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Sample records for aggressive surgical debridement

  1. Surgical debridement, vacuum therapy and pectoralis plasty in poststernotomy mediastinitis.

    PubMed

    Ennker, I C; Pietrowski, D; Vöhringer, L; Kojcici, B; Albert, A; Vogt, P M; Ennker, J

    2009-11-01

    In cardiac surgery poststernotomy mediastinitis continues to be a serious cause of morbidity and mortality. We report our experience with vacuum-assisted closure (VAC) therapy followed by reconstruction with M. pectoralis muscle flaps as treatment for deep sternal wound infections. Our group performed a retrospective analysis of 3630 consecutive cardiac surgical patients using median sternotomy from 11/2004 to 11/2007. After removing sternal wires, necrotic debris and potentially infective material, restabilisation of the sternum was performed and VAC therapy was employed. Wound closure and subsequent reconstruction were performed using a bilateral pectoralis muscle plasty. Of the analysed patients 16 female and 29 male patients suffered from deep sternal wound infections and were treated with VAC. The most common risk factors were diabetes mellitus odds ratio (OR 3.5), chronic obstructive pulmonary disease (COPD) (OR 2.9), use of bilateral mammarian artery (OR 2.0) and obesity (1.8). The median age of patients with deep sternal infections was similar to control patients. Staphylococcus epidermis was the most common pathogen (37.8%) followed by Enterococcus faecilis (22.2%) and Staphylococcus aureus (17.8). In 22.2% no pathogen could be detected. The 30 day mortality was 0%, the in-hospital mortality was 15.6%. The results of our studies demonstrate that vacuum therapy in conjunction with early and aggressive debridement is an effective strategy for treating poststernotomy mediastinitis. We consider pectoralis major muscle flap reconstruction as a safe technique and regard it as the primary choice for wound closure in poststernotomy mediastinitis. PMID:18996074

  2. Comparison of healing rate in diabetes-related foot ulcers with low frequency ultrasonic debridement versus non-surgical sharps debridement: a randomised trial protocol

    PubMed Central

    2014-01-01

    Background Foot ulceration has been reported as the leading cause of hospital admission and amputation in individuals with diabetes. Diabetes-related foot ulcers require multidisciplinary management and best practice care, including debridement, offloading, dressings, management of infection, modified footwear and management of extrinsic factors. Ulcer debridement is a commonly applied management approach involving removal of non-viable tissue from the ulcer bed. Different methods of debridement have been reported in the literature including autolytic debridement via moist wound healing, mechanical debridement utilising wet to dry dressings, theatre based sharps debridement, biological debridement, non-surgical sharps debridement and newer technology such as low frequency ultrasonic debridement. Methods People with diabetes and a foot ulcer, referred to and treated by the Podiatry Department at Monash Health and who meet the inclusion criteria will be invited to participate in this randomised controlled trial. Participants will be randomly and equally allocated to either the non-surgical sharps debridement (control) or low frequency ultrasonic debridement (intervention) group (n = 322 ulcers/n = 108 participants). Where participants have more than one ulcer, only the participant will be randomised, not the ulcer. An investigator not involved in participant recruitment or assessment will be responsible for preparing the random allocation sequence and envelopes. Each participant will receive weekly treatment for six months including best practice podiatric management. Each ulcer will be measured on a weekly basis by calculating total area in centimetres squared. Measurement will be undertaken by a trained research assistant to ensure outcomes are blinded from the treating podiatrist. Another member of the research team will assess the final primary outcome. Discussion The primary aim of this study is to compare healing rates for diabetes-related foot ulcers

  3. Open fractures and the incidence of infection in the surgical debridement 6 hours after trauma

    PubMed Central

    Fernandes, Miguel de Castro; Peres, Luciano Rodrigo; de Queiroz, Aristóteles Correia; Lima, José Queiroz; Turíbio, Flávio Moral; Matsumoto, Marcelo Hide

    2015-01-01

    Objectives: To determine whether a time delay greater than 6h from injury to surgical debridement influences the infection rate in open fractures. Methods: During a period of 18 months, from October 2010 to March 2012, 151 open fractures were available for study in 142 patients in our hospital. The data were collected prospectively and the patients were followed up for 6 weeks. The patients were divided into two groups regarding the time delay from injury to surgical debridement (more or less than 6 hours). Results: Surgical debridement was carried out in less than 6h from injury in 90 (59.6%) fractures and after 6 hours from injury in 61 (40.4%) fractures. Infection rates were 12.22% and 13.24%, respectively. The global infection rate was 13.24%. Conclusion: A significantly increased infection rate was not observed in patients whose surgical debridement occurred more than 6h after injury. However, in the fractures of high-energy trauma, a statistically significant increase of the rate of infection was observed in those operated 6 hours after trauma. Level of Evidence II, Study Type Comparative and Prospective. PMID:26327794

  4. EMLA and Lidocaine Spray: A Comparison for Surgical Debridement in Venous Leg Ulcers

    PubMed Central

    Cuomo, Roberto; D'Aniello, Carlo; Grimaldi, Luca; Nisi, Giuseppe; Botteri, Gaia; Zerini, Irene; Brandi, Cesare

    2015-01-01

    Objective: In this study the author proposes to compare eutectic mixture of local anesthetics (EMLA) and an odontoiatric spray solution of 10% Lidocaine (Ecocain) for surgical debridement in venous leg ulcers. Approach: Fifty patients were recruited and randomly assigned into two groups (A, B). All of them have venous leg ulcer in the medial and/or lateral malleolar region. Group A: topical anesthetic EMLA with film occlusion. Group B: topical anesthesia with Ecocain. The author proceeded to surgical debridement after local anesthesia. A questionnaire and a visual analog scale (VAS) were administered to assess the amount of pain felt during the debridement and during the following 6 h. Results: The analysis of the VAS revealed no major significant differences statistically. The analysis of the questionnaires showed patients treated with Ecocain took more analgesic drugs. Analysis of the timing and quality of procedure showed that Ecocain reduced the timing of debridement and dressing change, improving the outpatient management and patient compliance. Innovations: For rapid debridement, the most appropriate is to use Ecocain. Conclusion: Methods of local anesthesia are multiple and must be identified according to the needs of the patient and the surgeon trying to get the best anesthesia with minimal use of time and resources. PMID:26029486

  5. Coblation technology for surgical wound debridement: principle, experimental data, and technical data.

    PubMed

    Trial, Chloé; Brancati, Antonio; Marnet, Olivier; Téot, Luc

    2012-12-01

    Debridement is required to prepare the wound bed, essentially in removing undesired tissues observed both in acute wound after burns or trauma and in chronic wounds such as pressure ulcers, leg ulcers, and diabetic foot ulcers. Surgical debridement has been described as one of the most effective methods but can be contraindicated in the elderly, arteriopathic context, or patients under effective anticoagulation. Recently described debridement technologies are based on application of important mechanical severing forces over the wound surface using high-power hydrojets. High water flux acts as a vector for separating necrotic and sloughy tissues from the wound bed and aspirates them out of the wound immediately. Electrical powered techniques and lasers were also scarcely described. The Coblation debridement technology presented here is based on the local induction of a focused plasma field chemically deleting undesired tissues. This technique is a modification of conventional electrosurgical devices, developed in 1928 where tissue excision and coagulation of tissues were observed. Principles of plasma-mediated debridement are based on a bipolar radiofrequency energizing the molecules, thus creating a plasma field. This glow discharge plasma produces chemically active radical species from dissociation of water, breaking molecular bonds, and causing tissue dissolution. The thermal effects are a by-product, which can be modulated by modifying the electrode construction, limiting the local temperature to less than 50°C in order not to induce wound bed renecrosis. The authors describe here the principle, the first technical adaptation for wound debridement, and the potential clinical interest of the Coblation technology.

  6. Coblation technology for surgical wound debridement: principle, experimental data, and technical data.

    PubMed

    Trial, Chloé; Brancati, Antonio; Marnet, Olivier; Téot, Luc

    2012-12-01

    Debridement is required to prepare the wound bed, essentially in removing undesired tissues observed both in acute wound after burns or trauma and in chronic wounds such as pressure ulcers, leg ulcers, and diabetic foot ulcers. Surgical debridement has been described as one of the most effective methods but can be contraindicated in the elderly, arteriopathic context, or patients under effective anticoagulation. Recently described debridement technologies are based on application of important mechanical severing forces over the wound surface using high-power hydrojets. High water flux acts as a vector for separating necrotic and sloughy tissues from the wound bed and aspirates them out of the wound immediately. Electrical powered techniques and lasers were also scarcely described. The Coblation debridement technology presented here is based on the local induction of a focused plasma field chemically deleting undesired tissues. This technique is a modification of conventional electrosurgical devices, developed in 1928 where tissue excision and coagulation of tissues were observed. Principles of plasma-mediated debridement are based on a bipolar radiofrequency energizing the molecules, thus creating a plasma field. This glow discharge plasma produces chemically active radical species from dissociation of water, breaking molecular bonds, and causing tissue dissolution. The thermal effects are a by-product, which can be modulated by modifying the electrode construction, limiting the local temperature to less than 50°C in order not to induce wound bed renecrosis. The authors describe here the principle, the first technical adaptation for wound debridement, and the potential clinical interest of the Coblation technology. PMID:23222161

  7. Successful Treatment of Primary Cutaneous Mucormycosis Complicating Anti-TNF Therapy with a Combination of Surgical Debridement and Oral Posaconazole.

    PubMed

    Camargo, Jose F; Yakoub, Danny; Cho-Vega, Jeong Hee

    2015-10-01

    Lipid formulations of amphotericin B remain the first-line antifungal therapy for invasive mucormycosis. Posaconazole is an alternative for salvage therapy, but its use as primary therapy is not recommended due to the paucity of clinical data. Here we describe the case of a 57-year-old diabetic woman receiving etanercept and prednisone for the treatment of psoriatic arthritis who developed primary cutaneous mucormycosis after a minor gardening injury. Infection was successfully treated with aggressive surgical debridement followed by a 6-week course of the new delayed-release tablet formulation of posaconazole and temporary withholding of anti-TNF treatment. Primary antifungal therapy with posaconazole can be considered in selected cases of cutaneous mucormycosis. PMID:26112998

  8. Safety of instrumentation and fusion at the time of surgical debridement for spinal infection.

    PubMed

    Talia, Adrian J; Wong, Michael L; Lau, Hui C; Kaye, Andrew H

    2015-07-01

    The present study aims to assess the results of single-stage instrumentation and fusion at the time of surgical debridement of spinal infections; vertebral osteomyelitis or epidural abscess. Nine patients with spinal infection were treated with instrumentation and fusion after radical debridement in a single-stage operation. Predisposing factors and comorbidities, pain, American Spinal Injury Association motor scores, primary pathologies, microbiology and perioperative markers were recorded. Seven patients with pyogenic and two with tuberculous spinal infection were encountered; the most common pathogen was Staphylococcus aureus. Five patients were predisposed to infection because of diabetes mellitus. Duration of antibiotic therapy lasted up to 12 months. Six patients had thoracic infection, two lumbar and one cervical. No post-operative complications were encountered. There was a significant reduction in pain scores compared to pre-operatively. All patients with neurological deficits improved post-operatively. Despite introduction of hardware, no patients had a recurrence of their infection in the 12 month follow up period. Single-stage debridement and instrumentation appeared to be a safe and effective method of managing spinal infections. The combination of debridement and fusion has the dual benefit of removing a focus of infection and stabilising the spine. The current series confirms that placing titanium cages into an infected space is safe in a majority of patients. Stabilisation and correction of spinal deformity reduces pain, aids neurologic recovery and improves quality of life. The small patient population and retrospective nature limit the present study.

  9. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Surgical Technique.

    PubMed

    Cottom, James M; Maker, Jared M

    2016-01-01

    Plantar fasciitis is one the most common pathologies seen by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention is warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. The documented comorbidities associated with the release of the plantar fascia include lateral column overload and metatarsalgia. We present a new technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of this fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia would provide a minimally invasive technique with acceptable patient outcomes.

  10. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Surgical Technique.

    PubMed

    Cottom, James M; Maker, Jared M

    2016-01-01

    Plantar fasciitis is one the most common pathologies seen by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention is warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. The documented comorbidities associated with the release of the plantar fascia include lateral column overload and metatarsalgia. We present a new technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of this fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia would provide a minimally invasive technique with acceptable patient outcomes. PMID:26952313

  11. Invasive maxillary sinus aspergillosis: A case report successfully treated with voriconazole and surgical debridement

    PubMed Central

    Redondo-González, Luis-Miguel; Verrier-Hernández, Alberto

    2014-01-01

    Introduction: Invasive aspergillosis of the paranasal sinuses is a rare disease and often misdiagnosed; however, its incidence has seen substancial growth over the past 2 decades. Definitive diagnosis of these lesions is based on histological examination and fungal culture. Case Report: An 81-year-old woman with a history of pain in the left maxillary region is presented. The diagnosis was invasive maxillary aspergillosis in immunocompetent patient, which was successfully treated with voriconazole and surgical debridement. Possible clinical manifestations, diagnostic imaging techniques and treatment used are discussed. Since the introduction of voriconazole, there have been several reports of patients with invasive aspergillosis who responded to treatment with this new antifungal agent. Conclusions: We report the importance of early diagnosis and selection of an appropriate antifungal agent to achieve a successful treatment. Key words:Invasive aspergillosis, voriconazole, fungal sinusitis, antifungal agent, open sinus surgery. PMID:25593673

  12. Surgical Debridement Is Superior to Sole Antibiotic Therapy in a Novel Murine Posttraumatic Osteomyelitis Model

    PubMed Central

    Wallner, Christoph; Ismer, Britta; Schira, Jessica; Abraham, Stephanie; Harati, Kamran; Lehnhardt, Marcus; Behr, Björn

    2016-01-01

    Introduction Bone infections after trauma, i.e. posttraumatic osteomyelitis, pose one of the biggest problems of orthopedic surgery. Even after sufficient clinical therapy including vast debridement of infected bone and antibiotic treatment, regeneration of postinfectious bone seems to be restricted. One explanation includes the large sized defects resulting from sufficient debridement. Furthermore, it remains unclear if inflammatory processes after bone infection do affect bone regeneration. For continuing studies in this field, an animal model is needed where bone regeneration after sufficient treatment can be studied in detail. Methods For this purpose we created a stable infection in murine tibiae by Staphylococcus aureus inoculation. Thereafter, osteomyelitic bones were debrided thoroughly and animals were subsequently treated with antibiotics. Controls included debrided, non-infected, as well as infected animals exclusively treated with antibiotics. To verify sufficient treatment of infected bone, different assessments detecting S. aureus were utilized: agar plates, histology and RT-qPCR. Results All three detection methods revealed massive reduction or eradication of S. aureus within debrided bones 1 and 2 weeks postoperatively, whereas sole antibiotic therapy could not provide sufficient treatment of osteomyelitic bones. Debrided, previously infected bones showed significantly decreased bone formation, compared to debrided, non-infected controls. Discussion Thus, the animal model presented herein provides a reliable and fascinating tool to study posttraumatic osteomyelitis for clinical therapies. PMID:26872128

  13. REHABILITATION AND FUNCTIONAL OUTCOMES AFTER EXTENSIVE SURGICAL DEBRIDEMENT OF A KNEE INFECTED BY FUSOBACTERIUM NECROPHORUM: A CASE REPORT

    PubMed Central

    Briggs, Matthew S.; Kegelmeyer, Deborah K.; Kloos, Anne D.

    2013-01-01

    Background and Purpose: Joint infection is a rare but serious complication after knee injury that should be part of a physical therapist's differential diagnosis. This case report presents the care of a 17 year‐old female athlete with septic arthritis from a Fusobacterium infection after sustaining a right lateral meniscus tear. Joint pathology combined with the aggressive infectious agent led to arthrofibrosis of her knee joint and resultant activity limitations and participation restrictions. The purpose of this case report is to highlight a rare and unique pathology, the serious effects that a joint infection can have on musculoskeletal function, and the challenges encountered during the rehabilitation process. Case Description: The subject was a 17 year‐old volleyball player who injured her right knee while playing volleyball. Within 7 days, the subject developed a severe joint infection that spread into surrounding gluteal, quadriceps, and gastrocnemius musculature. The infection was surgically debrided eight times during a 10‐week inpatient hospital stay. A manipulation under anesthesia was performed to restore range of motion in her knee joint. Outpatient physical therapy was initiated 4 days later in order to restore musculoskeletal function. Outcome: Over eight months of physical therapy services were utilized to address the impairments and activity limitations caused by her joint dysfunction. She met her physical therapy goals and made significant improvements on the Knee Outcome Survey and the Lower Extremity Functional Scale. Success in physical therapy and completion of additional strength training exercise allowed this subject to return to competitive softball at the club level during her freshman year of college. Discussion: Though rare after musculoskeletal injury, joint infection can lead to soft tissue damage, partial or complete degradation of articular cartilage, and arthrofibrosis causing significant disability. Physical therapists must

  14. Comparison of standard surgical debridement versus the VERSAJET Plus™ Hydrosurgery system in the treatment of open tibia fractures: a prospective open label randomized controlled trial.

    PubMed

    Oosthuizen, Beyers; Mole, Trevor; Martin, Robin; Myburgh, Johannes G

    2014-01-01

    The aim of this study was to assess the efficacy of an alternative debridement technology in the treatment of Gustilo & Anderson grade III A and III B open tibia fractures. The objective was to explore whether improvements to the debridement using tangential hydrosurgery (VERSAJET™ Plus Smith & Nephew) could reduce the number of debridement episodes and the days before closure. A pilot scale randomized controlled trial was conducted against conventional surgery. A total of 40 patients were recruited. Sixteen patients received hydrosurgery and 24 patients were treated with standard surgical debridement. Baseline characteristics were well balanced. There was significant evidence (p < 0.001) that VERSAJET patients required fewer debridement procedures than standard surgical debridement prior to wound closure (ratio standard: VERSAJET = 1.747). The median time to wound closure was 3 days (95% CI 3 days, 5 days) for VERSAJET and 5 days (95% CI 4 days, 8 days) for standard debridement, although the difference was not statistically significant (p = 0.275). There were no instances of post-operative infection. PMID:25356370

  15. Comparison of standard surgical debridement versus the VERSAJET Plus™ Hydrosurgery system in the treatment of open tibia fractures: a prospective open label randomized controlled trial.

    PubMed

    Oosthuizen, Beyers; Mole, Trevor; Martin, Robin; Myburgh, Johannes G

    2014-01-01

    The aim of this study was to assess the efficacy of an alternative debridement technology in the treatment of Gustilo & Anderson grade III A and III B open tibia fractures. The objective was to explore whether improvements to the debridement using tangential hydrosurgery (VERSAJET™ Plus Smith & Nephew) could reduce the number of debridement episodes and the days before closure. A pilot scale randomized controlled trial was conducted against conventional surgery. A total of 40 patients were recruited. Sixteen patients received hydrosurgery and 24 patients were treated with standard surgical debridement. Baseline characteristics were well balanced. There was significant evidence (p < 0.001) that VERSAJET patients required fewer debridement procedures than standard surgical debridement prior to wound closure (ratio standard: VERSAJET = 1.747). The median time to wound closure was 3 days (95% CI 3 days, 5 days) for VERSAJET and 5 days (95% CI 4 days, 8 days) for standard debridement, although the difference was not statistically significant (p = 0.275). There were no instances of post-operative infection.

  16. Maggot Debridement: An Alternative Method for Debridement

    PubMed Central

    Gottrup, Finn; Jørgensen, Bo

    2011-01-01

    Debridement is an essential component to promote healing in a problem wound. Several techniques are available including maggot debridement therapy (MDT). Objective: To describe the efficacy of MDT for treating problem wound especially diabetic foot ulcers. Methods: The topic is elucidated from different points of view: the mode of action, when to use, use in a practice, clinical results, and discussing the problem of creating evidence for the clinical effect. Results: Literature and own results demonstrate that MDT is a safe method with few side effects. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. However, the evidence of these effects of MDT on the highest level is presently lacking. A detailed description of how to use MDT in practice is provided including a visual demonstration in a video. Conclusion: In spite of lacking clinical evidence, MDT clinical experience strongly suggests that this technique is effective and safe. It can be used for most types of problem wounds, but our indication is primarily diabetic foot ulcers, because of its selectivity for debriding necrotic dead tissue. It may be a valuable alternative surgical/sharp debridement. PMID:21776326

  17. Surgical treatment of aggressive vertebral hemangiomas.

    PubMed

    Vasudeva, Viren S; Chi, John H; Groff, Michael W

    2016-08-01

    OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of "hemangioma" between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3-65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the

  18. Surgical treatment of aggressive vertebral hemangiomas.

    PubMed

    Vasudeva, Viren S; Chi, John H; Groff, Michael W

    2016-08-01

    OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of "hemangioma" between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3-65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the

  19. Chemical Debridement of Burns

    PubMed Central

    Levenson, Stanley M.; Kan, Dorinne; Gruber, Charles; Crowley, Leo V.; Lent, Richard; Watford, Alvin; Seifter, Eli

    1974-01-01

    The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. The removal of the devitalized tissue, without damage to unburned skin or skin only partially injured by burning, and in ways which would permit immediate (or very prompt) skin grafting, would lessen substantially the problems of sepsis, speed convalescence and the return of these individuals to society as effective human beings, and would decrease deaths. The usefulness and limitations of surgical excision for patients with extensive third degree burns are discussed. Chemical debridement lends itself to complementary use with surgical excision and has the potential advantage over surgical excision in not requiring anesthesia or a formal surgical operation. The authors' work with the chemical debridement of burns, in particular the use of Bromelain, indicates that this approach will likely achieve clinical usefulness. The experimental studies indicate that rapid controlled debridement, with minimal local and systemic toxicity, is possible, and that effective chemotherapeutic agents may be combined with the Bromelain without either interfering with the actions of the other. The authors believe that rapid (hours) debridement accomplished by the combined use of chemical debriding and chemotherapeutic agents will obviate the possibility of any increase in infection, caused by the use of chemical agents for debridement, as reported for Paraenzyme21 and Travase.39,48 It is possible that the short term use of systemic antibiotics begun just before and continued during, and for a short time after, the rapid chemical debridement may prove useful for the prevention of infection, as appears to be the case for abdominal operations of the clean-contaminated and

  20. Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon

    PubMed Central

    Kobsar, Bradley; Alcantara, Joel

    2009-01-01

    The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence-based practice, we describe the chiropractic care of a professional ballet dancer following surgical calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon. The care provided involves an array of modalities from exercise and rehabilitation to spinal manipulative therapy. PMID:19421349

  1. Using color to guide debridement.

    PubMed

    Endara, Matthew; Attinger, Christopher

    2012-12-01

    Chronic wounds are typically halted in the inflammatory stage of wound healing secondary to a prolonged inflammatory response of the body to bacterial colonization, as planktonic bacteria and biofilm and senescent cells present at the wound's edges. Surgical debridement of these wounds is a critical step taken by the treating physician to attain complete healing. In order for debridement to successfully reset the stages of wound healing, residual biofilm and senescent cells must be removed. Despite the importance of complete and thorough debridement, few methods exist, and even fewer articles have been written describing techniques to ensure that all portions of a wound are equally addressed with each procedure. Using methylene blue dye to color the wound allows the surgeon to address and debride all portions of the wound adequately. In addition, the surgeon must be very familiar with what the normal tissue colors are following removal of the methylene blue-dyed tissue. Getting to tissue with those colors provides an end point to the debridement and helps prevent removal of excess healthy tissue. This article describes the primary author's technique for staining tissues with methylene blue dye prior to wound debridement, as well as the colors to look for to signal completion of surgery. In addition, a review of biofilm and senescent cells is presented as both are targeted but frequently missed when wounds are incompletely debrided.

  2. Maggot debridement therapy: a systematic review.

    PubMed

    Shi, Eric; Shofler, David

    2014-12-01

    Maggot debridement therapy is used extensively in the UK in both community and hospital situations, but remains a potentially under-used modality in many wound care markets. It promotes wound healing by performing three key processes: debridement, disinfection and growth-promoting activity. It can be used for the debridement of non-healing necrotic skin and soft tissue wounds, including pressure ulcers, venous stasis ulcers, neuropathic foot ulcers and non-healing traumatic of post-surgical wounds. With the increase in chronic diabetic foot wounds, maggot debridement therapy is a promising tool for health professionals dealing with difficult wounds. This article presents an overview of the research evidence surrounding maggot debridement therapy that serves as a guide to health professionals who may be users of this form of treatment now and in the future.

  3. Uncommon perineal tumours: caution with aggressive surgical management

    PubMed Central

    Duchalais, Emilie; Cassagnau, Elisabeth; Regenet, Nicolas; Meurette, Guillaume

    2013-01-01

    An asymptomatic 66-year-old woman showed a large perineal mass extending close to pelvic organs on MRI. CT-guided needle biopsies revealed a desmoid tumour (DT). The patient refused radical surgery. Four years later, the tumour had marginally increased in size and was still asymptomatic. The revision of earlier biopsies then revealed typical aspects of aggressive angiomyxoma (AA). AA and DT are rare mesenchymal tumours of low-grade malignancy, usually of large size, that occurs in female pelvi-perineal region. Radical resection with wide margins is classically advocated in such tumours in order to prevent the high risk of recurrences. However, due to a slow growth, rare infiltration of adjacent organs and a very low metastatic potential, a watchful waiting policy can be proposed when high postoperative morbidity is expected. In order to propose the accurate treatment, frontline biopsies of the tumour are essential. PMID:24243505

  4. Retroperitoneal endoscopic debridement for infected peripancreatic necrosis.

    PubMed

    Seifert, H; Wehrmann, T; Schmitt, T; Zeuzem, S; Caspary, W F

    2000-08-19

    Standard management of infected peripancreatic necrosis consists of open surgical debridement and lavage--a traumatic intervention with substantial morbidity and mortality. As an alternative and novel approach with minimum invasiveness, we present fenestration of the gastric wall and debridement of infected necrosis by direct retroperitoneal endoscopy. In three patients, this strategy led to rapid clinical improvement and no serious complications. Transgastric endoscopic therapy may be a less traumatic alternative to surgery and should be further assessed in prospective studies.

  5. Aggressive surgical resection for concomitant liver and lung metastasis in colorectal cancer

    PubMed Central

    Lee, Sung Hwan; Kim, Sung Hyun; Lim, Jin Hong; Kim, Sung Hoon; Lee, Jin Gu; Kim, Dae Joon; Choi, Gi Hong; Choi, Jin Sub

    2016-01-01

    Backgrounds/Aims Aggressive surgical resection for hepatic metastasis is validated, however, concomitant liver and lung metastasis in colorectal cancer patients is equivocal. Methods Clinicopathologic data from January 2008 through December 2012 were retrospectively reviewed in 234 patients with colorectal cancer with concomitant liver and lung metastasis. Clinicopathologic factors and survival data were analyzed. Results Of the 234 patients, 129 (55.1%) had synchronous concomitant liver and lung metastasis from colorectal cancer and 36 (15.4%) had metachronous metastasis. Surgical resection was performed in 33 patients (25.6%) with synchronous and 6 (16.7%) with metachronous metastasis. Surgical resection showed better overall survival in both groups (synchronous, p=0.001; metachronous, p=0.028). In the synchronous metastatic group, complete resection of both liver and lung metastatic lesions had better survival outcomes than incomplete resection of two metastatic lesions (p=0.037). The primary site of colorectal cancer and complete resection were significant prognostic factors (p=0.06 and p=0.003, respectively). Conclusions Surgical resection for hepatic and pulmonary metastasis in colorectal cancer can improve complete remission and survival rate in resectable cases. Colorectal cancer with concomitant liver and lung metastasis is not a poor prognostic factor or a contraindication for surgical treatments, hence, an aggressive surgical approach may be recommended in well-selected resectable cases. PMID:27621747

  6. Juvenile aggressive cemento-ossifying fibroma of the sphenoid sinus with proptosis: a surgical dilemma.

    PubMed

    Singh, Rohit; Ramaswamy, Balakrishnan; Hazarika, Manali

    2013-01-01

    The term fibro-osseous lesion has currently grown in popularity as an overall designation for a number of rare, histologically benign head and neck lesions that are made up of bone, fibrous tissue and cementum. Cemento-ossifying fibroma is a variant of cementifying fibroma and is a fibro-osseous disease. They are usually small innocuous lesions which follow a slow benign course and are commonly seen in the skull bone rather than the sphenoid. It is rare for these tumours to attain large size, behave aggressively, destroy bone and require a radical surgery. One such rapidly growing juvenile cemento-ossifying lesion of sphenoid in our 10-year-old young patient causing proptosis and impaired vision is reported here because of its uncommon nature and its surgical dilemma. Selection of surgical approach to resect this tumour becomes difficult because it is deeply seated and needs a multidisciplinary approach. PMID:24285811

  7. Juvenile aggressive cemento-ossifying fibroma of the sphenoid sinus with proptosis: a surgical dilemma.

    PubMed

    Singh, Rohit; Ramaswamy, Balakrishnan; Hazarika, Manali

    2013-11-27

    The term fibro-osseous lesion has currently grown in popularity as an overall designation for a number of rare, histologically benign head and neck lesions that are made up of bone, fibrous tissue and cementum. Cemento-ossifying fibroma is a variant of cementifying fibroma and is a fibro-osseous disease. They are usually small innocuous lesions which follow a slow benign course and are commonly seen in the skull bone rather than the sphenoid. It is rare for these tumours to attain large size, behave aggressively, destroy bone and require a radical surgery. One such rapidly growing juvenile cemento-ossifying lesion of sphenoid in our 10-year-old young patient causing proptosis and impaired vision is reported here because of its uncommon nature and its surgical dilemma. Selection of surgical approach to resect this tumour becomes difficult because it is deeply seated and needs a multidisciplinary approach.

  8. EVerT2—needling versus non-surgical debridement for the treatment of verrucae: study protocol for a single-centre randomised controlled trial

    PubMed Central

    Hashmi, Farina; Torgerson, David; Fairhurst, Caroline; Cockayne, Sarah; Bell, Kerry; Cullen, Michelle; Harrison-Blount, Michael

    2015-01-01

    Introduction Verrucae are extremely common, and are experienced by most people at some time during their lives. Although most verrucae will spontaneously disappear without treatment, many patients seek treatment, often because they have persisted for many years, are unsightly or painful or prevent them from doing sports or other activities. There are many different treatments available; including the Falknor's needling procedure. To date, there has only been one small trial evaluating the clinical effectiveness of this treatment and no health economic analysis has been undertaken. The Effective Verruca Treatments (EVerT2) trial aims to evaluate the clinical and cost-effectiveness of the needling procedure for the treatment of verrucae. Methods and analysis This single-centre randomised controlled trial will recruit 58 participants (aged 18 years and over with a plantar verruca) from Salford Podiatry Clinic patient lists and the surrounding area. If the participant presents with multiple verrucae, an ‘index’ verruca (largest and thickest lesion) will be identified and patients will be randomised 1:1 to the intervention group to receive the needling treatment or the control group to have the callus overlying the verruca debrided. The primary outcome is complete clearance of the index verruca at 12 weeks after randomisation. Secondary outcomes include clearance and recurrence of the treated verruca, clearance of all verrucae, number of verrucae remaining, change in size of the index verruca, pain, and participant satisfaction. A cost-effectiveness analysis of the needling versus callus debridement will be carried out from the perspective of health services over a time horizon of 12 weeks. Ethics and dissemination Ethical approval has been obtained from the University of Salford, Department of Health Sciences Ethical Approval Committee (HSCR15/24) and the University of York, Department of Health Sciences Research Governance Committee (HSRGC/2014/98/B

  9. Silicone moulding for pressure sore debridement.

    PubMed

    Erba, P; Wettstein, R; Schumacher, R; Schwenzer-Zimmerer, K; Pierer, G; Kalbermatten, D F

    2010-03-01

    The radicality of wound debridement is an important feature of the surgical treatment of pressure sores. Several methods such as injection of methylene blue or hydrogen peroxide have been proposed to facilitate and optimise the surgical debridement technique, but none of them proved to be sufficient. We present an innovative modification of the pseudo-tumour technique consisting in the injection of fluid silicone. Vulcanization of the silicone leads to pressure-sore moulding, permitting a more radical and sterile excision. In a series of 10 paraplegic patients presenting with ischial pressure sores, silicone moulding was used to facilitate debridement. Radical en bloc debridement was achieved in all patients. After a minimal follow-up of 2 years, no complications and recurrences occurred. A three-dimensional (3D) analysis of the silicone prints objectified the pyramidal shape of ischial pressure sores. Our study showed that complete resection without capsular lesion can be easily achieved. Further, it allows the surgeon to analyse the shape and size of the resected defect, which might be helpful to select the appropriate defect coverage technique.

  10. Silicone moulding for pressure sore debridement.

    PubMed

    Erba, P; Wettstein, R; Schumacher, R; Schwenzer-Zimmerer, K; Pierer, G; Kalbermatten, D F

    2010-03-01

    The radicality of wound debridement is an important feature of the surgical treatment of pressure sores. Several methods such as injection of methylene blue or hydrogen peroxide have been proposed to facilitate and optimise the surgical debridement technique, but none of them proved to be sufficient. We present an innovative modification of the pseudo-tumour technique consisting in the injection of fluid silicone. Vulcanization of the silicone leads to pressure-sore moulding, permitting a more radical and sterile excision. In a series of 10 paraplegic patients presenting with ischial pressure sores, silicone moulding was used to facilitate debridement. Radical en bloc debridement was achieved in all patients. After a minimal follow-up of 2 years, no complications and recurrences occurred. A three-dimensional (3D) analysis of the silicone prints objectified the pyramidal shape of ischial pressure sores. Our study showed that complete resection without capsular lesion can be easily achieved. Further, it allows the surgeon to analyse the shape and size of the resected defect, which might be helpful to select the appropriate defect coverage technique. PMID:19167279

  11. Limited surgical treatment of suspected necrotizing fasciitis of the upper extremity with a benign clinical presentation

    PubMed Central

    Gander, Brian; Kaye, Marc; Wollstein, Ronit

    2012-01-01

    Necrotizing fasciitis is a rapidly evolving, potentially fatal infection. Current recommendations advocate antibiotic administration and early aggressive surgical debridement. Aggressive surgery is associated with significant morbidity, leaving patients with substantial tissue loss and complex wounds. A case of suspected necrotizing fasciitis treated with minimal surgery is described. A previously healthy 48-year-old man presented with increased erythema, swelling and blistering of his left upper extremity. Despite a benign systemic clinical presentation, the hand and forearm were suspicious for necrotizing fasciitis, prompting surgical treatment. Surgical exploration found a significant amount of intradermal and subdermal clear fluid. It was decided to limit the amount of debridement. The diagnosis was Wells syndrome, eosinophilic cellulitis. Treated with steroids, the wounds healed uneventfully. It is important to consider the complete clinical picture before aggressive surgical treatment. A negative history for diabetes, atypical clinical presentation and benign operative findings are suggestive of a more benign diagnosis. PMID:23997598

  12. Advances in wound debridement techniques.

    PubMed

    Nazarko, Linda

    2015-06-01

    Dead and devitalised tissue interferes with the process of wound healing. Debridement is a natural process that occurs in all wounds and is crucial to healing; it reduces the bacterial burden in a wound and promotes effective inflammatory responses that encourage the formation of healthy granulation tissue (Wolcott et al, 2009). Wound care should be part of holistic patient care. Recent advances in debridement techniques include: biosurgery, hydrosurgery, mechanical debridement, and ultrasound. Biosurgery and mechanical debridement can be practiced by nonspecialist nurses and can be provided in a patient's home, thus increasing the patient's access to debridement therapy and accelerating wound healing.

  13. Experiences with waterjet hydrosurgery system in wound debridement

    PubMed Central

    Gurunluoglu, Raffi

    2007-01-01

    Background Recently, a new device, the Versajet™, involving "Hydrosurgery Technology" which combines lavage and sharp debridement instrumentation has been described for soft tissue debridement. Methods The Versajet™ Hydrosurgery System utilizes a reusable power console with foot pedal activation, disposable handpiece and tubing assembly in conjunction with sterile saline and standard waste receptacle. The purpose of this paper is to report our experiences with this instrument in debridement of a variety of wounds prior to final reconstructive surgery. Technical details and pitfalls are discussed to facilitate clinical use. Results Efficient, safe and fast debridement was achieved in all patients using the hydrosurgery system. The actual time the hydrosurgery system was used for debridement averaged as 15.5 minutes. In ten patients, an adequately debrided wound bed was achieved with a single operative procedure, in four patients; two stages were required prior to reconstructive surgery. In one patient with recurrent sacral-iscial pressure sore, two debridements were carried out followed by long term vacuum assisted closure. The postoperative course was uneventful in all patients, but in three with a minor breakdown of the skin graft, which eventually healed with no surgical intervention. Conclusion As a result of our clinical experience, the Versajet™ enables surgeon to precisely target damaged and necrotic tissue and spare viable tissue. This modality may be a useful alternative tool for soft tissue debridement in certain cases. However, further studies are required to investigate its cost-effectiveness in wound management. PMID:17475016

  14. The wound debrider: a new monofilament fibre technology.

    PubMed

    Haemmerle, Gilbert; Duelli, Heinz; Abel, Martin; Strohal, Robert

    Debridement is a basic necessity to induce the functional process of tissue repair, especially in chronic wounds. In this pilot study the authors used a new debrider technology with specific monofilament fibres in a unique texture to evaluate its efficacy, safety and tolerability. In eleven patients, exhibiting all types of wound-associated debris (biofilms, slough, necrotic crusts and hyperkeratotic plaques), the debrider, wetted with physiological solution, was wiped without specific force over the wound for about 2-4 minutes. This led to removal of almost all debris leaving healthy granulation tissue intact, including small epithelialized islands of vital tissue. The procedure was without pain and adverse events. Scanning electron microscopic analyses identified the majority of the removed debris tightly packed within the monofilament texture. A surgeon who blindly assessed pictures taken before and after the debridement categorized all except one wound without the need for surgical debridement and ranked all the debridement results with the new debrider as 'very good' (best category). This formulates the basic concept that the new debrider-based technology is easy, fast, highly efficient, well tolerated and cost effective.

  15. Percutaneous debridement of posttraumatic infected major hepatic necrosis.

    PubMed

    Sacks, David; Ong, Adrian; Fernandez, Forrest

    2014-08-01

    Although percutaneous drainage of liver abscesses has long been the standard of care, percutaneous drainage of infected necrotic liver tissue is usually used only to stabilize a patient's condition in the setting of sepsis before surgical debridement is ultimately required, frequently in the form of a hepatic lobectomy. The present report describes three cases of curative percutaneous drainage and percutaneous debridement of posttraumatic infected major hepatic necrosis. Techniques used included catheter suction, lavage, and foreign body retrieval.

  16. Endoscopic Plantar Fascia Debridement for Chronic Plantar Fasciitis.

    PubMed

    Cottom, James M; Baker, Joseph S

    2016-10-01

    When conservative therapy fails for chronic plantar fasciitis, surgical intervention may be an option. Surgical techniques that maintain the integrity of the plantar fascia will have less risk of destabilizing the foot and will retain foot function. Endoscopic debridement of the plantar fascia can be performed reproducibly to reduce pain and maintain function of the foot. PMID:27599439

  17. Endoscopic Plantar Fascia Debridement for Chronic Plantar Fasciitis.

    PubMed

    Cottom, James M; Baker, Joseph S

    2016-10-01

    When conservative therapy fails for chronic plantar fasciitis, surgical intervention may be an option. Surgical techniques that maintain the integrity of the plantar fascia will have less risk of destabilizing the foot and will retain foot function. Endoscopic debridement of the plantar fascia can be performed reproducibly to reduce pain and maintain function of the foot.

  18. Understanding methods of wound debridement.

    PubMed

    Atkin, Leanne

    Autolytic debridement describes the body's natural method of wound-bed cleansing, helping it to prepare the wound bed for healing. In acute wounds, autolytic debridement occurs automatically and often does not require intervention, as during the inflammatory stage of a wound, neutrophils and macrophages digest and removes devitalised tissue, cell debris and contaminants, clearing the wound of any cellular barriers to healing. In chronic wounds, by contrast, healing is often delayed, frequently because of inadequate debridement. The autolytic process becomes overwhelmed by high levels of endotoxins released from damaged tissue (Broadus, 2013). Therefore wound debridement becomes an integral part of chronic-wound management and practitioners involved in wound care must be fully competent at wound-bed assessment and have an awareness of the options available for debridement. This article will review wound-bed assessment, highlighting variations in devitalised tissue, and explore options available for wound debridement, taking into consideration patients’ pain and quality of life.

  19. An aggressive multidisciplinary approach reduces mortality in rhinocerebral mucormycosis

    PubMed Central

    Palejwala, Sheri K.; Zangeneh, Tirdad T.; Goldstein, Stephen A.; Lemole, G. Michael

    2016-01-01

    Background: Rhinocerebral mucormycosis occurs in immunocompromised hosts with uncontrolled diabetes, solid organ transplants, and hematologic malignancies. Primary disease is in the paranasal sinuses but often progresses intracranially, via direct extension or angioinvasion. Rhinocerebral mucormycosis is rapidly fatal with a mortality rate of 85%, even when maximally treated with surgical debridement, antifungal therapy, and correction of underlying processes. Methods: We performed a retrospective chart review of patients with rhinocerebral mucormycosis from 2011 to 2014. These patients were analyzed for symptoms, surgical and medical management, and outcome. We found four patients who were diagnosed with rhinocerebral mucormycosis. All patients underwent rapid aggressive surgical debridement and were started on antifungal therapy on the day of diagnosis. Overall, we observed a mortality rate of 50%. Results: An early aggressive multidisciplinary approach with surgical debridement, antifungal therapy, and correction of underlying disease have been shown to improve survivability in rhinocerebral mucormycosis. Conclusion: A multidisciplinary approach to rhinocerebral mucormycosis with otolaryngology, neurosurgery, and ophthalmology, infectious disease and medical intensivists can help reduce mortality in an otherwise largely fatal disease. Even despite these measures, outcomes remain poor, and a high index of suspicion must be maintained in at-risk populations, in order to rapidly execute a multifaceted approach. PMID:27280057

  20. Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts.

    PubMed

    Heitz-Mayfield, Lisa J A; Lang, Niklaus P

    2013-06-01

    This review aims to highlight concepts relating to nonsurgical and surgical periodontal therapy, which have been learned and unlearned over the past few decades. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. Advances in technology have resulted in the introduction of a range of new methods for use in nonsurgical periodontal therapy, including machine-driven instruments, lasers, antimicrobial photodynamic therapy and local antimicrobial-delivery devices. However, these methods have not been shown to offer significant benefits over and above nonsurgical debridement using hand instruments. The method of debridement is therefore largely dependent on the preferences of the operator and the patient. Recent evidence indicates that specific systemic antimicrobials may be indicated for use as adjuncts to nonsurgical debridement in patients with advanced disease. Full-mouth disinfection protocols have been proven to be a relevant treatment option. We have learned that while nonsurgical and surgical methods result in similar long-term treatment outcomes, surgical therapy results in greater probing-depth reduction and clinical attachment gain in initially deep pockets. The surgical technique chosen seems to have limited influence upon changes in clinical attachment gain. What has not changed is the importance of thorough mechanical debridement and optimal plaque control for successful nonsurgical and surgical periodontal therapy.

  1. Minimally invasive burn care: a review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (Nexobrid®)

    PubMed Central

    Rosenberg, L.; Shoham, Y.; Krieger, Y.; Rubin, G.; Sander, F.; Koller, J.; David, K.; Egosi, D.; Ahuja, R.; Singer, A.J.

    2015-01-01

    Summary Current surgical and non-surgical eschar removal-debridement techniques are invasive or ineffective. A bromelainbased rapid and selective enzymatic debriding agent was developed to overcome these disadvantages and compared with the standard of care (SOC). The safety and efficacy of a novel Debriding Gel Dressing (DGD) was determined in patients with deep partial and full thickness burns covering up to 67% total body surface area (TBSA). This review summarizes data from seven studies, four of which were randomized clinical trials that included a SOC or control vehicle. DGD eschar debridement efficacy was >90% in all studies, comparable to the SOC and significantly greater than the control vehicle. The total area excised was less in patients treated with DGD compared with the control vehicle (22.9% vs. 73.2%, P<0.001) or the surgical/non-surgical SOC (50.5%, P=0.006). The incidence of surgical debridement in patients treated with DGD was lower than the SOC (40/163 [24.5%] vs. 119/170 [70.0%], P0.001). Less autografting was used in all studies. Long-term scar quality and function were similar in DGD- and SOCtreated. DGD is a safe and effective method of burn debridement that offers an alternative to surgical and non-surgical SOC. PMID:27777547

  2. Maggot debridement therapy for laminitis.

    PubMed

    Morrison, Scott

    2010-08-01

    Maggot debridement therapy is a nontraumatic, minimally invasive method to treat infections in a foot compromised by chronic laminitis. A mechanical strategy must first be in place to address the instability of the distal phalanx and hoof capsule. Adverse reactions to maggot debridement therapy are uncommon and the only side effect observed has been irritation or hypersensitivity at the site. Chronic laminitic cases of sepsis/necrosis within the hoof benefit from this procedure due to the noninvasive, continuous debridement and healing properties provided by the larvae.

  3. Debridement of the noninfected wound.

    PubMed

    Cornell, Rhonda S; Meyr, Andrew J; Steinberg, John S; Attinger, Christopher E

    2010-01-01

    The utility of wound debridement has expanded to include the management of all chronic wounds, even in the absence of infection and gross necrosis. Biofilms, metalloproteases on the wound base, and senescent cells at the wound edge irreversibly change the physiologic features of wound healing and contribute to a pathologic, chronic inflammatory environment. The objective of this review is to provide surgeons with a basic understanding of the processes of debridement in the noninfected wound.

  4. Robotic cystogastrostomy and debridement of walled-off pancreatic necrosis.

    PubMed

    Nassour, Ibrahim; Ramzan, Zeeshan; Kukreja, Sachin

    2016-09-01

    Walled-off pancreatic necrosis is a known complication of acute pancreatitis and requires intervention if symptomatic or complicated. Laparoscopic cystogastrostomy as a minimally invasive surgical intervention has been well-described in surgical literature but data on a robotic approach is limited. Here we report a case of robotic cystogastrostomy and debridement of walled-off pancreatic necrosis in a patient with a history of severe biliary pancreatitis. PMID:27039191

  5. Suprainguinal vascular pythiosis: effective long-term outcome of aggressive surgical eradication.

    PubMed

    Hahtapornsawan, Suteekhanit; Wongwanit, Chumpol; Chinsakchai, Khamin; Hongku, Kiatisak; Sermsathanasawadi, Nuttawut; Ruangsetakit, Chanean; Mutirangura, Pramook

    2014-10-01

    Vascular pythiosis, a vascular infectious disease in hemoglobinopathy patients, caused by Pythium insidiosum, has an endemic area in tropical and subtropical countries. According to literature review, suprainguinal vascular pythiosis leads to 100% of mortality. The authors report a 35-year-old thalassemic patient who presented with a right inflammatory pulsatile groin mass and right limb ischemia. The computerized tomography angiography indicated a false aneurysm at the right external iliac artery and thrombosed entire right leg arteries. The management comprised antifungal agent, immunotherapy, and surgical removal of all infected arteries (high up to the right common iliac artery and above-knee amputation). The patient was found in a good condition at 36 months after the follow-up period. PMID:24911809

  6. Sulcular debridement with pulsed Nd:YAG

    NASA Astrophysics Data System (ADS)

    Harris, David M.; Gregg, Robert H., II; McCarthy, Delwin K.; Colby, Leigh E.; Tilt, Lloyd V.

    2002-06-01

    We present data supporting the efficacy of the procedure, laser sulcular debridement (laser curettage), as an important component in the treatment of inflammatory periodontal disease. Laser Assisted New Attachment Procedure (LANAP) is a detailed protocol for the private practice treatment of gum disease that incorporates use of the PerioLase pulsed Nd:YAG Dental Laser for laser curettage. Laser curettage is the removal of diseased or inflamed soft tissue from the periodontal pocket with a surgical dental laser. The clinical trial conducted at The University of Texas HSC at San Antonio, Texas, evaluated laser curettage as an adjunct to scaling and root planing. They measured traditional periodontal clinical indices and used a questionnaire to evaluate patient comfort and acceptance. The Texas data (N=10 patients) are compared with pocket depth changes following LANAP. LANAP data were obtained from a retrospective review of patient records at three private practices (N=65). No significant differences in post treatment probe depth changes were found among the four centers indicating that the procedure produced consistent, favorable outcomes, and that results from controlled scientific clinical trials can be replicated in private practices. Reduction in pocket depths following laser treatment compare well with results obtained with scalpel surgery. The use of the laser offers additional benefits. We also present quantitative evidence from digitized radiographs of increased bone density in affected areas following LANAP.

