mimetizam maus-tratos.

Reports of child abuse have increased significantly. The matter makes most physicians uncomfortable for two reasons: a) Little guidance or no training in recognizing the problem; b - Not understanding its true dimension. The most common form of child violence is physical abuse. The skin is the largest and frequently the most traumatized organ. Bruises and burns are the most visible signs. Physicians (pediatricians, general practitioners and dermatologists) are the first professionals to observe and recognize the signs of intentional injury. Dermatologists particularly, can help distinguish intentional injury from accidental, or from skin diseases that mimic maltreatment.

Primary identification of an abused child in dental office: a case report.

Although the injuries of child abuse are many and varied, several types of injuries are common to abuse. Many of these injuries are within the scope of dentistry or easily observed by the dental professional in the course of routine dental treatment. The authors present a case of child abuse with multiple bruises. The child had been spanked in the previous night and the morning of the attendance by his mother. This case emphasized that all practitioners should be vigilant when patients present with abnormal injuries which may be the result of abuse and further investigation should be instigated.

Prevalência de lesões na temporada 2002 da Seleção Brasileira Masculina de Basquete / Prevalence of injuries of Brazilian Basketball National Team during 2002 season

Este estudo objetiva apresentar a prevalência, provável etiologia e localizaçäo das lesöes da Seleçäo Brasileira de Basquete masculina adulta durante a fase de preparaçäo e o 14º Campeonato Mundial de Basquetebol, em 2002. No total, foram 102 queixas correspondendo ao período de 1/7/02 a 10/9/02, com média de 2,55 lesöes/mês/jogador. Encontrou-se maior índice de lesöes atraumáticas, incluindo as musculares, doenças sistêmicas e lesöes tendinosas (66/102 queixas), ou seja, 64,7 por cento do total. Dentre as lesöes traumáticas, as mais freqüentes foram as entorses de tornozelo (13/102 lesöes) com 12,8 por cento, seguidas dos traumas diretos (contusöes) na regiäo das mäos (9/102 lesöes), com 8,8 por cento. Em relaçäo ao local de acometimento, as maiores queixas foram nos membros inferiores (49 /102), com 48,0 por cento e membros superiores (14/102), com 13,7 por cento. Quanto à gravidade, lesöes leves representaram 57,8 por cento, seguidas das moderadas e graves, com 32,4 por cento e 9,8 por cento, respectivamente. Em relaçäo à posiçäo de jogo, os pivôs foram os atletas que apresentaram maior número de queixas, 45, representando 44,1 por cento do total, sendo estas devido, principalmente, ao contato físico na regiäo do garrafäo. Dessa forma, por ser um esporte de extremo contato, as lesöes traumáticas, principalmente em mäos e coxas, e as entorses de tornozelo säo altamente representativas, sendo os membros inferiores os mais acometidos

Contusion of lungs.

A 16 years old male with history of beating by army personnel was admitted in the hospital with the complaints of chest pain and breathlessness. After about 5 hours of admission, the patient died in spite of treatment with analgesics, antibiotics, fluids and oxygen inhalation. The autopsy report showed multiple bruises on different body parts and there were contusions on the lungs showing impression of rib patterns. Histological examination showed alveoli filled with blood and cellular infiltrate in interalveolar and interstitial spaces.

Contusión pulmonar / Pulmonary contusion

La contusión pulmonar es una afección frecuente que debe sospecharse en pacientes con traumatismo torácico que cursan con hipoxemia refractaria. El diagnóstico y tratamiento tempranos disminuyen de manera considerable la morbilidad y la mortalidad. En el presente artículo se revisa, a propósito de un caso, los conceptos actuales de la contusión pulmonar, así como la fisiopatología, manifestaciones clínicas, clasificación, diagnóstico y tratamiento

Trauma abdominal: um reflexo da violência urbana / Abdominal trauma: urban violence reflex

Os autores apresentam uma avaliaçao das lesoes decorrentes de traumas abdominais, baseada em dados de um serviço de urgência num período de sete anos. Sao analisados 272 casos, enfocando-se aspectos como: faixa etária atingida, orgaos intra-abdominais mais comumente acometidos e tipo de trauma sofrido. Tais dados sao avaliados em comparaçao a aspectos encontrados na literatura mundial.

