Global road traffic injury statistics: Challenges, mechanisms and solutions / 中华创伤杂志(英文版)

High-quality data are the foundation to monitor the progress and evaluate the effects of road traffic injury prevention measures. Unfortunately, official road traffic injury statistics delivered by governments worldwide, are often believed somewhat unreliable and invalid. We summarized the reported problems concerning the road traffic injury statistics through systematically searching and reviewing the literature. The problems include absence of regular data, under-reporting, low specificity, distorted cause spectrum of road traffic injury, inconsistency, inaccessibility, and delay of data release. We also explored the mechanisms behind the problematic data and proposed the solutions to the addressed challenges for road traffic statistics.

Effects of melatonin on tibia bone defects in rats / Efectos de la melatonina sobre defectos óseos en la tibia de ratas

The aim of this study was to evaluate the effects of melatonin healing in a tibial bone defect model in rats by means of histopathological and immunohistochemistry analysis. Twenty one male Wistar albino rats were used in this study. In each animal, bone defects (6 mm length ) were created in the tibias. The animals were divided into three groups. In group 1 control group (rats which tibial defects). Group 2 melatonin (10 mg/kg) + 14 days in the tibial defect group) was administered intraperitoneally to rats. Group 3 melatonin (10 mg/kg) + 28 days in the tibial defect group) was administered intraperitoneally to rats. Histopathological analysis of samples was performed to evaluate the process of osteoblastic activity, matrix formation, trabecular bone formation and myeloid tissue in bone defects. Immunohistochemical and immunoblot analysis demonstrated non-collagenous proteins (osteopontin and osteonectin) differences in tibial bone defects. The expression of osteopontin on tibia was increased by 14 days melatonin treatment. The expression of osteonectin on tibia was dramatically increased by 14 days melatonin treatment.

El objetivo fue evaluar por medio de análisis histopatológico e inmunohistoquímico los efectos cicatrizantes de la melatonina en un modelo de defecto óseo tibial en ratas. Se utilizaron 21 ratas albinas Wistar macho. En cada animal, se crearon defectos óseos en las tibias de 6 mm de longitud. Los animales se dividieron en tres grupos. El Grupo 1 correspondió al grupo control (defectos tibiales sin tratamiento). Al Grupo 2 se administró melatonina por vía intraperitoneal (10 mg/kg) 14 días posteriores al defecto tibial. Al Grupo 3 se administró melatonina por vía intraperitoneal (10 mg/kg) 28 días posteriores al defecto tibial. Se realizó un análisis histopatológico para evaluar los procesos de actividad osteoblástica, formación de matriz, formación de hueso trabecular y tejido mieloide en los defectos óseos. Los análisis inmunohistoquímicos y de inmunotransferencia mostraron diferencias de proteínas no colágenas (osteopontina y osteonectina). La expresión de osteopontina en defectos óseos tibiales se incrementó en el Grupo 2. La expresión de osteonectina en la tibia se incrementó fuertemente bajo el tratamiento con melatonina por 14 días.

Injuries sustained after falls from bridges across the United State - Mexico border at El Paso / Traumatismos por caídas desde puentes que atraviesan la frontera entre México y los Estados Unidos en El Paso

Objective. To compare demographics and motivations for falls from bridges at the UnitedStates–Mexico border and in El Paso County, Texas, and to analyze injuries and injury patternsto support intentionality and to provide treatment recommendations.Methods. A retrospective observational review was conducted of hospital admissions to atrauma center after falls from bridges from 1995 to 2009. Statistical methods used were chisquaretesting, T-test for means comparison, univariate correlations, and regression analysis.Results. Of the 97 evaluated patients, 81.4% fell from U.S.–Mexico border bridges, includingone patient who fell from a railway bridge; 74.7% of those falling from border bridges hada non–U.S. address, contrasting with 22.2% of those who fell within the United States. Fallsover the border were associated with more immigration-related motivations and fewer suicideattempts. Injuries included lower extremities in 76 (78.4%) and thoracolumbar spine in 27(27.8%) patients; 16 patients with a thoracolumbar spine fracture (59.3%) also had a lowerextremity injury. Mean hospital length of stay was 7.2 days. Mean injury severity score was8.45 (range 1–43). Age, injury severity score, and pelvic fracture increased the hospital lengthof stay.Conclusions. Patients fell while emigrating–immigrating based on residence and motivatingfactors. A dyad of lower extremity and thoracolumbar spine injuries coincided in 59.3% ofthose with a thoracolumbar spine injury; thoracolumbar spine imaging of patients evaluatedafter falls from bridges is recommended. Proposed prevention strategies include posting signson bridges and installing catch-net safety barriers.