  7. Wound bed preparation: ultrasonic-assisted debridement.

    PubMed

    Butcher, Gillian; Pinnuck, Loreto

    Wound bed preparation is essential for the healing of wounds. The TIME framework (tissue, infection/inflammation, moisture balance, edge of wound) for wound bed preparation shows the importance of debridement in the treatment of chronic wounds. Debridement involves the removal of devitalised tissue from the wound bed. It also facilitates the removal of biofilms-complex microbial communities that are known to contribute to delayed wound healing and chronicity of wounds. Ultrasonic-assisted wound debridement (UAWD) is a lesser known debridement method that uses low-frequency ultrasound waves. There is evidence to show that the three clinical effects of atraumatic selective tissue debridement, wound stimulatory effects and antibacterial activity facilitate early healing of wounds, reducing the cost to the healthcare system and improving the patient's quality of life.

  8. Debridement for osteoarthritis of the elbow in athletes.

    PubMed

    Oka, Y

    1999-01-01

    The results of surgical treatment for osteoarthritis of the elbow in athletes were investigated. Athletic activities consisted mainly of judo wrestling and baseball; and included 26 elbows. The mean age was 32 years. The radiological changes were mild in most cases. Debridement consisted of resecting osteophytes and removing loose bodies. Pain scores were improved, and the range of movement was improved by an average of 24 degrees with an average follow-up of 4 years and 2 months. Recurrence of mild symptoms occurred in most cases.

  9. Full mouth disinfection versus quadrant debridement: the clinician's choice.

    PubMed

    Kinane, Denis F; Papageorgakopoulos, Georgios

    2008-01-01

    Traditional periodontal therapy is subgingival debridement with maintenance of good oral hygiene. This approach is either definitive or the initial phase before surgical therapy in severe cases of periodontitis. Mechanical therapy, either hand instrumentation or ultrasonic debridement, is the most common therapy for periodontitis and its success is well documented (Badersten et al. 1984). This non-surgical therapy involves considerable amounts of time, a high level of operator skill and dedication, and some unavoidable discomfort for the patient. It has often been remarked that the time taken for periodontal therapy of severe periodontitis cases exceeds that needed for cardiac arterial bypass surgery. Quirynen et al. (1995) re-introduced the one-stage full-mouth disinfection and compared the clinical and microbiological effects of this treatment strategy (FMRP) with the widespread practice of quadrant scaling and root planing at 2-week intervals (QRP). The rationale behind their treatment strategy was to prevent re-infection of the treated sites from the remaining untreated pockets and intra-oral niches. The results revealed a significant reduction in pocket depth for the FMRP over QRP group for deep pockets. Quirynen et al. (2000) concluded that the elimination of the periodontopathogens in addition to the possible host response benefits after the one-stage full-mouth therapy is the effective aspect of this therapy rather than oral chlorhexidine disinfection. Recently, Kinane's group in Glasgow failed to demonstrate differences in the clinical, microbiological or immunological outcome between QRP and FMRP. FMRP was well tolerated by patients and these authors concluded that the clinician should select the treatment modality based on practical considerations related to patient preference and clinical workload. Koshy et al. (2005) re-analysed the effects of FMRP and QRP using ultrasonics and concluded that either full-mouth or quadrant ultrasonic debridement are

  10. Locally advanced adenocarcinoma of the rectum presenting with necrotising fasciitis of the perineum: successful management with early aggressive surgery and multimodal therapy.

    PubMed

    Ferreira, Luís; Alexandrino, Henrique; Soares Leite, Júlio; Castro Sousa, Francisco

    2015-12-16

    Colorectal cancer is a common malignant neoplasm and its treatment usually involves surgery associated, in some cases, depending on the staging, with chemoradiotherapy. Necrotising fasciitis of the perineum is a highly lethal infection of the perineum, perirectal tissues and genitals, requiring emergency surgical debridement, broad-spectrum antibiotics and control of sepsis. We present the case of a 59-year-old man with necrotising fasciitis of the perineum as the first clinical manifestation of locally advanced adenocarcinoma of the rectum, in which successful management consisted of early and aggressive surgical debridement, followed by multimodal therapy with curative intent. 2 years and 6 months after surgery the patient is well, with no evidence of local or systemic relapse.

  11. Warfarin-induced skin necrosis diagnosed on clinical grounds and treated with maggot debridement therapy.

    PubMed

    Biscoe, Anna Louise; Bedlow, Alison

    2013-01-01

    A patient with a history of deep vein thrombosis presented with painful bruising and blistering on his left leg 7-10 days after warfarin treatment. A complicated 2-month treatment followed, where vasculitis was originally diagnosed from histological findings before the final diagnosis of warfarin-induced skin necrosis (WISN) was made on clinical grounds. Warfarin was stopped, reversed and low molecular weight heparin started but, the lesions had progressed to full thickness necrosis. This was originally treated with conventional surgical debridement before introducing maggot debridement therapy (MDT) in an effort to try to salvage the limb.

  12. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    PubMed

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  13. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    PubMed

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  14. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only

    PubMed Central

    Tang, Ming‐xing; Wang, Yu‐xiang; Guo, Chao‐feng; Liu, Jin‐yang

    2016-01-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three‐column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68‐year‐old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone

  15. Alternative techniques in root canal debridement

    NASA Astrophysics Data System (ADS)

    Luca, Ruxandra; Todea, Carmen; Bǎlǎbuc, Cosmin; Nica, Luminita; Armani, Giacomo; Locovei, Cosmin

    2014-01-01

    Studies have demonstrated that conventional chemo-mechanical preparation is limited regarding the decontamination of the endodontic space, which is why alternative techniques such as laser radiation have their importance in the modern endodontic treatment. The present study aims to assess the possibility of improving the debridement of the root canals by removing smear layer using Er: YAG laser radiation. We used 18 extracted teeth, which were subjected to the same initial protocol and then divided into 5 study groups: the control group has not been treated with laser; the other 4 groups were exposed to laser radiation using two different geometries peaks of quartz and two energy levels. Scanning electronic microscopy revealed an increased efficiency in the debridement of all interested areas when using PIPS and XPulse tips at proper energy. In the two groups treated with inferior laser energy, the debridement didn't prove to be superior to the conventional treatment.

  16. Arthroscopic Debridement for Irreparable Rotator Cuff Tears

    PubMed Central

    Hawi, N.; Schmiddem, U.; Omar, M.; Stuebig, T.; Krettek, C.; Petri, M.; Meller, R.

    2016-01-01

    Background: Arthroscopic debridement represents a salvage procedure for irreparable rotator cuff tears. It is important to accurately diagnose the patient for irreparable rotator cuff tears. The diagnosis and the therapeutic options must be explained to the patient. It is mandatory that the patient understands the primary goal of the arthroscopic debridement being reduction of pain, not improving strength or function. Methods: The procedure consists of 7 distinct steps to debride the soft tissues and alleviate pain. Results: Even though there is a lack of evidence that this procedure is superior to other therapeutic options, it has shown good results in patients with the main complaint of pain. Conclusion: The results reported in some studies should, however, be interpreted with caution, taking into consideration the substantial structural damage in irreparable defects.

  17. The tropical diabetic hand syndrome: a surgical perspective.

    PubMed

    Nthumba, Peter; Cavadas, Pedro C; Landin, Luis

    2013-01-01

    Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with

  18. Maggot Debridement Therapy: Advancing to the Past in Wound Care.

    PubMed

    Klaus, Kelsey; Steinwedel, Cynthia

    2015-01-01

    Maggot debridement therapy (MDT) is experiencing resurgence as an effective alternative to conventional mechanical debridement in nonhealing wounds, especially those with antibiotic-resistant organisms. MDT has antibiotic, antifungal, and anti-inflammatory properties. Military use is on the rise.

  19. [Maggots in the wound, debridement, disinfection and wound healing].

    PubMed

    Schouten, Helga W; Knippels, Marion C J; Franken, Ralph J P M

    2009-01-01

    An 87-year-old man had a longstanding untreated large basosquamous carcinoma on his right ear. He was admitted to the emergency department at our hospital. A large portion of the auricle had perished, together with part of the tumour. Surgery was planned but two days before, the patient complained of an irritating loud noise in his ear. We discovered this was caused by maggots in his external acoustic meatus: myiasis. Dozens of maggots were removed. A striking finding was that the smell of the wound had disappeared and that the wound was much cleaner, with a reddish aspect and less necrosis. The surgical procedure was uneventful. Larval therapy has been known for centuries. In recent years it has gained renewed interest as it may enhance wound debridement, wound disinfection, and may promote wound healing.

  20. Suicide plus immune gene therapy prevents post-surgical local relapse and increases overall survival in an aggressive mouse melanoma setting.

    PubMed

    Villaverde, Marcela S; Combe, Kristell; Duchene, Adriana G; Wei, Ming X; Glikin, Gerardo C; Finocchiaro, Liliana M E

    2014-09-01

    In an aggressive B16-F10 murine melanoma model, we evaluated the effectiveness and antitumor mechanisms triggered by a surgery adjuvant treatment that combined a local suicide gene therapy (SG) with a subcutaneous genetic vaccine (Vx) composed of B16-F10 cell extracts and lipoplexes carrying the genes of human interleukin-2 and murine granulocyte and macrophage colony stimulating factor. Pre-surgical SG treatment, neither alone nor combined with Vx was able to slow down the fast evolution of this tumor. After surgery, both SG and SG + Vx treatments, significantly prevented (in 50% of mice) or delayed (in the remaining 50%) post-surgical recurrence, as well as significantly prolonged recurrence-free (SG and SG + Vx) and overall median survival (SG + Vx). The treatment induced the generation of a pseudocapsule wrapping and separating the tumor from surrounding host tissue. Both, SG and the subcutaneous Vx, induced this envelope that was absent in the control group. On the other hand, PET scan imaging of the SG + Vx group suggested the development of an effective systemic immunostimulation that enhanced (18)FDG accrual in the thymus, spleen and vertebral column. When combined with surgery, direct intralesional injection of suicide gene plus distal subcutaneous genetic vaccine displayed efficacy and systemic antitumor immune response without host toxicity. This suggests the potential value of the assayed approach for clinical purposes.

  1. The role of powered instrumentation in the surgical treatment of allergic fungal sinusitis.

    PubMed

    Mirante, J P; Krouse, J H; Munier, M A; Christmas, D A

    1998-08-01

    Allergic fungal sinusitis is a chronic disorder that is being more frequently recognized by otolaryngologists. It is a recurrent illness characterized by frequent exacerbations, and requires aggressive medical and surgical treatment. When surgical therapy is employed, it is necessary to ensure adequate debridement and removal of edematous tissue. We have been using powered dissection as our primary method in sinus surgery over the past three year. We have treated 11 patients with allergic fungal sinusitis, and find powered instrumentation to be very effective in removing the polypoid tissue from the nose and sinuses, and in providing a clear surgical field. The procedure can be performed safely with minimal trauma to normal tissue. We believe that the use of powered dissection greatly enhances the comprehensive treatment of allergic fungal sinusitis.

  2. [Aggressive fibromatoses].

    PubMed

    Döhler, J R; Hamelmann, H; Lasson, U

    1984-03-01

    Benign by nature, aggressive fibromatoses (desmoid fibromas) may represent as difficult therapeutic problems as malignant tumours. When subtotally resected they tend to recur. But spontaneous regression is possible. Expense and limits of their surgical treatment are discussed with reference to seven patients. In five cases primary affliction of bone was evident. There are three reports given in detail: In the first, malignant transformation may be due to radiation therapy and hemipelvectomy could not prevent recurrence. In the second, spontaneous regression of untreated pelvic affection may have occurred. In the third, several resections and amputation of the leg failed to cure congenital infantile fibromatosis.

  3. Cryosurgery and acrylic cementation as surgical adjuncts in the treatment of aggressive (benign) bone tumors. Analysis of 25 patients below the age of 21.

    PubMed

    Malawer, M M; Dunham, W

    1991-01-01

    This article reviews the clinical experience with cryosurgery (use of liquid nitrogen) and acrylic cementation (polymethylmethacrylate; PMMA) in the treatment of aggressive, benign bone sarcomas and the biologic basis of this technique. The results of 25 patients below the age of 21 treated by cryosurgery, with an average follow-up period of 60.8 months, are reported. Three approaches to surgical reconstruction were used: Group 1 (four patients) had cryosurgery with no reconstruction, Group 2 (13 patients) had bone graft reconstruction alone, and Group 3 (eight patients) had composite osteosynthesis with internal fixation, bone graft, and/or PMMA. The overall control rate was 96% (one recurrence). The tumor types were giant-cell tumor, chondroblastoma, aneurysmal bone cyst, and malignant giant-cell tumor. Nineteen lesions involved the lower extremity, and six lesions were located in the upper extremity. There were two secondary fractures (8%), one local flap necrosis, and one synovial fistula. There were no infections. Two epiphyseodeses were performed. The functional results were excellent (83%), good (13%), and fair (4%). The technique of composite osteosynthesis is recommended for all large tumors of the lower extremity. Cryosurgical results compare favorably with those obtained by en bloc resection and demonstrate the ability of cryosurgery to eradicate tumors while avoiding the need for extensive resections and reconstructive procedures. PMID:1984931

  4. The cost of wound debridement: a Canadian perspective.

    PubMed

    Woo, Kevin Y; Keast, David; Parsons, Nancy; Sibbald, R Gary; Mittmann, Nicole

    2015-08-01

    Debridement is integral to wound bed preparation by removing devitalised tissue, foreign material, senescent cells, phenotypically abnormal/dysfunctional cells (cellular burden) and bacteria sequestrum (biofilm). While the body of evidence to substantiate the benefits of debridement is growing, little is known about the cost-effectiveness of each debridement method. The purpose of this analysis was to compare cost-effectiveness of various debridement methods and clinical outcomes to help inform clinicians and policy makers of the cost-effectiveness associated with the various types of therapies and the impact they can have on the Canadian health care system. Results indicated that sharp debridement was the most cost-effective followed by enzymatic debridement method.

  5. Early antibiotics and debridement independently reduce infection in an open fracture model.

    PubMed

    Penn-Barwell, J G; Murray, C K; Wenke, J C

    2012-01-01

    Most animal studies indicate that early irrigation and debridement reduce infection after an open fracture. Unfortunately, these studies often do not involve antibiotics. Clinical studies indicate that the timing of initial debridement does not affect the rate of infection but these studies are observational and fraught with confounding variables. The purpose of this study was to control these variables using an animal model incorporating systemic antibiotics and surgical treatment. We used a rat femur model with a defect which was contaminated with Staphylococcus aureus and treated with a three-day course of systemic cefazolin (5 mg/kg 12-hourly) and debridement and irrigation, both of which were initiated independently at two, six and 24 hour time points. After 14 days the bone and hardware were harvested for separate microbiological analysis. No animal that received antibiotics and surgery two hours after injury had detectable bacteria. When antibiotics were started at two hours, a delay in surgical treatment from two to six hours significantly increased the development of infection (p = 0.047). However, delaying surgery to 24 hours increase the rate of infection, but not significantly (p = 0.054). The timing of antibiotics had a more significant effect on the proportion of positive samples than earlier surgery. Delaying antibiotics to six or 24 hours had a profoundly detrimental effect on the infection rate regardless of the timing of surgery. These findings are consistent with the concept that bacteria progress from a vulnerable planktonic form to a treatment-resistant biofilm.

  6. FUNCTIONAL EVALUATION OF PATIENTS WHO HAVE UNDERGONE ARTHROSCOPIC DEBRIDEMENT TO TREAT MASSIVE AND IRREPARABLE TEARS OF THE ROTATOR CUFF

    PubMed Central

    Veado, Marco Antônio de Castro; Rodrigues, Alessandro Ulhôa

    2015-01-01

    To evaluate the results from patients who underwent arthroscopic debridement of extensive irreparable rotator cuff injuries. Methods: 27 patients were operated between 2003 and 2007, and 22 of them were evaluated. The surgical procedure consisted of arthroscopic debridement of the stumps of the tendons involved, bursectomy, removal of acromial osteophytes and, possibly, biceps tenotomy and tuberoplasty. Results: All the patients showed involvement of the supraspinatus and infraspinatus tendons at the preoperative stage. In the postoperative evaluation, 14 patients had a complete teres minor muscle, and three had partial tears of the subscapularis tendon. There was an improvement in the UCLA criteria, from 15 preoperatively to 31 postoperatively. There was no improvement in muscle strength, but there was a reduction in the pain. Conclusion: Arthroscopic debridement is a recommended procedure for elderly patients with irreparable rotator cuff tears, good range of motion and low functional demand, when the main objective is to diminish pain. PMID:27022590

  7. Maggot Debridement Therapy for Peripheral Arterial Disease

    PubMed Central

    2013-01-01

    Introduction: Maggots are potent debriding agents capable of removing necrotic tissue and slough; however, it is still unclear which wounds are most likely to benefit from maggot debridement therapy (MDT). Thus, we performed this retrospective review to gain insight into the patient and therapy characteristics influencing outcome. Patients and Methods: We reviewed patients with foot ulcers caused by critical limb ischemia, encountered during the period between June 2005 and May 2010. The treatment outcomes were defined as effective or ineffective. Results: There were 16 patients with 16 leg ulcers. The patients were 13 men and 3 women, with an average age of 67.2 years (range, 47–85 years). Ten (63%) of the 16 ulcers were treated effectively. According to univariate analyses, an ankle brachial pressure index (ABI) lower than 0.6 (p = 0.03) had a negative impact on the outcome of MDT; however, outcome was not influenced by gender, obesity, ischemic heart disease, diabetes mellitus, hemodialysis, smoking, or laboratory findings. Conclusions: Some patient characteristics, such as gender, obesity, ischemic heart disease, diabetes mellitus, hemodialysis, and smoking, do not seem to contraindicate eligibility for MDT. However, a limb with an ABI lower than 0.6 is less likely to benefit. (*English Translation of J Jpn Coll Angiol 2011; 51: 209-213.) PMID:23825493

  8. Treating wounds in small animals with maggot debridement therapy: a survey of practitioners.

    PubMed

    Sherman, Ronald A; Stevens, Howard; Ng, David; Iversen, Eve

    2007-01-01

    Many small animals succumb to complications of serious wounds. Sometimes infection and sepsis overwhelm the animal; sometimes the costs of intensive care overwhelm the owner. Maggot therapy, a method of wound debridement using live fly larvae, could provide effective, simple, low cost wound care. All eight US veterinarians who had been provided with medicinal maggots were surveyed to determine if this treatment was being used for small animals, and for what indications. At least two dogs, four cats and one rabbit were treated with maggot therapy between 1997 and 2003. The most common indications for using maggot therapy were to effect debridement and control infection, especially if the wound failed to respond to conventional medical and/or surgical therapy. Practitioners reported the treatments as safe and often beneficial. Amputation and euthanasia may have been avoided. It is concluded that maggot therapy may have utility for small animals, and should be evaluated further. PMID:16386439

  9. Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

    PubMed Central

    McCallon, Stanley K.; Weir, Dorothy; Lantis, John C.

    2015-01-01

    Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%–50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation. PMID:26442207

  10. Robot planning for automated burn debridement

    NASA Astrophysics Data System (ADS)

    Nwodoh, Thomas A.; Nnaji, Bartholomew O.

    1996-12-01

    This research develops a robot plan for a system that automatically debrides burned tissue on burn victims using a high energy laser for the ablation of the burned tissue. The automated robotic system consists of: a robot whose end effector is equipped with a laser head whence the laser beam emanates and a vision system that is used to acquire the 3D coordinates of some points on the body surface; 3D surface modelling routines for generating the surface model of the treatment area; and control and interface hardware and software for control and integration of all the system components. The entire process of automated burn debridement is achieved in two phases: an initial survey phase during which a model of the treatment area on the skin is built and used to plan an appropriate trajectory for the robot in the subsequent phase--the treatment phase during which the laser surgery is performed. During the survey phase, the vision system acquires points on the surface of the patient's body by using a camera to capture the contour traced by a plane of low power laser light generated by the laser source gut distinct from the high power laser beam. During this phase, a robot plan is generated for moving the end effector along the correct direction so that the camera can capture enough contours needed to build an accurate surface model of the treatment are. During the treatment phase, the surface model developed during the survey phase is used to generate the robot plan for ablating the dead skin tissue. To achieve this, the burned area is first defined on the model. Then based on the shape of the patterns, the trajectory to be followed by the laser head to accomplish complete debridement of the dead tissue is generated. Fourthly, with the point interpolated trajectory necessary for effective treatment obtained, the robot plans the motions necessary for laser ablation of the dead tissue without an over- or under-cut. Accomplishing these steps leads to the generation of a

  11. Anterior Debridement and Strut Graft with Pedicle Screw Fixation for Pyogenic Spondylitis

    PubMed Central

    Kim, Hak-Sun; Ahn, Chang-Soo; Lee, Dong-Hoon; Lee, Soon-Chul

    2007-01-01

    Study Design A retrospective study. Purpose We evaluated the results of the use of anterior debridement and interbody fusion followed by posterior spinal instrumentation. Overview of Literature An early diagnosis of pyogenic spondylitis is difficult to obtain. The disease can be treated with various surgical methods (such as anterior debridement and bone graft, anterior instrumentation, and posterior instrumentation). Methods This study included 20 patients who received anterior debridement and interbody fusion with strut bone graft followed by posterior spinal fusion for pyogenic spondylitis between 1996 and 2005. We analyzed the culture studies, the correction of the kyphotic angle, blood chemistry, the bony union period, and the amount of symptom relief. Results In terms of clinical symptoms relief, eight patients were grouped as "excellent", eleven patients as "good", and one patient as "fair". The vertebral body cultures were positive in 14 patients showing coagulase (-) streptococcus and S. aureus. The average times for normalization of the erythrocyte sedimentation rate and C-reactive protein level were 3.3 and 1.9 months, respectively. Four months was required for bony union. For complications, meralgia paresthetica was found in two cases. Conclusions Due to early ambulation and the correction of the kyphotic angle, anterior interbody fusion with strut bone graft and posterior instrumentation could be another favorable method for the treatment of pyogenic spondyulitis. PMID:20411131

  12. MAGGOT DEBRIDEMENT THERAPY (MDT): IT IS SAFE AND ECONOMIC FOR TREATING A DIABETIC FOOT ULCER.

    PubMed

    El-Tawdy, Ahmed Hassan Fawzi; Ibrahim, Eissa Abdel Hamed; Abdallah, Eman Shokry; Al Sakhawy, Eman Mahmoud Aly; Morsy, Tosson A

    2016-04-01

    Diabetic foot ulcer (DFU) is the major global and devastating complication of diabetes mellitus that affects at least 20% of diabetic patients during their lifetime. This article presents an overview of the research evidence on maggot debridement therapy that serves as a guide to health professionals who may be users of this form of treatment now and in the future. It is a time to apply this sample and safe worldwide approved method for diabetic foot ulcer to save money and avoid surgical intervention. PMID:27363059

  13. MAGGOT DEBRIDEMENT THERAPY (MDT): IT IS SAFE AND ECONOMIC FOR TREATING A DIABETIC FOOT ULCER.

    PubMed

    El-Tawdy, Ahmed Hassan Fawzi; Ibrahim, Eissa Abdel Hamed; Abdallah, Eman Shokry; Al Sakhawy, Eman Mahmoud Aly; Morsy, Tosson A

    2016-04-01

    Diabetic foot ulcer (DFU) is the major global and devastating complication of diabetes mellitus that affects at least 20% of diabetic patients during their lifetime. This article presents an overview of the research evidence on maggot debridement therapy that serves as a guide to health professionals who may be users of this form of treatment now and in the future. It is a time to apply this sample and safe worldwide approved method for diabetic foot ulcer to save money and avoid surgical intervention.

  14. Maximising the secondary beneficial effects of larval debridement therapy.

    PubMed

    Pritchard, D I; Nigam, Y

    2013-11-01

    Laboratory-based clinical investigations have shown that maggots and their secretions promote, among other activities, fibroblast motogenesis and angiogenesis. These events would contribute to re-granulation if translated to the wound environment. Maggot secretions also have ascribed antibacterial actions and may exhibit anti-inflammatory effects. Many of these biological events would be lost in the presence of necrotic tissue, making debridement a prerequisite for the release of larval-secreted secondary beneficial effects on the wound. We argue that Larval Debridement Therapy (LDT) should be considered as a primary and secondary treatment in wound management, with the primary application designed to debride the wound, and with subsequent applications to the debrided wound targeted to cellular events that promote healing. This review lends support to a re-evaluation of larval application protocols, in order to optimally harness the potential secondary beneficial clinical effects of larval therapy.

  15. Corneal crosslinking and visual rehabilitation in keratoconus in one session without epithelial debridement: new technique.

    PubMed

    Daxer, Albert; Mahmoud, Haifa A; Venkateswaran, R S

    2010-10-01

    A new surgical technique for the treatment of keratoconus is presented. This technique combines a new corneal crosslinking method with implantation of a flexible full-ring implant into a "closed" corneal pocket via a narrow incision tunnel in 1 surgical session. Riboflavin is not applied in the form of eyedrops onto a corneal surface after epithelial removal but is instilled into the corneal pocket without the need for epithelial debridement. A case of advanced keratoconus treated in this manner is presented. Uncorrected visual acuity increased by 7 lines from 0.05 to 0.25, and the average central K reading decreased by 11 diopters. The haze seen during the early postoperative period diminished in the first month after surgery.

  16. Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds

    PubMed Central

    Herrington, Mark T; Swenor, Karen M; Eron, Lawrence J

    2011-01-01

    The growth and aging of the population of Hawai‘i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds. PMID:22162609

  17. Use of maggot debridement therapy for tropical diabetic hand syndrome.

    PubMed

    Jiang, K C; Luo, N; Chen, Y C; Wang, A P

    2013-05-01

    Diabetic patients with infectious hand ulceration, known as tropical diabetic hand syndrome (TDHS), are generally less well recognised than those with foot ulcers. Maggot debridement therapy (MDT) is usually used for the treatment of diabetic foot ulcers and, in these wounds, the remarkable wound cleansing properties can be of considerable value. However, it is less commonly used in TDHS. Here we present a case of TDHS in a 51-year-old man with type II diabetes, hypertension and dilated cardiomyopathy, in which conventional therapy had minimal effect, but significant wound debridement was achieved with MDT. This suggests that MDT may be a cost-effective alternative to conventional treatments for the debridement of TDHS.

  18. A review of maggot debridement therapy to treat chronic wounds.

    PubMed

    Hall, Sarah

    This literature review aims to clarify whether using maggot debridement therapy (MDT) for the removal of devitalized and infected tissue in chronic wounds is a valuable tool for healing. To undertake a literature review, the British Nursing Index, Ovid-Medline and the CINAHL databases were searched from January 1960 to June 2010 using the following terms: maggot debridement therapy, chronic wounds, granulation, infection, and cost-effective. The evidence suggests that MDT is more effective than other methods of debridement for wound bed preparation, although it has not been proven to eliminate problems associated with recurrent infections. This therapy has also not been proven to accelerate the healing process; however, more research needs to be undertaken into this and the cost-effectiveness of treatment.

  19. Maggot debridement therapy in the treatment of complex diabetic wounds.

    PubMed

    Marineau, Michelle L; Herrington, Mark T; Swenor, Karen M; Eron, Lawrence J

    2011-06-01

    The growth and aging of the population of Hawai'i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds.

  20. Secondary omental and pectoralis major double flap reconstruction following aggressive sternectomy for deep sternal wound infections after cardiac surgery

    PubMed Central

    2011-01-01

    Background Deep sternal wound infection after cardiac surgery carries high morbidity and mortality. Our strategy for deep sternal wound infection is aggressive strenal debridement followed by vacuum-assisted closure (VAC) therapy and omental-muscle flap reconstrucion. We describe this strategy and examine the outcome and long-term quality of life (QOL) it achieves. Methods We retrospectively examined 16 patients treated for deep sternal wound infection between 2001 and 2007. The most recent nine patients were treated with total sternal resection followed by VAC therapy and secondary closure with omental-muscle flap reconstruction (recent group); whereas the former seven patients were treated with sternal preservation if possible, without VAC therapy, and four of these patients underwent primary closure (former group). We assessed long-term quality of life after DSWI by using the Short Form 36-Item Health Survey, Version 2 (SF36v2). Results One patient died and four required further surgery for recurrence of deep sternal wound infection in the former group. The duration of treatment for deep sternal wound infection in the recent group was significantly shorter than that in previous group (63.4 ± 54.1 days vs. 120.0 ± 31.8 days, respectively; p = 0.039). Despite aggressive sternal resection, the QOL of patients treated for DSWI was only minimally compromised compared with age-, sex-, surgical procedures-matched patients without deep sternal wound infection. Conclusions Aggressive sternal debridement followed by VAC therapy and secondary closure with an omental-muscle flap is effective for deep sternal wound infection. In this series, it resulted in a lower incidence of recurrent infection, shorter hospitalization, and it did not compromise long-term QOL greatly. PMID:21501461

  1. Debridement Techniques in Pediatric Trauma and Burn-Related Wounds

    PubMed Central

    Block, Lisa; King, Timothy W.; Gosain, Ankush

    2015-01-01

    Significance: Traumatic injuries are the leading cause of morbidity and mortality in children. The purpose of this review is to provide an overview of the initial assessment and management of traumatic and burn wounds in children. Special attention is given to wound cleansing, debridement techniques, and considerations for pain management and psychosocial support for children and families. Recent Advances: Basic and translational research over the last 5–7 years has advanced our knowledge related to the optimal care of acute pediatric traumatic and burn wounds. Data concerning methods, volume, solution and timing for irrigation of acute traumatic wounds, timing and methods of wound debridement, including hydrosurgery and plasma knife coblation, and wound dressings are presented. Additionally, data concerning the long-term psychosocial outcomes following acute injury are presented. Critical Issues: The care of pediatric trauma and burn-related wounds requires prompt assessment, pain control, cleansing, debridement, application of appropriate dressings, and close follow-up. Ideally, a knowledgeable multidisciplinary team cares for these patients. A limitation in the care of these patients is the relative paucity of data specific to the care of acute traumatic wounds in the pediatric population. Future Directions: Research is ongoing in the arenas of new debridement techniques and instruments, and in wound dressing technology. Dedicated research on these topics in the pediatric population will serve to strengthen and advance the care of pediatric patients with acute traumatic and burn wounds. PMID:26487978

  2. Regular debridement is the main tool for maintaining a healthy wound bed in most chronic wounds.

    PubMed

    Wolcott, R D; Kennedy, J P; Dowd, S E

    2009-02-01

    Sharp debridement is the most clinically and cost-effective way of physically removing and suppressing a biofilm. Continued debridement, as part of a multifaceted treatment strategy, will keep the biofilm in a weakened state.

  3. Increase in skin perfusion pressure after maggot debridement therapy for critical limb ischaemia.

    PubMed

    Maeda, T M; Kimura, C K; Takahashi, K T; Ichimura, K I

    2014-12-01

    Skin perfusion pressure (SPP) is the perfusion pressure at the skin level, and it can serve as an index of peripheral circulation in the skin and subcutaneous tissue. We report a 78-year-old man with critical limb ischaemia who, despite having undergone several catheter interventions, still had severe ulcers with exposed bone on his right foot. We performed transmetatarsal amputation. The tissue around the surgical site became necrotic several days later, and did not respond to conservative therapy. Therefore, we opted for maggot debridement therapy (MDT), given that maggots favour necrotic tissue. After the therapy, SPP around the ulcer increased from 12 to 54 mmHg on the dorsal aspect, and from 17 to 44 mmHg on the plantar aspect. Wound healing was successfully activated by MDT, leading to complete healing within 2.5 months after MDT. We believe that MDT probably contributed to increase the blood supply to the ischaemic wound.

  4. Signaling aggression.

    PubMed

    van Staaden, Moira J; Searcy, William A; Hanlon, Roger T

    2011-01-01

    From psychological and sociological standpoints, aggression is regarded as intentional behavior aimed at inflicting pain and manifested by hostility and attacking behaviors. In contrast, biologists define aggression as behavior associated with attack or escalation toward attack, omitting any stipulation about intentions and goals. Certain animal signals are strongly associated with escalation toward attack and have the same function as physical attack in intimidating opponents and winning contests, and ethologists therefore consider them an integral part of aggressive behavior. Aggressive signals have been molded by evolution to make them ever more effective in mediating interactions between the contestants. Early theoretical analyses of aggressive signaling suggested that signals could never be honest about fighting ability or aggressive intentions because weak individuals would exaggerate such signals whenever they were effective in influencing the behavior of opponents. More recent game theory models, however, demonstrate that given the right costs and constraints, aggressive signals are both reliable about strength and intentions and effective in influencing contest outcomes. Here, we review the role of signaling in lieu of physical violence, considering threat displays from an ethological perspective as an adaptive outcome of evolutionary selection pressures. Fighting prowess is conveyed by performance signals whose production is constrained by physical ability and thus limited to just some individuals, whereas aggressive intent is encoded in strategic signals that all signalers are able to produce. We illustrate recent advances in the study of aggressive signaling with case studies of charismatic taxa that employ a range of sensory modalities, viz. visual and chemical signaling in cephalopod behavior, and indicators of aggressive intent in the territorial calls of songbirds.

  5. Localized Aggressive Periodontitis Treatment Response in Primary and Permanent Dentitions

    PubMed Central

    MERCHANT, SHERIN. N.; VOVK, ANDREA.; KALASH, DANNY.; HOVENCAMP, NICOLE; AUKHIL, IKRAMUDDIN.; HARRISON, PETER; ZAPERT, EDWARD; BIDWELL, JOHN; VARNADO, PHYLLIS; SHADDOX, LUCIANA. M.

    2014-01-01

    Background The comparative treatment response of children and young adults with localized aggressive periodontitis (LAP) affecting primary and permanent dentition is unknown. The objective of this study was to evaluate the influence of non-surgical periodontal therapy with adjunctive systemic antibiotics on the clinical outcome of children/young adults with primary versus permanent dentition affected by LAP. Methods A cohort of 97 African-American participants between the ages of 5–21 (30M; 66F; 22 primary and 75 permanent dentition affected), diagnosed with LAP were included. Patients presented with no significant medical history. All patients underwent periodontal therapy, which consisted of full mouth mechanical debridement at baseline, 3, 6, and 12 month appointments. Additionally, all patients were prescribed a one-week regimen of systemic antibiotics at the initial appointment. Clinical parameters were analyzed, including probing depth (PD), clinical attachment levels (CAL), bleeding on probing (BOP) and percentage of visible plaque. Results Overall, periodontal therapy was found to be effective in improving the clinical outcomes of both primary and permanent dentitions. Although baseline CAL were similar between the groups, the reductions in mean CAL at 3, 6 and 12 months as well as reduction in % Plaque at 3 months were significantly greater in primary dentition as compared to permanent dentition. Conclusions Non-surgical therapy with systemic antibiotics is effective for LAP in both primary and permanent dentitions. A greater reduction in CAL in LAP of primary dentition may suggest that younger children may carry a greater propensity for positive treatment outcomes and healing potential as compared to children/young adults with permanent dentition. PMID:25186780

  6. Infected forearm nonunion treated by bone transport after debridement

    PubMed Central

    2013-01-01

    Background This is a therapeutic study to evaluate the results of the management of forearm infected nonunion using bone transport with external fixators after debridement. Methods We have retrospectively reviewed a consecutive series of 21 patients from October 1994 to June 2010 in our institution who were treated for the forearm infected nonunion by bone transport with external fixator after debridement. There were 12 males and 9 females. The mean age of the patients was 27.1 years. Of the initial fractures, nonunion of the radius alone invovled in 7 patients, nonunion of the ulna alone invovled in 12, and nonunion of the radius and ulna invovled in 2. Nineteen limbs (85.7%) were in active infected state with sinus and drainage. The mean amount of bone defect was 3.1 cm (range 1.8-4.6 cm) as measured on plain radiographs. Results The mean follow-up was 77.5 months. All patients achieved bony union and were satisfied with the functional and cosmetic outcome. All the infection had been controlled. The mean external fixation index was 42.5 day/cm. The average time for wound healing was 42 days. The mean length gained was 3.5 cm (2.1-5.3 cm). Conclusions The technique of bone transport after debridement is a safe, effective, and minimally invasive treatment for forearm infected nonunion. PMID:24053582

  7. Maggot debridement therapy in modern army medicine: perceptions and prevalence.

    PubMed

    Heitkamp, Rae A; Peck, George W; Kirkup, Benjamin C

    2012-11-01

    Maggot debridement therapy (MDT), despite its long history and safety profile, finds limited use in the military health care system. Although new methods are continually being investigated to debride wounds more quickly and effectively, MDT remains largely a therapy of last resort. We evaluated the frequency of MDT in the Army sector of the MHS and the decision-making process surrounding its use. A 22 question survey of Army physicians was prepared and distributed through select Medical Corps Consultants in specialties likely to practice debridement. 83% of respondents were familiar with MDT, and of those familiar, 63% were aware of FDA approval for the product and 10% had used the product themselves. The three most frequently cited reasons for not using the therapy were no need (52%), no access (23%), and insufficient experience (19%). Informing the 37% of physicians who are not aware of FDA approval is an obvious target for program improvement. However, as many do not find a need for MDT, targeted improvements to MDT access and education for those physicians who encounter indications for MDT would permit them to apply MDT where there is an unmet need.

  8. Success of Debridement and Implant Retention in Periprosthetic Joint Infection – Does the Surgeon Matter?

    PubMed Central

    Young, Simon W; Zhu, Mark; Ravi, Saiprasad; Luey, Chris

    2016-01-01

    Objective: Prosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty (TJA). In acute haematogenous and early post-operative PJI, debridement and implant retention (DAIR) surgery is often the initial treatment and success rates vary. This study aimed to identify factors affecting success rates of DAIR and in particular whether involvement of a lower limb arthroplasty surgeon can affect outcome. Method: This retrospective review included one hundred and sixty-two patients undergoing DAIR for first-episode PJI following hip and knee arthroplasty at one of three tertiary hospitals. Treatment success was defined as no relapse within two years of DAIR. Data on patient, hospital, and surgical factors were identified including duration of symptoms, time from primary, previous revisions, age of prosthesis, bacterial subtype, whether modular component exchange was performed and whether an arthroplasty surgeon performed the procedure. Adjusted multivariate analysis was performed to identify factors associated with success of the DAIR procedure. Results: Overall success rate of DAIR in both hip and knee arthroplasty was 60%. A specialist arthroplasty surgeon was present in 42% of cases. Arthroplasty surgeons performed modular exchange in 51% of cases compared to 32.5% for other surgeons. Inclusion of modular exchange in the procedure was the only factor associated with DAIR success (OR 3.1, p<0.013). Time to theatre of less than 24 hours (OR 0.59), duration of symptoms less than one week (OR 1.28), age of prosthesis less than 3 months (OR 1.47) and having an arthroplasty surgeon perform DAIR (OR 1.6) did not lead to statistically significant improvements in success rate. Conclusions: Modular exchange was associated with a significantly higher success rate for both hip and knee PJI, suggesting thorough debridement is important in DAIR. Arthroplasty surgeons were more likely to perform modular exchange, but their presence in theatre alone

  9. Negative Pressure Wound Therapy With Instillation (NPWTi) Better Reduces Post-debridement Bioburden in Chronically Infected Lower Extremity Wounds Than NPWT Alone

    PubMed Central

    Goss, S.G.; Schwartz, J.A.; Facchin, F.; Avdagic, E.; Gendics, C.; Lantis, J.C.

    2014-01-01

    Objective An overabundance of bacteria in the chronic wound plays a significant role in the decreased ability for primary closure. One means of decreasing the bioburden in a wound is to operatively debride the wound for wound bed optimization prior to application of other therapy, such as Negative Pressure Wound Therapy (NPWT). We undertook a prospective pilot study to assess the efficacy of wound bed preparation for a standard algorithm (sharp surgical debridement followed by NPWT) versus one employing sharp surgical debridement followed by Negative Pressure Wound Therapy with Instillation (NPWTi). Methods Thirteen patients, corresponding to 16 chronic lower leg and foot wounds were taken to the operating room for debridement. The patients were sequentially enrolled in 2 treatment groups: the first receiving treatment with operative debridement followed by 1 week of NPWT with the instillation of quarter strength bleach solution; the other receiving a standard algorithm consisting of operative debridement and 1 week of NPWT. Quantitative cultures were taken pre-operatively after sterile preparation and draping of the wound site (POD # 0, pre-op), post-operatively once debridement was completed (POD # 0, post-op), and on post-operative day 7 after operative debridement (POD # 7, post-op). Results After operative debridement (post-operative day 0) there was a mean of 3 (±1) types of bacteria per wound. The mean CFU/gram tissue culture was statistically greater – 3.7 × 106 (±4 × 106) in the NPWTi group, while in the standard group (NPWT) the mean was 1.8 × 106 (±2.36 × 106) CFU/gram tissue culture (p = 0.016); at the end of therapy there was no statistical difference between the two groups (p = 0.44). Wounds treated with NPWTi had a mean of 2.6 × 105 (±3 × 105) CFU/gram of tissue culture while wounds treated with NPWT had a mean of 2.79 × 106 (±3.18 × 106) CFU/gram of tissue culture (p = 0.43). The mean absolute reduction in

  10. [Application of a hydrosurgery system in debridement of various types of burn wounds].

    PubMed

    Li, M Y; Mao, Y G; Guo, G H; Liu, D W

    2016-09-20

    Burn wound healing is closely associated with the depth of wound and early debridement. The traditional ways of debridement have certain limitations and often result in poor appearance and function of repaired area. At present, the hydrosurgery system has been applied clinically in burn field. This paper summarizes advantages and disadvantages of application of the hydrosurgery system in debridement of burn wound with different depths, different periods, extraordinary region, and uncommon agent. PMID:27647076

  11. Understanding Aggression.

    ERIC Educational Resources Information Center

    Scott, J. P.

    Research in many fields of the social and biological sciences indicates that there are ecological, cultural, social, psychological, physiological, and genetic causes of aggression. The agonistic behavior system, which adapts to situations of social conflict, includes several patterns of conduct ranging from overt fighting to complete passivity. In…

  12. Laser treatment as an adjunct to debridement of periodontal pockets.

    PubMed

    Sjöström, Lars; Friskopp, Johan

    2002-01-01

    The aim of the study was to investigate 1) whether laser treatment would enhance periodontal healing after debridement, 2) if laser treatment would facilitate instrumentation, and 3) if laser treatment would provide sufficient analgesia. The used apparatus produced radiation equivalent to a Nd:YAG-laser and was equipped with a water spray. 27 individuals with periodontitis took part in the study. Single-rooted teeth in one quadrant were assigned test teeth by lot with contralateral teeth serving as controls. Test areas were first laser irradiated to produce analgesia. The root surfaces were treated with the laser set at higher power and scaled with curettes followed by lasing again. Control areas were treated by scaling alone. Reduction of PPD and bleeding index after healing were similar in test and control areas. Laser treatment reduced the need of conventional anaesthetics, resulted in diminished bleeding and enhanced visual control at debridement. Thin calculus deposits were very easy to remove with hand instruments after lasing. The hemostatic effect of the laser may be an asset when performing periodontal scaling in individuals with a compromised coagulation mechanism. PMID:12462872

  13. Results of arthroscopic debridement of glenoid labral tears.

    PubMed

    Martin, D R; Garth, W P

    1995-01-01

    We studied the long-term results of a prospectively selected group of 24 patients with 12 anteroinferior and 12 posterior glenoid labral lesions; all patients had functional instability but none had ligamentous detachment. After arthroscopic debridement, patients involved in throwing sports were not allowed to return to full athletic activity until full strength of the external rotators was achieved and documented on isokinetic evaluation. Followup was 36 to 72 months with an average of 48 months. Follow-up isokinetic evaluation revealed an average +4.4% and +8.6% concentric strength and -4.3% and -0.4% eccentric strength of the operated shoulder compared with the uninvolved shoulder at 90 and 180 deg/sec, respectively. Long-term good or excellent results were achieved in 21 patients, and 16 were functioning at their preinjury level of sports activities. Sixty-two percent of baseball pitchers were unimpaired in pitching. The average University of California Los Angeles shoulder rating score was 31 of 35 (11 excellent, 10 good, and 3 poor) and the average Rowe-Zarins ratings scale was 85 of 100 (8 excellent, 13 good, and 3 poor). These results justify an initial arthroscopic debridement of anteroinferior or posterior labral flap tears rather than capsulorrhaphy when there is no gross instability or Bankart lesion.

  14. [Aggressive fibromatoses in orthopedics].

    PubMed

    Adler, C P; Stock, D

    1986-01-01

    Aggressive fibromatoses which may develop either in soft tissue or in the bone present considerable problems for the pathologist trying to establish a diagnosis as well as for the radiologist and surgeon. In radiographs, a destruction of the soft and osseous tissue is seen which suggests a malignant tumor. Histologically a monomorphic connective tissue prevails in the biopsy showing no essential signs of malignancy. Under pathoanatomical aspects often a benign proliferation of the connective tissue is assumed. Surgically the tumor may either be removed in a too radical and mutilating way, or the excision may remain incomplete. Two cases of desmoplastic bone fibroma (aggressive fibromatosis in the ulna and in the sacrum) are described in which the complete tumor removal led to healing, whereas the incomplete excision of the tumor resulted in recurrences. Aggressive fibromatosis represents a semimalignant tumor which has a locally destructive and invasive growth tendency but does not metastasize. The various fibromatoses are defined with regard to their biological growth tendency and the therapeutic consequences are discussed.

  15. Excimer laser debridement of necrotic erosions of skin without collateral damage

    NASA Astrophysics Data System (ADS)

    Wynne, James J.; Felsenstein, Jerome M.; Trzcinski, Robert; Zupanski-Nielsen, Donna; Connors, Daniel P.

    2011-07-01

    Pulsed ArF excimer laser radiation at 6.4 eV, at fluence exceeding the ablation threshold, will debride burn eschar and other dry necrotic erosions of the skin. Debridement will cease when sufficiently moist viable tissue is exposed, due to absorption by aqueous chloride ions (Cl-) through the non-thermal process of electron photodetachment, thereby inhibiting collateral damage to the viable tissue. ArF excimer laser radiation debrides/ablates ~1 micron of tissue with each pulse. While this provides great precision in controlling the depth of debridement, the process is relatively time-consuming. In contrast, XeCl excimer laser radiation debrides ~8 microns of tissue with each pulse. However the 4.0 eV photon energy of the XeCl excimer laser is insufficient to photodetach an electron from a Cl- ion, so blood or saline will not inhibit debridement. Consequently, a practical laser debridement system should incorporate both lasers, used in sequence. First, the XeCl excimer laser would be used for accelerated debridement. When the necrotic tissue is thinned to a predetermined thickness, the ArF excimer laser would be used for very precise and well-controlled debridement, removing ultra-thin layers of material with each pulse. Clearly, the use of the ArF laser is very desirable when debriding very close to the interface between necrotic tissue and viable tissue, where the overall speed of debridement need not be so rapid and collateral damage to viable tissue is undesirable. Such tissue will be sterile and ready for further treatment, such as a wound dressing and/or a skin graft.

  16. Holmium laser use in debridement of stable labral lesions: two-year experience in initial 50 patients

    NASA Astrophysics Data System (ADS)

    Dew, Douglas K.; Risch, E. David

    1994-09-01

    The purpose of this study is to determine the laser related complication rate for shoulder arthroscopy in the initial clinical experience of 50 patients, and to identify potential advantages of laser use in shoulder arthroscopy. Fifty patients spanning ages 25 to 87 were treated. Surgical debridement was selective and conservative creating a smooth post resection rim. In those that included rotator cuff tears, in addition to arthroscopic debridement, a mini arthrotomy and open acromioplasty were performed. Changes in arthroscopic technique due to laser use included no arthroscopic pump use and use of the shaver only when the fiber could not be easily seen with severe synovitis. We found that the hyper-vascular synovium did not need to be resected last, it could be resected at any point during the procedure. Four hundred and 600 micron fiberoptics were used as well as 20 watts average power. Technical advantage of the laser was felt to be the size of the instrument probe and the availability of excellent hemostasis. Complications include one case of arthroscope damage and one case with a broken fiber tip which was removed with a grasper. Long term follow up of these patients is now underway.

  17. Arthroscopic debridement and irrigation of periprosthetic total elbow infection.

    PubMed

    Mastrokalos, Dimitrios S; Zahos, Konstantinos A; Korres, Dimitrios; Soucacos, Panayotis N

    2006-10-01

    We report on a case of arthroscopic treatment of septic arthritis of the elbow joint in a 65-year-old man with an elbow endoprosthesis. Two months after arthroplasty of the elbow joint, the patient developed acute septic arthritis of the right elbow. Methicillin-sensitive Staphylococcus aureus was identified as the causative organism. Six days after the onset of symptoms, the patient was treated with a single arthroscopic procedure of the infected periprosthetic joint, including irrigation with 5 L of Ringer's lactate solution, debridement, and partial synovectomy with a 4.5-mm curved shaver. Intravenous antibiotic therapy was also used for 3 months including rifampicine and fucidic acid according to the intraoperative cultures. The acutely infected total elbow arthroplasty could be cured without removal of the endoprosthesis of the elbow. Ten months postoperatively, the patient remains free of symptoms and his blood rates are within normal limits.

  18. The Surgical Treatment of Mycetoma

    PubMed Central

    Suleiman, Suleiman Hussein; Wadaella, EL Sammani; Fahal, Ahmed Hassan

    2016-01-01

    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors’ experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan. PMID:27336736

  19. Identification and Characterization of Novel Matrix-Derived Bioactive Peptides: A Role for Collagenase from Santyl® Ointment in Post-Debridement Wound Healing?

