1/4. Injuries to avian researchers at Palmer Station, Antarctica from penguins, giant petrels, and skuas.This paper describes 5 cases of injury to seabird researchers between 1996 and 1999 at Palmer Station, Antarctica. The injuries were inflicted by 3 seabird species: the Adelie penguin (Pygoscelis adeliae); the southern giant petrel (Macronectes giganteus); and the brown skua (Catharacta lonnbergi). All injured parties were biologic researchers with previous field experience working under National science Foundation research grants; all sought medical evaluation and treatment voluntarily. The nature and frequency of such injuries seems not to have been greatly reported in the medical literature. Although these cases were largely soft tissue injuries that healed without serious complications, the possibility of exotic infections is considered. We have dubbed this constellation of injuries AVES (Antarctic Vogel [German for bird] Encounter syndrome).- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma.BACKGROUND: Injuries to the pancreas following blunt abdominal trauma are rare due to its protected retroperitoneal position. Many pancreatic lesions remain unnoticed at first and only become apparent when complications arise or during treatment of other injuries. The mortality rate is between 12 and 30%, and if treatment is delayed it is as high as 60%. methods: Using medical records over the past 5 years, we investigated when and in what circumstances endoscopic retrograde cholangiopancreaticography (ERCP) was used in the diagnosis and treatment of pancreas injuries after blunt abdominal trauma. Penetrating injuries were not taken into consideration. RESULTS: An ERCP was performed on a total of five patients with suspected injuries to the pancreas after blunt abdominal trauma. No duct participation could be determined in three of the patients with a first degree pancreatic lesion. A 44-year-old woman sustained severe internal and external injuries after a traffic accident. Because of the nature of her injuries, pancreatic left resection with splenectomy was necessary. After the operation, a pancreatic fistula diagnosed. The ductus pancreaticus (DP) was successfully treated by stenting with the use of endoscopic retrograde pancreaticography. A 24-year old woman was kicked in the epigastrium by a horse. On the day after the incident, she complained of increasing pain in the upper abdomen, and she had elevated amylase and lipase levels. Computed tomography scan showed free fluid. Less than 48 h after the accident, ERCP was performed and a leakage in the DP in the head-body region (fourth degree) was identified. We placed a stent, and during the subsequent laparoscopy the omental bursa was flushed out and a drainage laid. After 14 days, the patient was sent home. We removed the drainage 4 weeks after the accident, and the stent after 12 weeks. CONCLUSION: The major advantage of the prompt retrograde discription of the pancreatobiliary system after an accident in which pancreas involvement is suspected is the more precise assessment of the extent of the injuries. If a stent is placed in the same session, it is possible to carry out definitive and interventional treatment.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. Contusion injuries of the optic nerve.Indirect trauma to the optic nerve with secondary optic atrophy may result from minor trauma and has traditionally been associated with a poor visual prognosis. The case of a 32-year-old man who suffered a blow to his left supraorbital region and eyebrow in an automatic closing door is reported to draw attention to the uncommon but trivial nature of this injury which may result in profound visual loss. He suffered an initial inferonasal visual field loss which was related to vascular changes in the optic nerve head. Over the ensuing year there was deterioration in his central vision and visual field due to arachnoiditis. Current trends in the management of optic nerve contusion injuries are discussed. There is currently a move towards primary medical management with high-dose corticosteroids as in this case; surgery is reserved for those patients who fail to respond to steroids or deteriorate as the steroid dose is reduced.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. Traumatic serous detachments of the retinal pigment epithelium.Two cases of contusion injury to the anterior segment of the globe are reported which resulted in unusual fluorescein angiographic findings at the posterior pole of the eye. The posterior lesions seen in each case were difficult to interpret by conventional methods. It was thought that fluorescein angiography was of value in better delineating the nature of the clinical findings.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |