Estudio descriptivo sobre ataques y mordeduras de animales en el Município de San Juan, Puerto Rico, 1996-1998 / Descriptive study of animal attacks and bites in the municipality of San Juan, Puerto Rico, 1996-1998

The present study described the frequency of animal bites and attacks in the municipality of San Juan, Puerto Rico between the fiscal years 1996 through 1998. A total of 275 cases were reported to the San Juan Local Office of Environmental Health. The distribution of cases by gender was equal, and persons aged 18 years or older had the highest frequency of animal bites and attacks (52.9 percent). The animal species reported to be involved in the majority of animal bites was the dog (81.1 percent). Upper extremities were involved in 43 percent of these injuries. Animal bites caused by dogs were more often reported among male victims (87.4 percent) (p = 0.031). Approximately 41 percent of dog bites and attacks and 75 percent of bites and attacks caused by other animal species were documented as provoked (p = 0.002). More than 75 percent of the injuries in the head, face or neck involved children < 13 years whereas 65.9 percent of the injuries in the upper extremities involved adults (> 18 years) (p = 0.001). Animal bites and attacks in the upper extremities were more prominent among injuries caused by an animal species different to the dog (71 percent) (p < 0.001). We conclude that animal bites and attacks is a public health concern in light of the increasing pet population. Therefore, educational strategies towards the general population must stress careful supervision of the human-animal interaction as well as the general procedures to follow in case of an injury.

Vascular injuries of the upper arm.

Twenty eight patients who had subclavian, axillary, and brachial artery injuries were studied. Sixteen (57%) sustained blunt trauma and 12 (43%) sustained penetrating trauma. Motor cycle accidents were the most common cause of injuries (43%). Twenty patients (71.4%) were transferred from other hospitals. Nine patients (32%) were in shock on arrival. All patients had radial pulse abnormalities (3 decreased, 25 absent) of the affected limbs. Eighteen patients (64%) had associated injuries to other parts of the body. Eighteen patients (64%) also had associated nerve injuries, 7 of them had complete brachial plexus injuries from motor cycle accidents. Twelve patients (43%) had preoperative angiography. Twelve patients (43%) had brachial, 10 (35.7%) had axillary, 2 (7%) had axillary-subclavian, and 4 (14%) had subclavian artery injuries. Eight patients (28.6%) had concomitant venous injuries. Resection of the injured artery and reversed saphenous vein graft were performed in 23 patients (82%). The remaining had resection and end to end anastomosis in 3 patients (10.7%), lateral repair in 2 patients (7%), and ligation in 1 patient (3.6%). Concomitant venous repairs were performed in 5 patients. Fasciotomies were performed in 2 patients (7%). Excellent results of vascular repairs were obtained in all patients. Long-term disability occurred in patients who had associated nerve injuries. Avulsion injury of the brachial plexus usually resulted in severe impairment of limb function.

Hidatidosis del húmero complicada con fractura, infección bacteriana, fístula y localización extraósea / Humeral hydatidosis complicated with fracture, bacterial infection, fistula and extrabone location

The clinical case of an apparently healthy 63-year-old man from a rural area, with previous contact with dogs, who had a pathological fracture of the right humerus in presented. Initially he presented slight local pain, and functional discapacity. Eigh months later, after a radiological study and surgery (curettage), diagnosis of hydatid disease was made. Later on, after receiving two courses with albendazole, the parient continued in similar conditions for seven years, when his situation became complicated with bacterial, fistula and extraoseous hydatidosis. The humeral was resected and a segmentary prothesis was successfully set

Pig bite in Brazil: a case series from a teaching hospital

A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberl andia, in southeastern Brazil. Most cases (21) were from Uberl andia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5 per cent ) occurred between 7.00 a.m. and 7.00 p.m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 +/- SD 22.06, median 36). The bites were more common on the upper limbs, particularly on the forearms. In 11 (47.8 per cent ) cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation of the pig for slaughter. The following medical procedures were performed: local cleansing in 19(82.6 per cent ) cases, rabies vaccine (12; 52.2 per cent ), antirabies serum (2; 8.7 per cent ), suturing (6; 26.1 per cent ) and tetanus vaccine (12; 52.2 per cent ). There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberl andia can be estimated to be about 1.5/100,000