    PubMed

    Sheets, Anthony R; Demidova-Rice, Tatiana N; Shi, Lei; Ronfard, Vincent; Grover, Komel V; Herman, Ira M

    2016-01-01

    Debridement, the removal of diseased, nonviable tissue, is critical for clinicians to readily assess wound status and prepare the wound bed for advanced therapeutics or downstream active healing. Removing necrotic slough and eschar through surgical or mechanical methods is less specific and may be painful for patients. Enzymatic debridement agents, such as Clostridial collagenase, selectively and painlessly degrade devitalized tissue. In addition to its debriding activities, highly-purified Clostridial collagenase actively promotes healing, and our past studies reveal that extracellular matrices digested with this enzyme yield peptides that activate cellular migratory, proliferative and angiogenic responses to injury in vitro, and promote wound closure in vivo. Intriguingly, while collagenase Santyl® ointment, a sterile preparation containing Clostridial collagenases and other non-specific proteases, is a well-accepted enzymatic debridement agent, its role as an active healing entity has never been established. Based on our previous studies of pure Clostridial collagenase, we now ask whether the mixture of enzymes contained within Santyl® produces matrix-derived peptides that promote cellular injury responses in vitro and stimulate wound closure in vivo. Here, we identify novel collagen fragments, along with collagen-associated peptides derived from thrombospondin-1, multimerin-1, fibronectin, TGFβ-induced protein ig-h3 and tenascin-C, generated from Santyl® collagenase-digested human dermal capillary endothelial and fibroblastic matrices, which increase cell proliferation and angiogenic remodeling in vitro by 50-100% over controls. Using an established model of impaired healing, we further demonstrate a specific dose of collagenase from Santyl® ointment, as well as the newly-identified and chemically-synthesized ECM-derived peptides significantly increase wound re-epithelialization by 60-100% over saline-treated controls. These results not only confirm and

  20. Identification and Characterization of Novel Matrix-Derived Bioactive Peptides: A Role for Collagenase from Santyl® Ointment in Post-Debridement Wound Healing?

    PubMed Central

    Shi, Lei; Ronfard, Vincent; Grover, Komel V.; Herman, Ira M.

    2016-01-01

    Debridement, the removal of diseased, nonviable tissue, is critical for clinicians to readily assess wound status and prepare the wound bed for advanced therapeutics or downstream active healing. Removing necrotic slough and eschar through surgical or mechanical methods is less specific and may be painful for patients. Enzymatic debridement agents, such as Clostridial collagenase, selectively and painlessly degrade devitalized tissue. In addition to its debriding activities, highly-purified Clostridial collagenase actively promotes healing, and our past studies reveal that extracellular matrices digested with this enzyme yield peptides that activate cellular migratory, proliferative and angiogenic responses to injury in vitro, and promote wound closure in vivo. Intriguingly, while collagenase Santyl® ointment, a sterile preparation containing Clostridial collagenases and other non-specific proteases, is a well-accepted enzymatic debridement agent, its role as an active healing entity has never been established. Based on our previous studies of pure Clostridial collagenase, we now ask whether the mixture of enzymes contained within Santyl® produces matrix-derived peptides that promote cellular injury responses in vitro and stimulate wound closure in vivo. Here, we identify novel collagen fragments, along with collagen-associated peptides derived from thrombospondin-1, multimerin-1, fibronectin, TGFβ-induced protein ig-h3 and tenascin-C, generated from Santyl® collagenase-digested human dermal capillary endothelial and fibroblastic matrices, which increase cell proliferation and angiogenic remodeling in vitro by 50–100% over controls. Using an established model of impaired healing, we further demonstrate a specific dose of collagenase from Santyl® ointment, as well as the newly-identified and chemically-synthesized ECM-derived peptides significantly increase wound re-epithelialization by 60–100% over saline-treated controls. These results not only confirm

  1. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  2. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Technique and Prospective Study of 46 Consecutive Patients.

    PubMed

    Cottom, James M; Maker, Jared M; Richardson, Phillip; Baker, Joseph S

    2016-01-01

    Plantar fasciitis is one the most common pathologies treated by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention might be warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. Comorbidities associated with the release of the plantar fascia have been documented, including lateral column overload and metatarsalgia. We present an innovative technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of the fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia with or without heel spur resection would provide a minimally invasive technique with acceptable patient outcomes.

  3. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Technique and Prospective Study of 46 Consecutive Patients.

    PubMed

    Cottom, James M; Maker, Jared M; Richardson, Phillip; Baker, Joseph S

    2016-01-01

    Plantar fasciitis is one the most common pathologies treated by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention might be warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. Comorbidities associated with the release of the plantar fascia have been documented, including lateral column overload and metatarsalgia. We present an innovative technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of the fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia with or without heel spur resection would provide a minimally invasive technique with acceptable patient outcomes. PMID:27066869

  4. Comparing the hydrosurgery system to conventional debridement techniques for the treatment of delayed healing wounds: a prospective, randomised clinical trial to investigate clinical efficacy and cost-effectiveness.

    PubMed

    Liu, Jing; Ko, Jason H; Secretov, Erwin; Huang, Eric; Chukwu, Christiana; West, Julie; Piserchia, Katherine; Galiano, Robert D

    2015-08-01

    In these uncertain times of high health care costs, clinicians are looking for cost-effective devices to employ in their everyday practices. In an effort to promote cost-effective and proper wound repair, the hydrosurgical device allows accurate debridement of only unwanted tissue while precisely conserving viable structures for eventual repair. This prospective, randomised study compared procedures using the hydrosurgery system (VERSAJET™) with conventional debridement in order to assess clinical efficacy and cost-effectiveness when treating subjects with chronic wounds. A total of 40 subjects were recruited. There was no difference in time to achieve stable wound closure between the treatment groups (P = 0·77). There were no significant differences between the two groups in terms of cost of the first operative procedure (P = 0·28), cost of surgical procedures during the study (P = 0·51), cost of study treatment (P = 0·29) or cost to achieve stable wound closure (P = 0·85). There were no differences in quantitative bacterial counts after debridement with either methods (P = 0·376). However, the time taken for the first excision procedure was significantly faster using the hydrosurgery system (VERSAJET) when compared with conventional debridement (P < 0·001). The total excision time for all procedures was significantly less for the Hydrosurgery group than for the conventional group (P = 0·005). Also, the Hydrosurgery group demonstrated significantly less intraoperative blood loss than conventional group for all procedures (P = 0·003). In this study, although there were no differences in time to stable wound closure or bacterial reduction between the two groups, the hydrosurgery system (VERSAJET) did offer advantages in terms of operative times and intraoperative blood loss and was cost-neutral, despite the handpiece cost.

  5. CONCEPT ANALYSIS: AGGRESSION

    PubMed Central

    Liu, Jianghong

    2006-01-01

    The concept of aggression is important to nursing because further knowledge of aggression can help generate a better theoretical model to drive more effective intervention and prevention approaches. This paper outlines a conceptual analysis of aggression. First, the different forms of aggression are reviewed, including the clinical classification and the stimulus-based classification. Then the manifestations and measurement of aggression are described. Finally, the causes and consequences of aggression are outlined. It is argued that a better understanding of aggression and the causal factors underlying it are essential for learning how to prevent negative aggression in the future. PMID:15371137

  6. Bacteria aerosol spread and wound bacteria reduction with different methods for wound debridement in an animal model.

    PubMed

    Sönnergren, Henrik H; Polesie, Sam; Strömbeck, Louise; Aldenborg, Frank; Johansson, Bengt R; Faergemann, Jan

    2015-03-01

    Debridement is essential in wound treatment to remove necrotic tissue and wound bacteria but may lead to bacteria spread by aerosolization. This study investigated the wound bacterial reduction and bacterial transmission induced by debridement using curette, plasma-mediated bipolar radiofrequency ablation (Coblation®) or hydrodebridement (Versajet®). Full thickness dermal wounds in porcine joint specimens inoculated with S. aureus were debrided with curette, Coblation, Versajet, or were left untreated. During and after debridement, aerosolized bacteria were measured and to assess wound bacterial load, quantitative swab samples were taken from each wound. Only Coblation was able to reduce the bacterial load of the wound significantly. Versajet debridement resulted in a significant bacterial aerosolization, but this was not the case with Coblation and curette debridement. This study shows that Coblation is a promising wound debridement method, which effectively reduces the wound bed bacterial load without the risk of bacterial aerosolization.

  7. Prevention of post-operative infections after surgical treatment of bite wounds

    PubMed Central

    Kramer, Axel; Assadian, Ojan; Frank, Matthias; Bender, Claudia; Hinz, Peter

    2010-01-01

    After reviewing the literature about the microbial spectrum, the risk factors of post-operative infections, and the results of surgical interventions, the following recommendation can be made for the management of bite wounds: fresh, open wounds: surgical debridement, if appropriate, then an antiseptic lavage with a fluid consisting of povidone iodine and ethanol (e.g., Betaseptic®), no antibiotics, primary wound closure nearly closed fresh wounds (e.g., cat bites): surgical debridement, if appropriate, dressing with an antiseptic-soaked compress for ~60 minutes with repeated soaking (e.g., Betaseptic®), no antibiotics older wounds after ~4 hours: surgical debridement, if appropriate, dressing with an antiseptic-soaked compress or bandage for ~60 minutes with repeated soaking (e.g., Betaseptic®), at the same time intravenous or dose-adapted oral antibiotics (Amoxicillin and/or clavulanic acid) older wounds after ~24 hours: surgical debridement, then antiseptic lavage (Betaseptic®), in case of clinically apparent infection or inflammation surgical revision with opening of wound and treatment with antibiotics according to resistogram (empirical start with Amoxicillin and/or clavulanic acid). For each kind of bite wound, the patient’s tetanus immunization status as well as the risk of exposure to rabies have to be assessed. Similarly, the possibility of other infections, such as lues (Syphilis), hepatitis B (HBV), hepatitis C (HBC), hepatitis D (HDV) and HIV, in the rare case of a human bite wound, has to be taken into account. PMID:20941334

  8. Management of large aggressive nonfunctional pituitary tumors: experimental medical options when surgery and radiation fail.

    PubMed

    Miller, Brandon A; Rutledge, W Caleb; Ioachimescu, Adriana G; Oyesiku, Nelson M

    2012-10-01

    Pituitary adenomas are generally considered benign tumors; however, a subset of these tumors displays aggressive behavior and are not easily cured. The protocol for nonsurgical treatment of aggressive pituitary lesions is less standardized than that of other central nervous system tumors. Aggressive surgical treatment, radiation, dopamine agonists, antiangiogenic drugs, and other chemotherapeutics all have roles in the treatment of aggressive pituitary tumors. More studies are needed to improve outcomes for patients with aggressive pituitary tumors.

  9. Single-Stage Anterior Debridement and Fibular Allograft Implantation Followed by Posterior Instrumentation for Complicated Infectious Spondylitis

    PubMed Central

    Chung, Tzu-Chun; Yang, Shih-Chieh; Chen, Hung-Shu; Kao, Yu-Hsien; Tu, Yuan-Kun; Chen, Wen-Jer

    2014-01-01

    Abstract Complicated infectious spondylitis is an infrequent infection with severe spinal destruction, and is indicated for combined anterior and posterior surgeries. Staged debridement and subsequent reconstruction is advocated in the literature. The purpose of this study is to evaluate the feasibility and clinical outcome of patients who underwent single-stage combined anterior debridement and fibular allograft implantation followed by supplemental posterior fixation for complicated infectious spondylitis. We retrospectively reviewed the medical records of 20 patients who underwent single-stage combined anterior and posterior surgeries for complicated infectious spondylitis from January 2005 to December 2010. Complicated infectious spondylitis was defined as at least 1 vertebral osteomyelitis with pathological fracture or severe bony destruction and adjacent discitis, based on imaging studies. The severity of the neurological status was evaluated using the Frankel scale. The clinical outcomes were assessed by careful physical examination and regular serological tests to determine the visual analog scale (VAS) score and Macnab criteria. Correction of the sagittal Cobb angle on radiography was also compared before and after surgery. The Wilcoxon signed-rank test was used to analyze patient surgical prognosis and radiological findings. All patients with complicated infectious spondylitis were successfully treated by single-stage combined anterior and posterior surgeries. No patients experienced neurologic deterioration. The average VAS score was 7.8 before surgery and significantly decreased to 2.1 at discharge. Three patients had excellent outcomes and 17 had good outcomes, based on Macnab criteria. The average length of the allograft for reconstruction was 64.0 mm. Kyphotic deformity improved in all patients, with an average correction angle of 13.4°. There was no implant breakage or allograft dislodgement during at least 36 months of follow-up. Single

  10. [Acute therapeutic measures for limb salvage Part 2 : Debridement, lavage techniques and anti-infectious strategies].

    PubMed

    Willy, C; Stichling, M; Müller, M; Gatzer, R; Kramer, A; Back, D A; Vogt, D

    2016-05-01

    The quality of the primary care of Gustilo-Anderson (GA) type IIIB and IIIC extremity injuries is crucial to the success of the limb salvage procedure. This article provides a compilation of consistent, but often controversially discussed aspects of initial debridement, modern techniques of lavage and wound closure, in addition to current issues on the application of antibiotics and antiseptics, based on our own experiences and the latest literature. The following points should be stressed. Severe extremity injuries with gross contamination (GA IIIA, B, and C) will still be associated with an infection rate of up to 60 %. The initial debridement should be performed as soon as an experienced trauma surgeon is available. Tissue that is definitely avital will have to be removed, whereas traumatized but potentially surviving tissue will have to be re-evaluated during a second-look operation after 36-48 h. Given a high enough level of contamination, biofilms will form after as few as 6 h. The perioperative antibiotic prophylaxis has to be initiated early and should be continued for at least 24 h (GA I/II) or up to 5 days (GA III). In cases of bacterial contamination, wound irrigation will be useful with additives such as polyhexanide, octenidine or superoxidized water. Rinsing of the wound should be performed with 3-9 L and only slight manual pressure (no jet lavage). The definitive primary closure of a wound should be achieved in the initial operation, but only in the case of certain "decontamination" and overall vitality of the wound (GA I and II). In the presence of high-grade injuries, a temporary vacuum sealing technique can be used until the earliest possible definitive plastic surgical wound closure.

  11. Aggressive behavior problems.

    PubMed

    Beaver, B V

    1986-12-01

    Accurate diagnosis of the cause of aggression in horses is essential to determining the appropriate course of action. The affective forms of aggression include fear-induced, pain-induced, intermale, dominance, protective, maternal, learned, and redirected aggressions. Non-affective aggression includes play and sex-related forms. Irritable aggression and hypertestosteronism in mares are medical problems, whereas genetic factors, brain dysfunction, and self-mutilation are also concerns. PMID:3492250

  12. Surgical Adhesive Drape (IO-ban) as Postoperative Surgical Site Dressing

    PubMed Central

    Syed, Hasan R; Snyder, Rita; McGowan, Jason E; Jha, Ribhu T; Nair, Mani N

    2015-01-01

    Study Design: Retrospective chart analysis. Objective: The objective of this study is to describe the senior author’s (MNN) experience applying a widely available surgical drape as a postoperative sterile surgical site dressing for both cranial and spinal procedures. Summary of Background Data: Surgical site infection (SSI) is an important complication of spine surgery that can result in significant morbidity. There is wide variation in wound care management in practice, including dressing type. Given the known bactericidal properties of the surgical drape, there may be a benefit of continuing its use immediately postoperatively. Methods: All of the senior author’s cases from September 2014 through September 2015 were reviewed. These were contrasted to the previous year prior to the institution of a sterile surgical drape as a postoperative dressing. Results: Only one surgical case out of 157 operative interventions (35 cranial, 124 spinal) required operative debridement due to infection. From September 2013 to September 2014, prior to the institution of a sterile surgical drape as dressing, the author had five infections out of 143 operations (46 cranial, 97 spinal) requiring intervention. Conclusion: The implementation of a sterile surgical drape as a closed postoperative surgical site dressing has led to a decrease in surgical site infections. The technique is simple and widely available, and should be considered for use to diminish surgical site infections. PMID:26798570

  13. Post-surgical mediastinitis due to carbapenem-resistant Enterobacteriaceae: Clinical, epidemiological and survival characteristics.

    PubMed

    Abboud, C S; Monteiro, J; Stryjewski, M E; Zandonadi, E C; Barbosa, V; Dantas, D; Sousa, E E; Fonseca, M J; Jacobs, D M; Pignatari, A C; Kiffer, C; Rao, G G

    2016-05-01

    Invasive infections due to carbapenem-resistant Enterobacteriaceae (CRE), including polymyxin-resistant (PR-CRE) strains, are being increasingly reported. However, there is a lack of clinical data for several life-threatening infections. Here we describe a cohort of patients with post-surgical mediastinitis due to CRE, including PR-CRE. This study was a retrospective cohort design at a single cardiology centre. Patients with mediastinitis due to CRE were identified and were investigated for clinically relevant variables. Infecting isolates were studied using molecular techniques. Patients infected with polymyxin-susceptible CRE (PS-CRE) strains were compared with those infected with PR-CRE strains. In total, 33 patients with CRE mediastinitis were studied, including 15 patients (45%) with PR-CRE. The majority (61%) were previously colonised. All infecting isolates carried blaKPC genes. Baseline characteristics of patients with PR-CRE mediastinitis were comparable with those with PS-CRE mediastinitis. Of the patients studied, 70% received at least one agent considered active in vitro and most patients received at least three concomitant antibiotics. Carbapenem plus polymyxin B was the most common antibiotic combination (73%). Over 90% of patients underwent surgical debridement. Overall, in-hospital mortality was 33% and tended to be higher in patients infected with PR-CRE (17% vs. 53%; P=0.06). In conclusion, mediastinitis due to CRE, including PR-CRE, can become a significant challenge in centres with CRE and a high cardiac surgery volume. Despite complex antibiotic treatments and aggressive surgical procedures, these patients have a high mortality, particularly those infected with PR-CRE.

  14. Post-surgical mediastinitis due to carbapenem-resistant Enterobacteriaceae: Clinical, epidemiological and survival characteristics.

    PubMed

    Abboud, C S; Monteiro, J; Stryjewski, M E; Zandonadi, E C; Barbosa, V; Dantas, D; Sousa, E E; Fonseca, M J; Jacobs, D M; Pignatari, A C; Kiffer, C; Rao, G G

    2016-05-01

    Invasive infections due to carbapenem-resistant Enterobacteriaceae (CRE), including polymyxin-resistant (PR-CRE) strains, are being increasingly reported. However, there is a lack of clinical data for several life-threatening infections. Here we describe a cohort of patients with post-surgical mediastinitis due to CRE, including PR-CRE. This study was a retrospective cohort design at a single cardiology centre. Patients with mediastinitis due to CRE were identified and were investigated for clinically relevant variables. Infecting isolates were studied using molecular techniques. Patients infected with polymyxin-susceptible CRE (PS-CRE) strains were compared with those infected with PR-CRE strains. In total, 33 patients with CRE mediastinitis were studied, including 15 patients (45%) with PR-CRE. The majority (61%) were previously colonised. All infecting isolates carried blaKPC genes. Baseline characteristics of patients with PR-CRE mediastinitis were comparable with those with PS-CRE mediastinitis. Of the patients studied, 70% received at least one agent considered active in vitro and most patients received at least three concomitant antibiotics. Carbapenem plus polymyxin B was the most common antibiotic combination (73%). Over 90% of patients underwent surgical debridement. Overall, in-hospital mortality was 33% and tended to be higher in patients infected with PR-CRE (17% vs. 53%; P=0.06). In conclusion, mediastinitis due to CRE, including PR-CRE, can become a significant challenge in centres with CRE and a high cardiac surgery volume. Despite complex antibiotic treatments and aggressive surgical procedures, these patients have a high mortality, particularly those infected with PR-CRE. PMID:27155944

  15. Using a topical anaesthetic cream to reduce pain during sharp debridement of chronic leg ulcers.

    PubMed

    Rosenthal, D; Murphy, F; Gottschalk, R; Baxter, M; Lycka, B; Nevin, K

    2001-01-01

    This multicentre, double-blind, placebo-controlled, parallel-group study assessed the efficacy and safety of using Emla (lignocaine/prilocaine) anaesthetic cream to achieve pain control during sharp debridement of chronic leg ulcers of arterial, venous or arteriovenous aetiology. A total of 101 patients (51 Emla, 50 placebo), aged 29-99 years, who had experienced pain associated with previous debridement were included. Patients with an amide anaesthetic allergy, anaesthetic diabetic ulcers, or ulcers > 50 cm2 were excluded. Debridement was initiated approximately 30 minutes after the application of a thick layer of Emla or placebo cream to an ulcer occluded with a plastic wrap. The patient and investigator assessed the pain associated with debridement on a 100 mm visual analogue scale (VAS). The median patient VAS scores were 18 mm and 53.5 mm in the Emla and placebo groups, respectively (p < 0.0001). The corresponding investigator values in the two groups were 20 mm and 49.5 mm, respectively (p = 0.004). Local reactions were mainly transient and mild, and were observed in roughly the same percentage of placebo and Emla-treated patients. After a 30-minute application Emla cream significantly reduced the pain of debridement compared with the placebo. PMID:12964231

  16. Calcific myonecrosis of the leg treated by debridement and limited access dressing.

    PubMed

    Sreenivas, T; Nandish Kumar, K C; Menon, Jagdish; Nataraj, A R

    2013-03-01

    Calcific myonecrosis is a rare late complication of limb trauma characterized by liquefaction and dystrophic calcification of muscles in the single compartment, usually in the leg. This occurs many years after the trauma and is probably due to chronic compartment syndrome. We report 2 cases of calcific myonecrosis involving the anterior compartment of the leg that presented to us in an advanced stage of multiple sinuses discharging calcific material. Incision and drainage had been attempted at a local hospital prior to presentation at our hospital resulting in a non healing wound. Both patients had a history of antecedent trauma to the leg a few years ago. Patients were treated by thorough debridement of the involved muscles in the anterior compartment. Limited access dressing (LAD) was used to manage the dead space left after debridement. After application of the LAD, the wound was covered with split skin grafting. In both patients, healing of the cavity following debridement was facilitated by application of limited access dressing. While the wound completely healed, the disability due to extensive debridement of anterior compartment of the leg persisted. At the latest follow-up, the patients were asymptomatic without any recurrence. Thorough debridement of the compartment involved and application of LAD may be another option of treating calcific myonecrosis of the leg, which was initially considered a "do not touch" lesion. Morbidity due to surgery and need of repeated surgeries for recurrences should be kept in mind and regular follow-up should be considered. PMID:23446369

  17. Efficacy of different irrigation solutions on the early debridement of open fracture in rats

    PubMed Central

    CHENG, QIAN; ZHANG, XIAO-FEI; DI, DONG-HUA; ZHAO, GUO-YANG; CUI, XUE-WEN

    2015-01-01

    Contaminating bacteria are only found on wound surfaces in the initial stages of open fractures; therefore, effective debridement is critical for bacterial infection prevention and the reduction of inflammatory reactions. Various irrigation solutions are currently being used; however, a comprehensive study on their efficacy is lacking. In the present study, a comparison of the effects of normal saline, iodophor and hydrogen peroxide as the irrigation solutions for debridement of open femur fractures in rat models was conducted. It was revealed that all three solutions were comparably effective in bacterial removal while normal saline was superior in minimizing adverse wound inflammation; therefore, the use of normal saline for routine debridement is recommended in the early-stage treatment of open fractures in the trauma clinic and in relief fieldwork. PMID:26136863

  18. Medical and surgical treatment of chronic venous ulcers.

    PubMed

    Cooper, Michol A; Qazi, Umair; Bass, Eric; Zenilman, Jonathan; Lazarus, Gerald; Valle, M Frances; Malas, Mahmoud B

    2015-01-01

    Venous ulcer of the lower extremity is a common vascular condition and is associated with decreased quality of life, reduced mobility, and social isolation. Treatment of chronic venous ulcer (CVU) includes compression therapy, debridement of the ulcer when necessary, and wound care. Collagen and antimicrobial dressings can improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents can promote more rapid healing, particularly in patients with longstanding ulcers. Current vascular surgical practice is to eliminate documented reflux or obstruction in patients with CVU that have failed a 3-month period of compression dressing, debridement, and local wound care. We found that surgical treatment of the superficial venous system can decrease the time to healing of CVUs compared with compression therapy alone, but does not increase the proportion of ulcers healed. PMID:27113282

  19. Medical and surgical treatment of chronic venous ulcers.

    PubMed

    Cooper, Michol A; Qazi, Umair; Bass, Eric; Zenilman, Jonathan; Lazarus, Gerald; Valle, M Frances; Malas, Mahmoud B

    2015-01-01

    Venous ulcer of the lower extremity is a common vascular condition and is associated with decreased quality of life, reduced mobility, and social isolation. Treatment of chronic venous ulcer (CVU) includes compression therapy, debridement of the ulcer when necessary, and wound care. Collagen and antimicrobial dressings can improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents can promote more rapid healing, particularly in patients with longstanding ulcers. Current vascular surgical practice is to eliminate documented reflux or obstruction in patients with CVU that have failed a 3-month period of compression dressing, debridement, and local wound care. We found that surgical treatment of the superficial venous system can decrease the time to healing of CVUs compared with compression therapy alone, but does not increase the proportion of ulcers healed.

  20. Effective prevention of posttraumatic tattoo using hydrosurgical debridement in the ED.

    PubMed

    Park, Jung Soo; Min, Jin Hong

    2016-04-01

    Traumatic tattoos can result from the accidental deposition of foreign particles in the dermis. These pigmented particles can become permanently lodged in the dermis after wound re-epithelialization and lead to irregular black or blue skin discoloration. Different methods exist for tattoo removal. The best strategy is to prevent traumatic tattoo formation by immediately removing the foreign particles before the healing process begins. Here, we present a fine-tuned, hydrosurgical debridement system to selectively debride wounds and preserve as much viable tissue as possible. PMID:26482686

  1. Collateral damage-free debridement using 193nm ArF laser

    NASA Astrophysics Data System (ADS)

    Wynne, James J.; Felsenstein, Jerome M.; Trzcinski, Robert; Zupanski-Nielsen, Donna; Connors, Daniel P.

    2011-03-01

    Burn eschar and other necrotic areas of the skin and soft tissue are anhydrous compared to the underlying viable tissue. A 193 nm ArF excimer laser, emitting electromagnetic radiation at 6.4 eV at fluence exceeding the ablation threshold, will debride such necrotic areas. Because such radiation is strongly absorbed by aqueous chloride ions through the nonthermal process of electron photodetachment, debridement will cease when hydrated (with chloride ions) viable tissue is exposed, avoiding collateral damage to this tissue. Such tissue will be sterile and ready for further treatment, such as a wound dressing and/or a skin graft.

  2. Surgical smoke.

    PubMed

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown. PMID:19892630

  3. Relational aggression in marriage.

    PubMed

    Carroll, Jason S; Nelson, David A; Yorgason, Jeremy B; Harper, James M; Ashton, Ruth Hagmann; Jensen, Alexander C

    2010-01-01

    Drawing from developmental theories of relational aggression, this article reports on a study designed to identify if spouses use relationally aggressive tactics when dealing with conflict in their marriage and the association of these behaviors with marital outcomes. Using a sample of 336 married couples (672 spouses), results revealed that the majority of couples reported that relationally aggressive behaviors, such as social sabotage and love withdrawal, were a part of their marital dynamics, at least to some degree. Gender comparisons of partner reports of their spouse's behavior revealed that wives were significantly more likely to be relationally aggressive than husbands. Structural equation modeling demonstrated that relational aggression is associated with lower levels of marital quality and greater marital instability for both husbands and wives. Implications are drawn for the use of relational aggression theory in the future study of couple conflict and marital aggression.

  4. Methods for external disinfection of blow fly (Diptera: Calliphoridae) eggs prior to use in wound debridement therapy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Maggot debridement therapy (MDT) is the use of the larval stage of flies (i.e., Calliphoridae) to remove necrotic tissue and disinfect wounds. Effective MDT requires an aseptic technique to prevent the unintentional introduction of pathogenic bacteria into a wound to be debrided, yet the external s...

  5. Papain incorporated chitin dressings for wound debridement sterilized by gamma radiation

    NASA Astrophysics Data System (ADS)

    Singh, Durgeshwer; Singh, Rita

    2012-11-01

    Wound debridement is essential for the removal of necrotic or nonviable tissue from the wound surface to create an environment conducive to healing. Nonsurgical enzymatic debridement is an attractive method due to its effectiveness and ease of use. Papain is a proteolytic enzyme derived from the fruit of Carica papaya and is capable of breaking down a variety of necrotic tissue substrates. The present study was focused on the use of gamma radiation for sterilization of papain dressing with wound debriding activity. Membranes with papain were prepared using 0.5% chitin in lithium chloride/dimethylacetamide solvent and sterilized by gamma radiation. Fluid absorption capacity of chitin-papain membranes without glycerol was 14.30±6.57% in 6 h. Incorporation of glycerol resulted in significant (p<0.001) increase in the absorption capacity. Moisture vapour transmission rate of the membranes was 4285.77±455.61 g/m2/24 h at 24 h. Gamma irradiation at 25 kGy was found suitable for sterilization of the dressings. Infrared (IR) spectral scanning has shown that papain was stable on gamma irradiation at 25-35 kGy. The irradiated chitin-papain membranes were impermeable to different bacterial strains and also exhibited strong bactericidal action against both Gram-positive and Gram-negative bacteria. The fluid handling characteristics and the antimicrobial properties of chitin-papain membranes sterilized by gamma radiation were found suitable for use as wound dressing with debriding activity.

  6. Growth and Survival of Bagged Lucilia sericata Maggots in Wounds of Patients Undergoing Maggot Debridement Therapy

    PubMed Central

    Čičková, Helena; Čambal, Marek; Kozánek, Milan; Takáč, Peter

    2013-01-01

    Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n = 52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9–19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09–9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy. PMID:23983774

  7. The efficacy of maggot debridement therapy--a review of comparative clinical trials.

    PubMed

    Zarchi, Kian; Jemec, Gregor B E

    2012-10-01

    Over the last decade, maggot debridement therapy (MDT) has been recognized by many clinicians as a potential adjunct to conventional therapy, and many patients with non healing, chronic ulcers have been treated. Numerous case reports and case series have described the successful use of MDT in a variety of ulcers. However, comparative clinical trials and in particular randomized controlled trials investigating the efficacy of MDT are sparse. A systematic search in the literature showed three randomized clinical trials and five non randomized studies evaluating the efficacy of sterile Lucilia sericata applied on ulcers with various aetiologies. Of these, seven studies had debridement and/or healing as an outcome variable. When evaluating maggots as debriding agents, the studies report MDT as being significantly more effective than hydrogel or a mixture of conventional therapy modalities, including hydrocolloid, hydrogel and saline moistened gauze. However, the design of the studies was suboptimal, with important differences in the use of other therapies, such as compression, that may influence both debridement and healing between the compared groups, as well as inappropriately short follow-up times. The quality of the studies therefore makes it difficult to conclude that MDT shortens healing time. The poor quality of the data used for evaluating the efficacy of MDT highlights the need for more and better designed investigations.

  8. Maggot versus conservative debridement therapy for the treatment of pressure ulcers.

    PubMed

    Sherman, Ronald A

    2002-01-01

    To define the efficacy and safety of maggot therapy, a cohort of 103 inpatients with 145 pressure ulcers was evaluated. Sixty-one ulcers in 50 patients received maggot therapy at some point during their monitored course; 84 ulcers in 70 patients did not. Debridement and wound healing could be quantified for 43 maggot-treated wounds and 49 conventionally treated wounds. Eighty percent of maggot-treated wounds were completely debrided, while only 48% of wounds were completely debrided with conventional therapy alone (p=0.021). Within 3 weeks, maggot-treated wounds contained one-third the necrotic tissue (p = 0.05) and twice the granulation tissue (p < 0.001), compared to non-maggot-treated wounds. Of the 31 measurable maggot-treated wounds monitored initially during conventional therapy, necrotic tissue decreased 0.2 cm(2) per week during conventional therapy, while total wound area increased 1.2 cm(2) per week. During maggot therapy, necrotic tissue decreased 0.8 cm(2) per week (p = 0.003) and total wound surface area decreased 1.2 cm2 per week (p = 0.001). Maggot therapy was more effective and efficient in debriding chronic pressure ulcers than were the conventional treatments prescribed. Patients readily accepted maggot therapy, and adverse events were uncommon.

  9. Safety, effectiveness and economic aspects of maggot debridement therapy for wound healing

    PubMed Central

    Arabloo, Jalal; Grey, Serajaddin; Mobinizadeh, Mohammadreza; Olyaeemanesh, Alireza; Hamouzadeh, Pejman; Khamisabadi, Kiumars

    2016-01-01

    Background: Maggot therapy has recently attracted considerable attention as an emerging debridement technique for wound healing. This study aimed to review the safety, effectiveness and economic evaluations of Maggot Debridement Therapy for wound healing. Methods: To retrieve the relevant evidences, the Cochrane Library (until September 2014) was searched by appropriate keywords, using free text and Mesh. Systematic reviews, HTA reports and economic evaluation studies that compared larval therapy with other debridement therapies, such as hydrogel in patients with various kinds of ulcers in terms of side effects, the wound healing rate, the healing time, and cost per QALY, were included. Results: Five studies met the inclusion criteria which showed that healing with larval therapy happened a little earlier than the usual methods and that pain perception in larval therapy was a little more than usual methods (as by anesthetic conventional methods). However, the quality of life of those patients who received larval therapy was better and they showed a greater tendency to larval therapy as it was relatively safe and had a low rate of side effects. Conclusion: It seems that larval therapy has several advantages such as rapid wound debridement, infection elimination, pain control and ulcer healing. The use of larval therapy has the potential to reduce side effects and decrease the need for amputation. PMID:27390689

  10. Growth and Survival of Bagged Lucilia sericata Maggots in Wounds of Patients Undergoing Maggot Debridement Therapy.

    PubMed

    Cičková, Helena; Cambal, Marek; Kozánek, Milan; Takáč, Peter

    2013-01-01

    Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n = 52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9-19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09-9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy.

  11. Punishment of elicited aggression.

    PubMed

    Azrin, N H

    1970-07-01

    Aversive shocks are known to produce aggression when the shocks are not dependent on behavior and to suppress behavior when the shocks are arranged as a dependent punisher. These two processes were studied by presenting non-dependent shock to monkeys at regular intervals, thereby producing biting attacks on a pneumatic tube. Immediate shock punishment was stimultaneously delivered for each biting attack. The attacks were found to decrease as a function of increasing punishment intensity. These results show that aggression is eliminated by direct punishment of the aggression even when the stimulus that is used as a punisher otherwise causes the aggression. PMID:4988590

  12. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  13. A retrospective, quality improvement review of maggot debridement therapy outcomes in a foot and leg ulcer clinic.

    PubMed

    Campbell, Noreen; Campbell, Donna

    2014-07-01

    Maggot debridement is the deliberate use of larvae known to consume only necrotic tissue. A retrospective quality improvement analysis of maggot debridement therapy (MDT) was conducted among patients with devitalized tissue or gangrene attending a Canadian foot and leg ulcer clinic who received MDT between January 2001 and June 2006. MDT was applied every 48 hours until >90% of necrotic tissue was debrided. The authors identified MDT patients in the clinic database and reviewed their medical records for age, gender, presence of diabetes or peripheral arterial disease (PAD), type of wound, number of maggot applications required, wound outcomes, and nursing visit costs (week before, during, and after MDT) and noted patient experiences. Records of 68 patients (average age 71, range 22 to 95, years) were identified and abstracted. Of those, 44% had leg ulcers and 67% had both diabetes and PAD. The majority (39, 58%) of wounds required three debridement sessions. All but one patient achieved debridement of >90% of necrotic tissue in 2 to 10 days. Most wounds (56) healed with follow-up moist wound care. Only one patient withdrew from MDT. No other patient or safety concerns were documented. Total nursing visits for all patients the week before and then after MDT were 307 and 102, respectively. These findings confirm results of previous reports about the effectiveness of MDT for wound debridement. Randomized, controlled clinical studies are needed to confirm the efficacy and cost-effectiveness of MDT compared to other debridement modalities.

  14. A Strategic Approach to Aggression.

    ERIC Educational Resources Information Center

    Archer, John

    2001-01-01

    Discusses two issues raised by Underwood et al.: the distinction between indirect and relational forms of aggression, and implications of indirect aggression for definitions of aggression; and the normative view of aggression that indicates that aggressive individuals may be socially skilled. Suggests that both issues lead to the conclusion that…

  15. Surgical tracheotomy.

    PubMed

    Rowshan, Henry H; Baur, Dale A

    2010-03-01

    Tracheotomy is a surgical procedure that dates back to early history and medical advancement. The oral and maxillofacial surgeon routinely operates around the airway and should be able to master this procedure by adhering to the surgical principles outlined in this article.

  16. Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.

    PubMed

    Dave, Omkar H; Patel, Karan A; Andersen, Clark R; Carmichael, Kelly D

    2016-01-01

    Septic arthritis of the knee is encountered on a regular basis by orthopedists and nonorthopedists. No established therapeutic algorithm exists for septic arthritis of the knee, and there is much variability in management. This study assessed the number of surgical procedures, arthroscopic or open, required to eradicate infection. The study was a retrospective analysis of 79 patients who were treated for septic knee arthritis from 1995 to 2011. Patients who were included in the study had native septic knee arthritis that had resolved with treatment consisting of irrigation and debridement, either open or arthroscopic. Logistic regression analysis was used to explore the relation between the interval between onset of symptoms and index surgery and the use of arthroscopy and the need for multiple procedures. Fifty-two patients met the inclusion criteria, and 53% were male, with average follow-up of 7.2 years (range, 1-16.2 years). Arthroscopic irrigation and debridement was performed in 70% of cases. On average, successful treatment required 1.3 procedures (SD, 0.6; range, 1-4 procedures). A significant relation (P=.012) was found between time from presentation to surgery and the need for multiple procedures. With arthroscopic irrigation and debridement, most patients with septic knee arthritis require only 1 surgical procedure to eradicate infection. The need for multiple procedures increases with time from onset of symptoms to surgery.

  17. Girls' Aggressive Behavior

    ERIC Educational Resources Information Center

    Owens, Larry; Shute, Rosalyn; Slee, Phillip

    2004-01-01

    In contrast to boys' bullying behavior which is often overt and easily visible, girls' aggression is usually indirect and covert. Less research has been conducted on the types of bullying that girls usually engage in. Using focus groups composed of teenaged girls, Dr. Owens and colleagues examine the nature of teenage girls' indirect aggression.

  18. Third Person Instigated Aggression.

    ERIC Educational Resources Information Center

    Gaebelein, Jacquelyn

    Since many acts of aggression in society are more than simply an aggressor-victim encounter, the role played by third person instigated aggression also needs examination. The purpose of this study was to develop a laboratory procedure to systematically investigate instigation. In a competitive reaction time task, high and low Machiavellian Males…

  19. Social Aggression among Girls.

    ERIC Educational Resources Information Center

    Underwood, Marion K.

    Noting recent interest in girls' social or "relational" aggression, this volume offers a balanced, scholarly analysis of scientific knowledge in this area. The book integrates current research on emotion regulation, gender, and peer relations, to examine how girls are socialized to experience and express anger and aggression from infancy through…

  20. Vacuum-assisted closure of a large palmar defect after debriding a midpalmar tuberculous abscess.

    PubMed

    Kang, Gavin C W; Yam, Andrew

    2008-03-01

    A rare case of tuberculous deep palmar abscess of the hand was treated with radical excisional debridement, resulting in a large palmar skin and soft tissue defect that was successfully closed with a vacuum dressing followed by split skin grafting. Vacuum dressings are useful adjuncts to treat large soft tissue defects in patients who are unsuitable for complex reconstruction. The moist wound environment prevents desiccation of exposed vital structures and decreases pain, allowing early mobilisation in the hand. The wound granulates and contracts rapidly, allowing earlier skin grafting or faster healing by secondary intention. The closed system vacuum dressing is particularly useful in managing debrided tuberculous soft tissue infections. The dressing is perfectly sealed and requires less frequent changing, decreasing contamination and transmission of tuberculosis to other patients and health care staff, while minimising the risk of secondary nosocomial bacterial infection of the wound. PMID:18336379

  1. Treponemes-infected canker in a Japanese racehorse: efficacy of maggot debridement therapy.

    PubMed

    Kuwano, Atsutoshi; Niwa, Hidekazu; Higuchi, Tohru; Mitsui, Hideya; Agne, Robert A

    2012-01-01

    A 3-year-old thoroughbred colt presented with canker on its left hind foot. Subsequent development of cottage cheese-like horns and dermatitis disturbed healing, despite the use of miscellaneous orthodox treatment approaches to the lesions. Histological examination revealed exudative and suppurative dermatitis, and proliferatively suppurative epidermitis infected with helically coiled treponemes. Total debridement under general anesthesia led to a temporary improvement, but the ground surface regenerated abnormal epidermis similar to that observed initially after surgery. Maggot debridement therapy (MDT) was attempted, which removed all the abnormal tissue. After MDT, general farriery trimming helped to correct the distorted ground surface, and the horse returned to constant training and eventually raced. This case shows that MDT was successfully used for treatment of an intractable and treponemes-infected canker.

  2. Eikenella corrodens septic hip arthritis in a healthy adult treated with arthroscopic irrigation and debridement.

    PubMed

    Gowda, Ashok L; Mease, Samuel J; Dhar, Yasmin

    2014-09-01

    We present the case of a seemingly spontaneous septic hip arthritis in a patient with no pertinent medical history. Our patient presented with persistent and worsening sharp lower back pain and underwent arthrocentesis of the hip joint, yielding purulent fluid positive for Eikenella corrodens. Our patient's treatment consisted of arthroscopic irrigation with debridement and limited synovectomy that used a supine 2-incision technique. To our knowledge, this is the first reported case of an E corrodens septic hip arthritis.

  3. Efficacy and safety of human fibrinogen-thrombin patch (Tachosil®) in the management of diffuse bleeding after chest wall and spinal surgical resection for aggressive thoracic neoplasms

    PubMed Central

    Guerrera, Francesco; Sandri, Alberto; Zenga, Francesco; Lanza, Giovanni Vittorio; Ruffini, Enrico; Bora, Giulia; Lyberis, Paraskevas; Solidoro, Paolo; Oliaro, Alberto

    2016-01-01

    Diffuse bleeding after chest wall and spine resection represents a major problem in General Thoracic Surgery. Several fibrin sealants (FS) have been developed over the years and their use has been gradually increasing over time, becoming an important aid to the surgeons, justifying their use across numerous fields of surgery due to its valid haemostatic properties. Among the several FS available, TachoSil® (Takeda Austria GmbH, Linz, Austria) stands out for its haemostatic and aerostatic properties, the latter being demonstrated even in high-risk patients after pulmonary resections for primary lung cancers. Several papers available in literature demonstrated TachoSil®’s effectiveness in controlling intraoperative and postoperative bleeding in different surgical branches, including hepatic and pancreatic surgery, as well as cardiac and thoracic surgery. However, the use of TachoSil® to control diffuse bleeding following major resections for advanced lung cancers, with requirement of chest wall and vertebral body resection for oncological radicality, was never published so far. In this paper, we report three cases of pulmonary lobectomy associated to chest wall resection and haemivertebrectomy for primary malignant lung neoplasms and for a recurrence of malignant solitary fibrous tumour of the pleura in which we used TachoSil©, which demonstrated its efficacy in controlling diffuse bleeding following resection. PMID:26904247

  4. Surgical Reconstruction of Radiation Injuries

    PubMed Central

    Fujioka, Masaki

    2014-01-01

    Significance: Patients with cancer receive benefits from radiation therapy; however, it may have adverse effects on normal tissue such as causing radiation-induced ulcer and osteoradionecrosis. The most reliable method to treat a radiation ulcer is wide excision of the affected tissue, followed by coverage with well-vascularized tissue. As usual, radiation-induced skin ulcers are due to therapeutic irradiation for residual cancer or lymph nodes; the locations of radiation ulcers are relatively limited, including the head, neck, chest wall, lumbar, groin, and sacral areas. Thus, suitable reconstructive methods vary according to functional and aesthetic conditions. I reviewed the practices and surgical results for radiation ulcers over the past 30 years, and present the recommended surgical methods for these hard-to-heal ulcers. Recent Advances: At a minimum, flaps are required to treat radiation ulcers. Surgeons can recommend earlier debridement, followed by immediate coverage with axial-pattern musculocutaneous and fasciocutaneous flaps. Free flaps are also a useful soft tissue coverage option. The choice of flap varies with the location and size of the wounds. Critical Issues: The most crucial procedure is the complete resection of the radiation-affected area, followed by coverage with well-vascularized tissue. Future Directions: Recent developments in perforator flap techniques, which are defined as flaps with a blood supply from isolated perforating vessels of a stem artery, have allowed the surgeons to successfully resurface these difficult wounds with reduced morbidity. PMID:24761342

  5. Open flap debridement in combination with acellular dermal matrix allograft for the prevention of postsurgical gingival recession: a case series.

    PubMed

    Chavan, Ramesh Sundersing; Bhongade, Manohar Laxman; Tiwari, Ishan Ramakant; Jaiswal, Priyanka

    2013-01-01

    Open flap debridement with flap repositioning may result in significant gingival recession. Patients with chronic periodontitis were treated with open flap debridement followed by placement of an acellular dermal matrix allograft (ADMA) underneath the flap to minimize the occurrence of postsurgical gingival recession. Ten patients (total, 60 teeth) with periodontal pockets in the anterior dentition underwent open flap debridement combined with ADMA. Probing pocket depth, relative attachment level, and relative gingival margin level were recorded at baseline and 6 months postsurgery. The mean probing pocket depth at baseline and 6 months was 4.4 and 1.7 mm, respectively (P < .05); the mean relative attachment level at baseline and 6 months was 12.9 and 10.7 mm, respectively (P < .05); and the mean relative gingival margin level at baseline and 6 months was 8.4 and 9.0 mm, respectively. ADMA underneath the flap when combined with open flap debridement effectively minimizes postsurgical gingival recession.

  6. Editorial Commentary: Arthroscopic Debridement for Hip Dysplasia--The More Things Change, the More Things Stay the Same.

    PubMed

    Miller, G Klaud

    2016-02-01

    A systematic review of arthroscopic debridement versus open osteotomy for acetabular dysplasia documented essentially equivalent results; however, with much shorter follow-up and many fewer cases in the arthroscopic series. PMID:26814400

  7. Surgical Technologists

    MedlinePlus

    ... in place during the procedure, or set up robotic surgical equipment. Technologists also may handle specimens taken ... sterilization techniques, how to set up technical or robotic equipment, and preventing and controlling infections. In addition ...

  8. Aggression in Pretend Play and Aggressive Behavior in the Classroom

    ERIC Educational Resources Information Center

    Fehr, Karla K.; Russ, Sandra W.

    2013-01-01

    Research Findings: Pretend play is an essential part of child development and adjustment. However, parents, teachers, and researchers debate the function of aggression in pretend play. Different models of aggression predict that the expression of aggression in play could either increase or decrease actual aggressive behavior. The current study…

  9. Aggression in Drosophila.

    PubMed

    Kravitz, Edward A; Fernandez, Maria de la Paz

    2015-10-01

    Aggression is used by essentially all species of animals to gain access to desired resources, including territory, food, and potential mates: Fruit flies are no exception. In Drosophila, both males and females compete in same sex fights for resources, but only males establish hierarchical relationships. Many investigators now study aggression using the fruit fly model, mainly because (a) aggression in fruit flies is a quantifiable well-defined and easily evoked behavior; (b) powerful genetic methods allow investigators to manipulate genes of interest at any place or time during embryonic, larval, pupal or adult life, and while flies are behaving; (c) the growth of the relatively new field of optogenetics makes physiological studies possible at single neuron levels despite the small sizes of neurons and other types of cells in fly brains; and (d) the rearing of fly stocks with their short generation times and limited growth space requirements can easily be performed at relatively low cost in most laboratories. This review begins with an examination of the behavior, both from a historical perspective and then from the birth of the "modern" era of studies of aggression in fruit flies including its quantitative analysis. The review continues with examinations of the roles of genes, neurotransmitters and neurohormones, peptides, nutritional and metabolic status, and surface cuticular hydrocarbons in the initiation and maintenance of aggression. It concludes with suggestions for future studies with this important model system.

  10. [New surgical treatment options for bone tumors].

    PubMed

    Andreou, D; Henrichs, M P; Gosheger, G; Nottrott, M; Streitbürger, A; Hardes, J

    2014-11-01

    Primary bone neoplasms can be classified into benign, locally/aggressive and rarely metastasizing and malignant tumors. Patients with benign tumors usually undergo surgical treatment in cases of local symptoms, mainly consisting of pain or functional deficits due to compression of important anatomical structures, such as nerves or blood vessels. Locally/aggressive and rarely metastasizing tumors exhibit an infiltrative growth pattern, so that surgical treatment is necessary to prevent further destruction of bone leading to local instability. Finally, the surgical treatment of malignant tumors is, with few exceptions, considered to be a prerequisite for long-term survival, either alone or in combination with systemic chemotherapy. Whereas the main objective of surgery in the treatment of benign tumors is relief of local symptoms with a minimum amount of damage to healthy tissue and minimizing the risk of local recurrence while ensuring bone stability in locally aggressive and rarely metastasizing tumors, the primary goal in the operative treatment of bone sarcomas is the resection of the tumor with clear surgical margins followed by defect reconstruction and the preservation of function. This review examines the current developments in the surgical treatment of primary bone neoplasms with respect to the management of the tumors and novel reconstructive options.