Objetivo. Comparar la información demográfica y las motivaciones relacionadascon las caídas desde puentes que atraviesan la frontera entre México y los EstadosUnidos en el condado de El Paso, Texas; analizar las lesiones y los patrones de lesionesque avalan la intencionalidad; y proporcionar recomendaciones terapéuticas.Métodos. Se llevó a cabo un examen retrospectivo observacional de las internacionesen un centro traumatológico debidas a caídas desde puentes que tuvieron lugarentre 1995 y el 2009. Los métodos estadísticos usados fueron la prueba de ji al cuadrado,la prueba T de comparación de medias, correlaciones de una sola variable y elanálisis de regresión.Resultados. De los 97 pacientes evaluados, 81,4% cayeron desde puentes ubicadosen la frontera México–Estados Unidos, incluido un paciente que cayó desde unpuente ferroviario; 74,7% de las personas que cayeron desde puentes fronterizostenían un domicilio no residente, en comparación con 22,2% en las personas que cayerondesde puentes ubicados en el interior de los Estados Unidos. Las caídas desdelos puentes fronterizos estaban asociadas con más motivaciones relacionadas con lainmigración y con menos intentos de suicidio. Las lesiones afectaban las extremidadesinferiores en 76 pacientes (78,4%) y la columna vertebral toracolumbar en 27 (27,8%);16 pacientes con fractura de la columna toracolumbar (59,3%) también presentabanlesión de las extremidades inferiores. La duración media de la hospitalización fue 7,2días. La puntuación media de gravedad de la lesión fue 8,45 (rango 1 a 43). Una mayoredad, una puntuación alta en la escala de gravedad de la lesión y la fractura pelvianaaumentaron la duración de la hospitalización.Conclusiones. Los pacientes cayeron durante un intento de emigración o inmigraciónrelacionado con la residencia y otros factores motivadores. En 59,3% de lospacientes con lesión de la columna vertebral toracolumbar esta coexistía con lesiónde las extremidades inferiores; al evaluar a pacientes con lesiones por caídas desdepuentes se recomienda efectuar estudios de imágenes de la columna vertebral toracolumbar.Las estrategias de prevención propuestas comprenden la colocación deseñales en los puentes y la instalación de redes de seguridad.

Nuclear expression of PG-21, SRC-1, and pCREB in regions of the lumbosacral spinal cord involved in pelvic innervation in young adult and aged rats / 대한해부학회지

In rats, ageing results in dysfunctional patterns of micturition and diminished sexual reflexes that may reflect degenerative changes within spinal circuitry. In both sexes the dorsal lateral nucleus and the spinal nucleus of the bulbospongiosus, which lie in the L5-S1 spinal segments, contain motor neurons that innervate perineal muscles, and the external anal and urethral sphincters. Neurons in the sacral parasympathetic nucleus of these segments provide autonomic control of the bladder, cervix and penis and other lower urinary tract structures. Interneurons in the dorsal gray commissure and dorsal horn have also been implicated in lower urinary tract function. This study investigates the cellular localisation of PG-21 androgen receptors, steroid receptor co-activator one (SRC-1) and the phosphorylated form of c-AMP response element binding protein (pCREB) within these spinal nuclei. These are components of signalling pathways that mediate cellular responses to steroid hormones and neurotrophins. Nuclear expression of PG-21 androgen receptors, SRC-1 and pCREB in young and aged rats was quantified using immunohistochemistry. There was a reduction in the number of spinal neurons expressing these molecules in the aged males while in aged females, SRC-1 and pCREB expression was largely unchanged. This suggests that the observed age-related changes may be linked to declining testosterone levels. Acute testosterone therapy restored expression of PG-21 androgen receptor in aged and orchidectomised male rats, however levels of re-expression varied within different nuclei suggesting a more prolonged period of hormone replacement may be required for full restoration.

Assessment of association between consanguinity and fertility in Asian populations.

Although a high proportion of marriages in Asia are consanguineous (i.e. contracted between close biological relatives), with some notable exceptions, there is a death of demographic and anthropological literature on the association between consanguinity and fertility. This paper presents an overview of the prevalence of consanguineous marriages in selected South and Southeast Asian countries, followed by an assessment of the association between consanguinity and fertility. The association between consanguinity and fertility was assessed reviewing published literature and analyzing demographic and health survey (DHS) data from Pakistan and India. Results of the review of published literature showed higher fertility among women in the first-cousin unions compared to those married to non-relatives. In the DHS analyses, consanguinity was found to be associated with a number of direct and indirect determinants of fertility, including lower maternal education, lower maternal age at marriage, lower contraceptive use, and rural residence. At the multivariate level, adjusted mean fertility was found to be lower among women in the first-cousin unions in the Pakistani DHS data, while for the Indian DHS, adjusted mean fertility levels were similar in the first-cousin and non-consanguineous marriages. The pathways through which consanguinity affects fertility in Asian populations are evaluated and discussed.

