Prevalence and main determinants of early post-traumatic thromboembolism in patients requiring ICU admission.

BACKGROUND: Post-traumatic thromboembolism (PE) is now a common challenging particularly in critically ill patients referred to emergency wards. We aimed to identify main factors associated with PE within 72 h of admission after trauma among patients referred to emergency ward. METHODS: In this retrospective study, the database records of 240 patients, with the primary diagnosis of trauma requiring ICU admission and with a final diagnosis of pulmonary embolism, were reviewed. The patients were categorized as the subjects with early pulmonary embolism (≤3 days) and those with late pulmonary embolism (>3 days). RESULTS: According to our analysis, 48.5% of the patients suffered PE faced this event within 72 h of trauma events. The patients in early PE group were older than those who suffered late PE. The prevalence rate of long bone fractures in lower extremities was significantly higher in those with early PE compared with the other patients. The group with early PE had more severe injury when compared to those with later PE. The severe and very severe injuries were indicated in 49.5 and 15.4% in early PE group, and 14.0 and 6.9% in late PE group, respectively. Using the multivariable logistic regression model, older age, presence of long bone fractures, and more severe injury could predict occurrence of early PE in trauma patients referred to emergency ward. CONCLUSION: Occurring early PE is predicted in majority of traumatic patients requiring ICU admission especially in older ones, patients with long bone fractures and those with more severe injury.

Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium.

AIM: To compare the efficacy and complications of conjunctival limbal autograft (CLAU) and amniotic membrane transplantation (AMT) vsintraoperative mitomycin C (MMC) and AMT for treatment of recurrent pterygium. METHODS: Forty eyes of 40 patients with recurrent pterygium underwent CLAU and AMT (20 eyes) or intraoperative MMC (0.02%, 3 min) and AMT (20 eyes). Three eyes (15%) had symblepharon before surgery in each group. Recurrence was compared in each group by using chi(2) test. RESULTS: No major postoperative complications occurred during 6-19 months of follow-up. In CLAU/AMT group, no pterygium recurrence was observed. Recurrence occurred in four eyes (20%) in MMC/AMT group after 3 and 4 months (P-value=0.035, chi(2) test). No recurrence of pterygium or symblepharon was seen in six eyes with recurrent pterygium and symblepharon (three eyes in each group). CONCLUSION: CLAU with AMT seems to be more effective than intraoperative MMC with AMT for treatment of recurrent pterygium.

Effect of Indian red scorpion (Mesobuthus tamulus concanesis, Pocock) venom on thyroxine and triiodothyronine in experimental acute myocarditis and its reversal by species specific antivenom.

Acute myocarditis was induced in dogs and rabbits by injection of scorpion (M. tamulus concanesis, earlier called Buthus tamulus) venom by s.c., i.m. or i.v. routes. A decrease in thyroxine (T4) levels was observed following i.v. injection of venom in dogs. In rabbits the venom (i.m.) did not elicit any change in T4 levels. Envenomation (s.c.) resulted in a reduction in triiodothyronine (T3) levels in dogs. Venom injection (s.c.) along with i.v. administration of the species specific antivenom (AScVS) did not cause any change in T3 and T4 levels in general. However an increase in T3 levels following AScVS was observed in envenomated dogs. The results suggest that scorpion envenomation caused an autonomic storm releasing massive amounts of catecholamines, angiotensin II, suppressed insulin secretion and reduced circulating T4 and T3 levels. Decrease in thyroid hormones results in fall in body temperature. Changes in the body temperature may increase the sensitivity of the scorpion venom and influence the course of toxicity.