  11. [Emergency open surgical treatment of extravasations of cytostatic agents in the upper extremity].

    PubMed

    Telisselis, P; Heers, G; Plock, B; Baier, C; Neugebauer, R; Füchtmeier, B

    2010-08-01

    Extravasations of cytostatic agents can create necrosis of soft tissues in the hand and forearm. The early emergency subcutaneous "wash-out" with liposuction is the treatment of choice to avoid the development of soft-tissue defects. The objective of this study was to evaluate the open surgical debridement as a possible alternative method since the liposuction device is not commonly available in every hospital. In our study 10 patients were treated for extravasations of cytostatic drugs with a high potential for necrosis by emergency open debridement. All patients were evaluated prospectively by photography and clinical examination. 9 patients out of ten had a primary wound healing, one displayed a wound dehiscence with pre-existing MRSA infection. Another patient developed a seroma postoperatively which was treated by puncture. The mean functional outcome was good. The Eemergency open surgical treatment is a simple, in every hospital suitable therapy to prevent soft-tissue necrosis after extravasation of cytostatic drugs.

  12. [Aggressive fibromatosis of the frontal sinus].

    PubMed

    Jensen, Søren Gade; Krogdahl, Annelise; Godballe, Christian

    2009-01-26

    Aggressive fibromatosis (AF) is a benign tumour with expansive and locally invasive growth. It is very rarely seen in the head and neck area. We present a 52-year-old female patient with AF localized to the left frontal sinus. The condition was initially mistaken for chronic sinusitis however computed tomography indicated tumour. A biopsy showed AF and the patient received surgical treatment. Symptoms, signs and treatment are discussed. It is concluded that AF in the sino-nasal tract is a rare, but potentially life threatening condition which might be mistaken for a simple sinusitis. PMID:19176167

  13. Recurrent aggressive fibromatosis of the chest wall.

    PubMed

    Foà, Riccardo; Rizzo, Stefania; Petrella, Francesco; De Maria, Federica; Bellomi, Massimo

    2014-01-01

    A 57-year-old woman with a previous history of aesthetic surgery for breast reduction presented with a subcutaneous mass in the right axilla. A CT scan showed a solid mass on the chest wall, and she underwent surgical resection with a diagnosis of aggressive fibromatosis. After a 10-month period of follow-up, a local recurrence occurred, and in accordance with the up-to-date approach, the recurrence has been treated with a conservative approach (medical treatments) with good control of the symptoms and downsizing of the lesion.

  14. Surgical complications associated with primary closure in patients with diabetic foot osteomyelitis

    PubMed Central

    García-Morales, Esther; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; Cecilia-Matilla, Almudena; García-Álvarez, Yolanda; Beneit-Montesinos, Juan Vicente

    2012-01-01

    Background The aim of this study was to determine the incidence of complications associated with primary closure in surgical procedures performed for diabetic foot osteomyelitis compared to those healed by secondary intention. In addition, further evaluation of the surgical digital debridement for osteomyelitis with primary closure as an alternative to patients with digital amputation was also examined in our study. Methods Comparative study that included 46 patients with diabetic foot ulcerations. Surgical debridement of the infected bone was performed on all patients. Depending on the surgical technique used, primary surgical closure was performed on 34 patients (73.9%, Group 1) while the rest of the 12 patients were allowed to heal by secondary intention (26.1%, Group 2). During surgical intervention, bone samples were collected for both microbiological and histopathological analyses. Post-surgical complications were recorded in both groups during the recovery period. Results The average healing time was 9.9±SD 8.4 weeks in Group 1 and 19.1±SD 16.9 weeks in Group 2 (p=0.008). The percentage of complications was 61.8% in Group 1 and 58.3% in Group 2 (p=0.834). In all patients with digital ulcerations that were necessary for an amputation, a primary surgical closure was performed with successful outcomes. Discussion Primary surgical closure was not associated with a greater number of complications. Patients who received primary surgical closure had faster healing rates and experienced a lower percentage of exudation (p=0.05), edema (p<0.001) and reinfection, factors that determine the delay in wound healing and affect the prognosis of the surgical outcome. Further research with a greater number of patients is required to better define the cases for which primary surgical closure may be indicated at different levels of the diabetic foot. PMID:23050062

  15. Early diagnosis of post-varicella necrotising fasciitis: A medical and surgical emergency

    PubMed Central

    Xavier, Rose; Abraham, Bobby; Cherian, Vinod Jacob; Joseph, Jobin I.

    2016-01-01

    Necrotising fasciitis (NF) is an extremely rare complication of a rather common paediatric viral exanthem varicella. Delayed diagnosis and treatment can lead to significant morbidity and mortality. Laboratory risk indicator of NF score aids in early clinical diagnosis in suspected cases of post-varicella NF thus enabling timely intervention. Surgery delayed for more than 24 hours, is an independent risk factor for death. Surgical debridement with good antibiotic coverage is the definitive treatment for NF. PMID:27251524

  16. Maggot debridement therapy as primary tool to treat chronic wound of animals

    PubMed Central

    Choudhary, Vijayata; Choudhary, Mukesh; Pandey, Sunanda; Chauhan, Vandip D.; Hasnani, J. J.

    2016-01-01

    Maggot debridement therapy (MDT) is a safe, effective, and controlled method ofhealing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefernecrotic tissues over healthy for feeding. Since centuries, MDT is used in humanbeings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken. PMID:27182137

  17. Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly.

    PubMed

    Zhao, Jie; Lian, Xiao Feng; Hou, Tie Sheng; Ma, Hui; Chen, Zhi Ming

    2007-12-01

    Between 2000 and 2004, 40 cases (average age 38, range 16-65 years) of spinal tuberculosis were treated with anterior debridement and iliac bone graft with one-stage anterior or posterior instrumentation in our unit. All patients received at least 2 weeks of regular antituberculous chemotherapy before surgery. We followed up all patients for 12-48 months (mean 22 months). Local symptoms of all patients were relieved significantly 1-3 weeks postoperatively; 23 of 25 cases (92%) with neurogical deficit had excellent or good clinical results. Erythrocyte sedimentation rates (ESR) returned from 51 mm/h to 32 mm/h (average) two weeks postoperatively. Kyphosis degrees were corrected by a mean of 16 degrees . Fusion rate of the grafting bone was 72.5% one year postoperatively and 90% two years postoperatively. Severe complications did not occur. We therefore believe that patients undergoing anterior debridement and iliac bone grafting with one-stage anterior or posterior instrumentation achieve satisfactory clinical and radiographic outcomes.

  18. Maggot debridement therapy as primary tool to treat chronic wound of animals.

    PubMed

    Choudhary, Vijayata; Choudhary, Mukesh; Pandey, Sunanda; Chauhan, Vandip D; Hasnani, J J

    2016-04-01

    Maggot debridement therapy (MDT) is a safe, effective, and controlled method ofhealing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefernecrotic tissues over healthy for feeding. Since centuries, MDT is used in humanbeings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.

  19. Snakebite in Korea: A Guideline to Primary Surgical Management

    PubMed Central

    Kwon, Sung Min; Oh, Jin Rok; Han, Byung Keun; Lee, Kang Hyung; Kim, Jae Hyun

    2015-01-01

    Purpose Snakebite is an emergency which causes local symptoms such as pain and edema around the bite. Systemic symptoms may also develop, such as dizziness or renal failure, and may even cause death. The purpose of this research was to assess the validity and safety of snakebite protocol for surgery when treating snakebite patients. Materials and Methods Retrospective research was performed on patients who were admitted after being treated at the emergency center from January 2008 to December 2012. When necessary, debridement was also performed, and 46 of 111 patients (41.4%) underwent debridement. Those who had received debridement without antivenom administration due to a positive skin reaction test were classified as group A, and group B received antivenom and delayed debridement. We reviewed the emergency and admission charts of the patients in each group and recorded and compared their age, sex, bite site, severity of local and general symptoms, time to receive antivenin, and complications. Results Of the ten patients (21.7%) in group A, two (66.6%) developed cellulites, and one of them experienced skin necrosis, resulting in a skin graft. In group B, there were 36 patients (78.2%), 19 (52.7%) of whom developed cellulitis. Skin necrosis occurred in two patients, and one of these patients received a skin graft. Compartment syndrome was found in one patient, and fasciotomy and a skin graft were performed. Conclusion The treatment protocol implemented to treat snakebite patients admitted to the emergency center during this research was safely and properly followed during surgical treatment. PMID:26256993

  20. Surgical antiseptics.

    PubMed

    Sebben, J E

    1983-11-01

    The skin cannot be sterilized because approximately 20% of the resident flora are beyond the reach of surgical scrubs and antiseptics. The goal of surgical preparation of the skin with antiseptics is to remove transient and pathogenic microorganisms on the skin surface and to reduce the resident flora to a low level. Four antiseptics which have been popular over the past two decades are discussed. Benzalkonium chloride is somewhat unstable on the skin and is too prone to contamination to be in general use. Hexachlorophene is not recommended due to narrow spectrum and risks secondary to percutaneous absorption. The iodophors are excellent antiseptics, but recent studies raise questions about effectiveness and contamination. Chlorhexidine is a very safe and effective antiseptic. Comparison studies with chlorhexidine, hexachlorophene, and iodophors show chlorhexidine to be the most effective agent. Chlorhexidine can be toxic to the middle ear and irritating to the eyes with direct contact. Caution should be used in these areas with chlorhexidine and other antiseptics.

  1. Surgical heuristics.

    PubMed

    Patkin, Michael

    2008-12-01

    Heuristics are rules of thumb. Rarely described in surgical or other publications, they are an essential part of safe and expert performance. This study translates such implicit or procedural knowledge into explicit or declarative knowledge, with a view to improving both training and retraining of surgeons in the steps of dissection. Tools used include ordinary observation accompanied by introspection, and study of operative videos. Validation of the value of such heuristics is yet to be achieved.

  2. Aggressiveness and Disobedience

    ERIC Educational Resources Information Center

    Vaaland, Grete Sorensen; Idsoe, Thormod; Roland, Erling

    2011-01-01

    This study aims to conceptualize disobedient pupil behavior within the more general framework of antisocial behavior and to reveal how two forms of aggressiveness are related to disobedience. Disobedience, in the context of this article, covers disruptive pupil behavior or discipline problems when the pupil is aware of breaking a standard set by…

  3. Neuroimaging and Aggression.

    ERIC Educational Resources Information Center

    Mills, Shari; Raine, Adrian

    1994-01-01

    Brain imaging research allows direct assessment of structural and functional brain abnormalities, and thereby provides an improved methodology for studying neurobiological factors predisposing to violent and aggressive behavior. This paper reviews 20 brain imaging studies using four different types of neuroimaging techniques that were conducted in…

  4. Intellectual Competence and Aggression.

    ERIC Educational Resources Information Center

    Huesmann, L. Rowell; Yarmel, Patty Warnick

    Using data from a broader longitudinal study, this investigation explores within-subject and cross-generational stability of intellectual competence and the relationship of such stability to aggressive behavior. Data were gathered three times (when subjects' modal age was 8, 19, and 30 years). Initially, subjects included the entire population…

  5. Stability of Aggressive Behavior.

    ERIC Educational Resources Information Center

    Eron, Leonard D.; Huesmann, L. Rowell

    As indicated by multiple measures (including overt criminal behavior), stability of aggressive behavior was investigated across 22 years for males and females in a variety of situations. Originally, subjects included the entire population enrolled in the third grade in a semi-rural county in New York State. The sample included approximately 870…

  6. Relational Aggression among Students

    ERIC Educational Resources Information Center

    Young, Ellie L.; Nelson, David A.; Hottle, America B.; Warburton, Brittney; Young, Bryan K.

    2011-01-01

    "Relational aggression" refers to harm within relationships caused by covert bullying or manipulative behavior. Examples include isolating a youth from his or her group of friends (social exclusion), threatening to stop talking to a friend (the silent treatment), or spreading gossip and rumors by email. This type of bullying tends to be…

  7. Human Aggression and Suicide

    ERIC Educational Resources Information Center

    Brown, Gerald L.; Goodwin, Frederick K

    1986-01-01

    The central nervous system transmitter serontonin may be altered in aggressive/impulsive and suicidal behaviors in humans. These reports are largely consistent with animal data, and constitute one of the most highly replicated set of findings in biological psychiatry. Suggests that some suicidal behavior may be a special kind of aggressive…

  8. Efficacy of mechanical debridement with adjunct antimicrobial photodynamic therapy for the management of peri-implant diseases: a systematic review.

    PubMed

    Vohra, Fahim; Al-Rifaiy, Mohammad Qasim; Lillywhite, Graeme; Abu Hassan, Mohamed Ibrahim; Javed, Fawad

    2014-08-01

    The aim was to assess whether or not mechanical debridement with adjunct antimicrobial photodynamic therapy (aPDT) is effective for the management of peri-implant diseases. The addressed focused question was "Is mechanical debridement with adjunct aPDT more effective in treating peri-implant diseases as compared to when mechanical debridement is used alone?" PubMed/MEDLINE and Google-Scholar databases were searched from 1994 till April 2014 using different combinations of the following keywords: antimicrobial photodynamic therapy; bone loss; light activated disinfection; mechanical debridement; and peri-implant diseases. Review articles, case-reports, commentaries, letters to the editor, unpublished articles and articles published in languages other than English were excluded. Twelve studies (six clinical and six experimental) were included. In the clinical and experimental studies, 15-80 implants and 18-150 implants respectively were used. Laser wavelengths, duration of irradiation and power output ranged between 625 nm-830 nm, 10 s-300 s, and 30 mW-200 mW, respectively. Four studies reported mechanical debridement with adjunct aPDT to be effective in the treatment of peri-implant diseases; however, the benefits of aPDT were comparable with conventional treatments. Two studies reported aPDT to reduce bacteria more than when the laser and the photosensitizer were applied alone. In two studies, chemical disinfection and aPDT showed comparable outcomes in terms of bacterial disinfection. In two experimental studies, aPDT was shown to improve bone to implant contact and re-osseointegration. Efficacy of mechanical debridement with adjunct aPDT for the management of peri-implant diseases remains debatable.

  9. Parents' Aggressive Influences and Children's Aggressive Problem Solutions with Peers

    ERIC Educational Resources Information Center

    Duman, Sarah; Margolin, Gayla

    2007-01-01

    This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents' responses to similar hypothetical social scenarios and parents' actual marital aggression. The study included 118 children ages 9 to 10 years old and their mothers and fathers. Children's aggressive solutions correlated with…

  10. Relational Aggression and Physical Aggression among Adolescent Cook Islands Students

    ERIC Educational Resources Information Center

    Page, Angela; Smith, Lisa F.

    2016-01-01

    Both physical and relational aggression are characterised by the intent to harm another. Physical aggression includes direct behaviours such as hitting or kicking; relational aggression involves behaviours designed to damage relationships, such as excluding others, spreading rumours, and delivering threats and verbal abuse. This study extended…

  11. Reverse Discrimination and Aggressive Behavior.

    ERIC Educational Resources Information Center

    Johnson, Stephen D.

    1980-01-01

    White subjects were aggressive toward Black opponents when contest results appeared to reflect elements of reverse discrimination; but they showed less aggressive behavior toward Black opponents when they thought their loss was due to their opponents' superior ability. (RL)

  12. Surgical treatment of extra-abdominal desmoid tumours (aggressive fibromatoses).

    PubMed

    Higaki, S; Tateishi, A; Ohno, T; Abe, S; Ogawa, K; Iijima, T; Kojima, T

    1995-01-01

    Extra-abdominal desmoid tumours (EADT) are benign lesions but difficult to cure because of their infiltrative nature and tendency to recur. Among many treatments recommended in the past, wide excision has been successful, even in difficult cases. We have analyzed retrospectively 41 cases of histologically confirmed EADTs. A total of 98 operations were performed on these patients: 29 wide excisions on 22 patients, 52 intra-lesional excisions with wide margins on 16 patients, and 17 incomplete excisions on 3 patients. One patient, with intra-pelvic lesions, died of a massive haemorrhage 3 days after surgery. Forty patients were followed from between 3 and 29 years. One, who had a multicentric EADT for 21 years, died from the disease. The significant factors concerning local recurrence after wide procedures were an unsatisfactory initial wide local excision, disease affecting 4 or more muscles and the invasive nature of the recurrences. We recommend wide local excision of these tumours in all anatomical areas that allow this procedure. When major nerves and vessels are involved, we recommend an intralesional excision with wide margins in order to preserve limb function. Radiation therapy should be confined to cases in which wide local procedures are not feasible. Overall, 37 of our patients (90%) were cured of the disease, 2 had their disease controlled, and 2 died.

  13. Arthroscopic debridement and biological resurfacing of the glenoid in glenohumeral arthritis.

    PubMed

    de Beer, Joe F; Bhatia, Deepak N; van Rooyen, Karin S; Du Toit, Donald F

    2010-12-01

    The purpose of this study was to analyse the intermediate-term results of an arthroscopic procedure to debride and resurface the arthritic glenoid, in a middle-aged population, using an acellular human dermal scaffold. Between 2003 and 2005, thirty-two consecutive patients underwent an arthroscopic debridement and biological glenoid resurfacing for glenohumeral arthritis. The diagnoses included primary osteoarthrosis (28 patients), arthritis after arthroscopic reconstruction for anterior instability (1 patient) and inflammatory arthritis (3 patients). All shoulders were assessed clinically using the Constant and Murley score, and results graded according to Neer's criteria. Statistical analysis was performed to determine significant parameters and associations. A significant improvement (P < 0.0001) in each parameter of the subjective evaluation component (severity of pain, limitation in daily living and recreational activities) of the Constant score was observed. The Constant and Murley score increased significantly (P < 0.0001) from a median of 40 points (range 26-63) pre-operatively to 64.5 (range 19-84) at the final assessment. Overall, the procedure was considered as "successful outcome" in 23 patients (72%) and as a "failure" in 9 patients (28%). According to Neer's criteria, the result was categorized as excellent in 9 (28%), satisfactory in 14 (44%) and unsatisfactory in 9 (28%). Within the unsatisfactory group, there were five conversions to prosthetic arthroplasty. A standard magnetic resonance imaging was performed on 22 patients in the successful outcome group; glenoid cartilage was identified in 12 (thick in 5, intermediate in 1, thin in 6) and could not be identified in 10 patients (complete/incomplete loss in 5, technical difficulties in 5). Overall, five complications included transient axillary nerve paresis, foreign-body reaction to biological material, inter-layer dissociation, mild chronic non-specific synovitis and post-traumatic contusion

  14. "Ladettes," Social Representations, and Aggression.

    ERIC Educational Resources Information Center

    Muncer, Steven; Campbell, Anne; Jervis, Victoria; Lewis, Rachel

    2001-01-01

    Examined the relationship among "laddishness" (traditionally working-class, youthful, male social behavior by young women), social representations, and self-reported aggression among English college students. Measures of aggression correlated with holding more instrumental representations of aggression. Females indicated no relationship between…

  15. Children's normative beliefs about aggression and aggressive behavior.

    PubMed

    Huesmann, L R; Guerra, N G

    1997-02-01

    Normative beliefs have been defined as self-regulating beliefs about the appropriateness of social behaviors. In 2 studies the authors revised their scale for assessing normative beliefs about aggression, found that it is reliable and valid for use with elementary school children, and investigated the longitudinal relation between normative beliefs about aggression and aggressive behavior in a large sample of elementary school children living in poor urban neighborhoods. Using data obtained in 2 waves of observations 1 year apart, the authors found that children tended to approve more of aggression as they grew older and that this increase appeared to be correlated with increases in aggressive behavior. More important, although individual differences in aggressive behavior predicted subsequent differences in normative beliefs in younger children, individual differences in aggressive behavior were predicted by preceding differences in normative beliefs in older children. PMID:9107008

  16. CT and MRI of aggressive osteoblastoma of thyroid cartilage

    SciTech Connect

    Agarwala, R.; Graham, R.J.; Panella, J.S.

    1996-01-01

    We present a unique case of aggressive osteoblastoma arising from thyroid cartilage. A 52-year-old man presented with a 10 month history of neck discomfort but without frank pain. CT and MR examinations disclosed a well defined mass arising from the thyroid cartilage. This lesion had areas of coarse calcifications and a central area of lucency. The appearance suggested chondrosarcoma. Hemilaryngectomy was performed to remove the mass en bloc. Surgical pathology diagnosed aggressive osteoblastoma arising from thyroid cartilage. 8 refs., 2 figs.

  17. Aggressive drowsy cache cells

    NASA Astrophysics Data System (ADS)

    Shawkey, H. A.; El-Dib, D. A.; Abid, Z.

    2010-01-01

    An aggressive drowsy cache block management, where the cache block is forced into drowsy mode all the time except during write and read operations, is proposed. The word line (WL) is used to enable the normal supply voltage (V DD_high) to the cache line only when it is accessed for read or write whereas the drowsy supply voltage (V DD_low) is enabled to the cache cell otherwise. The proposed block management neither needs extra cycles nor extra control signals to wake the drowsy cache cell, thereby reducing the performance penalty associated with traditional drowsy caches. In fact, the proposed aggressive drowsy mode can reduce the total power consumption of the traditional drowsy mode by 13% or even more, depending on the cache access rate, access frequency and the CMOS technology used.

  18. Variables associated with remission in spinal surgical site infections

    PubMed Central

    Uçkay, Ilker; Faundez, Antonio; Douissard, Jonathan; Kuczma, Paulina; Suvà, Domizio; Zingg, Mathieu; Hoffmeyer, Pierre; Dominguez, Dennis E.; Racloz, Guillaume

    2016-01-01

    Background There is few medical literature regarding factors associated with remission after surgical and medical treatment of postoperative spine infections. Methods Single-centre case-control study 2007–2014. Cluster-controlled Cox regression model with emphasis on surgical and antibiotic-related parameters. Results Overall, we found 66 episodes in 48 patients (49 episodes with metalwork) who had a median follow-up of 2.6 years (range, 0.5 to 6.8 years). The patients had a median of two surgical debridements. The median duration of antibiotic therapy was 8 weeks, of which 2 weeks parenteral. Clinical recurrence after treatment was noted in 13 episodes (20%), after a median interval of 2 months. In 53 cases (80%), the episodes were considered as in remission. By multivariate analyses, no variable was associated with remission. Especially, the following factors were not significantly related to remission: number of surgical interventions [hazard ratio (HR) 0.9; 95% confidence interval (CI), 0.8–1.1]; infection due to Staphylococcus aureus (HR 0.9; 0.8–1.1), local antibiotic therapy (HR 1.2; 0.6–2.4), and, duration of total (HR 1.0; 0.99–1.01) (or just parenteral) (HR 1.0; 0.99–1.01) antibiotic use. Conclusions In patients with post-operative spine infections, remission is achieved in 80%. The number of surgical debridement or duration of antibiotic therapy shows no association with recurrence, suggesting that individual risk factors might be more important than the duration of antibiotic administration. PMID:27683709

  19. Variables associated with remission in spinal surgical site infections

    PubMed Central

    Uçkay, Ilker; Faundez, Antonio; Douissard, Jonathan; Kuczma, Paulina; Suvà, Domizio; Zingg, Mathieu; Hoffmeyer, Pierre; Dominguez, Dennis E.; Racloz, Guillaume

    2016-01-01

    Background There is few medical literature regarding factors associated with remission after surgical and medical treatment of postoperative spine infections. Methods Single-centre case-control study 2007–2014. Cluster-controlled Cox regression model with emphasis on surgical and antibiotic-related parameters. Results Overall, we found 66 episodes in 48 patients (49 episodes with metalwork) who had a median follow-up of 2.6 years (range, 0.5 to 6.8 years). The patients had a median of two surgical debridements. The median duration of antibiotic therapy was 8 weeks, of which 2 weeks parenteral. Clinical recurrence after treatment was noted in 13 episodes (20%), after a median interval of 2 months. In 53 cases (80%), the episodes were considered as in remission. By multivariate analyses, no variable was associated with remission. Especially, the following factors were not significantly related to remission: number of surgical interventions [hazard ratio (HR) 0.9; 95% confidence interval (CI), 0.8–1.1]; infection due to Staphylococcus aureus (HR 0.9; 0.8–1.1), local antibiotic therapy (HR 1.2; 0.6–2.4), and, duration of total (HR 1.0; 0.99–1.01) (or just parenteral) (HR 1.0; 0.99–1.01) antibiotic use. Conclusions In patients with post-operative spine infections, remission is achieved in 80%. The number of surgical debridement or duration of antibiotic therapy shows no association with recurrence, suggesting that individual risk factors might be more important than the duration of antibiotic administration.

  20. Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate.

    PubMed

    Smith, Daniel C; Maiman, Richard; Schwechter, Evan M; Kim, Sun Jin; Hirsh, David M

    2015-10-01

    Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period. Significant decrease was noted on all disks before reincubation. Postreincubation, significant decrease in CFUs was found in the 4% and 2% groups. This study demonstrated that I+D of an infected PJI model with 4% CG solution was effective at treating MRSA biofilm at concentrations as low as 2%.

  1. Hypnotherapy as an adjunct to narcotic analgesia for the treatment of pain for burn debridement.

    PubMed

    Patterson, D R; Questad, K A; de Lateur, B J

    1989-01-01

    This paper presents a hypnotherapeutic intervention for controlling pain in severely burned patients while they go through dressing changes and wound debridement. The technique is based on Barber's (1977) Rapid Induction Analgesia (RIA) and involves hypnotizing patients in their rooms and having their nurses provide posthypnotic cues for analgesia during wound cleaning. Five subjects who underwent hypnotherapy showed reductions on their pain rating scores (Visual Analogue Scale) relative to their own baselines and to the pain curves of a historical control group (N = 8) matched for initial pain rating scores. Although the lack of randomized assignment to experimental and control groups limited the validity of the results, the findings provide encouraging preliminary evidence that RIA offers an efficient and effective method for controlling severe pain from burns. PMID:2563925

  2. Maggot debridement therapy promotes diabetic foot wound healing by up-regulating endothelial cell activity.

    PubMed

    Sun, Xinjuan; Chen, Jin'an; Zhang, Jie; Wang, Wei; Sun, Jinshan; Wang, Aiping

    2016-03-01

    To determine the role of maggot debridement therapy (MDT) on diabetic foot wound healing, we compared growth related factors in wounds before and after treatment. Furthermore, we utilized human umbilical vein endothelial cells (HUVECs) to explore responses to maggot excretions/secretions on markers of angiogenesis and proliferation. The results showed that there was neo-granulation and angiogenesis in diabetic foot wounds after MDT. Moreover, significant elevation in CD34 and CD68 levels was also observed in treated wounds. In vitro, ES increased HUVEC proliferation, improved tube formation, and increased expression of vascular endothelial growth factor receptor 2 in a dose dependent manner. These results demonstrate that MDT and maggot ES can promote diabetic foot wound healing by up-regulating endothelial cell activity.

  3. Arthroscopic debridement for bilateral calcific tendinitis of the subscapularis tendons: a case report.

    PubMed

    Tung, Kam-Lung; Woo, Siu-Bon

    2015-04-01

    We report on a 36-year-old man who underwent arthroscopic debridement for bilateral calcific tendinitis of the subscapularis tendons. The patient had a positive coracoid impingement test for both shoulders. Radiology showed calcific deposits at the insertion of both subscapularis tendons, close to the lesser tuberosities and just posterior to the coracoid tips. The patient underwent sequential arthroscopic coracoplasty and removal of calcific deposits in the subscapularis tendons. The patient returned to work 6 weeks after each surgery. At 2 years, the patient had no shoulder pain, with full range of motion and full power of the subscapularis muscles. The coracoid impingement test was negative for both shoulders. There was no evidence of recurrence.

  4. A 12 Months Clinical and Radiographic Study to Assess the Efficacy of Open Flap Debridement and Subepithelial Connective Tissue Graft in Management of Supracrestal Defects

    PubMed Central

    Chhina, Shivjot

    2015-01-01

    Background: An improvement in clinical parameters along with regeneration is the desired outcome of periodontal therapy. The aim of this study was to analyze and contrast the efficaciousness of combined open flap debridement (OFD) and subepithelial connective tissue graft (SECTG) to OFD in the management of periodontal supracrestal defects. Materials and Methods: Totally, 20 paired sites exhibiting supracrestal defects were subjected to surgical treatment adopting the split mouth design. The defects were divided randomly for treatment with OFD and SECTG (test) or OFD alone (control). The clinical effectiveness of the two arms of treatment was evaluated at 6 months and 12 months post-operatively by assessing clinical and radiographic parameters. The measurements carried out included probing pocket depth (PPD), relative attachment level (RAL), gingival marginal level, radiographic bone level (BL). Results: The mean reduction in PPD at 0-12 months was 3.20 ± 0.82 mm and RAL gain of 3.10 ± 1.51 mm was observed, the OFD and SECTG (test) group; corresponding observations for OFD (control) were 2.10 ± 0.63 mm and 1.90 ± 0.57 mm. However, BL changes did not follow the pattern of clinical improvement on the radiographic assessment of either treatment group. Post-operative evaluation was made. Improvement in different clinical parameters was statistically significant (P < 0.01). Conclusion: Treatment of supracrestal defects with a combination of OFD and SECTG led to significantly better clinical results compared to OFD alone. PMID:26464551

  5. The effectiveness of different root debridement modalities in open flap surgery.

    PubMed

    Huerzeler, M B; Einsele, F T; Leupolz, M; Kerkhecker, U; Strub, J R

    1998-03-01

    It is unclear what degree of roughness or smoothness result from use of hand instruments alone in comparison to the use of hand instruments in combination with other aids and how it may effect the grade of cleanliness. The aim of this study was to determine in vivo whether the combination of hand instruments with other aids can increase the effectiveness of root debridement. 11 patients with holpless 4 mandibular incisors were involved in this study. After elevating a lingual and buccal mucoperiosteal flap, the 4 incisors were randomly treated with either: (1) no treatment (control); (2) 5-min scaling (method 1); (3) 4-min scaling and 1 min instrumentation with a perio-diamond bur (15 microm) (method 2); (4) 3-min scaling, 1-min instrumentation with a perio-diamond bur (15 microm) and 1 min with an air abrasive system (method 3). The cleanliness of the surface was determined using the method of Eschler and -Rapley. The degree of roughness (Ra and Rt) were measured with a laser beam (computer supported optical surface sensor system). In addition, an SEM analysis was performed. With regard to the remaining calculus (surface cleanliness), method 3 yielded significantly better results than the other 2 methods. The roughness analyses also exhibited that method 3 is superior to methods 1 and 2. The qualitative results of the SEM investigations demonstrated the most homogeneous and smooth surfaces with method 3. Root debridement in vivo was most significant using a combination of different treatment modalities (i. e., curettes, perio-diamond bur and air abrasive system).

  6. Surgical Treatment in Patients with Cervical Osteomyelitis: Single Institute's Experiences

    PubMed Central

    Hahn, Bang Sang; Kim, Kyung-Hyun; Park, Jung Yoon; Chin, Dong-Kyu; Kim, Keun-Su; Cho, Yong-Eun

    2014-01-01

    Objective To study practical guidelines and strategies in the treatment of cervical osteomyelitis. Methods We retrospectively reviewed 14 patients who underwent surgical treatment for cervical osteomyelitis from May 2000 to July 2008. We investigated their clinical course, antibiotic regimen, surgical methods, and laboratory and radiologic findings including X-ray, CT and MRI. Results 5 patients had primary spondylodiscitis, 5 patients had post operative spondylodiscitis and 4 patients had tuberculosis in cervical spine. The causative microorganisms were MRSA (5), P. aeruginosa (1), Methicillin resistant coagulase negative streptococcus (1), P. aeruginosa changed to MRSA (1), and 2 patients showed no growth on culture studies. Patients were treated 13.8 weeks (range, 5.4-25.8) with IV antibiotics and then treated for 58.2 days (range, 13-106) with oral antibiotics. Antituberculotic medications were used for a mean of 383.8 days. Patients were treated with anterior debridement and fusion (5), irrigation and debridement (5), simultaneous cervical anterior interbody and transthoracic thoracic interbody fusion (1). 3 patients underwent the planned 2-staged operation, which included an anterior debridement with or without fusion for the 1st operation and posterior instrumentation for 2nd operation. 10 patients (71.4%) had neurologic deficits at the time of diagnosis and 7 patients (70%) among them improved post-operatively. Conclusion Anterior cervical spine surgery is the preferable treatment option in patients with neurological deterioration, extensive bony destruction with expected kyphotic deformity, and uncontrolled infection being managed only with antibiotics. Antibiotics are also important for thorough treatment. PMID:25346763

  7. Unique surgical tool as an iatromagic charm.

    PubMed

    Somma, Alfredo Musajo; Somma, Laura Musajo

    2010-12-01

    Papyri are writings made on special sheets made out of reeds grown on the banks of the river Nile. The Authors comment on the relationship between a ritual text and surgical therapy with an exploration of an ancient charm as recorded in a Greek written papyrus stored in the Medicea Laurenziana Library papyri collection. This charm was presumably intended to act apotropaically, rendering harmless the aggressive surgical tool by means of still keeping its therapeutic value and thereby affording healing protection. This ritual charm acts as a "therapeutic medium" to help the surgical procedure useful to cut or to excise the uvula. The surgical power of stafillotomos is linked to the protective power of the iatromagic charm, giving the chance to analyze ancient data and to suggest a possible shape of the original scalpel. PMID:21657101

  8. Role of Radiotherapy in Aggressive Digital Papillary Adenocarcinoma.

    PubMed

    Feldmeyer, Laurence; Prieto, Victor G; Ivan, Doina; Nagarajan, Priyadharsini; Tetzlaff, Michael T; Curry, Jonathan L; Bell, Diana; Moon, Bryan S; Torres-Cabala, Carlos A; Aung, Phyu P

    2016-01-01

    Aggressive digital papillary adenocarcinoma (ADPA) is a rare and often misdiagnosed malignant tumor of the sweat glands, most commonly encountered on the extremities. Due to the relatively high metastatic potential of the tumor, aggressive surgical treatment, including amputation, is generally recommended. We present a case of a 36-year-old male with an over 10-year history of a skin lesion on the right hand in the web space between the index and the middle finger. Histologically, the lesion revealed a malignant epithelioid neoplasm with features consistent with ADPA. The lesion was treated with 5-weeks preoperative radiation (total 5000 cGy) followed by surgical resection. There was no evidence of residual disease confirmed by pathological study of re-excision specimen as well as imaging studies. This is, to the best of knowledge, the first report of complete regression of an ADPA after radiotherapy. PMID:27098633

  9. Girls, aggression, and emotion regulation.

    PubMed

    Conway, Anne M

    2005-04-01

    Many studies have demonstrated that boys are more aggressive than girls (see J. D. Coie & K. Dodge, 1997, for a review) and that emotion regulation difficulties are associated with problematic behaviors (N. Eisenberg & R. A. Fabes, 1999; M. Gilliom, D. S. Shaw, J. E. Beck, M. A. Schonberg, & J. L. Lukon, 2002). However, recent findings indicate that gender differences in aggressive behaviors disappear when assessments are broadened to include relational aggression--behaviors designed to harm the relationship goals of others by spreading rumors, gossiping, and eliciting peer rejection of others. Moreover, although difficulties regulating emotions have been reported for physically aggressive children, little research has examined these processes in relationally aggressive children. This article argues that investigation into the associations between emotion regulation and relational aggression is a critical direction for future research on the etiology and prevention of mental health problems in girls. PMID:15839769

  10. [The aggressive child (author's transl)].

    PubMed

    Harbauer, H

    1978-08-01

    In children a "normal" aggressiveness should be distinguished from "hostile" and "inhibited" aggression; the latter usually become apparent as heteroaggressive or autoaggressive behaviour. Autoaggression is more common with younger children. Different hypotheses about the origin of aggressiveness are discussed. In the younger child nail biting, trichotillomania, rocking, an intensified phase of contrariness and enkopresis may have components of aggressiveness. In older children and adolescents dissocial forms of development, drug taking, attempted suicid, and anorexia nervosa may be parts of aggressive behaviour. Minimal brain dysfunction, autism, and postencephalitic syndromes predominate amongst organic alterations of the brain as causes for aggressive behaviour. Particularly the Lesch-Nyhan-syndrome, but equally the Cornelia de Lange-syndrome show autoaggressive tendencies.

  11. Methicillin-resistant Staphylococcus aureus infection in vascular surgical patients.

    PubMed Central

    Murphy, G. J.; Pararajasingam, R.; Nasim, A.; Dennis, M. J.; Sayers, R. D.

    2001-01-01

    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is emerging as a major problem in vascular surgical practice. The aim of this study was to review the management of patients with MRSA infection complicating vascular surgical operations. METHODS: Data were obtained from the vascular audit, case notes, intensive therapy unit (ITU) notes, high dependency unit (HDU) notes and microbiological records of patients who underwent either arterial reconstruction (n = 464) or limb amputation (n = 110) between April 1994 and October 1998. RESULTS: Forty-nine vascular surgical patients developed clinical MRSA infection (9%). Clinical MRSA infection in patients who had undergone aorto-iliac reconstruction (n = 18) was associated with a 56% mortality (n = 10) and the most common infections were bacteraemia (55%) and pneumonia (50%). MRSA infection occurred in 17 patients who had undergone infra-inguinal bypass and was associated with a 29% mortality (n = 5). The most common site of MRSA infection was the groin wound (76%) leading to anastomotic dehiscence and death in one patient (11%) and necessitating wound debridement in 4 patients (22%). MRSA infection of the groin wound in the presence of a prosthetic graft (n = 3) led to anastomotic dehiscence in 2 patients, and graft excision in 2 patients. Similar complications were not observed in the presence of an underlying autogeneous long saphenous vein graft (n = 16). MRSA infection following major lower limb amputation (n = 14) was associated with death in 5 patients (36%). Wound infection in 10 amputees (71%) led to revision of the amputation to a higher level in 2 (14%) and wound debridement in 2 (14%). CONCLUSIONS: MRSA infection has a high mortality in vascular surgical patients in general, and following aorto-iliac reconstruction in particular. Autogeneous vein may confer some protection against local complications following groin wound infection. Strategies aimed at reducing the incidence of infection

  12. Aggressive fibromatosis of anterior maxilla

    PubMed Central

    Shetty, Devi C; Urs, Aadithya B; Ahuja, Puneet; Sikka, Seema

    2011-01-01

    Aggressive fibromatosis is a comparitively rare tumor with unpredictable growth and varying local recurrence rates. It does not develop distant metastases but locally it shows an aggressive and infiltrative behavior. Clinically, aggressive fibromatosis manifests as a painless, firm, often rapidly enlarging mass, fixed to underlying bone or soft tissue. It is never encapsulated. Histologically, it is rich in collagen and fibroblastic cells that are devoid of hyperchromatic or atypical nuclei, but with more variable cellularity in different tumor sections. PMID:21731285

  13. Nonsurgical treatment of aggressive fibromatosis in the head and neck

    SciTech Connect

    West, C.B. Jr.; Shagets, F.W.; Mansfield, M.J. )

    1989-09-01

    Aggressive fibromatosis is a poorly defined, locally aggressive, yet histologically benign fibroblastic proliferative lesion that may occur in the head and neck. The lesion is highly cellular and locally infiltrative and has a propensity to invade and erode bone, compromising vital structures within the head and neck. However, it is not a true malignancy because it does not have malignant cytologic characteristics nor does it metastasize. We present two cases of aggressive fibromatosis occurring in young adult men. The first case involved a rapidly enlarging mass of the anterior maxilla that involved the upper lip, nasal alae, nasal septum, inferior turbinates, and hard palate. The patient underwent incisional biopsy to confirm the diagnosis. Because of difficulty in determining the actual margins of this extensive lesion and the significant morbidity that would have resulted from surgical resection, we elected to treat this patient with chemotherapy and radiation therapy. The second case was an extensive lesion involving the right temporal bone, pterygomaxillary space, and infratemporal, temporal, and middle cranial fossae. Incisional biopsy confirmed the diagnosis. Because of the lack of functional and cosmetic deficits and the unavoidable morbidity of a surgical resection, this patient was treated with radiation therapy. Although wide field resection is the most satisfactory form of treatment, in situations in which this modality would result in unacceptable morbidity or if surgical margins are positive, then radiation therapy and chemotherapy should be considered. Support for these therapeutic modalities is found in larger series of cases outside the head and neck.

  14. Rethinking Aggression: A Typological Examination of the Functions of Aggression.

    ERIC Educational Resources Information Center

    Little, Todd D.; Brauner, Jessica; Jones, Stephanie M.; Nock, Matthew K.; Hawley, Patricia H.

    2003-01-01

    Compared five subgroups of aggressive children and adolescents on several adjustment correlates. Found that the reactive group and the group high on both instrumental and reactive reasons for aggression showed consistent maladaptive patterns across the adjustment correlates. The instrumental and typical groups (moderate on instrumental and…

  15. Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas with Adjuvant Temozolomide Chemotherapy: A Review

    PubMed Central

    Cruz, Aurora S; Benkers, Tara; Rostad, Steven; Broyles, Frances Broyles; Yuen, Kevin; Mayberg, Marc

    2016-01-01

    Most prolactin-secreting pituitary adenomas demonstrate slow growth and are effectively managed with medical/surgical therapy. Rarely, these tumors can behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical, or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman, which became progressively aggressive and refractory to usual treatment modalities, but responded to treatment with the chemotherapeutic agent temozolomide. In addition, we review the literature for treatment of refractory adenomas with temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy, and chemotherapy. PMID:27489751

  16. Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas with Adjuvant Temozolomide Chemotherapy: A Review.

    PubMed

    Moisi, Marc; Cruz, Aurora S; Benkers, Tara; Rostad, Steven; Broyles, Frances Broyles; Yuen, Kevin; Mayberg, Marc

    2016-01-01

    Most prolactin-secreting pituitary adenomas demonstrate slow growth and are effectively managed with medical/surgical therapy. Rarely, these tumors can behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical, or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman, which became progressively aggressive and refractory to usual treatment modalities, but responded to treatment with the chemotherapeutic agent temozolomide. In addition, we review the literature for treatment of refractory adenomas with temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy, and chemotherapy.

  17. Iontophoresis-Assisted Corneal Collagen Cross-Linking with Epithelial Debridement: Preliminary Results.

    PubMed

    Vinciguerra, Paolo; Romano, Vito; Rosetta, Pietro; Legrottaglie, Emanuela F; Kubrak-Kisza, Magdalena; Azzolini, Claudio; Vinciguerra, Riccardo

    2016-01-01

    Purpose. To report the early outcomes of iontophoresis-assisted corneal collagen cross-linking procedure with epithelial debridement (I-SCXL). Methods. Twenty eyes of twenty patients with progressive keratoconus were included in this prospective clinical study. Best spectacle corrected visual acuity (BSCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, anterior segment optical coherence tomography (AS-OCT), and endothelial cell count were assessed at baseline and at 1, 3, and 6 months of follow-up. The parameters considered to establish keratoconus progression were always proven with differential maps as change in curvature in the cone area of at least 1 diopter obtained with an instantaneous map. Results. Functional parameters showed a significant improvement (p < 0.05) of BSCVA after 3 and 6 months of follow-up. Morphological parameters indicated stabilization of the corneal ectasia during the follow-up; however, a positive trend was noted with a mean flattening of 1.73 D. Minimum pachymetry values showed thinning that remained constant after the treatment. The demarcation line was clearly visible in all patients, reaching a depth of 308.2 ± 37.74 μm. None of the patients had continuous progression of keratoconus or had to repeat cross-linking procedures. Endothelial cell counts did not change significantly (p > 0.05). Conclusion. The early results indicate that the I-SCXL may be able to reduce the treatment time and improve the riboflavin diffusion. PMID:27547758

  18. Iontophoresis-Assisted Corneal Collagen Cross-Linking with Epithelial Debridement: Preliminary Results

    PubMed Central

    Legrottaglie, Emanuela F.

    2016-01-01

    Purpose. To report the early outcomes of iontophoresis-assisted corneal collagen cross-linking procedure with epithelial debridement (I-SCXL). Methods. Twenty eyes of twenty patients with progressive keratoconus were included in this prospective clinical study. Best spectacle corrected visual acuity (BSCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, anterior segment optical coherence tomography (AS-OCT), and endothelial cell count were assessed at baseline and at 1, 3, and 6 months of follow-up. The parameters considered to establish keratoconus progression were always proven with differential maps as change in curvature in the cone area of at least 1 diopter obtained with an instantaneous map. Results. Functional parameters showed a significant improvement (p < 0.05) of BSCVA after 3 and 6 months of follow-up. Morphological parameters indicated stabilization of the corneal ectasia during the follow-up; however, a positive trend was noted with a mean flattening of 1.73 D. Minimum pachymetry values showed thinning that remained constant after the treatment. The demarcation line was clearly visible in all patients, reaching a depth of 308.2 ± 37.74 μm. None of the patients had continuous progression of keratoconus or had to repeat cross-linking procedures. Endothelial cell counts did not change significantly (p > 0.05). Conclusion. The early results indicate that the I-SCXL may be able to reduce the treatment time and improve the riboflavin diffusion. PMID:27547758

  19. Midgut lysozymes of Lucilia sericata - new antimicrobials involved in maggot debridement therapy.

    PubMed

    Valachova, I; Takac, P; Majtan, J

    2014-12-01

    Larvae of Lucilia sericata are used for maggot debridement therapy (MDT) because of their ability to remove necrotic tissue and eradicate bacterial pathogens of infected wounds. So far, very few antibacterial factors have been fully characterized (eg lucifensin). Using a molecular approach, some other putative antimicrobial compounds, including three novel lysozymes, have been previously identified and predicted to be involved in MDT. Nevertheless, data on lysozymes tissue origin and their functions have never been elucidated. Therefore, the aim of this study was to investigate the expression of three lysozymes in L. sericata and confirm their antibacterial effects within MDT. Moreover, we characterized the eradication process of bacteria within the digestive system of maggots and determined the role of lysozymes in this process. We found that three lysozymes are expressed in specific sections of the L. sericata midgut. Recombinant lysozymes displayed comparable antibacterial activity against Micrococcus luteus. Furthermore, the majority of Gram-positive bacteria were destroyed in vivo within the particular section of the L. sericata midgut where lysozymes are produced. Larval ingestion and subsequent eradication of wound pathogens during their passage through the intestine of maggots are due to, at least in part, antibacterial action of three midgut lysozymes.

  20. Surgical approaches for liver metastases in carcinoid tumors

    PubMed Central

    Saeed, Ahmad; Buell, Joseph

    2015-01-01

    Liver is the commonest site for metastasis in patients with neuroendocrine tumors (NETs); it occurs in 45-95% of patients. Available treatment options include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy. Typically, a multidisciplinary approach is a cornerstone for decision making while dealing with this aggressive disease. This review will focus on the performance and safety of open, laparoscopic, and liver transplant surgical approaches in NETs patients with liver metastases. PMID:26425458

  1. THE IMPACT OF AGGRESSION IN THE CLASSROOM.

    ERIC Educational Resources Information Center

    MCNEIL, ELTON B.; AND OTHERS

    IN THIS INVESTIGATION, AGGRESSION WAS MEASURED FROM FOUR PERSPECTIVES--(1) THE PERCEPTION THAT THE SUBJECT HAD OF HIS AGGRESSION, (2) HIS SATISFACTION, AS HE VIEWED IT, WITH HIS OWN AGGRESSION, (3) THE PERCEPTION THAT THE TEACHER HAD OF THE SUBJECT'S AGGRESSIVENESS, AND (4) THE PERCEPTION OF THE SUBJECT'S AGGRESSIVENESS HELD BY HIS CLASSMATES. IN…

  2. The Effects of Pornography on Aggressive Behavior.

    ERIC Educational Resources Information Center

    Stacy, Lauri L.

    This document reviews existing empirical research on the effect of pornography on aggressive behavior. Two types of pornography are distinguished: aggressive pornography and non-aggressive pornography. Conclusions drawn from the research review are presented, including: (1) aggressive pornograpy consistently increases aggressive attitudes and…

  3. Psychological Research on Human Aggressiveness

    ERIC Educational Resources Information Center

    Hamburg, D. A.; Brodie, H. K. H.

    1973-01-01

    Discusses research relating to the effects of hormones, neurophysiology, and the environment on animal and human aggression. Indicates that the interactions of biological, psychological and social processes in the development of human aggressiveness should constitute one of the principal frontiers for science in the next two decades. (JR)

  4. Aggression and Violence in Youth.

    ERIC Educational Resources Information Center

    William Gladden Foundation, York, PA.

    This booklet was written to provide an understanding of aggression and violence in youth. Its purpose is to help parents, professionals, and other concerned citizens prevent or reduce these potentially dangerous behaviors. The introduction notes that many experts agree that aggression and violence are on the rise in America. The first section of…

  5. Comparisons of negative pressure wound therapy and ultrasonic debridement for diabetic foot ulcers: a network meta-analysis

    PubMed Central

    Wang, Ruran; Feng, Yanhua; Di, Bo

    2015-01-01

    Objective: a network meta-analysis was performed to compare the strength and weakness of negative pressure wound therapy (NPWT) with ultrasound debridement (UD) as for diabetic foot ulcers (DFU). Methods: PubMed, Ovid EMBASE, Web of Science, Cochrane library databases, and Chinese Biomedical Literature Database were searched till February 2015. Clinical compared studies of negative pressure wound therapy and ultrasound debridement were enrolled. The primary efficacy outcomes included healed ulcers, reduction of ulcer areas and time to closure. Secondary amputation including major and minor amputations was used to assess the safety profile. Results: Out of 715 studies, 32 were selected which enrolled 2880 diabetic patients. The pooled analysis revealed that NPWT including vacuum assisted closure (VAC) and vacuum sealing drainage (VSD) were as efficacious as ultrasound debridement improving healed ulcers, odds ratio, 0.86; 95% CI 0.28 to 2.6 and 1.2; 95% CI 0.38 to 4, respectively. However, both were better to standard wound care in wound healing patients. Compared with the standard wound care treated diabetic foot ulcers, NPWT and UD resulted in a significantly superior efficacy in time to wound closure and decrement in area of wound. No significances were observed between NPWT and UD groups in both indicators. Fewer patients tended to receive amputation in NPWT and UD groups compared to standard wound care group. Conclusions: The results of the network meta-analysis indicated that negative pressure wound therapy was similar to ultrasound debridement for diabetic foot ulcers, but better than standard wound care both in efficacy and safety profile. PMID:26550165

  6. 75% success rate after open debridement, exchange of tibial insert, and antibiotics in knee prosthetic joint infections

    PubMed Central

    Thórhallsdóttir, Valdís Gudrún; Robertsson, Otto; W-Dahl, Annette; Stefánsdóttir, Anna

    2015-01-01

    Background and purpose Prosthetic joint infection (PJI) is a leading cause of early revision after total knee arthroplasty (TKA). Open debridement with exchange of tibial insert allows treatment of infection with retention of fixed components. We investigated the success rate of this procedure in the treatment of knee PJIs in a nationwide material, and determined whether the results were affected by microbiology, antibiotic treatment, or timing of debridement. Patients and methods 145 primary TKAs revised for the first time, due to infection, with debridement and exchange of the tibial insert were identified in the Swedish Knee Arthroplasty Register (SKAR). Staphylococcus aureus was the most common pathogen (37%) followed by coagulase-negative staphylococci (CNS) (23%). Failure was defined as death before the end of antibiotic treatment, revision of major components due to infection, life-long antibiotic treatment, or chronic infection. Results The overall healing rate was 75%. The type of infecting pathogen did not statistically significantly affect outcome. Staphylococcal infections treated without a combination of antibiotics including rifampin had a higher failure rate than those treated with rifampin (RR = 4, 95% CI: 2–10). In the 16 cases with more than 3 weeks of symptoms before treatment, the healing rate was 62%, as compared to 77% in the other cases (p = 0.2). The few patients with a revision model of prosthesis at primary operation had a high failure rate (5 of 8). Interpretation Good results can be achieved by open debridement with exchange of tibial insert. It is important to use an antibiotic combination including rifampin in staphylococcal infections. PMID:25753311

  7. A Jonah-like chymotrypsin from the therapeutic maggot Lucilia sericata plays a role in wound debridement and coagulation.

    PubMed

    Pöppel, Anne-Kathrin; Kahl, Mareike; Baumann, Andre; Wiesner, Jochen; Gökçen, Anke; Beckert, Annika; Preissner, Klaus T; Vilcinskas, Andreas; Franta, Zdeněk

    2016-03-01

    Lucilia sericata larvae are used in maggot debridement therapy, a traditional wound healing approach that has recently been approved for the treatment of chronic wounds. Maggot excretion products (MEP) contain many different proteases that promote disinfection, debridement and the acceleration of wound healing, e.g. by activating the host contact phase/intrinsic pathway of coagulation. In order to characterise relevant procoagulant proteases, we analysed MEP and identified a chymotrypsin-like serine protease with similarities to Jonah proteases from Drosophila melanogaster and a chymotrypsin from Lucilia cuprina. A recombinant form of the L. sericata Jonah chymotrypsin was produced in Escherichia coli. The activated enzyme (Jonahm) had a pH optimum of 8.0 and a temperature optimum of 37 °C, based on the cleavage of the chromogenic peptide s-7388 and casein. Jonahm reduced the clotting time of human plasma even in the absence of the endogenous protease kallikrein, factor XI or factor XII and digested the extracellular matrix proteins fibronectin, laminin and collagen IV, suggesting a potential mechanism of wound debridement. Based on these characteristics, the novel L. sericata chymotrypsin-like serine protease appears to be an ideal candidate for the development of topical drugs for wound healing applications.

  8. Instrumental and Social Outcome Expectations of High-Aggressive and Low-Aggressive Boys.

    ERIC Educational Resources Information Center

    Cillessen, Antonius H. N.; Hubbard, Julie A.

    This study examined high-aggressive and low-aggressive boys' ratings of the effectiveness of aggressive and assertive strategies for solving social problems involving hypothetical peers and actual peers. Subjects were 66 third-grade boys (11 groups of 6 boys each for a total of 22 high-aggressive, 22 low-aggressive, and 22 average aggressive boys)…

  9. Aggressive Erotica and Violence against Women.

    ERIC Educational Resources Information Center

    Donnerstein, Edward

    1980-01-01

    Examines the effects of aggressive-erotic stimuli on male aggression toward females. Male subjects' deliveries of electric shocks to males or females after viewing either a neutral, erotic, or aggressive-erotic film were measured. (Author/SS)

  10. Involvement in internet aggression during early adolescence.

    PubMed

    Werner, Nicole E; Bumpus, Matthew F; Rock, Daquarii

    2010-06-01

    The current study examined concurrent and longitudinal predictors of early adolescents' involvement in Internet aggression. Cross-sectional results (N = 330; 57% female) showed that the likelihood of reporting Internet aggression was higher among youth who spent more time using Internet-based technologies to communicate with friends and who were themselves targets of Internet aggression. Offline relational aggression and beliefs supportive of relational and physical aggression also predicted concurrent involvement in Internet aggression. We used longitudinal data (N = 150; 51% female) to distinguish between youth who were aggressive in traditional contexts only (i.e., school) from those who were aggressive both online and offline. These results indicated that youth who were aggressive both online and offline were older at the initial assessment, were targets of Internet aggression, and held beliefs more supportive of relational aggression than youth who were aggressive offline only. Implications and directions for future research are discussed.

  11. [Principles of surgical therapy concepts for postoperative and chronic osteomyelitis].

    PubMed

    Kutscha-Lissberg, F; Hebler, U; Kälicke, T; Arens, S

    2004-04-01

    Infection of the bone is one of the most serious complications in the field of orthopedic and trauma orthopedic surgery. Sufficient treatment protocols not only contain complex surgical procedures but also sophisticated diagnostic tools, proper use of antibiotics, and intensive physical therapy right from the beginning. Even in light of these advanced treatment protocols, which have great impact on both patients and health care systems, persisting infection and residual functional deficits of the extremities are not rare. In cases of early (acute) infection, the main objective is to avoid chronification by diligent surgical interventions. The surgical principle is the meticulous debridement and lavage of the situs. Revision of only the epifascial layers is as inadequate as the simple reopening of the wound without excision of the whole wound including all tissue layers. In cases of chronic soft tissue and bone infection, radical debridement of all infected and scar tissue is also the basic requirement of treatment. Reconstruction of the soft tissue envelope is done by local or free flap surgery. Because of they are better resistant to infection, musculo(cutaneous)flaps are preferred. Bony reconstruction is done by autologous cancellous bone grafting (partial defects), segment transport (full thickness defects), or freely transplanted vascularized bone grafts (large partial defects). Both soft tissue and osseous reconstruction take a relatively long period of time requiring several operations and periods of hospitalization. These have to be discussed and explained to the patients extensively. If the required amount of resection and the capability of reconstruction do not coincide, the surgeon and the patient have to decide whether restoration of function without definitive infection care, symptomatic infection therapy, or amputation is the most proper treatment option according to the patient's everyday needs and lifestyle. Because each treatment protocol is a

  12. Surgical approaches for the gliomas.

    PubMed

    Watts, Colin; Sanai, Nader

    2016-01-01

    Neurosurgical intervention remains the first step in effective glioma management. Mounting evidence suggests that cytoreduction for low- and high-grade gliomas is associated with a survival benefit. Beyond conventional neurosurgical principles, an array of techniques have been refined in recent years to maximize the effect of the neurosurgical oncologist and facilitate the impact of subsequent adjuvant therapy. With intraoperative mapping techniques, aggressive microsurgical resection can be safely pursued even when tumors occupy essential functional pathways. Other adjunct techniques, such as intraoperative magnetic resonance imaging, intraoperative ultrasonography, and fluorescence-guided surgery, can be valuable tools to safely reduce the tumor burden of low- and high-grade gliomas. Taken together, this collection of surgical strategies has pushed glioma extent of resection towards the level of cellular resolution.

  13. Simulation in Surgical Education

    PubMed Central

    de Montbrun, Sandra L.; MacRae, Helen

    2012-01-01

    The pedagogical approach to surgical training has changed significantly over the past few decades. No longer are surgical skills solely acquired through a traditional apprenticeship model of training. The acquisition of many technical and nontechnical skills is moving from the operating room to the surgical skills laboratory through the use of simulation. Many platforms exist for the learning and assessment of surgical skills. In this article, the authors provide a broad overview of some of the currently available surgical simulation modalities including bench-top models, laparoscopic simulators, simulation for new surgical technologies, and simulation for nontechnical surgical skills. PMID:23997671

  14. Aggression Can be Contagious: Longitudinal Associations between Proactive Aggression and Reactive Aggression Among Young Twins

    PubMed Central

    Dickson, Daniel J.; Richmond, Ashley; Brendgen, Mara; Vitaro, Frank; Laursen, Brett; Dionne, Ginette; Boivin, Michel

    2015-01-01

    The present study examined sibling influence over reactive and proactive aggression in a sample of 452 same-sex twins (113 male dyads, 113 female dyads). Between and within siblings influence processes were examined as a function of relative levels of parental coercion and hostility to test the hypothesis that aggression contagion between twins occurs only among dyads who experience parental coerciveness. Teacher reports of reactive and proactive aggression were collected for each twin in kindergarten (M = 6.04 years; SD = 0.27) and in first grade (M = 7.08 years; SD = 0.27). Families were divided into relatively low, average, and relatively high parental coercion-hostility groups on the basis of maternal reports collected when the children were 5 years old. In families with relatively high levels of parental coercion-hostility, there was evidence of between-sibling influence, such that one twin’s reactive aggression at age 6 predicted increases in the other twin’s reactive aggression from ages 6 to 7, and one twin’s proactive aggression at age 6 predicted increases in the other twin’s proactive aggression from ages 6 to 7. There was also evidence of within-sibling influence such that a child’s level of reactive aggression at age 6 predicted increases in the same child’s proactive aggression at age 7, regardless of parental coercion-hostility. The findings provide new information about the etiology of reactive and proactive aggression and individual differences in their developmental interplay. PMID:25683448

  15. Effects of different sonic activation protocols on debridement efficacy in teeth with single-rooted canals

    PubMed Central

    Niu, Li-na; Luo, Xiao-juan; Li, Guo-hua; Bortoluzzi, Eduardo A.; Mao, Jing; Chen, Ji-hua; Gutmann, James L.; Pashley, David H.; Tay, Franklin R.

    2014-01-01

    Objectives The effects of different EndoActivator® (EA) sonic activation protocols on root canal debridement efficacy were examined. Methods Root canals in 48 single-rooted teeth were instrumented, irrigated initially with NaOCl and divided into 6 groups (N=8) based on the application time of QMix (antimicrobial calcium-chelating irrigant), and the time and sequence of EA irrigant activation - Positive Control: 90 sec QMix; Negative Control: 90 sec saline; Group 1A: 15 sec QMix + 15 sec QMix with EA-activation; Group 1B: 30 sec QMix + 30 sec of QMix with EA-activation; Group 2A: 15 sec QMix with EA-activation + 15 sec QMix; Group 2B: 30 sec QMix with EA-activation + 30 sec QMix. Split roots were examined with scanning electron microscopy for assignment of smear and debris scores in locations along the coronal, middle and apical thirds of the canals. The overall cleanliness of pooled canal locations in the Positive Control and the 4 experimental groups were compared with chi-square tests. Results Significant differences were detected among the 5 groups (p<0.001). Post-hoc pairwise comparisons indicated that the overall canal cleanliness was in the order (from best to worst): 1B = 2B > 2A > 1A > Positive Control. Completely clean canals could not be achieved due to the absence of continuous irrigant flow for EA to clear intraradicular debris. Conclusions Irrespective of the sonic activation sequence, irrigant activation for 30 seconds during a 60-second period of QMix application appears to maximize the smear layer and debris removal potential of the EndoActivator® system. PMID:24878251

  16. A novel approach to the antimicrobial activity of maggot debridement therapy

    PubMed Central

    Andersen, Anders S.; Sandvang, Dorthe; Schnorr, Kirk M.; Kruse, Thomas; Neve, Søren; Joergensen, Bo; Karlsmark, Tonny; Krogfelt, Karen A.

    2010-01-01

    Objectives Commercially produced sterile green bottle fly Lucilia sericata maggots are successfully employed by practitioners worldwide to clean a multitude of chronic necrotic wounds and reduce wound bacterial burdens during maggot debridement therapy (MDT). Secretions from the maggots exhibit antimicrobial activity along with other activities beneficial for wound healing. With the rise of multidrug-resistant bacteria, new approaches to identifying the active compounds responsible for the antimicrobial activity within this treatment are imperative. Therefore, the aim of this study was to use a novel approach to investigate the output of secreted proteins from the maggots under conditions mimicking clinical treatments. Methods cDNA libraries constructed from microdissected salivary glands and whole maggots, respectively, were treated with transposon-assisted signal trapping (TAST), a technique selecting for the identification of secreted proteins. Several putative secreted components of insect immunity were identified, including a defensin named lucifensin, which was produced recombinantly as a Trx-fusion protein in Escherichia coli, purified using immobilized metal affinity chromatography and reverse-phase HPLC, and tested in vitro against Gram-positive and Gram-negative bacterial strains. Results Lucifensin was active against Staphylococcus carnosus, Streptococcus pyogenes and Streptococcus pneumoniae (MIC 2 mg/L), as well as Staphylococcus aureus (MIC 16 mg/L). The peptide did not show antimicrobial activity towards Gram-negative bacteria. The MIC of lucifensin for the methicillin-resistant S. aureus and glycopeptide-intermediate S. aureus isolates tested ranged from 8 to >128 mg/L. Conclusions The TAST results did not reveal any highly secreted compounds with putative antimicrobial activity, implying an alternative antimicrobial activity of MDT. Lucifensin showed antimicrobial activities comparable to other defensins and could have potential as a future drug

  17. Wound debridement potential of glycosidases of the wound-healing maggot, Lucilia sericata.

    PubMed

    Telford, G; Brown, A P; Rich, A; English, J S C; Pritchard, D I

    2012-09-01

    The wound-healing maggot, Lucilia sericata Meigen (Diptera: Calliphoridae), degrades extracellular matrix components by releasing enzymes. The purpose of this study was to investigate the glycosylation profiles of wound slough/eschar from chronic venous leg ulcers and the complementary presence of glycosidase activities in first-instar excretions/secretions (ES1) and to define their specificities. The predominant carbohydrate moieties present in wound slough/eschar were determined by probing one-dimensional Western blots with conjugated lectins of known specificities. The presence of specific glycosidase activities in ES1 was determined using chromogenic and fluorogenic substrates. The removal of carbohydrate moieties from slough/eschar proteins by glycosidases in ES1 was determined by two-dimensional electrophoresis and Emerald 300 glycoprotein staining. α-D-glucosyl, α-D-mannosyl and N-acetylglucosamine residues were detected on slough/eschar-derived proteins. Furthermore, it was demonstrated that the treatment of slough/eschar with ES1 significantly reduced uptake of the carbohydrate-specific stain. Subsequently, α-D-glucosidase, α-D-mannosidase and N-acetylglucosaminidase activities were identified in ES1. Specific chromogenic and fluorogenic substrates and gel filtration chromatography showed that these activities result from distinct enzymes. These activities were mirrored in the removal of α-D-glucosyl, α-D-mannosyl and N-acetylglucosamine residues from proteins of slough/eschar from maggot-treated wounds. These data suggest that maggot glycosidases remove sugars from slough/eschar proteins. This may contribute to debridement, which is ultimately accomplished by a suite of biochemically distinct enzymes present in ES1.

  18. Perioperative Rehabilitation Using a Knee Extension Device and Arthroscopic Debridement in the Treatment of Arthrofibrosis

    PubMed Central

    Biggs-Kinzer, Angie; Murphy, Brian; Shelbourne, K. Donald; Urch, Scott

    2010-01-01

    Background: Arthrofibrosis is a postoperative complication of intra-articular knee surgery that can be difficult to treat. Evidence suggests that maximizing knee range of motion may improve outcomes in patients with arthrofibrosis who undergo arthroscopic debridement. Hypothesis: Patients who achieve greater knee range of motion will have better subjective scores. Study Design: Retrospective case series analysis. Methods: A review of records was performed for 33 patients with arthrofibrosis who underwent knee arthroscopy and scar resection coupled with perioperative rehabilitation to maximize knee range of motion. Patient demographics and preoperative and postoperative range of motion measurements were extracted from the records. The International Knee Documentation Committee (IKDC) Subjective Knee Form was administered to assess pain, activity, and knee function. Patients performed a preoperative and postoperative rehabilitation program utilizing a knee extension device to maximize knee extension. Results: According to the IKDC range of motion criteria, 27 of 33 patients achieved normal knee extension, and 14 of 33 achieved normal knee flexion at a mean of 8.6 months after surgery. Patients with normal knee motion had a mean IKDC Subjective Knee Form score of 72.6 ± 13.6, which was significantly higher than patients who did not achieve normal motion (P = .04). Overall, mean IKDC Subjective Knee Form scores improved from 45.3 ± 16.7 preoperatively to 67.1 ± 18.0 postoperatively (P < .01) at a mean of 14.7 months after surgery. Conclusions: Perioperative rehabilitation that emphasizes restoration of normal knee range of motion appears to improve outcomes in patients with arthrofibrosis who undergo arthroscopic scar resection. In support of our hypothesis, patients who achieved greater knee range of motion had better subjective knee scores. PMID:23015970

  19. Effect of radiation and surgical trauma on gastrointestinal function

    SciTech Connect

    Dubois, A.

    1983-04-29

    The response of the gastrointestinal tract to physical and psychological aggression is initially characterized by an inhibition of its motor and secretory activity. The subsequent response is highly variable and depends on the type and intensity of the stimulus. In the present review, we will consider only the effect of ionizing radiation and of surgical trauma on gastrointestinal motility and secretion.

  20. Surgical innovation as sui generis surgical research.

    PubMed

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  1. Predicting workplace aggression and violence.

    PubMed

    Barling, Julian; Dupré, Kathryne E; Kelloway, E Kevin

    2009-01-01

    Consistent with the relative recency of research on workplace aggression and the considerable media attention given to high-profile incidents, numerous myths about the nature of workplace aggression have emerged. In this review, we examine these myths from an evidence-based perspective, bringing greater clarity to our understanding of the predictors of workplace aggression. We conclude by pointing to the need for more research focusing on construct validity and prevention issues as well as for methodologies that minimize the likelihood of mono-method bias and that strengthen the ability to make causal inferences.

  2. Craniocervical necrotizing fasciitis of odontogenic origin with mediastinal extension.

    PubMed

    Edwards, John D; Sadeghi, Nader; Najam, Farzad; Margolis, Mark

    2004-08-01

    We review an interesting case of craniocervical necrotizing fasciitis with thoracic extension in an immunocompetent 44-year-old man. The patient underwent aggressive medical and surgical management during a long hospitalization. Multiple surgical debridements, including transcervical mediastinal debridement, and eventually a thoracotomy for mediastinal abscess were required. The patient eventually recovered, and 3 months later he showed no sign of complications or recurrence. Craniocervical necrotizing fasciitis is a fulminant soft-tissue infection, usually of odontogenic origin, that requires prompt identification and treatment to ensure survival. Broad-spectrum intravenous antibiotics, aggressive surgical debridement and wound care, hyperbaric oxygen, and good intensive care are the mainstays of treatment.

  3. Gender differences in reactive and proactive aggression.

    PubMed

    Connor, Daniel F; Steingard, Ronald J; Anderson, Jennifer J; Melloni, Richard H

    2003-01-01

    The purpose of our investigation was to study gender differences in proactive and reactive aggression in a sample of 323 clinically referred children and adolescents (68 females and 255 males). Proactive aggression and reactive aggression were assessed using the Proactive/Reactive Aggression Scale. Demographic, historical, family, diagnostic, and treatment variables were entered into stepwise regression analyses to determine correlates of proactive and reactive aggression in males and females. Results reveal high rates of aggression in both males and females in the sample. Self reported drug use, expressed hostility, and experiences of maladaptive parenting were correlated with proactive aggression for both genders. Hyperactive/impulsive behaviors were correlated with male reactive aggression. An early age of traumatic stress and a low verbal IQ were correlated with female proactive aggression. Gender differences in correlates of proactive and reactive aggression may provide possible targets for research, prevention, and treatment efforts focused on reducing maladaptive aggression in clinically referred youth. PMID:12723901

  4. Quantifying Aggressive Behavior in Zebrafish.

    PubMed

    Teles, Magda C; Oliveira, Rui F

    2016-01-01

    Aggression is a complex behavior that influences social relationships and can be seen as adaptive or maladaptive depending on the context and intensity of expression. A model organism suitable for genetic dissection of the underlying neural mechanisms of aggressive behavior is still needed. Zebrafish has already proven to be a powerful vertebrate model organism for the study of normal and pathological brain function. Despite the fact that zebrafish is a gregarious species that forms shoals, when allowed to interact in pairs, both males and females express aggressive behavior and establish dominance hierarchies. Here, we describe two protocols that can be used to quantify aggressive behavior in zebrafish, using two different paradigms: (1) staged fights between real opponents and (2) mirror-elicited fights. We also discuss the methodology for the behavior analysis, the expected results for both paradigms, and the advantages and disadvantages of each paradigm in face of the specific goals of the study. PMID:27464816

  5. Aggressive Angiomyxoma in Pregnancy: A Rare Condition, a Common Misdiagnosis.

    PubMed

    Sampaio, J; Sarmento-Gonçalves, I; Ramada, D; Amaro, T; Tiago-Silva, P

    2016-01-01

    Introduction. Aggressive angiomyxoma is a rare mesenchymal neoplasm. Although benign in the majority of the cases, these neoplasms usually present a locally infiltrative nature and high rates of recurrence. Due to its rarity, misdiagnosis is a common problem. Case Presentation. We present one case of aggressive angiomyxoma in a 25-year-old pregnant woman. The patient presented with a large vaginal mass that was interpreted as a vaginal cyst. We performed surgical resection of the neoplasm and the correct diagnosis was only achieved after histological examination. With this case, we highlight the importance of considering this diagnosis in patients with genital and perineal masses of unknown origin and the impact of a correct preoperative diagnosis in patient's management and follow-up. Conclusion. Although aggressive angiomyxoma is rare, it should be considered in differential diagnosis of pelviperineal masses in young women. Its positivity to estrogen and progesterone receptors can justify enlargement and recurrence during pregnancy, although few cases are reported. Early recognition demands high index of suspicion for both gynaecologists and pathologists. Wide surgical excision with tumor free margins is the basis of curative treatment. Adjuvant therapy may be necessary for residual or recurrent tumors. Long-term follow-up is recommended. PMID:27274877

  6. Music, Substance Use, and Aggression

    PubMed Central

    Chen, Meng-Jinn; Miller, Brenda A.; Grube, Joel W.; Waiters, Elizabeth D.

    2016-01-01

    Objective This study investigated whether young people’s substance use and aggressive behaviors are related to their listening to music containing messages of substance use and violence. Method Data were collected using self-administered questionnaires and from a sample of community college students aged 15-25 (N = 1056; 43% male). A structural equation modeling method was used to simultaneously assess the associations between listening to various genres of music, alcohol use, illicit drug use, and aggressive behaviors, taking into account respondents’ age, gender, race/ethnicity, and level of sensation seeking. Results Listening to rap music was significantly and positively associated with alcohol use, problematic alcohol use, illicit drug use, and aggressive behaviors when all other variables were controlled. Additionally, alcohol and illicit drug use were positively associated with listening to musical genres of techno and reggae. Control variables such as sensation seeking, age, gender and race/ethnicity were significantly related to substance use and aggressive behaviors. Conclusion The findings suggest that young people’s substance use and aggressive behaviors may be related to their frequent exposure to music containing references to substance use and violence. Conversely, music listening preference may reflect some personal predispositions or lifestyle preferences. Alternatively, substance use, aggression and music preference are independent constructs, but share common “third factors.” PMID:16608146

  7. Normative beliefs about aggression and cyber aggression among young adults: a longitudinal investigation.

    PubMed

    Wright, Michelle F; Li, Yan

    2013-01-01

    This longitudinal study examined normative beliefs about aggression (e.g., face-to-face, cyber) in relation to the engagement in cyber aggression 6 months later among 126 (69 women) young adults. Participants completed electronically administered measures assessing their normative beliefs, face-to-face and cyber aggression at Time 1, and cyber aggression 6 months later (Time 2). We found that men reported more cyber relational and verbal aggression when compared to women. After controlling for each other, Time 1 face-to-face relational aggression was positively related to Time 2 cyber relational aggression, whereas Time 1 face-to-face verbal aggression was positively related to Time 2 cyber verbal aggression. Normative beliefs regarding cyber aggression was positively related to both forms of cyber aggression 6 months later, after controlling for normative beliefs about face-to-face aggression. Furthermore, a significant two-way interaction between Time 1 cyber relational aggression and normative beliefs about cyber relational aggression was found. Follow-up analysis showed that Time 1 cyber relational aggression was more strongly related to Time 2 cyber relational aggression when young adults held higher normative beliefs about cyber relational aggression. A similar two-way interaction was found for cyber verbal aggression such that the association between Time 1 and Time 2 cyber verbal aggression was stronger at higher levels of normative beliefs about cyber verbal aggression. Results are discussed in terms of the social cognitive and behavioral mechanisms associated with the engagement of cyber aggression.

  8. Normative beliefs about aggression and cyber aggression among young adults: a longitudinal investigation.

    PubMed

    Wright, Michelle F; Li, Yan

    2013-01-01

    This longitudinal study examined normative beliefs about aggression (e.g., face-to-face, cyber) in relation to the engagement in cyber aggression 6 months later among 126 (69 women) young adults. Participants completed electronically administered measures assessing their normative beliefs, face-to-face and cyber aggression at Time 1, and cyber aggression 6 months later (Time 2). We found that men reported more cyber relational and verbal aggression when compared to women. After controlling for each other, Time 1 face-to-face relational aggression was positively related to Time 2 cyber relational aggression, whereas Time 1 face-to-face verbal aggression was positively related to Time 2 cyber verbal aggression. Normative beliefs regarding cyber aggression was positively related to both forms of cyber aggression 6 months later, after controlling for normative beliefs about face-to-face aggression. Furthermore, a significant two-way interaction between Time 1 cyber relational aggression and normative beliefs about cyber relational aggression was found. Follow-up analysis showed that Time 1 cyber relational aggression was more strongly related to Time 2 cyber relational aggression when young adults held higher normative beliefs about cyber relational aggression. A similar two-way interaction was found for cyber verbal aggression such that the association between Time 1 and Time 2 cyber verbal aggression was stronger at higher levels of normative beliefs about cyber verbal aggression. Results are discussed in terms of the social cognitive and behavioral mechanisms associated with the engagement of cyber aggression. PMID:23440595

  9. Excessive Aggression as Model of Violence: A Critical Evaluation of Current Preclinical Methods

    PubMed Central

    Miczek, Klaus A.; de Boer, Sietse F.; Haller, Jozsef

    2013-01-01

    Rationale Preclinical experimental models of pathological aggressive behavior are a sorely understudied and difficult research area. Objectives How valid, reliable, productive and informative are the most frequently used animal models of excessive aggressive behavior? Methods The rationale, key methodological features, supporting data and arguments as well as their disadvantages and limitations of the most frequently used animal models for excessive aggressive behavior are summarized and their validity and reliability are evaluated. Results Excessive aggressive behavior is validly and reliably seen in (1) a proportion of feral-derived rats and selectively bred mice, (2) rats with compromised adrenal function resulting in a hypoglucocorticoid state, (3) a significant minority of mice, rats and monkeys after consumption of a moderate dose of alcohol, and (4) resident animals of various species after social instigation. Limitations of these procedures include restrictive animal research regulations, the requirement of expertise in surgical, pharmacological and behavioral techniques, and the behaviorally impoverished mouse strains that are used in molecular genetics research. Promising recent initiatives for novel experimental models include aggressive behaviors that are evoked by optogenetic stimulation and induced by the manipulation of early social experiences such as isolation rearing or social stress. Conclusions One of the most significant challenges for animal models of excessive, potentially abnormal aggressive behavior is the characterization of distinctive neurobiological mechanisms that differ from those governing species-typical aggressive behavior. Identifying novel targets for effective intervention requires increased understanding of the distinctive molecular, cellular and circuit mechanisms for each type of abnormal aggressive behavior. PMID:23430160

  10. Do Teachers Misbehave? Aggression in School Teams

    ERIC Educational Resources Information Center

    Ben Sasson, Dvora; Somech, Anit

    2015-01-01

    Purpose: Despite growing research on school aggression, significant gaps remain in the authors' knowledge of team aggression, since most studies have mainly explored aggression on the part of students. The purpose of this paper is to focus on understanding the phenomenon of workplace aggression in school teams. Specifically, the purpose of the…

  11. Adolescents' Social Reasoning about Relational Aggression

    ERIC Educational Resources Information Center

    Goldstein, Sara E.; Tisak, Marie S.

    2010-01-01

    We examined early adolescents' reasoning about relational aggression, and the links that their reasoning has to their own relationally aggressive behavior. Thinking about relational aggression was compared to thinking about physical aggression, conventional violations, and personal behavior. In individual interviews, adolescents (N = 103) rated…

  12. The Debrisoft(®) Monofilament Debridement Pad for Use in Acute or Chronic Wounds: A NICE Medical Technology Guidance.

    PubMed

    Meads, Catherine; Lovato, Eleonora; Longworth, Louise

    2015-12-01

    As part of its Medical Technology Evaluation Programme, the National Institute for Health and Care Excellence (NICE) invited a manufacturer to provide clinical and economic evidence for the evaluation of the Debrisoft(®) monofilament debridement pad for use in acute or chronic wounds. The University of Birmingham and Brunel University, acting as a consortium, was commissioned to act as an External Assessment Centre (EAC) for NICE, independently appraising the submission. This article is an overview of the original evidence submitted, the EAC's findings and the final NICE guidance issued. The sponsor submitted a simple cost analysis to estimate the costs of using Debrisoft(®) to debride wounds compared with saline and gauze, hydrogel and larvae. Separate analyses were conducted for applications in home and applications in a clinic setting. The analysis took an UK National Health Service (NHS) perspective. It incorporated the costs of the technologies and supplementary technologies (such as dressings) and the costs of their application by a district nurse. The sponsor concluded that Debrisoft(®) was cost saving relative to the comparators. The EAC made amendments to the sponsor analysis to correct for errors and to reflect alternative assumptions. Debrisoft(®) remained cost saving in most analyses and savings ranged from £77 to £222 per patient compared with hydrogel, from £97 to £347 compared with saline and gauze, and from £180 to £484 compared with larvae depending on the assumptions included in the analysis and whether debridement took place in a home or clinic setting. All analyses were severely limited by the available data on effectiveness, in particular a lack of comparative studies and that the effectiveness data for the comparators came from studies reporting different clinical endpoints compared with Debrisoft(®). The Medical Technologies Advisory Committee made a positive recommendation for adoption of Debrisoft(®) and this has been published

  13. Optimal Er:YAG laser irradiation parameters for debridement of microstructured fixture surfaces of titanium dental implants.

    PubMed

    Taniguchi, Yoichi; Aoki, Akira; Mizutani, Koji; Takeuchi, Yasuo; Ichinose, Shizuko; Takasaki, Aristeo Atsushi; Schwarz, Frank; Izumi, Yuichi

    2013-07-01

    Er:YAG laser (ErL) irradiation has been reported to be effective for treating peri-implant disease. The present study seeks to evaluate morphological and elemental changes induced on microstructured surfaces of dental endosseous implants by high-pulse-repetition-rate ErL irradiation and to determine the optimal irradiation conditions for debriding contaminated microstructured surfaces. In experiment 1, dual acid-etched microstructured implants were irradiated by ErL (pulse energy, 30-50 mJ/pulse; repetition rate, 30 Hz) with and without water spray and for used and unused contact tips. Experiment 2 compared the ErL treatment with conventional mechanical treatments (metal/plastic curettes and ultrasonic scalers). In experiment 3, five commercially available microstructures were irradiated by ErL light (pulse energy, 30-50 mJ/pulse; pulse repetition rate, 30 Hz) while spraying water. In experiment 4, contaminated microstructured surfaces of three failed implants were debrided by ErL irradiation. After the experiments, all treated surfaces were assessed by stereomicroscopy, scanning electron microscopy (SEM), and/or energy-dispersive X-ray spectroscopy (EDS). The stereomicroscopy, SEM, and EDS results demonstrate that, unlike mechanical treatments, ErL irradiation at 30 mJ/pulse and 30 Hz with water spray induced no color or morphological changes to the microstructures except for the anodized implant surface, which was easily damaged. The optimized irradiation parameters effectively removed calcified deposits from contaminated titanium microstructures without causing substantial thermal damage. ErL irradiation at pulse energies below 30 mJ/pulse (10.6 J/cm(2)/pulse) and 30 Hz with water spray in near-contact mode seems to cause no damage and to be effective for debriding microstructured surfaces (except for anodized microstructures). PMID:22886137

  14. Stent-Graft Placement with Early Debridement and Antibiotic Treatment for Femoral Pseudoaneurysms in Intravenous Drug Addicts

    SciTech Connect

    Fu, Qining Meng, Xiyun Li, Fenghe Wang, Xuehu Cheng, Jun Huang, Wen Ren, Wei Zhao, Yu

    2015-06-15

    PurposeExplore the application of endovascular covered stent-graft (SG) placement in femoral pseudoaneurysms in intravenous drug addicts.Materials and MethodsWe evaluated a consecutive series of pseudoaneurysm in intravenous drug addicts treated with SGs from August 2010 to December 2013.Results15 patients with 16 arterial pseudoaneurysms were enrolled in this study. All were males with a mean age of 36.9 years. Hemorrhage was the most common reason (93.8 %) for seeking medical care, and 3 of these patients were in hemorrhagic shock at admission. All patients received broad-spectrum antibiotics, and debridement and drainage were implemented after SG placement. 7 of the 13 cases which had microbiologic results showed mixed infections, while gram-negative bacteria were the major pathogens. Except for 2 patients, who were lost to follow-up, two new pseudoaneurysms formed due to delayed debridement, and one stent thrombosis occurred, none of the remaining cases had SG infection or developed claudication.ConclusionsSG placement controls massive hemorrhage rapidly, gives enough time for subsequent treatment for pseudoaneurysms due to intravenous drug abuse, and reduces the incidence of postoperative claudication. With appropriate broad-spectrum antibiotics and early debridement, the incidence of SG infection is relatively low. It is an effective alternative especially as temporary bridge measure for critical patients. However, the high cost, uncertain long-term prospects, high demand for medical adherence, and the risk of using the conduits for re-puncture call for a cautious selection of patients. More evidence is required for the application of this treatment.

  15. Multimodal treatment of aggressive forms of breast cancer

    PubMed Central

    Mihai, D; Voiculescu, S; Cristian, D; Constantinescu, F; Popa, E; Burcos, T

    2014-01-01

    Abstract Aggressive breast cancer is an invasive form with G3, G4 differentiation degree, the absence of receptors for estrogen and progesterone and the absence or presence of HER2 (+ or 3+) gene. The final diagnosis is established by cumulating the clinical, paraclinical, histopathological and immunohistochemical diagnosis. Material and method: 84 out of 268 aggressive breast cancer cases were presented in the study, which were operated in October 2011-September 2013. The inclusion and exclusion criteria are exposed in the study lot and the treatment schemes. Results: For the study lot (lot A made up of 36 cases, lot B made up of 41 cases, lot C made up of 7 cases) the distribution was presented on age groups, histopathological and immunohistochemical classification, etiologic factors, type of surgery, postoperative staging and complications. Conclusions: The treatment of aggressive breast cancer depends on the level of the aggressiveness of the disease, the biologic status and the age that imposes the order of chemotherapy, radiotherapy, surgical treatment and target therapy. PMID:25408768

  16. Abortion - surgical - aftercare

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  17. Rehabilitation after surgical management of the thrower's shoulder.

    PubMed

    Leggin, Brian G; Sheridan, Scott; Eckenrode, Brian J

    2012-03-01

    The overhead throwing motion is a complex and coordinated movement pattern involving the lower extremities, the trunk, and the upper extremity. Because of these tremendous demands on the shoulder, various shoulder injuries may occur. Two of the more common injuries to throwers are shoulder instability and superior labrum anterior-posterior lesions. Although nonoperative treatment is frequently successful in treating these conditions, surgical management may be necessary for the athlete to return to their sport. The purpose of this article is to review the first 3 phases of rehabilitation after arthroscopic capsular stabilization and superior labrum anterior-posterior debridement or repair. The fourth phase, return to throwing, will be covered in the final section.

  18. Kindergarten Children's Genetic Vulnerabilities Interact with Friends' Aggression to Promote Children's Own Aggression

    ERIC Educational Resources Information Center

    van Lier, Pol; Boivin, Michel; Dionne, Ginette; Vitaro, Frank; Brendgen, Mara; Koot, Hans; Tremblay, Richard E.; Perusse, Daniel

    2007-01-01

    Objective: To examine whether kindergarten children's genetic liability to physically aggress moderates the contribution of friends' aggression to their aggressive behaviors. Method: Teacher and peer reports of aggression were available for 359 6-year-old twin pairs (145 MZ, 212 DZ) as well as teacher and peer reports of aggression of the two best…

  19. Systemic antimicrobial therapy (minocycline) as an adjunct to non-surgical approach to recurrent chronic generalized gingival hyperplasia.

    PubMed

    Khatri, Parag M; Bacha, Shraddanand

    2014-03-01

    Systemic antibiotic treatment has emerged as a powerful adjunct to conventional mechanical debridement for therapeutic management of the periodontal diseases. The conceptual basis for treating periodontal diseases as infections is particularly attractive in part because of substantial data indicating that these diseases may be associated with specific putative pathogens. Further, discrete groups of patients respond well to systemic antibiotics and exhibit improvement of clinical parameters, including attachment level and inflammation. This bacterial-host interaction, which is ever-so-present in periodontitis, directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report presents a case of a female patient with recurrence of the chronic generalized periodontitis with gingival enlargement, which is treated thrice by referral dentist. A through clinical examination was carried out pre-operatively and treatment was planned with systemic minocycline in conjunction with the conventional non-surgical approach. There was a significant reduction of pocket depth, gain in attachment with dramatic improvement clinically.

  20. Is nonstructural bone graft useful in surgical treatment of lumbar spinal tuberculosis?

    PubMed Central

    Liu, Jia-Ming; Chen, Xuan-Yin; Zhou, Yang; Long, Xin-Hua; Chen, Wen-Zhao; Liu, Zhi-Li; Huang, Shan-Hu; Yao, Hao-Qun

    2016-01-01

    Abstract Surgical intervention is an important option for treating spinal tuberculosis. Previous studies have reported different surgical procedures and bone grafts for it. To our knowledge, few studies demonstrated the clinical results of using nonstructural autogenous bone graft in surgical treatment of spinal tuberculosis. The purpose of this study is to compare the clinical outcomes of surgical management lumbar spinal tuberculosis by one-stage posterior debridement with nonstructural autogenous bone grafting and instrumentation versus anterior debridement, strut bone grafting combined with posterior instrumentation. A total of 58 consecutive patients who underwent surgical treatment due to lumbar spinal tuberculosis from January 2011 to December 2013 were included. A total of 22 patients underwent one-stage posterior debridement, nonstructural autogenous bone grafting, and instrumentation (group A), and 36 patients received anterior debridement, strut bone grafting combined with posterior instrumentation (group B). The operative duration, total blood loss, perioperative transfusion, length of hospital stay, hospitalization cost, and complications were recorded. The bony fusion of the graft was assessed by computed tomography scans. American Spinal Injury Association (ASIA) Impairment Scale was used to evaluate the neurological function of patients in the 2 groups. All the patients were followed up, with a mean follow-up duration of 21.6 ± 5.7 months in group A and 22.3 ± 6.2 months in group B (P = 0.47). The average operative duration was 257.5 ± 91.1 minutes in group A and 335.7 ± 91.0 minutes in group B (P = 0.002). The mean total blood loss was 769.6 ± 150.9 mL in group A and 1048.6 ± 556.9 mL in group B (P = 0.007). Also, significant differences were found between the 2 groups in perioperative transfusion volumes, length of hospital stay, and hospitalization cost (P < 0.05), which were less in group A

  1. Aggressive Extraocular Sebaceous Carcinoma Recurring after Mohs Micrographic Surgery

    PubMed Central

    Grigoryan, Konstantin V.; Leithauser, Laurel; Gloster, Hugh M.

    2015-01-01

    Sebaceous carcinomas (SC) are rare adnexal tumors with possible aggressive behavior usually arising in the head and neck region of adults in the seventh decade of life. Treatment has traditionally been with surgical excision with 5-6 mm wide margins but Mohs micrographic surgery (MMS) has also been reported as an effective treatment modality. We present a case of a Caucasian female renal transplant patient with a rapidly enlarging nodule on the left preauricular cheek that was excised with MMS with negative margins. The tumor recurred rapidly and metastasized ultimately leading to the death of the patient. There was some disagreement amongst pathologists as to the possible nature of the diagnosis with the original biopsy being labeled as a poorly differentiated carcinoma. We aim to highlight the potential aggressive nature of SC and review the features of the neoplasm including histological features that help in making the diagnosis. PMID:25685571

  2. Systematic Review and Meta-analysis of Osteochondral Autograft Transplantation versus Debridement in the Treatment of Osteochondritis Dessicans of the Capitellum

    PubMed Central

    Bowman, Seth; Braunstein, Jacob; Rabinowitz, Justin; Barfield, William R.; Chhabra, Bobby; Haro, Marc Scott

    2016-01-01

    Objectives: The purpose of this systematic review and meta- analysis is to compare clinical results and functional outcomes in patients with osteochondritis dessicans (OCD) lesions of the capitellum treated with either osteochondral autograft transplantation (OATS) or debridement with or without microfracture. Methods: Systematic review of multiple medical databases was performed after PROSPERO registration and using PRISMA guidelines. A literature search was performed using the multiple medical databases and the methodological quality of the individual studies was assessed by two review authors using the Cochrane Collaboration’s “Risk of Bias” tool. Case reports were excluded and only case series of more than five patients and higher level of evidence were included. All study, subject, and surgery parameters were collected. Data was analyzed using statistical software. Odds ratios (OR) were calculated when possible. Data were compared using Pearson Chi-Square and independent sample T tests when applicable. Results: Fifteen studies were included involving 368 patients (326 males and 42 females). There were a total of 197 patients in the debridement group and 171 patients in the OATS group. The mean age was 16.9 +/-4.1 for the debridement group and 14.6 +/-1.2 for the OATS group. Mean follow up was 29.0 +/-24.3 and 38.0 +/-12.8 for the debridement and OATS groups, respectively. Patients that underwent an OATS procedure had a statistically significant improvement in overall arc range of motion compared to patients that had a debridement (P≤0.001). When compared to patients with debridement, patients with OATS were 5.6 times more likely to return to at least their pre-injury level of sports participation (p≤0.002). Conclusion: Post-operative range of motion was significantly improved in patients undergoing an OATS procedure versus a debridement for OCD lesions of the capitellum. Patients with an OATS were 5.7 times more likely to return to at least the pre

  3. Sharpening of periodontal instruments with different sharpening stones and its influence upon root debridement--scanning electronic microscopy assessment.

    PubMed

    Silva, Marcelo Vieira; Gomes, Débora Aline Silva; Leite, Fábio Renato Manzolli; Sampaio, José Eduardo Cezar; de Toledo, Benedicto Egbert Correia; Mendes, Ary José Dias

    2006-01-01

    The objective of this study was to evaluate, through scanning electronic microscopy, the effect of sharpening with different sharpening stones on the cutting angle of periodontal curettes (Gracey 5-6), and the influence on root surfaces after debridement and planing. The experimental model consisted of two different phases. In the first, the cutting angles of fifteen stainless steel Gracey 5-6 curettes were analyzed under a scanning electronic microscope after being sharpened with different types of stones. In the second phase, the root surfaces of 25 newly extracted teeth were evaluated with a scanning electronic microscope after being debrided with curettes sharpened with different stones. Analysis of the results showed that the synthetic stones (aluminum oxide and carborundum) are more abrasive and produce more irregular cutting angles, whereas Arkansas stones are less abrasive and produce smoother and more defined cutting angles. There was no significant statistical differences among the five groups tested with regard to the degree of irregularity of the root surfaces after instrumentation.

  4. Topical Mitomycin-C enhances subbasal nerve regeneration and reduces erosion frequency in the debridement wounded mouse cornea.

    PubMed

    Pal-Ghosh, Sonali; Pajoohesh-Ganji, Ahdeah; Tadvalkar, Gauri; Kyne, Briana M; Guo, Xiaoqing; Zieske, James D; Stepp, Mary Ann

    2016-05-01

    Corneal epithelial basement membrane dystrophies and superficial injuries caused by scratches can lead to recurrent corneal erosion syndrome (RCES). Patients and animals with reduced corneal sensory nerve innervation can also develop recurrent erosions. Multiple wild-type mouse strains will spontaneously develop recurrent corneal erosions after single 1.5 mm debridement wounds. Here we show that this wound is accompanied by an increase in corneal epithelial cell proliferation after wound closure but without a commensurate increase in corneal epithelial thickness. We investigated whether excess corneal epithelial cell proliferation contributes to erosion formation. We found that topical application of Mitomycin C (MMC), a drug used clinically to improve healing after glaucoma and refractive surgery, reduces erosion frequency, enhances subbasal axon density to levels seen in unwounded corneas, and prevents excess epithelial cell proliferation after debridement wounding. These results suggest that topically applied MMC, which successfully reduces corneal haze and scarring after PRK, may also function to enhance subbasal nerve regeneration and epithelial adhesion when used to treat RCES.

  5. An accidental but safe and effective use of Lucilia cuprina (Diptera: Calliphoridae) in maggot debridement therapy in Alexandria, Egypt.

    PubMed

    Tantawi, Tarek I; Williams, Kirstin A; Villet, Martin H

    2010-05-01

    The calliphorid fly, Lucilia cuprina (Wiedemann), is known to cause serious malign myiasis in animals, whereas its sibling species Lucilia sericata (Meigen) is commonly a carrion breeder and is used in maggot debridement therapy (MDT). The current study reports an accidental involvement of L. cuprina in MDT in Alexandria, Egypt, that has proved to be safe and effective. In November 2008, the laboratory colonies of L. sericata (the species regularly used in MDT) at the Faculty of Science, Alexandria University were renewed by Lucilia flies collected as third instar larvae on exposed rabbit carcasses. Flies from the new colonies were successfully used to heal the diabetic foot wounds of two patients at Alexandria Main University Hospital. Analysis of DNA sequences and adult and larval morphology then revealed that these flies were and still are L. cuprina. Breeding of this species in carrion in Alexandria is a new record. Despite the safety of this strain of L. cuprina in MDT, entomologists rearing blow flies for the purpose of wound debridement should regularly maintain high quality assurance of their species' identity to avoid possible clinical complications that may result from the introduction of an unexpected and invasive species to their laboratory colonies.

  6. Scanning electron microscopic evaluation of the successful sterilization of Lucilia cuprina (Wiedemann) utilized in maggot debridement therapy (mdt).

    PubMed

    Yeong, Y S; Nazni, W A; Santana, R L; Mohd Noor, I; Lee, H L; Mohd Sofian, A

    2011-08-01

    In Malaysia, maggot debridement therapy (MDT) utilizes maggots of Lucilia cuprina (Wiedemann) to debride necrotic tissue from wound surface, reduce bacterial infection and therefore, enhance wound healing process. To evaluate the sterility of the sterile maggots produced after sterilization process before delivering onto patient wounds. Sterility of sterile maggots is crucial in ensuring the safe usage of MDT and patient's health. Eggs of L. cuprina collected from a laboratory colony were divided into treated group (sterilized) and control group (non-sterilized). Treated group underwent sterilization while eggs from control group were allowed to hatch without sterilization. Sodium hypochlorite and formaldehyde were the main disinfectants used in this sterilization process. Scanning electron microscope (SEM) was used to examine and ascertain the sterility of sterile maggots. SEM results showed that all sterilized L. cuprina eggs and maggots achieved sterility and all were cleared from bacterial contamination. In contrast, all non-sterilized eggs and maggots were found to be colonized by microorganisms. Sterilization method employed to sterilize eggs and maggots used in Malaysia MDT was proven successful and MDT is safe to be used as wound management tools.