Graded experimental myocardial contusion in rabbits: antemortem and postmortem diagnosis

A controlled animal model was used to clarify the role of serum total creatine phosphokinase [CPK] and creatine phosphokinase-MB [CPK-MB] fraction in the diagnosis of myocardial contusion in patients, as well as, the role of cardiac tissue levels of creatine phosphate [CP] and adenosine triphosphate [ATP] in the diagnosis of fatal myocardial injury on autopsy. Graded myocardial contusion was produced by a single blow with a weight pendulum in two groups of rabbits [group I received a moderate impact, 78 +/- 5 m Joules/g, group II received a major impact, 87 +/- 7 m Joules/g]. Gross and microscopic examinations on autopsy showed a minor pathologic entity in group I, while in group II a distinct pathological entity could be identified. 20 minutes after the impact, a very highly significant [p <0.001] increase in the serum total CPK appeared in both groups. CPK-MB fraction was not detected in the serum of control animals [uninjuried group], but its level and percentage were 10.9 +/- 0.80 IU/L, 6.98% in group I and 29.7 +/- 1.23 IU/L, 8.18% in group II. Cardiac tissue levels of CP and ATP, 25 minutes after impact, revealed a very highly significant [p <0.001] reduction in both groups. It is clear that, the increase in the serum enzyme and the decrease in the cardiac tissue levels of high-energy phosphates were proportional to the severity of the blow. These results suggested that the serum total CPK and CPK-MB fraction are most reliable indicators of myocardial contusion following blunt chest trauma. The cardiac tissue CP and ATP levels, also can be used as diagnostic criteria for a suspected fatal cardiac injury and clearly apparent on autopsy

Síndrome de injuria de cordón medular sin alteración radiográfica en niños (SCIWORA)

Se presenta un caso de la Unidad de Cuidados Intensivos Pediátricos del Hospital Militar Central, quien presenta insuficiencia respiratoria secundaria a atelectasias pulmonares migratorias masivas. Antecedente de trauma automovilístico 20 días antes por lo que permaneció 24 horas en observación en otra institución sin evidencia de alteración. Al ingreso además del cuadro respiratorio presenta cambios neurológicos consistentes en hemiparesia izquierda e hipotonia generalizada que evolucionan hacia cuadriparesia espástica, TAC cerebral y de columna cervical normales. RMN cerebral normal y de columna cervical muestra cambios compatibles con contusión medular a nivel de C5 Diagnóstico de síndrome de injuria medular sin alteración radiográfica (Sciwora) y atelectasias pulmonares secundarias.

Estudo clínico e classificäo das lesöes musculares / Classification and clinical study of muscular injuries

No período de 15 anos, 18.095 pacientes foram cadastrados na clínica privada, Centro Médico Esportivo Säo Francisco da Penitênciaria e no Serviço Médico do Fluminense Football Club. Observamos que 10.719 (59,23 por cento) pacientes eram portadores de lesöes esportivas sendo que 2.670 (24 por cento) correspondiam a lesöes musculares. Apresentamos uma classificaçäo analisada criteriosamente, baseada na observaçäo clínica evolutiva de atletas de alto nível, com um minucioso registro diário, cumprindo cada etapa terapêutica até sua total rebilitaçäo

Estudo multicêntrico do nimesulide em afecçöes tráumato-ortopédicas / Multicenter study with nimesulide in traumato-ortopedic conditions

Num estudo multicêntrico, 1.862 pacientes foram avaliados com o uso do nimesulide em afecçöes tráumato-ortopédicas. A dose utilizada foi de 1 comprimido (100mg) duas vezes ao dia durante pelo menos 6 dias. Quato à eficácia, houve uma acentuada regressäo dos sinais e sintomas avaliados, estatisticamente significante, ao término do estudo. A tolerabilidade do nimesulide foi boa, sendo observadas reaçöes adversas somente em 6,17% dos doentes avaliados

Traumatic heart disease.

Five cases of traumatic heart disease (THD) who sustained blunt chest injury in road accidents are reported. In addition to fracture of the ribs (observed in all the cases), there was fracture of the sternum and rupture of the liver and spleen in one case each. Two patients had flail chest. One presented with recurrent ventricular tachycardia lasting for 72 hours followed by changes suggestive of subendocardial infarction. The second case also had changes like subendocardial infarction and it was preceded by junctional tachycardia with aberrant conduction during the first 48 hours. Ventricular premature beats (VPB) were the only abnormality noted in one case and the remaining two had ST-T wave changes suggestive of inferolateral ischaemia without any arrhythmias. The patient with VPB developed pericardial rub without effusion. There was one death and postmortem revealed ruptured liver and spleen in addition to laceration of the right ventricle and haemopericardium. The electrocardiographic changes persisted for two to eight weeks. All four cases were symptom-free at 12 weeks and treadmill exercise test done after 12 to 18 weeks was normal.

Traumatismo renal / Renal trauma

O rim é um dos orgäos mais atingidos por traumatismos do trato genitourinário, ocorrendo em maior freqüência nos indivíduos do sexo masculino entre vinte e quarenta anos. Os autores abordam a etiologia, classificaçäo e quadro clínico dos traumatismos renais. Confrontam os métodos diagnósticos mais utilizados, dos mais simples aos mais complexos. Explanam sobre o tratamento conservador e cirúrgico abordando as complicaçöes imediatas e tardias