8-Methoxy-naphtho[2,3-b]thiophen-4,9-quinone, a non-competitive inhibitor of trypanothione reductase

The enzyme trypanothione reductase is a recognised drug target in trypanosomatids and has been used in the search of new compounds with potential activity against diseases such as leishmaniasis, Chagas disease and African trypanosomiasis. 8-Methoxy-naphtho [2,3-b] thiophen-4,9-quinone was selected in a screening of natural and synthetic compounds using an in vitro assay with the recombinant enzyme from Trypanosoma cruzi. Its mode of inhibition fits a non-competitive model with respect to the substrate (trypanothione) and to the co-factor (NADPH), with Ki-values of 5 and 3.6 æM, respectively. When tested against human glutathione reductase, this compound did not display any significant inhibition at 100 æM, indicating a good selectivity against the parasite enzyme

Inactivación de la tripanotiona reductasa del Trypanosoma Cruzi por radicales libres catiónicos de fenotiazinas / Inactivation of Trypanosoma Cruzi, trypanothione reductase by peroxidase/H202/phenothiazine systems

La incubación de la tripanotiona reductasa (TR) de Trypanosoma cruzi con sistemas peroxidasa/H2O2/fenotiazina (FTZ) produjo la inhibición irreversible (inactivación) de TR. El grado de inactivación dependió de: (a) el tiempo de incubación de TR con el sistema peroxidasa/H2O2/FTZ; (b) la naturaleza de la peroxidasa y (c) la estructura de la FTZ. Con las FTZ más activas, la cinética de la inactivación presentó una fase inicial no mayor de 10 minutos, durante la cual TR perdió cerca del 90 por ciento de su actividad. Esa fase fue seguida por otra más lenta, y después de 30 minutos de incubación, TR fue completamente inactiva. Se ensayaron tres peroxidasas, a saber: la peroxidasa de rábano (HRP), la mieloperoxidasa de leucocitos (MPO) y la mioglobina modificada (Mb). En condiciones experimentales comparables, la actividad de las peroxidasas como componentes de los sistemas ensayados decreció en el orden indicado. Con el sistema HRP/H2O2/FTZ, la inactivación final de TR fue de 95-100 por ciento con Tioridazina (TRDZ), Promazina (PZ), Trimeprazina (TMPZ), Proclorpromazina (PCP), Propionilpromazina (PPZ) y Perfenazina (PFZ), todas en concentración 10 µM. Con los sistemas MPO/H2O2/FTZ, las FTZ más activas fueron PZ, TRDZ, TMPZ, PCP y Clorpromazina (CPZ). En iguales condiciones, los sistemas Mb/H2O2/FTZ también inactivaron a TR, utilizando PZ, TMPZ, TRDZ y CPZ. Grupos alquilamino, piperazinilo o piperidilo en la posición 10 (el N) y átomos o grupos -CI, -CF3, -SCH3, COCH2CH3 y -CN en la posición C2 de FTZ afectaron significativamente la actividad de las FTZs. El glutatión (GSH) previno la inactivación de TR por los sistemas HRP/H2O2/PZ y MPO/H2O2/PZ. Los sistemas HRP/H2O2/FTZ y MPO/H2O2/FTZ generaron los radicales catiónicos FTZú+, con estabilidad limitada por su conversión en fenotiazina-sulfoxidos (FTZ-SO), aparentemente inactivos sobre TR. El GSH reaccionó con los radicales catiónicos, regenerando las FTZ originales, lo que concuerda con la protección de TR por GSH frente a los sistemas peroxidasa/H2O2/PZ y, por lo tanto, con la intervención de los radicales catiónicos en la inactivación de TR por los mismos sistemas.

Prevalence of antibodies to the repeat epitope of the circumsporozoite protein of Plasmodium vivax in San Luis Potosi, Mexico

The prevalence of antibodies against the repeat epitope of the circumsporozoite protein (cs) of the standard (PV210) and variant (PVK247) strain of Plasmodium vivax was determined by ELISA in 1170 sera from individual residents of seven localities of the Region Huasteca of San Luis Potosi, Mexico. The capture antigens were the synthetic peptides DDAAD and (ANGAGNQPG)4 that correspond to the repeats of the PV210 and PVK247 cs proteins, respectively. Of the analyzed serum samples, 34.1 percent (400/1170) were positive with one or both of these antigens. Of the sera, 18.2 percent (214/1170) reacted with the DDAADF peptide and 6.6 percent (78/1170) were positive with the variant synthetic peptide. Additionally, 9.2 percent (108/1170) of the samples reacted with both peptides. A sample of 10 percent of positive sera for the variant cs repeat (18/78) was tested with the cs repeat peptide of P. malariae/P. brasilianum (NAAG); almost all of them (16/18, 89 percent) being positive. These results confirm that the transmission of the variant strain of P. vivax is a common Phenomenon in endemic regions in Latin America, as well as in other tropical regions of the world. These findings may have implications for the development of a P. vivax vaccine since that based on the standard cs repeat only would not be universally protective

Medical Education: An Area of Constant Change

@#"There is no subject which has given rise to more rational and irrational discussion than Medicine".