  7. Growth and survival of blowfly Lucilia sericata larvae under simulated wound conditions: implications for maggot debridement therapy.

    PubMed

    Čičková, H; Kozánek, M; Takáč, P

    2015-12-01

    Maggot debridement therapy has become a well-established method of wound debridement. Despite its success, little information is available about the optimum duration of the treatment cycle and larval growth in wounds. This study examines the development of Lucilia sericata (Diptera: Calliphoridae) larvae under two containment conditions (bagged and free range) under simulated wound conditions and assesses the impact of transport and further storage of larvae on their survival and growth. There was no significant difference in size between bagged and free-range larvae over the 72-h experimental period. Larvae grew fastest 8-24 h after inoculation and completed their growth at 40-48 h. Mortality rates were similar (0.12-0.23% per hour) in both containment conditions and did not differ significantly (P = 0.3212). Survival of free-range larvae was on average 16% lower than survival of bagged larvae. Refrigeration of larvae upon simulated delivery for > 1 day reduced their survival to < 50% and caused a reduction in growth of up to 30% at 12 h, but not at 48 h, of incubation. Therefore, it is recommended that free-range larvae are left in the wound for a maximum of 40-48 h, and bagged larvae for 48-72 h. Larvae should be used within 24 h of delivery to avoid high mortality caused by prolonged refrigeration.

  8. Statin Effects on Aggression: Results from the UCSD Statin Study, a Randomized Control Trial

    PubMed Central

    Golomb, Beatrice A.; Dimsdale, Joel E.; Koslik, Hayley J.; Evans, Marcella A.; Lu, Xun; Rossi, Steven; Mills, Paul J.; Criqui, Michael H.

    2015-01-01

    Background Low/ered cholesterol is linked to aggression in some study designs. Cases/series have reported reproducible aggression increases on statins, but statins also bear mechanisms that could reduce aggression. Usual statin effects on aggression have not been characterized. Methods 1016 adults (692 men, 324 postmenopausal women) underwent double-blind sex-stratified randomization to placebo, simvastatin 20mg, or pravastatin 40mg (6 months). The Overt-Aggression-Scale-Modified–Aggression-Subscale (OASMa) assessed behavioral aggression. A significant sex-statin interaction was deemed to dictate sex-stratified analysis. Exploratory analyses assessed the influence of baseline-aggression, testosterone-change (men), sleep and age. Results The sex-statin interaction was significant (P=0.008). In men, statins tended to decrease aggression, significantly so on pravastatin: difference=-1.0(SE=0.49)P=0.038. Three marked outliers (OASMa-change ≥40 points) offset otherwise strong significance-vs-placebo: statins:-1.3(SE=0.38)P=0.0007; simvastatin:-1.4(SE=0.43)P=0.0011; pravastatin:-1.2(SE=0.45)P=0.0083. Age≤40 predicted greater aggression-decline on statins: difference=-1.4(SE=0.64)P=0.026. Aggression-protection was emphasized in those with low baseline aggression: age<40-and-low-baseline-aggression (N=40) statin-difference-vs-placebo=-2.4(SE=0.71)P=0.0016. Statins (especially simvastatin) lowered testosterone, and increased sleep problems. Testosterone-drop on statins predicted aggression-decline: β=0.64(SE=0.30)P=0.034, particularly on simvastatin: β=1.29(SE=0.49)P=0.009. Sleep-worsening on statins significantly predicted aggression-increase: β=2.2(SE=0.55)P<0.001, particularly on simvastatin (potentially explaining two of the outliers): β=3.3(SE=0.83)P<0.001. Among (postmenopausal) women, a borderline aggression-increase on statins became significant with exclusion of one younger, surgically-menopausal woman (N=310) β=0.70(SE=0.34)P=0.039. The increase was

  9. Aggressive surgery for management of recurrent intraabdominal carcinoma.

    PubMed

    Roseman, J M; Minton, J P

    1983-06-01

    With the evolution of effective multimodality control of various tumors, the role of surgery for recurrent malignancies is emerging as significant factor in not only maintaining that control, but in permitting the possibility of late cure of certain, even advanced intraabdominal malignancies. Several patients with Stage IV colon or ovarian carcinoma were evaluated and found to benefit from such an aggressive surgical approach with the result of long term control as well as apparent clinical cure in the several instances. These possibilities are becoming increasingly significant as progress is made in the various treatment modalities for neoplastic diseases.

  10. [Surgical treatment of extensive craniofacial juvenile angiofibromas].

    PubMed

    Cherekaev, V A; Gol'bin, D A; Kapitanov, D N; Belov, A I; Arustamian, S R; Gromova, V V; Imaev, A A

    2009-01-01

    Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor occurring almost exclusively in adolescent and young adult males. The tumor is characterized by slow progression, aggressive growth, high vascularization and increased rate of persistence and recurrence. From 2000 till 2008 29 consecutive male patients with JNA Fisch grade III and IV (intracranial extradural or intradural extension) were operated in Burdenko Neurosurgical Institute (Moscow, Russia). Most patients received different kinds of treatment before admission to the Institute. All patients underwent surgical resection using predominantly orbitozygomatic approach. Preoperative endovascular embolization was applied. Total removal was achieved in 86% of cases. Postoperative complications included osteomyelitis of the bone flap (4 cases), nasal CSF leak (1 case) etc. Recurrences were observed in 3 patients, all of them underwent repeated surgeries. 4 cases are presented (3 patients with Fisch grade IV tumor and 1 with grade III). Surgical treatment is the basic tactics in management of extensive JNAs. The authors recommend to use orbitozygomatic approach and endoscopic assistance.

  11. Surgical Lasers In Gynecology

    NASA Astrophysics Data System (ADS)

    Schellhas, Helmut F.; Barnes, Alfonso E.

    1982-12-01

    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  12. Biocompatibility of antimicrobials to maggot debridement therapy: medical maggots Lucilia sericata (Diptera: Calliphoridae) exhibit tolerance to clinical maximum doses of antimicrobials.

    PubMed

    Peck, George W; Kirkup, Benjamin C

    2012-09-01

    The larvae of calliphorid flies are used to debride wounds of patients with severe tissue destruction, often concurrently with antimicrobials. The current study evaluates the effects of ceftazidime, tobramycin, amikacin, gentamicin, polymyxin B, doxycycline, paromomycin, amphotericin B, sodium stibogluconate, and miltefosine at 1, 10, and 100 x the Maximum Clinical Concentration (mg/kg/d) in raw liver assays. Effects on larvae were small and depended on dose and antimicrobial formulation, with hours in assay (24 or 48 h) having a significant effect on larval survival. Sodium stibgluconate had the strongest effect on maggot survival (80.0% at 48 h). These results suggest that the antimicrobials tested here may be used simultaneously with maggot debridement therapy, and may actually increase the effectiveness of maggot debridement therapy in certain applications where >1 x Maximum Clinical Concentration is indicated, such as topical creams for cutaneous leishmaniasis.

  13. A two-factor model of aggression.

    PubMed

    Kingsbury, S J; Lambert, M T; Hendrickse, W

    1997-01-01

    This article synthesizes theoretical material from psychology research into a practical model for conceptualizing violence in psychiatric settings. Relevant research and theory are reviewed, focusing on two important behavioral models of aggressive behavior, hostile aggression and instrumental aggression. The concepts of reinforcement, anticipated rewards, specific and nonspecific stimulus-driven aggression, intermediary emotional states in aroused persons, and the aggression stimulus threshold are developed into a bimodal model applicable to the clinical management of violence. The model provides a broad framework for categorizing, understanding, and addressing aggressive behavior in clinical settings.

  14. A randomized controlled trial of larval therapy for the debridement of leg ulcers: results of a multicenter, randomized, controlled, open, observer blind, parallel group study.

    PubMed

    Mudge, Elizabeth; Price, Patricia; Walkley, Neal; Neal, Walkley; Harding, Keith G

    2014-01-01

    It has been known for centuries that the application of larvae is useful to heal certain wounds by facilitating debridement of necrotic tissue,(1) yet the efficacy of larval therapy continues to be debatable. This study compared the clinical effectiveness of a larval therapy dressing (BioFOAM) with a standard debridement technique (Purilon gel; hydrogel) in terms of time to debridement of venous (VLU) or mixed arterial/venous (MLU) leg ulcers. Data analyses were conducted on 88 subjects. Sixty-four subjects completed the full study. Of these, 31 of the 32 (96.9%) patients who completed treatment in the larvae arm debrided fully, compared with 11 of the 32 (34.4%) patients who completed the hydrogel arm. In addition, 42 (48%) ulcers fully debrided within the 21-day intervention phase, 31 (67.4%) from the larvae arm (n = 46), and 11 (26.2%) from the hydrogel arm (n = 42), which was statistically significant (p = 0.001) in support of larvae. A statistically significant difference was also observed between treatment arms with regard to numbers of dressing changes during the intervention phase of the study (p < 0.001) in that subjects in the larvae arm required significantly fewer dressing changes(mean = 2.83) than those in the hydrogel arm (mean = 5.40). There were no statistically significant differences in the clinical condition of the wound bed and surrounding skin by intervention. Subjects in the larvae arm experienced more ulcer-related pain or discomfort than subjects in the hydrogel arm (p < 0.001). This study provided good evidence to show that larval therapy, in the form of a BioFOAM dressing, debrided VLU and MLU considerably more quickly than a hydrogel, although the possibility of resloughing should be closely monitored. PMID:24299513

  15. Surgical research IV.

    PubMed

    Toledo-Pereyra, Luis H

    2010-08-01

    Harvey W. Cushing (1869-1939) is the only surgeon represented in Surgical Research IV and one of the most accomplished American contributors to surgical research in general and to neurological and endocrine surgery research in particular. Other surgical research leaders of the 19th and 20th centuries who preceded Harvey Cushing have been introduced before. First, we highlighted the "importance of medical and surgical research" as the basic elements in the advancement of medicine and surgery could be considered as Surgical Research I. Second, in Surgical Research II, we presented William Beaumont, Samuel Gross, and William Halsted as the most important participants of the first wave of American surgical researchers. Next, in Surgical Research III, we considered surgeon researchers who moved ahead in the field of surgery with their research initiatives at the time, including John B. Murphy, the Mayo Brothers William J. and Charles H. Mayo, and George W. Crile. With Harvey Cushing, we enter an era of surgical research associated with neurosurgery and endocrine surgery as part of Surgical Research IV. PMID:20690841

  16. The Passive Aggressive Conflict Cycle

    ERIC Educational Resources Information Center

    Whitson, Signe

    2013-01-01

    Understanding the Passive Aggressive Conflict Cycle (PACC) helps observers to be able to look beyond behavior and better understand what is occurring beneath the surface. This article presents a real-life example of a seemingly minor conflict between a teacher and child that elicited an apparent major overreaction by the adult. Also provided is a…

  17. Epilepsy, aggression, and criminal responsibility.

    PubMed

    Borum, R; Appelbaum, K L

    1996-07-01

    Although epilepsy-related violence can occur, accounts of criminal behavior caused by epilepsy remain rare and unconvincing. The authors describe a case of apparent postictal aggression, resulting in felony assault charges, by a patient who had nocturnal complex partial seizures, followed by what appeared to be sleepwalking and periods of postictal wandering and confusion.

  18. Television Portrayal and Aggressive Behavior.

    ERIC Educational Resources Information Center

    Comstock, George

    This is a review of research relating to the attributes of portrayals which play a role in affecting aggressive behavior. The effects of portrayal can occur at any of three successive stages: acquisition, disinhibition/stimulation/arousal, performance. The older the individual, the more likely the influence is to be in all three stages of…

  19. Enrichment and aggression in primates.

    PubMed

    Honess, P E; Marin, C M

    2006-01-01

    There is considerable evidence that primates housed under impoverished conditions develop behavioural abnormalities, including, in the most extreme example, self-harming behaviour. This has implications for all contexts in which primates are maintained in captivity from laboratories to zoos since by compromising the animals' psychological well-being and allowing them to develop behavioural abnormalities their value as appropriate educational and research models is diminished. This review examines the extensive body of literature documenting attempts to improve living conditions with a view to correcting behavioural abnormalities and housing primates in such a way that they are encouraged to exhibit a more natural range and proportion of behaviours, including less self-directed and social aggression. The results of housing, feeding, physical, sensory and social enrichment efforts are examined with specific focus on their effect on aggressive behaviour and variation in their use and efficacy. It is concluded that while inappropriate or poorly distributed enrichment may encourage aggressive competition, enrichment that is species, sex, age and background appropriate can dramatically reduce aggression, can eliminate abnormal behaviour and substantially improve the welfare of primates maintained in captivity.

  20. Biochemistry and Aggression: Psychohematological Model.

    ERIC Educational Resources Information Center

    Foster, Hilliard G., Jr.; Spitz, Reuben T.

    1994-01-01

    Examines biochemical measures in a population of forensic psychiatric inpatients. Regression equations utilizing chemical and biological variables were developed and evaluated to determine their value in predicting the severity and frequency of aggression. Findings strongly suggest the presence of specific biochemical alteration among those…

  1. Risperidone and Explosive Aggressive Autism.

    ERIC Educational Resources Information Center

    Horrigan, Joseph P.; Barnhill, L. Jarrett

    1997-01-01

    In this study, 11 males with autism and mental retardation were administered risperidone. Substantial clinical improvement was noted almost immediately; patients with aggression, self-injury, explosivity, and poor sleep hygiene were most improved. The modal dose for optimal response was 0.5 mg bid. Weight gain was a significant side effect.…

  2. Personal standards for judging aggression by a relationship partner: How much aggression is too much?

    PubMed

    Arriaga, Ximena B; Capezza, Nicole M; Daly, Christine A

    2016-01-01

    What determines whether people tolerate partner aggression? This research examined how norms, relationship experiences, and commitment predict personal standards for judging aggressive acts by a partner. Studies 1a and 1b (n = 689) revealed that experiencing aggression in a current relationship and greater commitment predicted greater tolerance for common partner aggression. Study 2 longitudinally tracked individuals who had never experienced partner aggression (n = 52). Once aggression occurred, individuals adopted more tolerant standards, but only if they were highly committed. Study 3 involved experimentally manipulating the relevance of partner aggression among individuals who reported current partner aggression (n = 73); they were more tolerant of aggressive acts imagined to occur by their partner (vs. the same acts by a stranger), but only if they were highly committed. Personal standards for judging partner aggression are dynamic. They shift toward greater tolerance when committed people experience aggression in a current relationship.

  3. Outcome of Acute Prosthetic Joint Infections Due to Gram-Negative Bacilli Treated with Open Debridement and Retention of the Prosthesis▿

    PubMed Central

    Martínez-Pastor, Juan C.; Muñoz-Mahamud, Ernesto; Vilchez, Félix; García-Ramiro, Sebastián; Bori, Guillem; Sierra, Josep; Martínez, José A.; Font, Lluis; Mensa, Josep; Soriano, Alex

    2009-01-01

    The aim of our study was to evaluate the outcome of acute prosthetic joint infections (PJIs) due to gram-negative bacilli (GNB) treated without implant removal. Patients with an acute PJI due to GNB diagnosed from 2000 to 2007 were prospectively registered. Demographics, comorbidity, type of implant, microbiology data, surgical treatment, antimicrobial therapy, and outcome were recorded. Classification and regression tree analysis, the Kaplan-Meier survival method, and the Cox regression model were applied. Forty-seven patients were included. The mean age was 70.7 years, and there were 15 hip prostheses and 32 knee prostheses. The median number of days from the time of arthroplasty was 20. The most frequent pathogens were members of the Enterobacteriaceae family in 41 cases and Pseudomonas spp. in 20 cases. Among the Enterobacteriaceae, 14 were resistant to ciprofloxacin, while all Pseudomonas aeruginosa isolates were susceptible to ciprofloxacin. The median durations of intravenous and oral antibiotic treatment were 14 and 64 days, respectively. A total of 35 (74.5%) patients were in remission after a median follow-up of 463 days (interquartile range, 344 to 704) days. By use of the Kaplan-Meier survival curve, a C-reactive protein (CRP) concentration of ≤15 mg/dl (P = 0.03) and receipt of a fluoroquinolone, when all GNB isolated were susceptible (P = 0.0009), were associated with a better outcome. By use of a Cox regression model, a CRP concentration of ≤15 mg/dl (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.05 to 12.5; P = 0.043) and receipt of a fluoroquinolone (OR, 9.09; 95% CI, 1.96 to 50; P = 0.005) were independently associated with better outcomes. Open debridement without removal of the implant had a success rate of 74.5%, and the factors associated with good prognosis were a CRP concentration at the time of diagnosis ≤15 mg/dl and treatment with a fluoroquinolone. PMID:19687237

  4. Implicit cognitive aggression among young male prisoners: Association with dispositional and current aggression.

    PubMed

    Ireland, Jane L; Adams, Christine

    2015-01-01

    The current study explores associations between implicit and explicit aggression in young adult male prisoners, seeking to apply the Reflection-Impulsive Model and indicate parity with elements of the General Aggression Model and social cognition. Implicit cognitive aggressive processing is not an area that has been examined among prisoners. Two hundred and sixty two prisoners completed an implicit cognitive aggression measure (Puzzle Test) and explicit aggression measures, covering current behaviour (DIPC-R) and aggression disposition (AQ). It was predicted that dispositional aggression would be predicted by implicit cognitive aggression, and that implicit cognitive aggression would predict current engagement in aggressive behaviour. It was also predicted that more impulsive implicit cognitive processing would associate with aggressive behaviour whereas cognitively effortful implicit cognitive processing would not. Implicit aggressive cognitive processing was associated with increased dispositional aggression but not current reports of aggressive behaviour. Impulsive implicit cognitive processing of an aggressive nature predicted increased dispositional aggression whereas more cognitively effortful implicit cognitive aggression did not. The article concludes by outlining the importance of accounting for implicit cognitive processing among prisoners and the need to separate such processing into facets (i.e. impulsive vs. cognitively effortful). Implications for future research and practice in this novel area of study are indicated.

  5. Husbands' and Wives' Marital Adjustment, Verbal Aggression, and Physical Aggression as Longitudinal Predictors of Physical Aggression in Early Marriage

    ERIC Educational Resources Information Center

    Schumacher, Julie A.; Leonard, Kenneth E.

    2005-01-01

    Marital adjustment, verbal aggression, and physical aggression have long been associated in the marital literature, but the nature of their associations remains unclear. In this study, the authors examined these 3 constructs as risk factors for physical aggression during the first 2 years of marriage in 634 couples recruited as they applied for…

  6. Talus fractures: surgical principles.

    PubMed

    Rush, Shannon M; Jennings, Meagan; Hamilton, Graham A

    2009-01-01

    Surgical treatment of talus fractures can challenge even the most skilled foot and ankle surgeon. Complicated fracture patterns combined with joint dislocation of variable degrees require accurate assessment, sound understanding of principles of fracture care, and broad command of internal fixation techniques needed for successful surgical care. Elimination of unnecessary soft tissue dissection, a low threshold for surgical reduction, liberal use of malleolar osteotomy to expose body fracture, and detailed attention to fracture reduction and joint alignment are critical to the success of treatment. Even with the best surgical care complications are common and seem to correlate with injury severity and open injuries. PMID:19121756

  7. Innovative Surgical Management of the Synovial Chondromatosis of Temporo-Mandibular Joints: Highly Conservative Surgical Technique.

    PubMed

    Ionna, Franco; Amantea, Massimiliano; Mastrangelo, Filiberto; Ballini, Andrea; Maglione, Maria Grazia; Aversa, Corrado; De Cecio, Rossella; Russo, Daniela; Marrelli, Massimo; Tatullo, Marco

    2016-07-01

    Synovial chondromatosis (SC) is an uncommon disease characterized by a benign nodular cartilaginous proliferation arising from the joint synovium, bursae, or tendon sheaths. Although the temporomandibular joint is rarely affected by neoplastic lesions, SC is the most common neoplastic lesion of this joint. The treatment of this disease consists in the extraoral surgery with a wide removal of the lesion; in this study, the authors described a more conservative intraoral surgical approach. Patient with SC of temporomandibular joint typically refer a limitation in the mouth opening, together with a persistent not physiological mandibular protrusion and an appearance of a neoformation located at the right preauricular region: the authors reported 1 scholar patient. After biopsy of the neoformation, confirming the synovial chondromatosis, the patient underwent thus to the surgical excision of the tumor, via authors' conservative transoral approach, to facilitate the enucleation of the neoformation. The mass fully involved the pterygo-maxillary fossa with involvement of the parotid lodge and of the right TMJ: this multifocal extension suggested for a trans-oral surgical procedure, in the light of the suspicion of a possible malignant nature of the neoplasm. Our intraoral conservative approach to surgery is aimed to reduce the presence of unaesthetic scars in preauricular and facial regions, with surgical results undoubtedly comparable to the traditional surgical techniques much more aggressive. Our technique could be a valid, alternative, and safe approach to treat this rare and complex kind of oncological disease.

  8. Relational Aggression among Middle School Girls

    ERIC Educational Resources Information Center

    Dallape, Aprille

    2008-01-01

    The purpose of this study was to examine the correlates that define relational aggression among middle school girls, the relationships among these factors, and the association between the correlates of relational aggression and the type of relational aggression (e.g., verbal, withdrawal) exhibited among middle school girls. The findings of this…

  9. Aggression induced by intermittent positive reinforcement.

    PubMed

    Looney, T A; Cohen, P S

    1982-01-01

    Mammalian and non-mammalian species engage in aggressive behavior toward animate and inanimate targets when exposed to intermittent access to a positive reinforcer. This behavior, called extinction- or schedule-induced aggression, typically includes a biting or striking topography that inflicts damage on a target. This paper critically reviews research and theoretical issues concerning such aggression and suggests directions for future investigation.

  10. Treating Comorbid Anxiety and Aggression in Children

    ERIC Educational Resources Information Center

    Levy, Karyn; Hunt, Caroline; Heriot, Sandra

    2007-01-01

    Objective: The aim of the study was to evaluate the effectiveness of an intervention that targeted both anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report. Method: The effects of a cognitive-behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared…

  11. The next generation of burns treatment: intelligent films and matrix, controlled enzymatic debridement, and adult stem cells.

    PubMed

    Drago, H; Marín, G H; Sturla, F; Roque, G; Mártire, K; Díaz Aquino, V; Lamonega, R; Gardiner, C; Ichim, T; Riordan, N; Raimondi, J C; Bossi, S; Samadikuchaksaraei, A; van Leeuwen, M; Tau, J M; Núñez, L; Larsen, G; Spretz, R; Mansilla, E

    2010-01-01

    We describe a novel technology based on nanoengineered multifunctional acellular biologic scaffolds combined with wound dressings and films of the same kind. This method allows selective delivery and release of shielded biomaterials and bioactive substances to a desired wound or damaged tissue while stimulating the selective anchoring and adhesion of endogenous circulating repairing cells, such as mesenchymal stem cells, to obtain a faster and more physiologic healing process. We also present a new controlled enzymatic debridement process for more effective burned tissue scarolysis. In light of our preliminary in vitro and in vivo data, we are convinced that these approaches can include the use of other kinds of adult stem cells, such as endometrial regenerative cells, to improve the vascularization of the constructs, with great potential in the entire tissue and organ regeneration field but especially for the treatment of severely burned patients, changing the way these lesions may be treated in the future.

  12. Normative Beliefs and Relational Aggression: An Investigation of the Cognitive Bases of Adolescent Aggressive Behavior

    ERIC Educational Resources Information Center

    Werner, Nicole E.; Nixon, Charisse L.

    2005-01-01

    The relations between normative beliefs about different forms of aggression and corresponding aggressive behaviors were investigated in 2 studies of adolescents. In Study 1, we revised an instrument designed to assess normative beliefs about aggression to include beliefs about the acceptability of relational aggression, and we examined the…

  13. Social Aggression on Television and Its Relationship to Children's Aggression in the Classroom

    ERIC Educational Resources Information Center

    Martins, Nicole; Wilson, Barbara J.

    2012-01-01

    A survey was conducted with over 500 children in grades K-5 to examine whether exposure to socially aggressive content was related to children's use of social aggression. The results of the survey revealed a significant relationship between exposure to televised social aggression and increased social aggression at school, but only for girls and…

  14. Rehabilitation and return-to-sports activity after debridement and bone marrow stimulation of osteochondral talar defects.

    PubMed

    van Eekeren, Inge C M; Reilingh, Mikel L; van Dijk, C Niek

    2012-10-01

    An osteochondral defect (OD) is a lesion involving the articular cartilage and the underlying subchondral bone. ODs of the talus can severely impact on the quality of life of patients, who are usually young and athletic. The primary treatment for ODs that are too small for fixation, consists of arthroscopic debridement and bone marrow stimulation. This article delineates levels of activity, determines times for return to activity and reviews the factors that affect rehabilitation after arthroscopic debridement and bone marrow stimulation of a talar OD. Articles for review were obtained from a search of the MEDLINE database up to January 2012 using the search headings 'osteochondral defects', 'bone marrow stimulation', 'sports/activity', 'rehabilitation', various other related factors and 'talus'. English-, Dutch- and German-language studies were evaluated.The review revealed that there is no consensus in the existing literature about rehabilitation times or return-to-sports activity times, after treatment with bone marrow stimulation of ODs in the talus. Furthermore, scant research has been conducted on these issues. The literature also showed that potential factors that aid rehabilitation could include youth, lower body mass index, smaller OD size, mobilization and treatment with growth factors, platelet-rich plasma, biphosphonates, hyaluronic acid and pulse electromagnetic fields. However, most studies have been conducted in vitro or on animals. We propose a scheme, whereby return-to-sports activity is divided into four phases of increasing intensity: walking, jogging, return to non-contact sports (running without swerving) and return to contact sports (running with swerving and collision). We also recommend that research, conducted on actual sportsmen, of recovery times after treatment of talar ODs is warranted.

  15. Methods for external disinfection of blow fly (Diptera: Calliphoridae) eggs prior to use in wound debridement therapy.

    PubMed

    Brundage, Adrienne L; Crippen, Tawni L; Tomberlin, Jeffery K

    2016-03-01

    Maggot debridement therapy (MDT) is the use of the larval stage of flies (i.e., Calliphoridae) to remove necrotic tissue and disinfect wounds. Effective MDT requires aseptic technique to prevent the unintentional introduction of pathogenic bacteria into a wound to be debrided; yet the external surface of Calliphoridae eggs is often heavily contaminated with bacteria. Studies of external disinfection of dipteran eggs have been reported, but neither their efficacy nor effect on egg viability has been adequately assessed. The present study evaluated the efficacy of ten disinfection techniques involving immersion, rinse, or a combination of both in formalin, Lysol, formaldehyde, bleach, ethanol, Sporgon, or benzalkonium chloride. All techniques resulted in significant decreases in culturable, aerobic bacterial load on Lucilia cuprina eggs. For L. cuprina, a 10 minute 3% Lysol immersion was the most efficacious, disinfecting 96.67% of egg samples, while resulting in 31.84% egg mortality. The 5% formalin immersion was least efficacious, disinfecting only 3.33% of L. cuprina egg samples, while resulting in 33.51% egg mortality. A formaldehyde immersion, one of the most commonly used disinfection techniques, was moderately effective, disinfecting 66.7% of egg samples, while resulting in 40.16% egg mortality. For Chrysomya rufifacies and Cochliomyia macellaria egg samples, the 10 minute 3% Lysol immersion disinfected 100% of the samples, and for Lucilia sericata, 80% of egg samples, while resulting in 33.97%, 7.34%, and 36.96% egg mortality, respectively. H2 CO disinfected 16.67% of Ch. rufifacies, 26.67% of C. macellaria, and 56.67% of L. sericata egg samples, while resulting in 21.98%, 10.18%, and 32.19% egg mortality, respectively. Due to its high disinfection efficacy and relatively low egg mortality, a 10 minutes 3% Lysol immersion is recommended for sterilizing Calliphoridae eggs prior to rearing of larvae for use in MDT.

  16. Surgical ethics and the challenge of surgical innovation.

    PubMed

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  17. Read anything mean lately? associations between reading aggression in books and aggressive behavior in adolescents.

    PubMed

    Stockdale, Laura A; Coyne, Sarah M; Nelson, David A; Padilla-Walker, Laura M

    2013-01-01

    Although there have been hundreds of studies on media violence, few have focused on literature, with none examining novels. Accordingly, the aim of the current study was to examine whether reading physical and relational aggression in books was associated with aggressive behavior in adolescents. Participants consisted of 223 adolescents who completed a variety of measures detailing their media use and aggressive behavior. A non-recursive structural equation model revealed that reading aggression in books was positively associated with aggressive behavior, even after controlling for exposure to aggression in other forms of media. Associations were only found for congruent forms of aggression. Implications regarding books as a form of media are discussed.

  18. DIAGNOSIS AND MEDICAL AND SURGICAL MANAGEMENT OF CHRONIC INFECTIOUS FIBRINOUS PLEURITIS IN AN OKAPI (OKAPIA JOHNSTONI).

    PubMed

    Franzen, Dana; Lamberski, Nadine; Zuba, Jeffery; Richardson, G Lynn; Fischer, A T; Rantanen, Norman W

    2015-06-01

    A 10-yr-old female okapi (Okapia johnstoni) at the San Diego Zoo Safari Park was evaluated for intermittent malaise, inappetence, occasional cough, abdominal splinting, and licking at both flanks. Physical examination revealed tachypnea, tachycardia, and fluid sounds on thoracic auscultation. Transthoracic ultrasound showed multiple uniform, anechoic filled structures in the right and left pleural space. Surgical exploration of the thoracic cavity revealed bilateral, mature, fibrous, compartmentalizing adhesions between the visceral and parietal pleura, confirming a diagnosis of chronic, infectious, fibrinous pleuritis. The suspected etiology was occult aspiration pneumonia secondary to historical episodes of regurgitation associated with general anesthesia. Culture of the pleural fluid and fibrous adhesions grew Trueperella (Arcanobacterium) pyogenes, Arcanobacterium haemolyticum, and few Fusobacterium species. Treatment consisted of chest-tube placement to establish drainage, thoracic lavage, unilateral surgical debridement, and long-term antibiotics. The animal made a complete clinical recovery over 7 mo. PMID:26056911

  19. Deployment and testing of a second prototype expandable surgical chamber in microgravity

    NASA Technical Reports Server (NTRS)

    Markham, Sanford M.; Rock, John A.

    1991-01-01

    During microgravity exposure, two separate expandable surgical chambers were tested. Both chambers had been modified to fit the microgravity work station without extending over the sides of the table. Both chambers were attached to a portable laminar flow generator which served two purposes: to keep the chambers expanded during use; and to provide an operative area environment free of contamination. During the tests, the chambers were placed on various parts of a total body moulage to simulate management of several types of trauma. The tests consisted of cleansing contusions, debridement of burns, and suturing of lacerations. Also, indigo carmine dye was deliberately injected into the chamber during the tests to determine the ease of cleansing the chamber walls after contamination by escaping fluids. Upon completion of the tests, the expandable surgical chambers were deflated, folded, and placed in a flattened state back into their original containers for storage and later disposal. Results are briefly discussed.

  20. Molecular Profiling of Aggressive Lymphomas

    PubMed Central

    Rossi, Maura; Laginestra, Maria Antonella; Gazzola, Anna; Sapienza, Maria Rosaria; Pileri, Stefano A.; Piccaluga, Pier Paolo

    2012-01-01

    In the last years, several studies of molecular profiling of aggressive lymphomas were performed. In particular, it was shown that DLBCL can be distinguished in two different entities according to GEP. Specifically, ABC and GCB subtypes were characterized by having different pathogenetic and clinical features. In addition, it was demonstrated that DLBCLs are distinct from BL. Indeed, the latter is a unique molecular entity. However, relevant pathological differences emerged among the clinical subtypes. More recently, microRNA profiling provided further information concerning BL-DLBCL distinction as well as for their subclassification. In this paper, the authors based on their own experience and the most updated literature review, the main concept on molecular profiling of aggressive lymphomas. PMID:22190944

  1. Mapping Brain Development and Aggression

    PubMed Central

    Paus, Tomás

    2005-01-01

    Introduction This article provides an overview of the basic principles guiding research on brain-behaviour relationships in general, and as applied to studies of aggression during human development in particular. Method Key literature on magnetic resonance imaging of the structure and function of a developing brain was reviewed. Results The article begins with a brief introduction to the methodology of techniques used to map the developing brain, with a special emphasis on magnetic resonance imaging (MRI). It then reviews briefly the current knowledge of structural maturation, assessed by MRI, of the human brain during childhood and adolescence. The last part describes some of the results of neuroimaging studies aimed at identifying neural circuits involved in various aspects of aggression and social cognition. Conclusion The article concludes by discussing the potential and limitations of the neuroimaging approach in this field. PMID:19030495

  2. Homeostatic disturbances and human aggression.

    PubMed

    Naisberg, Y

    1997-04-01

    A new model on the nature of human aggression is presented. It rests on the assumption that a pre-established organismic homeostatic modification, based on a decrease in neuronal membrane electric threshold, causes neural facilitation. In turn, this influences the cut-off phenomenon, in particular, neuronal network and therefore either inherited schemata representation, or acquired engram linkage programs run inadequately. These programs adjust the response to working loads of the eight normal serial stages in the body's operational regime activity. The effect of facilitation on these programs is: (1) loss of discrimination when approaching involuntary multi-stimuli; (2) the corruption of acquired engram linkage portions used in neural networks; (3) significant reduction of the voluntary degrees of freedom of response, thus narrowing the body's operational regime activity. This results in damage to certain cognitive links from some acquired engram linkages, enhancing impulse-like program mismatches and causing a unilateral 'fight' response of an aggressive nature.

  3. Recent surgical management of gliomas.

    PubMed

    Sanai, Nader; Berger, Mitchel S

    2012-01-01

    Refinement of neurosurgical technique has enabled safer operations with more aggressive outcomes. One cornerstone of modern-day practice is the utilization of intraoperative stimulation mapping. In addition to identifying critical motor pathways, this technique can be adapted to reliable identify language pathways, as well. Given the individual variability of cortical language localization, such awake language mapping is essential to minimize language deficits following tumor resection. Our experience suggests that cortical language mapping is a safe and efficient adjunct to optimize tumor resection while preserving essential language sites, even in the setting of negative mapping data. However, the value of maximizing glioma resections remains surprisingly unclear, as there is no general consensus in the literature regarding the efficacy of extent of glioma resection in improving patient outcome. While the importance of resection in obtaining tissue diagnosis and to alleviate symptoms is clear, a lack of Class I evidence prevents similar certainty in assessing the influence of extent of resection. Beyond an analysis of modern intraoperative mapping techniques, we examine every major clinical publication since 1990 on the role of extent of resection in glioma outcome. The mounting evidence suggests that, despite persistent limitations in the quality of available studies, a more extensive surgical resection is associated with longer life expectancy for both low-grade and high-grade gliomas.

  4. Leptin increases prostate cancer aggressiveness.

    PubMed

    López Fontana, Constanza M; Maselli, María E; Pérez Elizalde, Rafael F; Di Milta Mónaco, Nicolás A; Uvilla Recupero, Ana L; López Laur, José D

    2011-12-01

    Recent studies indicate that adipose tissue and adipocytokines might affect the development of prostate cancer (PCa). Leptin would have a stimulating effect on prostate cancer cells by inducing promotion and progression, whereas adiponectin would have a protective effect. The aim of this study was to determine the relation between body composition, leptin, and adiponectin levels with the prevalence and aggressiveness of PCa in men of Mendoza, Argentina. Seventy volunteers between 50 and 80 years (35 healthy men as control group and 35 with PCa) were selected. The PCa group was subclassified according to the Gleason Score (GS). Digital rectal examination, transrectal ultrasound, and prostatic biopsy were performed; PSA, testosterone, leptin, and adiponectin levels were determined; and a nutritional interview including anthropometric measurements and a food frequency questionnaire was carried out. Statistical analysis was performed by Student t test, ANOVA I, and Bonferroni (p < 0.05). Body mass index and percentage of body fat mass were not statistically different between PCa and control groups. However, body fat mass was higher in subjects with more aggressive tumors (p = 0.032). No differences were observed regarding leptin levels between the groups. Nevertheless, leptin levels were higher in subjects with high GS (p < 0.001). Adiponectin levels showed no statistical differences regarding the presence and aggressiveness of the tumor (p = 0.131). Finally, consumption and nutrient intake did not differ in the studied groups. In conclusion, body composition and leptin are related to the PCa aggressiveness but not with its prevalence.

  5. Neurobiology of aggression and violence.

    PubMed

    Siever, Larry J

    2008-04-01

    Acts of violence account for an estimated 1.43 million deaths worldwide annually. While violence can occur in many contexts, individual acts of aggression account for the majority of instances. In some individuals, repetitive acts of aggression are grounded in an underlying neurobiological susceptibility that is just beginning to be understood. The failure of "top-down" control systems in the prefrontal cortex to modulate aggressive acts that are triggered by anger provoking stimuli appears to play an important role. An imbalance between prefrontal regulatory influences and hyper-responsivity of the amygdala and other limbic regions involved in affective evaluation are implicated. Insufficient serotonergic facilitation of "top-down" control, excessive catecholaminergic stimulation, and subcortical imbalances of glutamatergic/gabaminergic systems as well as pathology in neuropeptide systems involved in the regulation of affiliative behavior may contribute to abnormalities in this circuitry. Thus, pharmacological interventions such as mood stabilizers, which dampen limbic irritability, or selective serotonin reuptake inhibitors (SSRIs), which may enhance "top-down" control, as well as psychosocial interventions to develop alternative coping skills and reinforce reflective delays may be therapeutic.

  6. Lateralization of aggression in fish.

    PubMed

    Bisazza, Angelo; de Santi, Andrea

    2003-05-15

    Recent research has suggested that lateralization of aggressive behaviors could follow an homogeneous pattern among all vertebrates. A left eye/right hemisphere dominance in eliciting aggressive responses has been demonstrated for all groups of tetrapods but teleost fish for which data is lacking. Here we studied differential eye use during aggressive interactions in three species of teleosts: Gambusia holbrooki, Xenotoca eiseni and Betta splendens. In the first experiment we checked for lateralization in the use of the eyes while the subject was attacking its own mirror image. In order to confirm the results, other tests were performed on two species and eye preference was scored during attacks or displays directed toward a live rival. All three species showed a marked preference for using the right eye when attacking a mirror image or a live rival. Thus, the direction of asymmetry in fish appears the opposite to that shown by all the other groups of vertebrates. Hypotheses on the origin of the difference are discussed.

  7. Rural neighborhoods and child aggression.

    PubMed

    Bowen, Natasha K; Wretman, Christopher J

    2014-12-01

    Structural equation modeling with latent variables was used to evaluate the direct and mediated effects of a neighborhood risk factor (negative teen behaviors) on the parent-report aggressive behavior of 213 students in grades 3 through 5 attending a school in a low-income, rural community. Contagion and social control hypotheses were examined as well as hypotheses about whether the neighborhood served as a microsystem or exosystem for rural pre-adolescents. Analyses took into account the clustering of students and ordinal nature of the data. Findings suggest that rural neighborhoods may operate as both a microsystem and exosystem for children, with direct contagion effects on their aggressive behaviors as well as indirect social control effects through parenting practices. Direct effects on aggression were also found for parenting practices and child reports of friends' negative behaviors. Pre-adolescence may be a transitional stage, when influences of the neighborhood on child behavior begin to compete with influences of caregivers. Findings can inform the timing and targets of violence prevention in rural communities.

  8. Lateralization of aggression in fish.

    PubMed

    Bisazza, Angelo; de Santi, Andrea

    2003-05-15

    Recent research has suggested that lateralization of aggressive behaviors could follow an homogeneous pattern among all vertebrates. A left eye/right hemisphere dominance in eliciting aggressive responses has been demonstrated for all groups of tetrapods but teleost fish for which data is lacking. Here we studied differential eye use during aggressive interactions in three species of teleosts: Gambusia holbrooki, Xenotoca eiseni and Betta splendens. In the first experiment we checked for lateralization in the use of the eyes while the subject was attacking its own mirror image. In order to confirm the results, other tests were performed on two species and eye preference was scored during attacks or displays directed toward a live rival. All three species showed a marked preference for using the right eye when attacking a mirror image or a live rival. Thus, the direction of asymmetry in fish appears the opposite to that shown by all the other groups of vertebrates. Hypotheses on the origin of the difference are discussed. PMID:12742249

  9. Osteochondral Autograft from the Ipsilateral Femoral Head by Surgical Dislocation for Treatment of Femoral Head Fracture Dislocation: A Case Report.

    PubMed

    Won, Yougun; Lee, Gi Soo; Kim, Sang Bum; Kim, Sun Joong; Yang, Kyu Hyun

    2016-11-01

    As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation. The osteochondral graft was harvested from the inferior non-weight-bearing articular surface and grafted to the osteochondral defect. One year later, the clinical and radiological results were good, without the collapse of the femoral head or arthritic change. This procedure introduced in our case is considered convenient and able to lessen surgical time without morbidity of the donor site associated with the harvest. PMID:27593886

  10. Osteochondral Autograft from the Ipsilateral Femoral Head by Surgical Dislocation for Treatment of Femoral Head Fracture Dislocation: A Case Report

    PubMed Central

    Won, Yougun; Kim, Sang Bum; Kim, Sun Joong; Yang, Kyu-Hyun

    2016-01-01

    As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation. The osteochondral graft was harvested from the inferior non-weight-bearing articular surface and grafted to the osteochondral defect. One year later, the clinical and radiological results were good, without the collapse of the femoral head or arthritic change. This procedure introduced in our case is considered convenient and able to lessen surgical time without morbidity of the donor site associated with the harvest. PMID:27593886

  11. [Pharmacological treatment of syndromes of aggressivity].

    PubMed

    Itil, T M

    1978-01-01

    In the treatment of violent-aggressive behavior, four major groups of drugs emerged: 1. Major tranquilizers in the treatment of aggressive-violent behavior associated with psychotic syndromes. 2. Anti-epileptic drugs such as diphenylhydantoin and barbiturates in the treatment of aggressive-violent behavior within the epileptic syndrome. 3. Psychostimulants in the treatment of aggressive behavior of adolescents and children within behavior disturbances. 4. Anti-male hormones such as cyproterone acetate in the treatment of violent-aggressive behavior associated with pathological sexual hyperactivity. Whereas each category of drug is predominantly effective in one type of aggressive syndrome, it may also be effective in other conditions as well. Aggression as a result of a personality disorder is most difficult to treat with drugs. PMID:34189

  12. [Pharmacological treatment of syndromes of aggressivity].

    PubMed

    Itil, T M

    1978-01-01

    In the treatment of violent-aggressive behavior, four major groups of drugs emerged: 1. Major tranquilizers in the treatment of aggressive-violent behavior associated with psychotic syndromes. 2. Anti-epileptic drugs such as diphenylhydantoin and barbiturates in the treatment of aggressive-violent behavior within the epileptic syndrome. 3. Psychostimulants in the treatment of aggressive behavior of adolescents and children within behavior disturbances. 4. Anti-male hormones such as cyproterone acetate in the treatment of violent-aggressive behavior associated with pathological sexual hyperactivity. Whereas each category of drug is predominantly effective in one type of aggressive syndrome, it may also be effective in other conditions as well. Aggression as a result of a personality disorder is most difficult to treat with drugs.

  13. Is nonstructural bone graft useful in surgical treatment of lumbar spinal tuberculosis?: A retrospective case-control study.

    PubMed

    Liu, Jia-Ming; Chen, Xuan-Yin; Zhou, Yang; Long, Xin-Hua; Chen, Wen-Zhao; Liu, Zhi-Li; Huang, Shan-Hu; Yao, Hao-Qun

    2016-08-01

    Surgical intervention is an important option for treating spinal tuberculosis. Previous studies have reported different surgical procedures and bone grafts for it. To our knowledge, few studies demonstrated the clinical results of using nonstructural autogenous bone graft in surgical treatment of spinal tuberculosis.The purpose of this study is to compare the clinical outcomes of surgical management lumbar spinal tuberculosis by one-stage posterior debridement with nonstructural autogenous bone grafting and instrumentation versus anterior debridement, strut bone grafting combined with posterior instrumentation.A total of 58 consecutive patients who underwent surgical treatment due to lumbar spinal tuberculosis from January 2011 to December 2013 were included. A total of 22 patients underwent one-stage posterior debridement, nonstructural autogenous bone grafting, and instrumentation (group A), and 36 patients received anterior debridement, strut bone grafting combined with posterior instrumentation (group B). The operative duration, total blood loss, perioperative transfusion, length of hospital stay, hospitalization cost, and complications were recorded. The bony fusion of the graft was assessed by computed tomography scans. American Spinal Injury Association (ASIA) Impairment Scale was used to evaluate the neurological function of patients in the 2 groups.All the patients were followed up, with a mean follow-up duration of 21.6 ± 5.7 months in group A and 22.3 ± 6.2 months in group B (P = 0.47). The average operative duration was 257.5 ± 91.1 minutes in group A and 335.7 ± 91.0 minutes in group B (P = 0.002). The mean total blood loss was 769.6 ± 150.9 mL in group A and 1048.6 ± 556.9 mL in group B (P = 0.007). Also, significant differences were found between the 2 groups in perioperative transfusion volumes, length of hospital stay, and hospitalization cost (P < 0.05), which were less in group A compared with

  14. Moderating role of trait aggressiveness in the effects of violent media on aggression.

    PubMed

    Bushman, B J

    1995-11-01

    Three studies were conducted to test the hypothesis that high trait aggressive individuals are more affected by violent media than are low trait aggressive individuals. In Study 1, participants read film descriptions and then chose a film to watch. High trait aggressive individuals were more likely to choose a violent film to watch than were low trait aggressive individuals. In Study 2, participants reported their mood before and after the showing of a violet or nonviolent videotape. High trait aggressive individuals felt more angry after viewing the violent videotape than did low trait aggressive individuals. In Study 3, participants first viewed either a violent or a nonviolent videotape and then competed with an "opponent" on a reaction time task in which the loser received a blast of unpleasant noise. Videotape violence was more likely to increase aggression in high trait aggressive individuals than in low trait aggressive individuals.

  15. Multiscale Surgical Telerobots

    SciTech Connect

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  16. Surgical progress: surgical management of infective endocarditis.

    PubMed Central

    Mills, S A

    1982-01-01

    Infective endocarditis of bacterial or fungal origin may arise in either the left or the right heart and can involve both natural and prosthetic valves. The diagnosis is based primarily upon clinical criteria and positive blood cultures, but serial electrocardiograms, fluoroscopy, and two-dimensional echocardiograms may also be helpful. The initial treatment should consist of antibiotic therapy and is itself often adequate in effecting cure. However, careful observation during antibiotic treatment is mandatory, since the development of congestive heart failure due to valvular obstruction or destruction can be an indication for surgical intervention. Other surgical indications include a failure to respond to antibiotic therapy, pulmonary or systemic emboli, evidence of abscess involving the valvular ring (particularly prevalent with prosthetic valve endocarditis), Brucella infection, and the onset of conduction disturbances. The goals of surgical treatment are removal of infective tissue, restoration of valve function, and correction of associated mechanical disorders. The results are surprisingly good, especially for a condition of this severity. Images Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:7065743

  17. Aggressive and acute periodontal diseases.

    PubMed

    Albandar, Jasim M

    2014-06-01

    Inflammatory periodontal diseases are highly prevalent, although most of these diseases develop and progress slowly, often unnoticed by the affected individual. However, a subgroup of these diseases include aggressive and acute forms that have a relatively low prevalence but show a rapid-course, high rate of progression leading to severe destruction of the periodontal tissues, or cause systemic symptoms that often require urgent attention from healthcare providers. Aggressive periodontitis is an early-onset, destructive disease that shows a high rate of periodontal progression and distinctive clinical features. A contemporary case definition of this disease is presented. Population studies show that the disease is more prevalent in certain geographic regions and ethnic groups. Aggressive periodontitis is an infectious disease, and recent data show that in affected subjects the subgingival microbiota is composed of a mixed microbial infection, with a wide heterogeneity in the types and proportions of microorganisms recovered. Furthermore, there are significant differences in the microbiota of the disease among different geographic regions and ethnicities. There is also evidence that the Aggregatibacter actinomycetemycomitans-JP2 clone may play an important role in the development of the disease in certain populations. The host response plays an important role in the susceptibility to aggressive periodontitis, where the immune response may be complex and involve multiple mechanisms. Also, genetic factors seem to play an important role in the pathogenesis of this disease, but the mechanisms of increased susceptibility are complex and not yet fully understood. The available data suggest that aggressive periodontitis is caused by mutations either in a few major genes or in multiple small-effect genes, and there is also evidence of gene-gene and gene-environment interaction effects. Diagnostic methods for this disease, based on a specific microbiologic, immunologic or

  18. The effectiveness of salicylic acid plasters compared with ‘usual’ scalpel debridement of corns: a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Corns are a common foot problem and surveys have indicated that between 14-48% of people suffer from them. Many of these will seek podiatry treatment, however there is little evidence to indicate which current treatments provide long term resolution. This study compared ‘usual’ treatment (enucleation with a scalpel) with the application of 40% salicylic acid plasters to corns to investigate which is the most effective in terms of clinical, economic and patient-centred outcomes. Methods A parallel-group randomised controlled trial was carried out in two centres where adults who presented with one or more corns and who met the inclusion criteria were allocated to either ‘usual’ scalpel debridement or corn plaster treatment. All participants had measurements of corn size, pain using a 100 mm visual analogue scale (VAS) and health-related quality of life (EQ-5D) measures by an independent podiatrist, blind to treatment allocation at baseline, 3, 6, 9 and 12 months. Results 202 participants were randomised to receive scalpel debridement or corn plaster treatment (101 in each group). At 3 months 34% (32/95) of corns had completely resolved in the corn plaster group compared with 21% (20/94) in the scalpel group (p = 0.044), and 83% (79/95) had reduced in size in the corn plaster group compared with 56% (53/94) in the scalpel group (p < 0.001). At 12 months, time to corn recurrence was longer in the corn plaster group (p < 0.001). Pain from the corns was significantly lower in the corn plaster group at 3 months (p < 0.001) and EQ-5D scores changed (improved), from baseline, by 0.09 (SD ±0.31) and 0.01 (SD ±0.25) points in the corn plaster and scalpel groups respectively (p = 0.056). By month 12, EQ-5D scores had changed by 0.12 and −0.05 in the corn plaster and scalpel groups respectively (p = 0.005). The EQ-5D, VAS scores and the four domains of the Foot Disability Scale were similar in both groups at 3 and 12

  19. Surgical Treatments for Fibroids

    MedlinePlus

    ... Clinical Trials Resources and Publications Surgical Treatments for Fibroids Skip sharing on social media links Share this: ... If you have moderate or severe symptoms of fibroids, surgery may be the best treatment for you. ...

  20. American Pediatric Surgical Association

    MedlinePlus

    ... Us Login The Hendren Project Resources Research Continuing Education Residents / Fellows Membership About APSA American Pediatric Surgical Association One Parkview Plaza, Suite 800 Oakbrook Terrace, IL 60181 USA Phone: +1-847-686-2237 Fax: +1-847- ...

  1. Guide to Surgical Specialists

    MedlinePlus

    ... may also deal with the liver, urinary, and female reproductive systems if they are involved with primary intestinal disease. ... The focus for this specialty is on the female reproductive system, including performing surgical procedures, managing the care of ...

  2. Hernia Surgical Mesh Implants

    MedlinePlus

    ... Surgical Clinics of North America; 83(5):1045-51, v-vi. 2 . http://www.facs.org/public_ ... FDA Contact FDA Browse by Product Area Product Areas back Food Drugs Medical Devices Radiation-Emitting Products ...

  3. Urogynecologic Surgical Mesh Implants

    MedlinePlus

    ... Boston Scientific's urogynecologic surgical mesh may contain counterfeit raw material. We are examining these allegations to determine any ... are currently not aware that the alleged counterfeit raw material contributes to adverse events associated with these products. ...

  4. Disruptive visions: surgical education.

    PubMed

    Satava, R M

    2004-05-01

    Technological change, decreased financial support for medical education, and social oversight (in the form of the "To Err Is Human" report, HIPPA, and reduced work hours) are forcing a rethinking of the traditional model of surgical education to improve patient safety. New approaches to evaluating surgical competence, such as objective assessment, in combination with new technologies, such as the Internet and surgical simulators, provide the tools to effect a revolution in surgical education and training. Competency based upon quantifiable criteria measures must replace the traditional subjective assessment. The implementation requires accurately defining the elements of training, establishing new quantifiable metrics, stringently measuring performance against criterion, and reporting outcomes throughout the career of a surgeon.

  5. Juvenile aggressive cemento-ossifying fibroma of the sinonasal tract: case report.

    PubMed

    Bist, Sampan Singh; Varshney, Saurabh; Kumar, Rakesh; Bhagat, Sanjeev; Gupta, Nitin

    2011-11-01

    Cemento-ossifying fibroma (COF) is a rare nonodontogenic tumor of the periodontal membrane that arises from the mesodermal germ layer. Clinically, these lesions are usually asymptomatic, slowly growing, and well circumscribed. However, they have demonstrated an aggressive course of development in a very small number of cases, particularly in younger patients. Surgical management via wide local excision is necessary because COF is notorious for recurrence, particularly lesions in the paranasal sinuses. We describe a case of juvenile aggressive COF of the sinonasal tract in a 12-year-old boy. This tumor presented with various overlapping clinical, radiologic, and pathologic features, which led to initial confusion and a diagnostic dilemma. We also discuss the radiologic interpretation of COF, which can be helpful in making the diagnosis and in selecting the appropriate surgical approach in a growing child.

  6. Surgical correction of brachymetatarsia.

    PubMed

    Bartolomei, F J

    1990-02-01

    Brachymetatarsia describes the condition of an abnormally short metatarsal. Although the condition has been recorded since antiquity, surgical options to correct the deformity have been available for only two decades. Most published procedures involve metaphyseal lengthening with autogenous grafts from different donor sites. The author discusses one such surgical technique. In addition, the author proposes specific criteria for the objective diagnosis of brachymetatarsia. PMID:2406417

  7. Smart surgical tool

    NASA Astrophysics Data System (ADS)

    Huang, Huan; Yang, Lih-Mei; Bai, Shuang; Liu, Jian

    2015-02-01

    A laser-induced breakdown spectroscopy (LIBS) guided smart surgical tool using a femtosecond fiber laser is developed. This system provides real-time material identification by processing and analyzing the peak intensity and ratio of atomic emissions of LIBS signals. Algorithms to identify emissions of different tissues and metals are developed and implemented into the real-time control system. This system provides a powerful smart surgical tool for precise robotic microsurgery applications with real-time feedback and control.

  8. Laparoscopic adrenalectomy: Surgical techniques

    PubMed Central

    Mellon, Matthew J.; Sethi, Amanjot; Sundaram, Chandru P.

    2008-01-01

    Since its first description in 1992, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal conditions. The benefits of a minimally invasive approach to adrenal resection such as decreased hospital stay, shorter recovery time and improved patient satisfaction are widely accepted. However, as this procedure becomes more widespread, critical steps of the operation must be maintained to ensure expected outcomes and success. This article reviews the surgical techniques for the laparoscopic adrenalectomy. PMID:19468527

  9. Posterior Titanium Screw Fixation without Debridement of Infected Tissue for the Treatment of Thoracolumbar Spontaneous Pyogenic Spondylodiscitis

    PubMed Central

    Iacoangeli, Maurizio; Nasi, Davide; Nocchi, Niccolo; Di Rienzo, Alessandro; di Somma, Lucia; Colasanti, Roberto; Vaira, Carmela; Benigni, Roberta; Liverotti, Valentina; Scerrati, Massimo

    2016-01-01

    Study Design Retrospective study. Purpose The aim of our study was to analyze the safety and effectiveness of posterior pedicle screw fixation for treatment of pyogenic spondylodiscitis (PSD) without formal debridement of the infected tissue. Overview of Literature Posterior titanium screw fixation without formal debridement of the infected tissue and anterior column reconstruction for the treatment of PSD is still controversial. Methods From March 2008 to June 2013, 18 patients with PSD underwent posterior titanium fixation with or without decompression, according to their neurological deficit. Postero-lateral fusion with allograft transplantation alone or bone graft with both the allogenic bone and the autologous bone was also performed. The outcome was assessed using the visual analogue scale (VAS) for pain and the Frankel grading system for neurological status. Normalization both of C-reactive protein (CRP) and erythrocyte sedimentation rate was adopted as criterion for discontinuation of antibiotic therapy and infection healing. Segmental instability and fusion were also analyzed. Results At the mean follow-up time of 30.16 months (range, 24–53 months), resolution of spinal infection was achieved in all patients. The mean CRP before surgery was 14.32±7.9 mg/dL, and at the final follow-up, the mean CRP decreased to 0.5±0.33 mg/dL (p <0.005). Follow-up computed tomography scan at 12 months after surgery revealed solid fusion in all patients. The VAS before surgery was 9.16±1.29 and at the final follow-up, it improved to 1.38±2.03, which was statistically significant (p <0.05). Eleven patients out of eighteen (61.11%) with initial neurological impairment had an average improvement of 1.27 grades at the final follow-up documented with the Frankel grading system. Conclusions Posterior screw fixation with titanium instrumentation was safe and effective in terms of stability and restoration of neurological impairment. Fixation also rapidly reduced back pain

  10. Sleep deprivation suppresses aggression in Drosophila

    PubMed Central

    Kayser, Matthew S; Mainwaring, Benjamin; Yue, Zhifeng; Sehgal, Amita

    2015-01-01

    Sleep disturbances negatively impact numerous functions and have been linked to aggression and violence. However, a clear effect of sleep deprivation on aggressive behaviors remains unclear. We find that acute sleep deprivation profoundly suppresses aggressive behaviors in the fruit fly, while other social behaviors are unaffected. This suppression is recovered following post-deprivation sleep rebound, and occurs regardless of the approach to achieve sleep loss. Genetic and pharmacologic approaches suggest octopamine signaling transmits changes in aggression upon sleep deprivation, and reduced aggression places sleep-deprived flies at a competitive disadvantage for obtaining a reproductive partner. These findings demonstrate an interaction between two phylogenetically conserved behaviors, and suggest that previous sleep experiences strongly modulate aggression with consequences for reproductive fitness. DOI: http://dx.doi.org/10.7554/eLife.07643.001 PMID:26216041

  11. Studying aggression in Drosophila (fruit flies).

    PubMed

    Mundiyanapurath, Sibu; Certel, Sarah; Kravitz, Edward A

    2007-01-01

    Aggression is an innate behavior that evolved in the framework of defending or obtaining resources. This complex social behavior is influenced by genetic, hormonal and environmental factors. In many organisms, aggression is critical to survival but controlling and suppressing aggression in distinct contexts also has become increasingly important. In recent years, invertebrates have become increasingly useful as model systems for investigating the genetic and systems biological basis of complex social behavior. This is in part due to the diverse repertoire of behaviors exhibited by these organisms. In the accompanying video, we outline a method for analyzing aggression in Drosophila whose design encompasses important eco-ethological constraints. Details include steps for: making a fighting chamber; isolating and painting flies; adding flies to the fight chamber; and video taping fights. This approach is currently being used to identify candidate genes important in aggression and in elaborating the neuronal circuitry that underlies the output of aggression and other social behaviors.

  12. Sleep deprivation suppresses aggression in Drosophila.

    PubMed

    Kayser, Matthew S; Mainwaring, Benjamin; Yue, Zhifeng; Sehgal, Amita

    2015-01-01

    Sleep disturbances negatively impact numerous functions and have been linked to aggression and violence. However, a clear effect of sleep deprivation on aggressive behaviors remains unclear. We find that acute sleep deprivation profoundly suppresses aggressive behaviors in the fruit fly, while other social behaviors are unaffected. This suppression is recovered following post-deprivation sleep rebound, and occurs regardless of the approach to achieve sleep loss. Genetic and pharmacologic approaches suggest octopamine signaling transmits changes in aggression upon sleep deprivation, and reduced aggression places sleep-deprived flies at a competitive disadvantage for obtaining a reproductive partner. These findings demonstrate an interaction between two phylogenetically conserved behaviors, and suggest that previous sleep experiences strongly modulate aggression with consequences for reproductive fitness.

  13. Sleep deprivation suppresses aggression in Drosophila.

    PubMed

    Kayser, Matthew S; Mainwaring, Benjamin; Yue, Zhifeng; Sehgal, Amita

    2015-01-01

    Sleep disturbances negatively impact numerous functions and have been linked to aggression and violence. However, a clear effect of sleep deprivation on aggressive behaviors remains unclear. We find that acute sleep deprivation profoundly suppresses aggressive behaviors in the fruit fly, while other social behaviors are unaffected. This suppression is recovered following post-deprivation sleep rebound, and occurs regardless of the approach to achieve sleep loss. Genetic and pharmacologic approaches suggest octopamine signaling transmits changes in aggression upon sleep deprivation, and reduced aggression places sleep-deprived flies at a competitive disadvantage for obtaining a reproductive partner. These findings demonstrate an interaction between two phylogenetically conserved behaviors, and suggest that previous sleep experiences strongly modulate aggression with consequences for reproductive fitness. PMID:26216041

  14. Video media-induced aggressiveness in children.

    PubMed

    Cardwell, Michael Steven

    2013-09-01

    Transmission of aggressive behaviors to children through modeling by adults has long been a commonly held psychological concept; however, with the advent of technological innovations during the last 30 years, video media-television, movies, video games, and the Internet-has become the primary model for transmitting aggressiveness to children. This review explores the acquisition of aggressive behaviors by children through modeling behaviors in violent video media. The impact of aggressive behaviors on the child, the family, and society is addressed. Suggestive action plans to curb this societal ill are presented.

  15. [Aggressive clients in Dutch veterinary practice].

    PubMed

    Barbonis, T S A E; Endenburg, N

    2007-05-15

    Aggressive clients seem to be becoming more common. This article describes a study in which questionnaires on client behaviour were sent to veterinary assistants and veterinarians in randomly selected practices in the Netherlands. Results showed that 26.4% of the veterinarians and 29.3% of the assistants had experienced aggressive clients in the last year. Age, experience, and sex of the veterinarian or assistant did not influence the frequency with which aggressive clients were encountered. The same was true for the type of veterinary practice (companion animals, farm animals, horses, etc). The risk of encountering aggressive clients was higher among practices in large towns and in practices with a small turnover Of the veterinarians who had encountered aggressive clients at least once in their career, 31% has taken some kind of action after the aggressive encounter Nearly a quarter (24.9%) of veterinary practices have adopted a Risk Inventarization and Evaluation (RI&E) approach to preventing client aggression and 26.6% of practices have adopted another approach. While veterinarians tend not to consider aggression a big problem, they are often open to the suggestion that more attention should be paid to aggression in veterinary practice. PMID:17578228

  16. Intimate partner aggression and women's work outcomes.

    PubMed

    LeBlanc, Manon Mireille; Barling, Julian; Turner, Nick

    2014-10-01

    Using conservation of resources theory, we examined the relationship between intimate partner aggression enacted against heterosexual women and 3 types of work-related outcomes for these women: withdrawal while at work (i.e., cognitive distraction, work neglect), withdrawal from work (i.e., partial absenteeism, intentions to quit), and performance. In Study 1, we compared withdrawal both at and from work across 3 clinically categorized groups of women (n = 50), showing that experiencing physical aggression is related to higher work neglect. We replicated and extended these findings in Study 2 using a community sample of employed women (n = 249) by considering the incremental variance explained by both physical aggression and psychological aggression on these same outcomes. Results showed that physical aggression predicted higher levels of withdrawal both at and from work, with psychological aggression predicting additional variance in partial absenteeism over and above the effects of physical aggression. Study 3 extended the model to include academic performance as an outcome in a sample of female college students (n = 122) in dating relationships. Controlling for the women's conscientiousness, psychological aggression predicted lower academic performance after accounting for the effects of physical aggression. We discuss theoretical and practical implications of these results, as well as directions for future research. PMID:25068818

  17. Aggression and coexistence in female caribou

    USGS Publications Warehouse

    Weckerly, Floyd W.; Ricca, Mark A.

    2014-01-01

    Female caribou (Rangifer tarandus) are highly gregarious, yet there has been little study of the behavioral mechanisms that foster coexistence. Quantifying patterns of aggression between male and female, particularly in the only cervid taxa where both sexes grow antlers, should provide insight into these mechanisms. We asked if patterns of aggression by male and female caribou followed the pattern typically noted in other polygynous cervids, in which males display higher frequencies and intensity of aggression. From June to August in 2011 and 2012, we measured the frequency and intensity of aggression across a range of group sizes through focal animal sampling of 170 caribou (64 males and 106 females) on Adak Island in the Aleutian Archipelago, Alaska. Males in same-sex and mixed-sex groups and females in mixed-sex groups had higher frequencies of aggression than females in same-sex groups. Group size did not influence frequency of aggression. Males displayed more intense aggression than females. Frequent aggression in mixed-sex groups probably reflects lower tolerance of males for animals in close proximity. Female caribou were less aggressive and more gregarious than males, as in other polygynous cervid species.

  18. Video media-induced aggressiveness in children.

    PubMed

    Cardwell, Michael Steven

    2013-09-01

    Transmission of aggressive behaviors to children through modeling by adults has long been a commonly held psychological concept; however, with the advent of technological innovations during the last 30 years, video media-television, movies, video games, and the Internet-has become the primary model for transmitting aggressiveness to children. This review explores the acquisition of aggressive behaviors by children through modeling behaviors in violent video media. The impact of aggressive behaviors on the child, the family, and society is addressed. Suggestive action plans to curb this societal ill are presented. PMID:24002556

  19. Neural control of aggression in Drosophila.

    PubMed

    Hoopfer, Eric D

    2016-06-01

    Like most animal species, fruit flies fight to obtain and defend resources essential to survival and reproduction. Aggressive behavior in Drosophila is genetically specified and also strongly influenced by the fly's social context, past experiences and internal states, making it an excellent framework for investigating the neural mechanisms that regulate complex social behaviors. Here, I summarize our current knowledge of the neural control of aggression in Drosophila and discuss recent advances in understanding the sensory pathways that influence the decision to fight or court, the neuromodulatory control of aggression, the neural basis by which internal states can influence both fighting and courtship, and how social experience modifies aggressive behavior. PMID:27179788

  20. Gibbon Aggression During Introductions: An International Survey.

    PubMed

    Harl, Heather; Stevens, Lisa; Margulis, Susan W; Petersen, Jay

    2016-01-01

    Little is known regarding the prevalence of aggression seen during introductions of captive gibbons (Hylobatidae). In this study, an online survey was developed to quantify and collect contextual details regarding the frequency and types of aggression seen during introductions of captive gibbons (Hylobatidae). Nineteen percent of institutions (17 institutions) reported observing aggression, and 6 of these institutions recorded multiple instances of aggression, though a vast majority of these cases resulted in mild injuries or none at all. The female was the primary aggressor in 23% of cases, the male was the primary aggressor in 58% of cases, and both were the primary aggressor in 1 case. Although these aggressive interactions were often not associated with a known cause, 27% of cases were associated with food displacement. In most cases, management changes, including trying new pairings, greatly reduced situational aggression, suggesting that individual personalities may play a factor in aggression. These data begin to explain the extent of aggression observed in captive gibbons; future studies will address possible correlations with aggression and introduction techniques. PMID:26963568

  1. [Motives and interpersonal functions of aggression].

    PubMed

    Ohbuchi, K

    1987-06-01

    In this review, the author theoretically and empirically examined motives and interpersonal functions of aggression. A factor-analysis of Averill's questionnaire items on anger revealed that motives involved in aggressive responses were clustered into two groups: the hostile and the instrumental. It was also clarified that an individual is likely to engage in aggression particularly when some hostile motives are evoked. Concerning the interpersonal functions, the author proposed that aggression might serve four principal goals. (1) Aggression can be generated as an avoidance response to an aversive stimulus, such as frustration, annoyance, or pain, and so on. It depends on the severity of the stimulus. It was however emphasized that aggression is also mediated by social cognition, such as an attribution of intent to a harm-doer. (2) Aggression can be used as a means of coercing the other person into doing something. An individual is likely to use such a power strategy if he/she is lacking in self-confidence or a perspective for influencing the target person by more peaceful strategies. (3) Aggression can be interpreted as a punishment when it is directed toward a transgressor. In this case, aggression is motivated by restoration of a social justice, and thus its intensity is determined by the perceived moral responsibility of the transgressor. Further, it was indicated that aggression is intensified if it is justified as a sanctional conduct against the immoral. (4) Aggression can be also evoked when an individual's social identity is threatened. It was suggested that impression management motives are involved in aggression by an unexpected finding that the presence of audience or the identifiability rather facilitated retaliative aggression. The aggression-inhibition effect of apology was also explained in terms of impression management. In conclusion, it was presented that aggression is a behavioral strategy as an attempt to resolve interpersonal conflicts

  2. Gibbon Aggression During Introductions: An International Survey.

    PubMed

    Harl, Heather; Stevens, Lisa; Margulis, Susan W; Petersen, Jay

    2016-01-01

    Little is known regarding the prevalence of aggression seen during introductions of captive gibbons (Hylobatidae). In this study, an online survey was developed to quantify and collect contextual details regarding the frequency and types of aggression seen during introductions of captive gibbons (Hylobatidae). Nineteen percent of institutions (17 institutions) reported observing aggression, and 6 of these institutions recorded multiple instances of aggression, though a vast majority of these cases resulted in mild injuries or none at all. The female was the primary aggressor in 23% of cases, the male was the primary aggressor in 58% of cases, and both were the primary aggressor in 1 case. Although these aggressive interactions were often not associated with a known cause, 27% of cases were associated with food displacement. In most cases, management changes, including trying new pairings, greatly reduced situational aggression, suggesting that individual personalities may play a factor in aggression. These data begin to explain the extent of aggression observed in captive gibbons; future studies will address possible correlations with aggression and introduction techniques.

  3. Does bone debris in anterior cruciate ligament reconstruction really matter? A cohort study of a protocol for bone debris debridement

    PubMed Central

    Imam, Mohamed A.; Abdelkafy, Ashraf; Dinah, Feroz; Adhikari, Ajeya

    2015-01-01

    Background: The purpose of the current study was to determine whether a systematic five-step protocol for debridement and evacuation of bone debris during anterior cruciate ligament reconstruction (ACLR) reduces the presence of such debris on post-operative radiographs. Methods: A five-step protocol for removal of bone debris during arthroscopic assisted ACLR was designed. It was applied to 60 patients undergoing ACLR (Group 1), and high-quality digital radiographs were taken post-operatively in each case to assess for the presence of intra-articular bone debris. A control group of 60 consecutive patients in whom no specific bone debris protocol was applied (Group 2) and their post-operative radiographs were also checked for the presence of intra-articular bone debris. Results: In Group 1, only 15% of post-operative radiographs showed residual bone debris, compared to 69% in Group 2 (p < 0.001). Conclusion: A five-step systematic protocol for bone debris removal during arthroscopic assisted ACLR resulted in a significant decrease in residual bone debris seen on high-quality post-operative radiographs. PMID:27163060

  4. Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement

    PubMed Central

    Topcu, K. Meltem; Karatas, Ertugrul; Ozsu, Damla; Ersoy, Ibrahim

    2014-01-01

    Objectives: The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Materials and Methods: Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. Results: An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P < 0.001). The ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). Conclusions: None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups. PMID:25202211

  5. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    PubMed

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery. PMID:27064368

  6. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    PubMed

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery.

  7. Surgical treatment of gall-bladder cancer.

    PubMed

    Masior, Łukasz; Krasnodębski, Maciej; Kobryń, Konrad; Grąt, Michał; Krawczyk, Marek

    2015-06-01

    Despite the aggressive nature and poor prognosis of gall-bladder cancer there is a group of patients who can achieve significant benefits from a radical surgical treatment. The possibility of obtaining long-term survival, even in case of patients with locally advanced cancer and metastases to regional lymph nodes, prompts to verify nihilistic approach to the treatment of this disease. Obviously such therapy can and should be performed only in centers specializing in hepatobiliary surgery. Due to the high recurrence rate, most of which are systemic, the hope of improving treatment outcomes should be sought in the use of combination therapy, based on a new chemotherapy and chemoradiotherapy regimens with the addition of targeted therapy. Unfortunately, the current application of these methods did not bring the expected benefits. PMID:26247506

  8. [Surgical treatment of a solitary hepatic abscess].

    PubMed

    Boĭko, V V; Tishchenko, A M; Gusak, I V; Maloshtan, A A; Skoryĭ, D I; Smachilo, R M

    2013-06-01

    Retrospective analysis of the treatment results of 120 patients, suffering solitary hepatic abscess (SHA), was conducted. The sanation methods, in accordance to technology, the treatment impact intensity and aggressiveness, may be divided on three lines: aspirational, draining and resectional. The method of sanation is selected on the background of morphological peculiarities of abscess--its sizes, by presence of sequesters, divisioning septs, dense rigid capsule, grade of periprocess. Surgical access is determined by the abscess localization, the patient's state severity, instrumental equipment of the clinic. Differentiated approach, taking into account genesis, sizes, localization and stage of its formation, constitutes a background of successful treatment of SHA. In totally formatted acute SHA, as a rule, the methods of choice are aspirational and aspiration-draining methods of sanation under ultrasonographic control or laparoscopy. In the presence of chronic SHA or suppurated parasitic hepatic cyst it is mandatory to select the resectional methods.

  9. Threatened Retaliation as an Inhibitor of Human Aggression: Mediating Effects of the Instrumental Value of Aggression.

    ERIC Educational Resources Information Center

    Baron, Robert A.

    Whereas threatened punishment proves effective under conditions where the instrumental value of aggressive behavior is quite low, the following techniques of control may work better in situations where the value of aggression is relatively high: (1) the use of restrained, non-aggressive models; (2) empathic arousal among aggressors; or (3)…

  10. Predicting Aggressive Behavior in Children with the Help of Measures of Implicit and Explicit Aggression

    ERIC Educational Resources Information Center

    Grumm, Mandy; Hein, Sascha; Fingerle, Michael

    2011-01-01

    Aggressive behavior between children in schools is a topic that receives much interest as violence and aggressive behavior cause many maladaptive social outcomes in the school setting. In the current study the Implicit Association Test (IAT) was adapted as a measure of children's implicit aggression, by assessing the association of the self…

  11. Stability of Aggression during Early Adolescence as Moderated by Reciprocated Friendship Status and Friend's Aggression

    ERIC Educational Resources Information Center

    Adams, Ryan E.; Bukowski, William M.; Bagwell, Catherine

    2005-01-01

    The effect of friendship reciprocation and friend aggression on the stability of aggression across a 6-month period following the transition to secondary school was studied in a sample of 298 Grade 6 children from a predominately white, middle-class, Midwestern American community. The stability of aggression was generally high but it varied as a…

  12. Daily associations among anger experience and intimate partner aggression within aggressive and nonaggressive community couples.

    PubMed

    Crane, Cory A; Testa, Maria

    2014-10-01

    Anger is an empirically established precipitant to aggressive responding toward intimate partners. The current investigation examined the effects of anger, as experienced by both partners, as well as gender and previous aggression, on in vivo intimate-partner aggression (IPA) using a prospective daily diary methodology. Participants (N = 118 couples) individually provided 56 consecutive, daily reports of affective experience and partner aggression. Multilevel models were estimated using the actor-partner interdependence model (APIM) framework to analyze the daily associations between anger and partner-aggression perpetration among participating men and women, as moderated by aggression history. Results revealed that both actor and partner anger were generally associated with subsequently reported daily conflict. Further, increases in daily partner anger were associated with corresponding increases in partner aggression among both women who reported high levels of anger and men, regardless of their own anger experience. Increases in actor anger were associated with increases in daily partner aggression only among previously aggressive women. Previously aggressive men and women consistently reported greater perpetration than their nonaggressive counterparts on days of high levels of actors' anger experiences. Results emphasize the importance of both actor and partner factors in partner aggression and suggest that female anger may be a stronger predictor of both female-to-male and male-to-female partner aggression than male anger, when measured at the daily level.

  13. Physiological Arousal, Exposure to a Relatively Lengthy Aggressive Film, and Aggressive Behavior.

    ERIC Educational Resources Information Center

    Thomas, Margaret Hanratty

    1982-01-01

    Studied male students who viewed an aggressive television program or a neutral one. Half of the students were then angered by a confederate. Results indicated angered men who had seen the aggressive film were most aggressive and exhibited the lowest average pulse rates both before and after shock delivery. (Author/JAC)

  14. Relational and Overt Aggression in Urban India: Associations with Peer Relations and Best Friends' Aggression

    ERIC Educational Resources Information Center

    Bowker, Julie C.; Ostrov, Jamie M.; Raja, Radhi

    2012-01-01

    This study explored the associations between relational and overt aggression and social status, and tested whether the peer correlates of aggression vary as a function of best friends' aggression during early adolescence in urban India. One hundred and ninety-four young adolescents from primarily middle-to-upper-class families in Surat, India…

  15. The Relationship of Aggression and Bullying to Social Preference: Differences in Gender and Types of Aggression

    ERIC Educational Resources Information Center

    Lee, Eunju

    2009-01-01

    With 338 fifth-grade students as subjects, this study found the variations in the relation between school bullying and social preference as a function of gender and types of aggressive behavior utilized. Aggressive boys were likely to be rejected by peers, whereas aggressive girls were both rejected and accepted by peers. Children nominated…

  16. Competitive Aggression without Interaction: Effects of Competitive versus Cooperative Instructions on Aggressive Behavior in Video Games.

    ERIC Educational Resources Information Center

    Anderson, Craig A.; Morrow, Melissa

    1995-01-01

    Extended and tested Deutsch's theory of competition effects. Predicted that people view competitive situations as inherently more aggressive than cooperative ones. Predicted that leading people to think of an aggressive situation in competitive terms would increase aggressive behavior. Increase of kill ratio occurred in absence of changes in…

  17. Neurotransmitters regulating feline aggressive behavior.

    PubMed

    Siegel, A; Schubert, K

    1995-01-01

    The experiments described in this review reveal that the expression and modulation of aggressive responses in the cat are organized by two distinct sets of pathways. One set of pathways is associated with the elicitation of a specific form of attack behavior. It includes the medial hypothalamus and its projections to the PAG for the expression of defensive rage behavior and the lateral hypothalamus and its descending projections for the expression of predatory attack behavior. The primary focus of the present review is upon the analysis of defensive rage behavior. It was demonstrated that the pathway from the medial hypothalamus to the PAG, which appears to be essential for elicitation of defensive rage, is powerfully excitatory and utilizes excitatory amino acids that act upon NMDA receptors within the PAG. The other pathways examined in this review arise from different nuclei of the amygdala and are modulatory in nature. Here, two facilitatory systems have been identified. The first involves a projection system from the basal complex of amygdala that projects directly to the PAG. Its excitatory effects are manifest through excitatory amino acids that act upon NMDA receptors within the PAG. The second facilitatory pathway arises from the medial nucleus of the amygdala. However, its projection system is directed to the medial hypothalamus rather than the PAG. Its neurotransmitter appears to be substance P that acts upon NK1 receptors within the medial hypothalamus (see Figure 10). It has yet to be determined whether substance P acts upon any of the other neurokinin receptor subtypes. It should also be pointed out that the substance P pathway from the medial amygdala to the medial hypothalamus functions to suppress predatory attack behavior elicited from the lateral hypothalamus. In this network, it is likely that the modulatory effects of the medial amygdala require the presence of a second, inhibitory pathway from the medial hypothalamus that innervates the

  18. Genetics of aggressive behavior: An overview.

    PubMed

    Veroude, Kim; Zhang-James, Yanli; Fernàndez-Castillo, Noèlia; Bakker, Mireille J; Cormand, Bru; Faraone, Stephen V

    2016-01-01

    The Research Domain Criteria (RDoC) address three types of aggression: frustrative non-reward, defensive aggression and offensive/proactive aggression. This review sought to present the evidence for genetic underpinnings of aggression and to determine to what degree prior studies have examined phenotypes that fit into the RDoC framework. Although the constructs of defensive and offensive aggression have been widely used in the animal genetics literature, the human literature is mostly agnostic with regard to all the RDoC constructs. We know from twin studies that about half the variance in behavior may be explained by genetic risk factors. This is true for both dimensional, trait-like, measures of aggression and categorical definitions of psychopathology. The non-shared environment seems to have a moderate influence with the effects of shared environment being unclear. Human molecular genetic studies of aggression are in an early stage. The most promising candidates are in the dopaminergic and serotonergic systems along with hormonal regulators. Genome-wide association studies have not yet achieved genome-wide significance, but current samples are too small to detect variants having the small effects one would expect for a complex disorder. The strongest molecular evidence for a genetic basis for aggression comes from animal models comparing aggressive and non-aggressive strains or documenting the effects of gene knockouts. Although we have learned much from these prior studies, future studies should improve the measurement of aggression by using a systematic method of measurement such as that proposed by the RDoC initiative. PMID:26345359

  19. Innovative use of povidone-iodine to guide burn wound debridement and predict the success of biobrane as a definitive treatment for burns.

    PubMed

    Lau, Yu Sin; Brooks, Peter

    2014-03-01

    The success of Biobrane (Smith & Nephew, St. Petersburg, Florida) dressing in superficial burns depends on wound selection and preparation. After wound debridement, povidone-iodine is applied, and changes in wound color are recorded. Next, Biobrane is applied, and adherence is checked after 48 hours. The authors' study showed that remaining brown areas of the wound are predictive of Biobrane nonadherence, which is indicative of deeper burns.

  20. CO2 laser debridement of sulphur mustard (bis-2-chloroethyl sulphide) induced cutaneous lesions accelerates production of a normal epidermis with elimination of cytological atypia.

    PubMed

    Smith, K J; Skelton, H G; Martin, J L; Hurst, C G; Hackley, B E

    1997-10-01

    Sulphur mustard (bis-2-chloroethyl sulphide; HD) exposure acutely produces lesions that vary from mild erythema, to blister formation, to necrosis. When blisters occur, with or without necrosis, healing of the lesions is delayed. Weanling pigs exposed to a mild erythema-producing dose of HD and to a moderate erythema-producing dose that consistently gave microblister formation were treated with CO2 laser (Tru-Pulse) debridement at 6, 24 or 48 h after exposure. The histopathological features observed at 14 days after exposure in control skin and skin exposed to both HD doses were compared with the features observed in CO2 laser-debrided skin in non-exposed and HD-exposed skin sites. The overlying epidermis in the non-laser treated lesions was thin, with cytological atypia and squamoid changes within the basal cell layer, as well as scattered apoptotic/necrotic keratinocytes. An increased inflammatory infiltrate and necrobiotic changes in the dermis were seen at the higher HD dose. All laser-treated lesions appeared identical, with a thick, differentiated epidermis and a well-formed basal cell layer. There was minimal inflammatory infiltrate. In the papillary dermis there were increased stromal cells. Laser debridement of mild clinical lesions induced by HD produced a more functional epidermis by 14 days as well as clearing the epidermis of damaged keratinocytes.

  1. Debridement of cartilage lesions before autologous chondrocyte implantation by open or transarthroscopic techniques: a comparative study using post-mortem materials.

    PubMed

    Drobnic, M; Radosavljevic, D; Cör, A; Brittberg, M; Strazar, K

    2010-04-01

    We compared the quality of debridement of chondral lesions performed by four arthroscopic (SH, shaver; CU, curette; SHCU, shaver and curette; BP, bipolar electrodes) and one open technique (OPEN, scalpel and curette) which are used prior to autologous chondrocyte implantation (ACI). The ex vivo simulation of all five techniques was carried out on six juvenile equine stifle joints. The OPEN, SH and SHCU techniques were tested on knees harvested from six adult human cadavers. The most vertical walls with the least adjacent damage to cartilage were obtained with the OPEN technique. The CU and SHCU methods gave inferior, but still acceptable results whereas the SH technique alone resulted in a crater-like defect and the BP method undermined the cartilage wall. The subchondral bone was severely violated in all the equine samples which might have been peculiar to this model. The predominant depth of the debridement in the adult human samples was at the level of the calcified cartilage. Some minor penetrations of the subchondral end-plate were induced regardless of the instrumentation used. Our study suggests that not all routine arthroscopic instruments are suitable for the preparation of a defect for ACI. We have shown that the preferred debridement technique is either open or arthroscopically-assisted manual curettage. The use of juvenile equine stifles was not appropriate for the study of the cartilage-subchondral bone interface. PMID:20357342

  2. Surgical bleeding in microgravity

    NASA Technical Reports Server (NTRS)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  3. [Electoro-surgical device].

    PubMed

    Matsumura, Yuji

    2009-07-01

    Electro-surgical device is an essential instrument for bloodless surgery after the 1st introduction by Harvey Cushing in 1926. Basal mechanisms of electric scalpels (monopolar and bipolar), current waveforms (cut, coagulation and blend), high-frequency currents and electrical shocks were commented. After 1990s, several new electro-surgical devices such as argon beam coagulator, bipolar scissors and vessel sealing system (LigaSure) were developed and introduced in chest surgery. Argon beam coagulator is useful in sealing and hemostasis of bleeding from chest walls after extrapleural dissections. Bipolar scissors can seal small vessels less than diameter 2 mm and is useful in mediastinal lymphnode dissections. Vessel sealing system is able to seal and cut vessels up to diameter 7 mm. LigaSure V is the most suitable instrument for thymic vein handling in thoracoscopic thymectomy. Clinical applications of these new surgical devices in chest surgery are discussed. PMID:20715684

  4. Desensitization to Media Violence: Links With Habitual Media Violence Exposure, Aggressive Cognitions, and Aggressive Behavior

    PubMed Central

    Krahé, Barbara; Möller, Ingrid; Huesmann, L. Rowell; Kirwil, Lucyna; Felber, Juliane; Berger, Anja

    2015-01-01

    This study examined the links between desensitization to violent media stimuli and habitual media violence exposure as a predictor and aggressive cognitions and behavior as outcome variables. Two weeks after completing measures of habitual media violence exposure, trait aggression, trait arousability, and normative beliefs about aggression, undergraduates (N = 303) saw a violent film clip and a sad or a funny comparison clip. Skin conductance level (SCL) was measured continuously, and ratings of anxious and pleasant arousal were obtained after each clip. Following the clips, participants completed a lexical decision task to measure accessibility of aggressive cognitions and a competitive reaction time task to measure aggressive behavior. Habitual media violence exposure correlated negatively with SCL during violent clips and positively with pleasant arousal, response times for aggressive words, and trait aggression, but it was unrelated to anxious arousal and aggressive responding during the reaction time task. In path analyses controlling for trait aggression, normative beliefs, and trait arousability, habitual media violence exposure predicted faster accessibility of aggressive cognitions, partly mediated by higher pleasant arousal. Unprovoked aggression during the reaction time task was predicted by lower anxious arousal. Neither habitual media violence usage nor anxious or pleasant arousal predicted provoked aggression during the laboratory task, and SCL was unrelated to aggressive cognitions and behavior. No relations were found between habitual media violence viewing and arousal in response to the sad and funny film clips, and arousal in response to the sad and funny clips did not predict aggressive cognitions or aggressive behavior on the laboratory task. This suggests that the observed desensitization effects are specific to violent content. PMID:21186935

  5. Desensitization to media violence: links with habitual media violence exposure, aggressive cognitions, and aggressive behavior.

    PubMed

    Krahé, Barbara; Möller, Ingrid; Huesmann, L Rowell; Kirwil, Lucyna; Felber, Juliane; Berger, Anja

    2011-04-01

    This study examined the links between desensitization to violent media stimuli and habitual media violence exposure as a predictor and aggressive cognitions and behavior as outcome variables. Two weeks after completing measures of habitual media violence exposure, trait aggression, trait arousability, and normative beliefs about aggression, undergraduates (N = 303) saw a violent film clip and a sad or a funny comparison clip. Skin conductance level (SCL) was measured continuously, and ratings of anxious and pleasant arousal were obtained after each clip. Following the clips, participants completed a lexical decision task to measure accessibility of aggressive cognitions and a competitive reaction time task to measure aggressive behavior. Habitual media violence exposure correlated negatively with SCL during violent clips and positively with pleasant arousal, response times for aggressive words, and trait aggression, but it was unrelated to anxious arousal and aggressive responding during the reaction time task. In path analyses controlling for trait aggression, normative beliefs, and trait arousability, habitual media violence exposure predicted faster accessibility of aggressive cognitions, partly mediated by higher pleasant arousal. Unprovoked aggression during the reaction time task was predicted by lower anxious arousal. Neither habitual media violence usage nor anxious or pleasant arousal predicted provoked aggression during the laboratory task, and SCL was unrelated to aggressive cognitions and behavior. No relations were found between habitual media violence viewing and arousal in response to the sad and funny film clips, and arousal in response to the sad and funny clips did not predict aggressive cognitions or aggressive behavior on the laboratory task. This suggests that the observed desensitization effects are specific to violent content. PMID:21186935

  6. Desensitization to media violence: links with habitual media violence exposure, aggressive cognitions, and aggressive behavior.

    PubMed

    Krahé, Barbara; Möller, Ingrid; Huesmann, L Rowell; Kirwil, Lucyna; Felber, Juliane; Berger, Anja

    2011-04-01

    This study examined the links between desensitization to violent media stimuli and habitual media violence exposure as a predictor and aggressive cognitions and behavior as outcome variables. Two weeks after completing measures of habitual media violence exposure, trait aggression, trait arousability, and normative beliefs about aggression, undergraduates (N = 303) saw a violent film clip and a sad or a funny comparison clip. Skin conductance level (SCL) was measured continuously, and ratings of anxious and pleasant arousal were obtained after each clip. Following the clips, participants completed a lexical decision task to measure accessibility of aggressive cognitions and a competitive reaction time task to measure aggressive behavior. Habitual media violence exposure correlated negatively with SCL during violent clips and positively with pleasant arousal, response times for aggressive words, and trait aggression, but it was unrelated to anxious arousal and aggressive responding during the reaction time task. In path analyses controlling for trait aggression, normative beliefs, and trait arousability, habitual media violence exposure predicted faster accessibility of aggressive cognitions, partly mediated by higher pleasant arousal. Unprovoked aggression during the reaction time task was predicted by lower anxious arousal. Neither habitual media violence usage nor anxious or pleasant arousal predicted provoked aggression during the laboratory task, and SCL was unrelated to aggressive cognitions and behavior. No relations were found between habitual media violence viewing and arousal in response to the sad and funny film clips, and arousal in response to the sad and funny clips did not predict aggressive cognitions or aggressive behavior on the laboratory task. This suggests that the observed desensitization effects are specific to violent content.

  7. Parental Behavior, TV Habits, IQ Predict Aggression.

    ERIC Educational Resources Information Center

    Greenberg, J.

    1983-01-01

    Highlights a longitudinal study on key factors in the metamorphosis of childhood aggression into adult crime in more than 400 males/females. Results (which began with study of 875 third graders in 1960) indicate that aggressive youngsters at age eight have much higher rates of criminal/violent behavior at age 30. (JN)

  8. Moral Judgments of Aggressive and Nonaggressive Children.

    ERIC Educational Resources Information Center

    Keltikangas-Jarvinen, Liisa

    1989-01-01

    Reports on a study of moral judgments in aggressive and nonaggressive children. Assessed moral judgment by presenting the children with stories of moral conflict in everyday life using peer rating. Results showed significant differences according to gender and no constant level of moral reasoning was measured in either aggressive or nonaggressive…

  9. Forgivingness, anger, and hostility in aggressive driving.

    PubMed

    Kovácsová, Natália; Rošková, Eva; Lajunen, Timo

    2014-01-01

    This study was aimed at investigating the relationship between trait forgivingness, general anger, hostility, driving anger, and self-reported aggressive driving committed by the driver him/herself ("self" scale) and perceiving him/herself as an object of other drivers' aggressive acts ("other" scale). The Slovak version of questionnaires was administrated to a sample of 612 Slovak and Czech drivers. First, the factor structure of the Driver Anger Indicators Scale (DAIS) was investigated. Factor analyses of the self and other parts of the DAIS resulted in two factors, which were named as aggressive warnings and hostile aggression and revenge. Next, the results showed that from all dependent variables (scales of the DAIS), self-reported aggressive warnings (self) on the road were predicted best by chosen person-related factors. The path model for aggressive warnings (self) suggested that trait forgivingness and general anger were fully mediated by driving anger whereas hostility proved to be a unique predictor of aggressive behavior in traffic. Driving anger was found to be the best predictor of perceptions that other drivers behave aggressively. PMID:24211562

  10. Understanding Aggressive Behavior Across the Life Span

    PubMed Central

    Liu, Jianghong; Lewis, Gary; Evans, Lois

    2012-01-01

    Aggressive behavior is the observable manifestation of aggression and is often associated with developmental transitions and a range of medical and psychiatric diagnoses across the lifespan. As healthcare professionals involved in the medical and psychosocial care of patients from birth through death, nurses frequently encounter—and may serve as—both victims and perpetrators of aggressive behavior in the workplace. While the nursing literature has continually reported research on prevention and treatment approaches, less emphasis has been given to understanding the etiology, including contextual precipitants of aggressive behavior. This paper provides a brief review of the biological, social, and environmental risk factors that purportedly give rise to aggressive behavior. Further, many researchers have focused specifically on aggressive behavior in adolescence and adulthood. Less attention has been given to understanding the etiology of such behavior in young children and older adults. This paper emphasizes the unique risk factors for aggressive behavior across the developmental spectrum, including childhood, adolescence, adulthood, and late life. Appreciation of the risk factors of aggressive behavior, and, in particular, how they relate to age-specific manifestations, can aid nurses in better design and implementation of prevention and treatment programs. PMID:22471771

  11. Sibling Aggression: Sex Differences and Parents' Reactions

    ERIC Educational Resources Information Center

    Martin, Jacqueline L.; Ross, Hildy S.

    2005-01-01

    Thirty-nine families were observed extensively at home when children were 2 1/2 and 4 1/2 years of age and again 2 years later. The Social Relations Model is used to investigate children's sex differences in aggression and parents' prohibiting aggression during sibling conflict. In the first observation period, boys engaged in more severe and mild…

  12. Involvement in Internet Aggression during Early Adolescence

    ERIC Educational Resources Information Center

    Werner, Nicole E.; Bumpus, Matthew F.; Rock, Daquarii

    2010-01-01

    The current study examined concurrent and longitudinal predictors of early adolescents' involvement in Internet aggression. Cross-sectional results (N = 330; 57% female) showed that the likelihood of reporting Internet aggression was higher among youth who spent more time using Internet-based technologies to communicate with friends and who were…

  13. Aggressive and foraging behavioral interactions among ruffe

    USGS Publications Warehouse

    Savino, Jacqueline F.; Kostich, Melissa J.

    2000-01-01

    The ruffe, Gymnocephalus cernuus, is a nonindigenous percid in the Great Lakes. Ruffe are aggressive benthivores and forage over soft substrates. Laboratory studies in pools (100 cm in diameter, 15 cm water depth) were conducted to determine whether fish density (low = 2, medium = 4, high = 6 ruffe per pool) changed foraging and aggressive behaviors with a limited food supply of chironomid larvae. All fish densities demonstrated a hierarchy based on aggressive interactions, but ruffe were most aggressive at low and high fish densities. Time spent in foraging was lowest at the low fish density. The best forager at the low fish density was the most aggressive individual, but the second most aggressive fish at the medium and high fish density was the best forager and also the one chased most frequently. A medium fish density offered the best energetic benefits to ruffe by providing the lowest ratio of time spent in aggression to that spent foraging. Based on our results, ruffe should grow best at an intermediate density. With high ruffe densities, we would also expect disparity in size as the more aggressive fish are able to garner a disproportionate amount of the resources. Alternatively, as the Great Lakes are a fairly open system, ruffe could migrate out of one area to colonize another as populations exceed optimal densities.

  14. Relational Aggression and Victimization in College Students

    ERIC Educational Resources Information Center

    Dahlen, Eric R.; Czar, Katherine A.; Prather, Emily; Dyess, Christy

    2013-01-01

    For this study we explored relational aggression and victimization in a college sample (N = 307), examining potential gender and race differences, correlates, and the link between relational aggression and common emotional and behavioral problems, independent of relational victimization. Gender and race differences were observed on relational…

  15. Human Aggression: Current Theories and Research.

    ERIC Educational Resources Information Center

    Geen, Russell G.

    The literature on human aggression is large and diverse. Some of it is theory-driven, but much of it dwells on solving social problems rather than on building general models and research paradigms. This paper examines some of the research programs and theoretical emphases in aggression research and presents theory convergences to see how these…

  16. Game location and aggression in rugby league.

    PubMed

    Jones, Marc V; Bray, Steven R; Olivier, Stephen

    2005-04-01

    The present study examined the relationship between aggression and game location in rugby league. We videotaped a random sample of 21 professional rugby league games played in the 2000 Super League season. Trained observers recorded the frequency of aggressive behaviours. Consistent with previous research, which used territoriality theories as a basis for prediction, we hypothesized that the home team would behave more aggressively than the away team. The results showed no significant difference in the frequency of aggressive behaviours exhibited by the home and away teams. However, the away teams engaged in substantially more aggressive behaviours in games they lost compared with games they won. No significant differences in the pattern of aggressive behaviours for home and away teams emerged as a function of game time (i.e. first or second half) or game situation (i.e. when teams were winning, losing or drawing). The findings suggest that while home and away teams do not display different levels of aggression, the cost of behaving aggressively (in terms of game outcome) may be greater for the away team.

  17. Normative Beliefs Regarding Aggression in Emerging Adulthood

    ERIC Educational Resources Information Center

    Nelson, David A.; Springer, Melanie M.; Nelson, Larry J.; Bean, Nathaniel H.

    2008-01-01

    Few studies have examined the nature of aggression in emerging adulthood (ages 18-25), a unique developmental period wherein relationships become increasingly important and intimate. Consistent with a greater emphasis on relationships, relationally manipulative forms of aggression may be particularly salient during this time period. Based on…

  18. The Barrier within: Relational Aggression among Women

    ERIC Educational Resources Information Center

    Brock, Barbara L.

    2010-01-01

    Relational aggression among women presents an overlooked barrier to women's quest for advancement in the workplace. Although research on women's leadership extols their ability to collaborate and form lasting, supportive relationships, one cannot assume that all women are supportive of other women. Research reveals that relational aggression,…

  19. Forgivingness, anger, and hostility in aggressive driving.

    PubMed

    Kovácsová, Natália; Rošková, Eva; Lajunen, Timo

    2014-01-01

    This study was aimed at investigating the relationship between trait forgivingness, general anger, hostility, driving anger, and self-reported aggressive driving committed by the driver him/herself ("self" scale) and perceiving him/herself as an object of other drivers' aggressive acts ("other" scale). The Slovak version of questionnaires was administrated to a sample of 612 Slovak and Czech drivers. First, the factor structure of the Driver Anger Indicators Scale (DAIS) was investigated. Factor analyses of the self and other parts of the DAIS resulted in two factors, which were named as aggressive warnings and hostile aggression and revenge. Next, the results showed that from all dependent variables (scales of the DAIS), self-reported aggressive warnings (self) on the road were predicted best by chosen person-related factors. The path model for aggressive warnings (self) suggested that trait forgivingness and general anger were fully mediated by driving anger whereas hostility proved to be a unique predictor of aggressive behavior in traffic. Driving anger was found to be the best predictor of perceptions that other drivers behave aggressively.

  20. Problems in Aggression: Three Case Studies.

    ERIC Educational Resources Information Center

    Holt, Wilma J.

    This paper reviews three studies which illustrate the use of two different techniques of behavior modification to control aggression in preschool children in classroom situations. The first technique demonstrated the use of "time-out" as a mild punishment procedure. The teacher changed events following aggression by briefly removing the child from…

  1. Surgical prosthetic treatment

    PubMed Central

    Carulli, Christian; Matassi, Fabrizio; Civinini, Roberto; Villano, Marco; Innocenti, Massimo

    2010-01-01

    Fragility fractures typically occur in elderly patients related principally to osteoporosis. A significative percentage of these fractures have to be treated surgically but comorbilities are often present, and need to be grossly stabilized before surgery. However, there is for these fractures a high rate of morbidity and mortality at short-term. Moreover, patients affected by a fragility fracture are at risk for another fragility fracture later in life. The Authors present an overview of the main patterns of proximal femoral fractures, underlining the peculiar features and choices of surgical treatment, and relating to specific indications and results of each treatment. PMID:22461289

  2. [Pulmonary Echinococcosis: Surgical Aspects].

    PubMed

    Eichhorn, M E; Hoffmann, H; Dienemann, H

    2015-10-01

    Pulmonary cystic echinococcosis is a very rare disease in Germany. It is caused by the larvae of the dog tapeworm (echinococcus granulosus). The liver is the most affected organ, followed by the lungs. Surgery remains the main therapeutic approach for pulmonary CE. Whenever possible, parenchyma-preserving lung surgery should be preferred over anatomic lung resections. To ensure best therapeutic results, surgery needs to be performed under precise consideration of important infectiological aspects and patients should be treated in specialised centres based on interdisciplinary consensus. In addition to surgical aspects, this review summarises special infectiological features of this disease, which are crucial to the surgical approach. PMID:26351761

  3. Intraoperative Electron Radiotherapy for the Management of Aggressive Fibromatosis

    SciTech Connect

    Roeder, Falk; Timke, Carmen; Oertel, Susanne; Hensley, Frank W.; Bischof, Marc; Muenter, Marc W.; Weitz, Juergen; Buchler, Markus W.; Lehner, Burkhard; Debus, Juergen; Krempien, Robert

    2010-03-15

    Purpose: We analyzed our experience with intraoperative electron radiotherapy (IOERT) followed by moderate doses of external beam radiotherapy (EBRT) after organ-sparing surgery in patients with primary or recurrent aggressive fibromatosis. Methods and Materials: Indication for IOERT and postoperative EBRT as an individual treatment approach to avoid mutilating surgical procedures was seen when complete surgical removal seemed to be unlikely or impossible. A total of 31 lesions in 30 patients were treated by surgery and IOERT with a median dose of 12 Gy. Median age was 31 years (range, 13-59 years). Resection status was close margin in six lesions, microscopically positive in 13, and macroscopically positive in 12. Median tumor size was 9 cm. In all, 25 patients received additional EBRT, with a median dose of 45 Gy (range, 36-54 Gy). Results: After a median follow-up of 32 months (range, 3-139 months), no disease-related deaths occurred. A total of five local recurrences were seen, resulting in actuarial 3-year local control rates of 82% overall and 91% inside the IOERT areas. Trends to improved local control were seen for older age (>31 years) and negative margins, but none of these factors reached significance. Perioperative complications were found in six patients, in particular as wound healing disturbances in five patients and venous thrombosis in one patient. Late toxicity was seen in five patients. Conclusion: Introduction of IOERT into a multimodal treatment approach in patients with aggressive fibromatosis is feasible with low toxicity and yielded good local control rates even in patients with microscopical or gross residual disease.

  4. [Aggressive and prosocial behavior in childhood psychopathology].

    PubMed

    Vida, Péter; Halász, József; Gádoros, Júlia

    2013-01-01

    Aggressive/attacking and helpful/emphatic/prosocial behaviors are extremely important in human relationships. Both high levels of aggression and deficits of prosociality play important role in the development and conservation of mental disorders. We review the measurement options and clinical importance of aggressive and prosocial behavior. The typical developmental pathways and the genetic and environmental background of these behaviors are presented. The clinical tools used in the measurement of aggression and prosociality are summarized in the present paper, with specific attention on questionnaires applied in Hungarian practice. The connections between diagnostic categories (conduct disorder, oppositional-defiant disorder, attention deficit and hyperactive disorder, autism spectrum disorders) and the two behaviors are evaluated. In the end, we present those additional research projects that explore the cognitive-emotional background of aggressive or prosocial behavior with clinical relevance either in the diagnosis or in the treatment of child psychiatric diseases. PMID:24142292

  5. Hollingsworth - Aggressive vs Indolent 2012 — EDRN Public Portal

    Cancer.gov

    Study Overview. We will examine DNA extracted from FFPE sections from approximately 200 different surgically resected primary pancreatic tumors from the UNMC Department of Pathology and Microbiology. DNA will be purified from those sections and subjected to deep sequencing for the entire TP53 locus. Expected Outcomes We expect to find a difference in the p53 mutation status between tumor samples from patients that ultimately experienced tumor recurrence (more aggressive) compared to those that did not. Parallel studies to develop ICP will enable us to rapidly develop a low cost platform to extend these studies to larger patient populations for future validation studies. Future Studies The experiments proposed in this application represent a state-of-the-art approach to identify molecular markers that will help clinicians to ascertain the tumor recurrence risk for their pancreatic cancer patients who have undergone a Whipple procedure. If our initial studies support the hypothesis that p53 mutations are associated with early metastasis of pancreatic cancer, these studies would be extended to other cohorts of patient samples that are available at other major centers that see pancreatic cancer patients. Development of ICE COLD-PCR platforms to screen for these mutations will facilitate a reliable, rapid and low cost method for predicting tumor aggressiveness in these patients, which will be deployed in future studies should the hypothesis be supported.

  6. Perspectives in prevention and treatment of surgical site infection - a narrative review of the literature.

    PubMed

    Leaper, David; Fry, Donald; Assadian, Ojan

    2013-11-01

    Health care-associated infections (HCAIs) are infections acquired through contact with any aspect of health care. They can cause minor complications or serious disability or death, and can involve a wide variety of resistant or emergent organisms. Surgical site infections make up approximately one-fifth of HCAIs, and at least 5% of patients undergoing open surgery develop an SSI. Surgical site infections are probably the most preventable HCAI but have received the least attention; although that is changing with increased surveillance and public awareness of published data of individual specialty and hospital incidence rates. Surgical site infection continues to be a complication of surgical care. These infections span a continuum of severity with some being quite innocent and easy to manage, while others are life-threatening. Considerable evidence provides direction in the prevention of SSI (eg, systemic antibiotic prophylaxis) but many preventive strategies need better definition, with additional clinical studies. When SSI occurs, the clinician needs to quickly recognize it and tailor management to the specific needs of the patient. In general, drainage, debridement, and specific antibiotics for the putative pathogen are the hallmarks of management. .

  7. When do normative beliefs about aggression predict aggressive behavior? An application of I3 theory.

    PubMed

    Li, Jian-Bin; Nie, Yan-Gang; Boardley, Ian D; Dou, Kai; Situ, Qiao-Min

    2015-01-01

    I(3) theory assumes that aggressive behavior is dependent on three orthogonal processes (i.e., Instigator, Impellance, and Inhibition). Previous studies showed that Impellance (trait aggressiveness, retaliation tendencies) better predicted aggression when Instigator was strong and Inhibition was weak. In the current study, we predicted that another Impellance (i.e., normative beliefs about aggression) might predict aggression when Instigator was absent and Inhibition was high (i.e., the perfect calm proposition). In two experiments, participants first completed the normative beliefs about aggression questionnaire. Two weeks later, participants' self-control resources were manipulated either using the Stroop task (study 1, N = 148) or through an "e-crossing" task (study 2, N = 180). Afterwards, with or without being provoked, participants played a game with an ostensible partner where they had a chance to aggress against them. Study 1 found that normative beliefs about aggression negatively and significantly predicted aggressive behavior only when provocation was absent and self-control resources were not depleted. In Study 2, normative beliefs about aggression negatively predicted aggressive behavior at marginal significance level only in the "no-provocation and no-depletion" condition. In conclusion, the current study provides partial support for the perfect calm proposition and I(3) theory.

  8. The relationships among perceived peer acceptance of sexual aggression, punishment certainty, and sexually aggressive behavior.

    PubMed

    Strang, Emily; Peterson, Zoë D

    2013-12-01

    Researching the correlates of men's sexually aggressive behavior (i.e., verbal coercion and rape) is critical to both understanding and preventing sexual aggression. This study examined 120 men who completed an anonymous online questionnaire. The study aimed to determine the relative importance of two potential correlates of men's self-reported use of sexual aggression: (a) perceptions that male peers use and support sexual aggression and (b) perceptions of punishment likelihood associated with sexual aggression. Results revealed that perceptions of male friends' acceptance of sexual aggression were strongly associated with individual men's reports of using verbal coercion and rape. Perceptions of punishment likelihood were negatively correlated with verbal coercion but not with rape through intoxication and force. Implications for sexual aggression prevention are discussed.

  9. The relationships among perceived peer acceptance of sexual aggression, punishment certainty, and sexually aggressive behavior.

    PubMed

    Strang, Emily; Peterson, Zoë D

    2013-12-01

    Researching the correlates of men's sexually aggressive behavior (i.e., verbal coercion and rape) is critical to both understanding and preventing sexual aggression. This study examined 120 men who completed an anonymous online questionnaire. The study aimed to determine the relative importance of two potential correlates of men's self-reported use of sexual aggression: (a) perceptions that male peers use and support sexual aggression and (b) perceptions of punishment likelihood associated with sexual aggression. Results revealed that perceptions of male friends' acceptance of sexual aggression were strongly associated with individual men's reports of using verbal coercion and rape. Perceptions of punishment likelihood were negatively correlated with verbal coercion but not with rape through intoxication and force. Implications for sexual aggression prevention are discussed. PMID:24014542

  10. Aggression on inpatient units: Clinical characteristics and consequences.

    PubMed

    Renwick, Laoise; Stewart, Duncan; Richardson, Michelle; Lavelle, Mary; James, Karen; Hardy, Claire; Price, Owen; Bowers, Len

    2016-08-01

    Aggression and violence are widespread in UK Mental Health Trusts, and are accompanied by negative psychological and physiological consequences for both staff and other patients. Patients who are younger, male, and have a history of substance use and psychosis diagnoses are more likely to display aggression; however, patient factors are not solely responsible for violence, and there are complex circumstances that lead to aggression. Indeed, patient-staff interactions lead to a sizeable portion of aggression and violence on inpatient units, thus they cannot be viewed without considering other forms of conflict and containment that occur before, during, and after the aggressive incident. For this reason, we examined sequences of aggressive incidents in conjunction with other conflict and containment methods used to explore whether there were particular profiles to aggressive incidents. In the present study, 522 adult psychiatric inpatients from 84 acute wards were recruited, and there were 1422 incidents of aggression (verbal, physical against objects, and physical). Cluster analysis revealed that aggressive incident sequences could be classified into four separate groups: solo aggression, aggression-rule breaking, aggression-medication, and aggression-containment. Contrary to our expectations, we did not find physical aggression dominant in the aggression-containment cluster, and while verbal aggression occurred primarily in solo aggression, physical aggression also occurred here. This indicates that the management of aggression is variable, and although some patient factors are linked with different clusters, these do not entirely explain the variation.

  11. Aggression on inpatient units: Clinical characteristics and consequences.

    PubMed

    Renwick, Laoise; Stewart, Duncan; Richardson, Michelle; Lavelle, Mary; James, Karen; Hardy, Claire; Price, Owen; Bowers, Len

    2016-08-01

    Aggression and violence are widespread in UK Mental Health Trusts, and are accompanied by negative psychological and physiological consequences for both staff and other patients. Patients who are younger, male, and have a history of substance use and psychosis diagnoses are more likely to display aggression; however, patient factors are not solely responsible for violence, and there are complex circumstances that lead to aggression. Indeed, patient-staff interactions lead to a sizeable portion of aggression and violence on inpatient units, thus they cannot be viewed without considering other forms of conflict and containment that occur before, during, and after the aggressive incident. For this reason, we examined sequences of aggressive incidents in conjunction with other conflict and containment methods used to explore whether there were particular profiles to aggressive incidents. In the present study, 522 adult psychiatric inpatients from 84 acute wards were recruited, and there were 1422 incidents of aggression (verbal, physical against objects, and physical). Cluster analysis revealed that aggressive incident sequences could be classified into four separate groups: solo aggression, aggression-rule breaking, aggression-medication, and aggression-containment. Contrary to our expectations, we did not find physical aggression dominant in the aggression-containment cluster, and while verbal aggression occurred primarily in solo aggression, physical aggression also occurred here. This indicates that the management of aggression is variable, and although some patient factors are linked with different clusters, these do not entirely explain the variation. PMID:26892149

  12. Surgical Instrument Restraint in Weightlessness

    NASA Technical Reports Server (NTRS)

    Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

    2000-01-01

    Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

  13. [The utility of aspiration cytology for the distinction of aggressive and non-aggressive papillary carcinoma of the thyroid].

    PubMed

    Caprara, G; Collina, G

    2007-06-01

    Preoperative identification of the aggressive variants of papillary thyroid carcinoma (PTC) by fine needle aspiration (FNAC) has been suggested and different systems for distinguishing them from classical variant of PTC have been employed, including a point-based cytology grading system as suggested by Damiani et al., that we currently use in our Institution. The aim of this paper is to verify if distinction of PTC in aggressive or nonaggressive variants impacts on surgical treatment. In 7 years, from 1998 to 2005, 13586 cases of FNAC of thyroid have been performed; among them 156 PTC. The cytological material of thirty complete thyroidectomies with histology proven papillary thyroid carcinoma were reviewed. 11/30 cases were correctly stratified into the appropriate low or high-grade category. The cytological grading system was discordant with the final histopathological diagnosis in 9/30 cases while in 10 cases the grade was not assessed. Eight cases were downgraded and therefore the low grade papillary carcinoma diagnosed at cytological level turned to be high grade at histology. When those cases were reviewed, the histology of seven cases diagnosed as tall cell variant of PTC failed to show a percentage of tumour cells higher than 50% and therefore it would be better to diagnose them as classical variant of PTC. One case was under-graded at FNAC. The case that was cytologically upgraded was a follicular variant of PTC in Hashimoto thyroiditis with a focus of tall cells. All patients underwent thyroidectomy or thyroidectomy plus lymphadenectomy and from our results the pre-operative diagnosis did not effect the surgical treatment. No patient died of the disease.

  14. A novel mechanism in maggot debridement therapy: protease in excretion/secretion promotes hepatocyte growth factor production.

    PubMed

    Honda, Kenjiro; Okamoto, Koji; Mochida, Yasuhiro; Ishioka, Kunihiro; Oka, Machiko; Maesato, Kyoko; Ikee, Ryota; Moriya, Hidekazu; Hidaka, Sumi; Ohtake, Takayasu; Doi, Kent; Fujita, Toshiro; Kobayashi, Shuzo; Noiri, Eisei

    2011-12-01

    Maggot debridement therapy (MDT) is effective for treating intractable wounds, but its precise molecular mechanism, including the association between MDT and growth factors, remains unknown. We administered MDT to nine patients (66.3 ± 11.8 yr, 5 male and 4 female) with intractable wounds of lower extremities because they did not respond to conventional therapies. Significant increases of hepatocyte growth factor (HGF) levels were observed in femoral vein blood during 48 h of MDT (P < 0.05), but no significant change was found for vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor-β1 (TGF-β1), or tumor necrosis factor-α (TNF-α). We conducted NIH-3T3 cell stimulation assay to evaluate the relation between HGF and protease activity in excretion/secretion (ES) derived from maggots. Compared with the control group, HGF was significantly higher in the 0.05 μg/ml ES group (P < 0.01). Furthermore, protease inhibitors suppressed the increase of HGF (P < 0.05). The HGF expression was increased in proportion to the ES protein concentration of 0.025 to 0.5 μg/ml. In fact, ES showed stronger capability of promoting HGF production and less cytotoxicity than chymotrypsin or bromelain. HGF is an important factor involved in cutaneous wound healing. Therefore, these results suggest that formation of healthy granulation tissue observed during MDT results from the increased HGF. Further investigation to identify molecules enhancing HGF expression by MDT will contribute greatly to drug target discovery for intractable wound healing therapy.

  15. Surgical wound care - open

    MedlinePlus

    Surgical incision care; Open wound care ... your wound again with sutures, you need to care for it at home, since it may take ... Your health care provider will tell you how often to change your dressing . To prepare for the dressing change: Clean your ...

  16. Surgical treatment of constipation.

    PubMed

    Błachut, K; Bednarz, W; Paradowski, L

    2004-01-01

    Constipation is a common symptom in clinical practice. Definition of constipation includes abnormal bowel frequency, difficulty during defecation and abnormal stool consistency. There are many classifications of constipation based on constipation etiology (constipation in healthy people caused by life style, constipation as a symptom of digestive tract diseases, secondary constipation in the course of systemic disorders or associated with drugs) and/or constipation mechanisms (functional, mechanical). The numerous disorders leading to constipation make often diagnostic management difficult and complicated. Treatment of constipation includes dietary and behavioral approaches, pharmacologic therapy and in selected patient surgical treatment. Surgical treatment is recommended in young patients with severe slow transit constipation refractory to conservative treatment. Confirmation of indication to surgical treatment requires studies of colonic and anorectal function (colonic transit studies, anorectal manometry, studies of defecation). Preferred surgical technique is colectomy with ileorectal anastomosis. Authors reported good results and patient satisfaction in 50-100 percent of cases. Postoperative complications include intestinal obstruction, abdominal pain, flatulence, diarrhea. PMID:15631313

  17. Ancient Egyptian surgical heritage.

    PubMed

    Saber, Aly

    2010-12-01

    Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

  18. [Surgical peculiarities of gunshot injuries to arteries of the extremities caused by modern small arms and light weapons].

    PubMed

    Samokhvalov, I M; Reva, V A; Denisov, A V; Ozeretskovskiĭ, L B; Pronchenko, A A

    2014-10-01

    The aim of the given study was development of surgical tactics in case of femoral artery injury, caused by medium-calibre bullet, on the basis acute experiment on large biological objects. Experimental animals were shot into mid third of the femora by a rifle cartridge in 7,62-mm calibre (AK-47 made in 1943). The analysis of microstructure, made in 5 cross-sections performed every 1-centimetre way from the wound canal, showed that there were no any damages of arterial wall. Authors came to conclusion that the surgical debridement of the gunshot wound, made by a rifle cartridge in 7,62-mm calibre of AK-47, should consist of exsection of devitalized section of artery.

  19. [Surgical peculiarities of gunshot injuries to arteries of the extremities caused by modern small arms and light weapons].

    PubMed

    Samokhvalov, I M; Reva, V A; Denisov, A V; Ozeretskovskiĭ, L B; Pronchenko, A A

    2014-10-01

    The aim of the given study was development of surgical tactics in case of femoral artery injury, caused by medium-calibre bullet, on the basis acute experiment on large biological objects. Experimental animals were shot into mid third of the femora by a rifle cartridge in 7,62-mm calibre (AK-47 made in 1943). The analysis of microstructure, made in 5 cross-sections performed every 1-centimetre way from the wound canal, showed that there were no any damages of arterial wall. Authors came to conclusion that the surgical debridement of the gunshot wound, made by a rifle cartridge in 7,62-mm calibre of AK-47, should consist of exsection of devitalized section of artery. PMID:25532307

  20. Adjunct Antimicrobial Therapy and Periodontal Surgery to Treat Generalized Aggressive Periodontitis: A Case Report.

    PubMed

    Irokawa, Daisuke; Makino-Oi, Asako; Fujita, Takahisa; Yamamoto, Shigeki; Tomita, Sachiyo; Saito, Atsushi

    2016-01-01

    Here we report a case of generalized aggressive periodontitis treated with periodontal therapy including adjunct antimicrobial therapy and periodontal surgery. The patient was a 22-year-old woman who presented with the chief complaint of gingival recession. Baseline examination revealed generalized plaque deposition and gingival inflammation. Thirty-nine percent of the sites had a probing depth (PD) of 4-6 mm and 2% a PD of ≥7 mm; 63% exhibited bleeding on probing (BOP). Radiographic examination revealed vertical bone loss in the molars and horizontal bone loss in other teeth. Microbiological examination of subgingival plaque revealed the presence of Aggregatibacter actinomycetemcomitans and Tannerella forsythia. Oral health-related quality of life was assessed as a measure of patient-reported outcome. Based on a clinical diagnosis of generalized aggressive periodontitis, initial periodontal therapy and adjunct antimicrobial therapy were implemented. After reducing inflammation and subgingival bacteria, open flap debridement was performed for teeth with a PD of ≥4 mm. Reevaluation showed no sites with a PD of ≥5 mm, a minimal level of BOP, and a marked reduction in the level of the targeted periodontal pathogens. The patient's oral health-related quality of life was slightly worsened during supportive periodontal therapy (SPT). Implementation of adjunct antimicrobial therapy targeting periodontal pathogens and subsequent periodontal surgery resulted in improvement in periodontal and microbiological parameters. This improvement has been adequately maintained over a 2-year period. However, additional care is necessary to further improve the patient's oral health-related quality of life during SPT. PMID:27320300

  1. Assessment of aggression in inpatient settings.

    PubMed

    McDermott, Barbara E; Holoyda, Brian J

    2014-10-01

    The threat of violence is a major concern for all individuals working or receiving treatment in an inpatient psychiatric setting. One major focus in forensic psychology and psychiatry over the past several decades has been the development of risk assessments to aid in the identification of those individuals most at risk of exhibiting violent behavior. So-called second- and third-generation risk assessments were developed to improve the accuracy of decision making. While these instruments were developed for use in the community, many have proven to be effective in identifying patients more likely to exhibit institutional aggression. Because the purpose of risk assessment is the reduction of violence, dynamic factors were included in third-generation risk instruments to provide opportunities for intervention and methods for measuring change. Research with these instruments indicates that both static factors (second-generation) and dynamic factors (third-generation) are important in identifying those patients most likely to engage in institutional aggression, especially when the aggression is categorized by type (impulsive/reactive, organized/predatory/instrumental, psychotic). Recent research has indicated that developing a typology of aggressive incidents may provide insight both into precipitants to assaults as well as appropriate interventions to reduce such aggression. The extant literature suggests that both static and dynamic risk factors are important, but may be differentially related to the type of aggression exhibited and the characteristics of the individuals exhibiting the aggression. PMID:25296966

  2. Predicting aggression in children with ADHD

    PubMed Central

    2014-01-01

    Objective The present study uses structural equation modeling of latent traits to examine the extent to which family factors, cognitive factors and perceptions of rejection in mother-child relations differentially correlate with aggression at home and at school. Methods Data were collected from 476 school-age (7–15 years old) children with a diagnosis of ADHD who had previously shown different types of aggressive behavior, as well as from their parents and teachers. Structural equation modeling was used to examine the differential relationships between maternal rejection, family, cognitive factors and aggression in home and school settings. Results Family factors influenced aggression reported at home (.68) and at school (.44); maternal rejection seems to be related to aggression at home (.21). Cognitive factors influenced aggression reported at school (.-05) and at home (-.12). Conclusions Both genetic and environmental factors contribute to the development of aggressive behavior in ADHD. Identifying key risk factors will advance the development of appropriate clinical interventions and prevention strategies and will provide information to guide the targeting of resources to those children at highest risk. PMID:24860616

  3. The neurobiology of aggression and violence.

    PubMed

    Rosell, Daniel R; Siever, Larry J

    2015-06-01

    Aggression and violence represent a significant public health concern and a clinical challenge for the mental healthcare provider. A great deal has been revealed regarding the neurobiology of violence and aggression, and an integration of this body of knowledge will ultimately serve to advance clinical diagnostics and therapeutic interventions. We will review here the latest findings regarding the neurobiology of aggression and violence. First, we will introduce the construct of aggression, with a focus on issues related to its heterogeneity, as well as the importance of refining the aggression phenotype in order to reduce pathophysiologic variability. Next we will examine the neuroanatomy of aggression and violence, focusing on regional volumes, functional studies, and interregional connectivity. Significant emphasis will be on the amygdala, as well as amygdala-frontal circuitry. Then we will turn our attention to the neurochemistry and molecular genetics of aggression and violence, examining the extensive findings on the serotonergic system, as well as the growing literature on the dopaminergic and vasopressinergic systems. We will also address the contribution of steroid hormones, namely, cortisol and testosterone. Finally, we will summarize these findings with a focus on reconciling inconsistencies and potential clinical implications; and, then we will suggest areas of focus for future directions in the field.

  4. [Non-surgical management after blunt traumatic liver injuries: A review article].

    PubMed

    Noyola-Villalobos, Héctor Faustino; Loera-Torres, Marco Antonio; Jiménez-Chavarría, Enrique; Núñez-Cantú, Olliver; García-Núñez, Luis Manuel; Arcaute-Velázquez, Fernando Federico

    2016-01-01

    Hepatic trauma is a common cause for admissions in the Emergency Room. Currently, non-surgical management is the standard treatment in haemodynamically stable patients with a success rate of around 85 to 98%. This haemodynamic stability is the most important factor in selecting the appropriate patient. Adjuncts in non-surgical management are angioembolisation, image-guided drainage and endoscopic retrograde cholangiopancreatography. Failure in non-surgical management is relatively rare but potentially fatal, and needs to be recognised and aggressively treated as early as possible. The main cause of failure in non-surgical management is persistent haemorrhage. The aim of this paper is to describe current evidence and guidelines that support non-surgical management of liver injuries in blunt trauma.

  5. Verbal versus Physical Aggression in Intermittent Explosive Disorder

    PubMed Central

    Look, Amy E.; McCloskey, Michael S.; Coccaro, Emil F.

    2015-01-01

    Intermittent Explosive Disorder (IED) is the only adult psychiatric diagnosis for which pathological aggression is primary. DSM-IV criteria focused on physical aggression, but DSM-5 allows for an IED diagnosis in the presence of frequent verbal aggression with or without concurrent physical aggression. It remains unclear how individuals with verbal aggression differ from those with physical aggression with respect to cognitive-affective deficits and psychosocial functioning. The current study compared individuals who met IED criteria with either frequent verbal aggression without physical aggression (IED-V), physical aggression without frequent verbal aggression (IED-P), or both frequent verbal aggression and physical aggression (IED-B) as well as a non-aggressive personality-disordered (PD) comparison group using behavioral and self-report measures of aggression, anger, impulsivity, and affective lability, and psychosocial impairment. Results indicate all IED groups showed increased anger/aggression, psychosocial impairment, and affective lability relative to the PD group. The IED-B group showed greater trait anger, anger dyscontrol, and aggression compared to the IED-V and IED-P groups. Overall, the IED-V and IED-P groups reported comparable deficits and impairment. These results support the inclusion of verbal aggression within the IED criteria and suggest a more severe profile for individuals who engage in both frequent verbal arguments and repeated physical aggression. PMID:25534757

  6. Aggressive behaviors in the psychiatric emergency service

    PubMed Central

    Chaput, Yves; Beaulieu, Lucie; Paradis, Michel; Labonté, Edith

    2011-01-01

    Introduction: Studies of aggressive behaviors in a nonforensic mental health setting have focused primarily on the inpatient ward and, on event prediction, using behavior-based clinical rating scales. Few studies have specifically targeted aggressive behaviors in the psychiatric emergency service or determined whether assessing the demographic and clinical characteristics of such patients might prove useful for their more rapid identification. Methods: We used a prospectively acquired database of over 20,900 visits to four services in the province of Quebec, Canada, over a two-year period from September 2002 onwards. A maximum of 72 variables could be acquired per visit. Visits with aggression (any verbally or physically intimidating behavior), both present and past, were tagged. Binary logistic regressions and cross-tabulations were used to determine whether the profile of a variable differed in visits with aggression from those without aggression. Results: About 7% of visits were marked by current aggression (verbal 49%, physical 12%, verbal and physical 39%). Including visits with a “past only” history of aggression increased this number to 20%. Variables associated with aggression were gender (male), marital status (single/separated), education (high school or less), employment (none), judicial history (any type), substance abuse (prior or active), medication compliance (poor), type of arrival to psychiatric emergency services (involuntary, police, judiciary, landlord), reason for referral (behavioral dyscontrol), diagnosis (less frequent in anxiety disorders), and outcome (more frequently placed under observation or admitted). Conclusion: Our results suggest that many state-independent variables are associated with aggressive behaviors in the psychiatric emergency service. Although their sum may not add up to a specific patient profile, they can nevertheless be useful in service planning, being easily integrated alongside state-dependent rating scales in a

  7. Testosterone and Aggressive Behavior in Man

    PubMed Central

    Batrinos, Menelaos L.

    2012-01-01

    Atavistic residues of aggressive behavior prevailing in animal life, determined by testosterone, remain attenuated in man and suppressed through familial and social inhibitions. However, it still manifests itself in various intensities and forms from; thoughts, anger, verbal aggressiveness, competition, dominance behavior, to physical violence. Testosterone plays a significant role in the arousal of these behavioral manifestations in the brain centers involved in aggression and on the development of the muscular system that enables their realization. There is evidence that testosterone levels are higher in individuals with aggressive behavior, such as prisoners who have committed violent crimes. Several field studies have also shown that testosterone levels increase during the aggressive phases of sports games. In more sensitive laboratory paradigms, it has been observed that participant’s testosterone rises in the winners of; competitions, dominance trials or in confrontations with factitious opponents. Aggressive behavior arises in the brain through interplay between subcortical structures in the amygdala and the hypothalamus in which emotions are born and the prefrontal cognitive centers where emotions are perceived and controlled. The action of testosterone on the brain begins in the embryonic stage. Earlier in development at the DNA level, the number of CAG repeats in the androgen receptor gene seems to play a role in the expression of aggressive behavior. Neuroimaging techniques in adult males have shown that testosterone activates the amygdala enhancing its emotional activity and its resistance to prefrontal restraining control. This effect is opposed by the action of cortisol which facilitates prefrontal area cognitive control on impulsive tendencies aroused in the subcortical structures. The degree of impulsivity is regulated by serotonin inhibiting receptors, and with the intervention of this neurotransmitter the major agents of the neuroendocrine

  8. A COGNITIVE PERSPECTIVE ON AGGRESSIVE MIMICRY

    PubMed Central

    JACKSON, ROBERT R.; CROSS, FIONA R.

    2013-01-01

    We use the term ‘aggressive mimic’ for predators that communicate with their prey by making signals to indirectly manipulate prey behaviour. For understanding why the aggressive mimic’s signals work, it is important to appreciate that these signals interface with the prey’s perceptual system, and that the aggressive mimic can be envisaged as playing mind games with its prey. Examples of aggressive mimicry vary from instances in which specifying a model is straight forward to instances where a concise characterisation of the model is difficult. However, the less straightforward examples of aggressive mimicry may be the more interesting examples in the context of animal cognition. In particular, there are spiders that prey on other spiders by entering their prey’s web and making signals. Web invasion brings about especially intimate contact with their prey’s perceptual system because the prey spider’s web is an important component of the prey spider’s sensory apparatus. For the web-invading spider, often there is also a large element of risk when practising aggressive mimicry because the intended prey is also a potential predator. This element of risk, combined with exceptionally intimate interfacing with prey perceptual systems, may have favoured the web-invading aggressive mimic’s strategy becoming strikingly cognitive in character. Yet a high level of flexibility may be widespread among aggressive mimics in general and, on the whole, we propose that research on aggressive mimicry holds exceptional potential for advancing our understanding of animal cognition. PMID:23976823

  9. Myelomeningocele (open spina bifida) - surgical management.

    PubMed

    Akalan, N

    2011-01-01

    Myelomeningocele has been recognized since ancient times although written descriptions began not before the 17th century. Among all serious congenital malformations, myelomeningocele is unique that is has a steady and considerable prevalence while being compatible with life. It has a dismal prognosis when left untreated where virtually all die within the first year while aggressive treatment have a profound effect on survival and quality of life. Effective surgical treatment became possible parallel to the treatment of hydrocephalus in the late 1950s. Advent of the shunt systems undoubtedly changed the morbidity and mortality rates due to associated hydrocephalus. Aggressive and effective treatment improved survival rates but also those suffering physical and mental disabilities have increased as well. Ethical and socioeconomic concerns have led to proposal for selective treatment criteria which have raised arguments on medical and ethico-legal rounds. After the swing of the pendulum between early treatment in all affected children and selective treatment of those who fulfilled the criteria for good prognosis, early myelomeningocele repair is practiced widely unless the infant is critically ill.Incidence of myelomeningocele has been decreasing especially in the Western world, partly due to prenatal diagnosis and elective terminations, dietary folate supplementation. Still, it is the most common central nervous system malformation and one of the leading causes of paraplegia, worldwide. Unfortunately, gains in the management of myelomeningocele have been mainly on antenatal diagnosis and prevention while efforts on understanding its cause, mechanisms involved are still tentative. Concerning the surgical management, no revolutionary modification improving outcome has been introduced unlike other fields of neurosurgery.Medical management of a child with myelomeningocele requires a lifelong effort of several disciplines including urology, orthopedics physical and social

  10. Agreeableness and Alcohol-Related Aggression: The Mediating Effect of Trait Aggressivity

    PubMed Central

    Miller, Cameron A.; Parrott, Dominic J.; Giancola, Peter R.

    2009-01-01

    This study investigated the mediating effect of trait aggressivity on the relation between agreeableness and alcohol-related aggression in a laboratory setting. Participants were 116 healthy male social drinkers between 21 and 30 years of age. Agreeableness and trait aggressivity were measured using the Big Five Inventory and the Buss-Perry Aggression Questionnaire, respectively. Following the consumption of an alcohol or no-alcohol control beverage, participants completed a modified version of the Taylor Aggression Paradigm, in which electric shocks were received from and administered to a fictitious opponent during a competitive task. Aggression was operationalized as the proportion of the most extreme shocks delivered to the fictitious opponent under conditions of low and high provocation. Results indicated that lower levels of agreeableness were associated with higher levels of trait aggressivity. In turn, higher levels of trait aggressivity predicted extreme aggression in intoxicated, but not sober, participants under low, but not high, provocation. Findings highlight the importance of examining determinants of intoxicated aggression within a broader theoretical framework of personality. PMID:19968409

  11. Understanding the personality disorder and aggression relationship: an investigation using contemporary aggression theory.

    PubMed

    Gilbert, Flora; Daffern, Michael; Talevski, Diana; Ogloff, James R P

    2015-02-01

    Research has consistently demonstrated a link between certain personality disorders (PDs) and increased rates of aggression and violence. At present, understanding of the mechanisms that underlie this relationship is limited. This study was designed to examine the contention (Gilbert & Daffern, 2011) that the application of a contemporary psychological aggression theory, the General Aggression Model (GAM; Anderson & Bushman, 2002), may assist in elucidating the PD-aggression relationship. Eighty-seven offenders undergoing presentence evaluation were assessed for Axis II PDs and psychopathy, aggression, and three constructs delineated by the GAM: scripts, normative beliefs, and anger. Regression analyses were undertaken to examine the relative contributions of these variables to aggression. The results upheld a relationship between several PDs and aggression, and suggested that for these PDs, the consideration of scripts, beliefs supportive of aggression, and anger facilitated an improved understanding of aggressiveness. Overall, the findings indicate that the GAM offers valuable insight into the psychological features that characterize individuals with PD who are prone to aggression.

  12. Escalation of aggression: experimental studies.

    PubMed

    Goldstein, J H; Davis, R W; Herman, D

    1975-01-01

    A finding commonly obtained in research using the Buss "aggression machine" is a main effect for trail blocks, indicating an escalation in shock intensity over trails. Theoretical explanations for this effect were tested in a modified verbal operant-conditioning situation. In Experiment 1, subjects could administer any of 10 levels of positive reinforcement to a "learner" for correct verbal responses or any of 10 levels of negative reinforcement to a learner for incorrect responses. Half of the subjects were required to begin with weak, half with strong, reinforcements. Results indicated that, regardless of condition, subjects gave more intense reinforcements as the learning trails progressed. Those who administered negative reinforcements devalued the learner relative to those who administered positive reinforcements. In Experiment 2, a role-playing procedure was used in which subjects administered either positive or negative reinforcements to a learner whose performance either did or did not improve over trials. Again, in all experimental groups, subjects administered increasingly intense reinforcements over trials. The results are interpreted as supporting a disinhibition theory of anti- and prosocial behavior.

  13. [Aggressive behavior: theoretical and biological aspects].

    PubMed

    Giotakos, O

    2013-01-01

    The susceptibility to aggression may manifest differently depending on the psychological context in which it occurs. In the context of psychopathy, characterized by a lack of empathy, this may manifest in aggression with criminal acts, which is characteristic of antisocial personality disorder. When the susceptibility is associated with psychotic impairment, aggression may be manifested in highly deviant behavior, like murder or serial killing. While the great majority of persons with schizophrenia do not commit violent acts, clinicians suggest that some schizophrenics may pose a risk in the community, particularly those patients with co-occurring substance abuse diagnoses, those who are noncompliant with prescribed psychiatric treatment, and those with a history of frequent relapses resulting in hospitalization or arrest. Episodic violence and aggression often accompany dementia. When coupled with emotional dysregulation, impulsive aggression often occurs in an interpersonal context, as in borderline personality disorder. However, the most common comorbidity is the substance abuse disorder, which contributes to both the cognitive distortions and disinhibition associated with the substance use. According to the biological data, aggression seems to emerge when the drive of limbic-mediated affective prefrontal response to provocative producing stimuli is insufficiently constrained by inhibition. Thus, excessive reactivity in the amygdale, coupled with inadequate prefrontal regulation, increase the possibility of aggressive behavior. The PET/SPECT studies focusing on schizophrenia have shown reduced activity in fronto-temoral circuitry. The fMRI studies concord with the hypothesis that among violent persons with schizophrenia, those with sociopathetic features and/or substance abuse constitute a highly different subgroup, in which cognitive, neurological and behavioral patterns are more closely associated with the personality traits than schizophrenia. It is known

  14. [Surgical aspects of acute aortic dissection].

    PubMed

    Laas, J; Heinemann, M; Jurmann, M; Borst, H G

    1992-12-01

    This paper highlights some of the surgical aspects of acute aortic dissections such as: emergency diagnosis, indications for surgery, reconstructive operative techniques, malperfusion phenomena and necessity for follow-up. Aortic dissection is caused by an intimal tear, called the "entry", and subsequent splitting of the media by the stream of blood. Two lumina are thus created, which may communicate through "re-entries". As this creates severe weakness of the aortic wall, rupture and/or dilatation are the imminent dangers of acute aortic dissection. Acute aortic dissection type A, by definition involving the ascending aorta (Figures 1 and 2), is an absolute indication for emergency surgical treatment, because its natural history shows an extremely poor outcome (Figure 3). Due to impending (intrapericardial) aortic rupture, it may be necessary to limit diagnostic procedures to a minimum. Transesophageal echocardiography is the method of choice for establishing a quick, precise and reliable diagnosis (Figure 4). In stable patients, computed tomography gives additional information about aortic diameters or sites of extrapericardial perforation. Digital subtraction angiography (DSA) shows perfusion of the lumina and dependent organs. The surgical strategy in acute aortic dissection type A aims at replacement of the ascending aorta. Reconstructive techniques have to be considered, especially in aortic valve regurgitation without annuloectasia (Figures 5 and 6). In recent times, the use of GRF tissue glue has reduced the need for teflon felt. Involvement of the aortic arch should be treated aggressively up to the point of total arch replacement in deep hypothermic circulatory arrest as part of the primary procedure (Figure 7). Malperfusion phenomena of aortic branches remain risk-factors.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Surgical Outcome of Intradural Spinal Tumors.

    PubMed

    Ahsan, M K; Sakeb, N; Ali, M Y; Awwal, M A; Khan, S I; Goni, M M; Mia, M B; Alam, M B; Zaman, N; Jannat, S N

    2016-07-01

    Results of 63 surgically treated intradural spinal tumors between the period of October 2003 and December 2014 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and in our private settings, Dhaka, were analyzed retrospectively. There were 33 males, 30 females with an average age of 52.4 years (13-70 years) and followed up for at least a year. The preoperative symptom with duration, tumors location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade. The tumors were located as, thoracic (n=32, 50.79%), lumbar (n=16, 25.39%), cervical (n=05, 07.93%), and junctional (n=10, 15.87%, CervicoThoracic-01, Thoracolumbar-09). The histopathological diagnosis included schwannoma (n=30, 47.7%), meningiomas (n=14, 22.3%), neurofibroma, arachnoid cyst and myxopapillary ependymoma (n=03, 04.76%) each and paraganglioma (n=01, 01.59%). Among the intramedullary tumors, ependymoma (n=03, 04.76%), astrocytoma and epidermoid cyst (n=02, 03.17%), haemangioblastoma, paraganglioma and cavernous haemangioma (n=01, 01.59%) each. The VAS score was reduced in all cases from 8.0±1.2 to 1.2±0.8 (p<0.003) and the Nurick's grade was improved in all cases from 3.0±1.3 to 1.0±0.0 (p<0.005). The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Complications included cerebrospinal fluid leakage, parasthesia and further neurological deterioration (Astrocytoma) (n=02, 03.17%) and dependant bedsore and recurrence (Ependymoma) (n=01, 01.59%). Aggressive surgical excision potentially minimizes neurologic morbidity and improved outcome except intramedullary tumors where initial treatment consists of maximum safe surgical resection or biopsy. PMID:27612900

  16. Earthquake injuries and the use of ketamine for surgical procedures: the Kashmir experience.

    PubMed

    Mulvey, J M; Qadri, A A; Maqsood, M A

    2006-08-01

    The October 8, 2005 earthquake in Northern Pakistan had widespread destructive effects throughout the northern subcontinent. Large numbers of people were killed or severely injured and many medical services destroyed. This report describes the experience of the only standing surgical hospital in the Kashmir region of Bagh District. More than 1,500 people were triaged in 72 hours, many critically injured; 78.4% of patients had upper or lower limb injuries; 50.3% of patients had fractures, mainly closed; 37% of patients required extensive wound debridements. A total of 149 patients received emergency surgery using ketamine anaesthesia with benzodiazepine premedication. This was found to be safe, effective and with a low incidence of major adverse effects. We recommend that ketamine anaesthesia be encouraged in disaster area surgery, particularly in under-resourced regional centres.

  17. Surgical and interventional management of complications caused by acute pancreatitis

    PubMed Central

    Karakayali, Feza Y

    2014-01-01

    Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. PMID:25309073

  18. Brachymetatarsia. A new surgical approach.

    PubMed

    Martin, D E; Kalish, S R

    1991-01-01

    Although most practitioners are familiar with brachymetatarsia, it is a relatively uncommon clinical entity presenting for surgical correction. Traditional methods of surgical correction have been successful for the most part; however, a number of potentially devastating complications exist with these procedures. The authors present a review of the deformity, including the historical surgical techniques, and introduce a new surgical approach that minimizes the risk of complication. PMID:1993972

  19. Trajectories of change in physical aggression and marital satisfaction.

    PubMed

    Lawrence, Erika; Bradbury, Thomas N

    2007-06-01

    Physical aggression and marital satisfaction were assessed in 172 newlywed couples annually over the first 4 years of marriage to examine (a) stability of aggression over time and (b) the degree to which fluctuations in aggression precede versus follow fluctuations in marital satisfaction. The stability of aggression varied as a function of initial levels of severity; spouses who were most aggressive early in marriage had greater fluctuations in aggression. Rates of change in aggression predicted changes in satisfaction more than dissatisfaction predicted aggression. Husbands' physical aggression predicted marital discord, whereas wives' aggression predicted marital dissolution. By indicating that aggression (a) is a precursor to adverse marital outcomes and (b) varies across spouses in initial levels and in patterns of temporal change, the present findings highlight the need to understand the contextual factors that govern within-person and within-couple fluctuations in intimate violence.

  20. Surgical management of presbyopia

    PubMed Central

    Torricelli, André AM; Junior, Jackson B; Santhiago, Marcony R; Bechara, Samir J

    2012-01-01

    Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages. PMID:23055664

  1. Spacecraft surgical scrub system

    NASA Technical Reports Server (NTRS)

    Abbate, M.

    1980-01-01

    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  2. Postthrombotic Syndrome: Surgical Possibilities

    PubMed Central

    Khanna, Ajay K.; Singh, Shivanshu

    2012-01-01

    Postthrombotic syndrome (PTS) is a late outcome of deep vein thrombosis characterized by cramping pain, swelling, hyperpigmentation, eczema, lipodermatosclerosis, and ulceration in the leg due to increased venous outflow resistance and reflux venous flow. Newer surgical and endovascular interventions have a promising result in the management of postthrombotic syndrome. Early surgical or endovascular interventions in appropriately selected patients may decrease the incidence of recurrent ulceration and skin changes and provide a better quality of life. Duplex and IVUS (intravenous ultrasound) along with venography serve as cornerstone investigative tools for assessment of reflux and obstruction. Venous obstruction, if present, should be addressed earlier than reflux. It requires endovenous stenting, endophlebectomy, or open bypass procedures. Venous stripping, foam sclerotherapy, radiofrequency, or laser ablation are used to abolish superficial venous reflux. Valvuloplasty procedures are useful for incompetent but intact deep venous valves, while transposition or axillary vein autotransplantation is done for completely destroyed valves. PMID:22084674

  3. Hepatic surgical anatomy.

    PubMed

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  4. Surgical lessons from the lake.

    PubMed

    Kothari, Shanu N

    2014-12-01

    After circumnavigating Lake Michigan during a sabbatical in the summer of 2011, the lessons learned from this experience and the surgical parallels between boating and life as a surgeon will be discussed. Topics will include the use of surgical checklists, teamwork and communication, leadership, and surgical mentorship. PMID:25440476

  5. Guideline implementation: Surgical attire.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  6. Robotic surgical training.

    PubMed

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey. PMID:23528718

  7. Robotic surgical training.

    PubMed

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  8. Louis Pasteur surgical revolution.

    PubMed

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  9. The aggression paradox: understanding links among aggression, sensation seeking, and the consideration of future consequences.

    PubMed

    Joireman, Jeff; Anderson, Jonathan; Strathman, Alan

    2003-06-01

    Four studies involving 573 female and 272 male college students demonstrated that multiple forms and measures of aggression were associated with high levels of sensation seeking, impulsivity, and a focus on the immediate consequences of behavior. Multiple regression analyses and structural equation models supported a theoretical model based on the general aggression model (C.A. Anderson & B.J. Bushman. 2002), positing that hostile cognition and negative affect mediate the relationships between the aforementioned individual differences and aggression. Sensation seeking also predicted a desire to engage in physical and verbal aggression. The final study demonstrated that relative to those scoring low, individuals scoring high on the consideration of future consequences are only less aggressive when aggression is likely to carry future costs. PMID:12793590

  10. Subscapularis Transthoracic Versus Posterolateral Approaches in the Surgical Management of Upper Thoracic Tuberculosis

    PubMed Central

    Lin, Bin; Shi, Ji-Sheng; Zhang, Hai-Shen; Xue, Chao; Zhang, Bi; Guo, Zhi-Min

    2015-01-01

    Abstract The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis. There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years. A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20–52 years) was followed up for a minimum of 12 months (range: 12–60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation. Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb's angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb's angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed

  11. Surgical pathology of skeletal coccidioidomycosis: a clinical and histopathologic analysis of 25 cases.

    PubMed

    Ricciotti, Robert W; Shekhel, Tatyana A; Blair, Janis E; Colby, Thomas V; Sobonya, Richard E; Larsen, Brandon T

    2014-12-01

    Skeletal coccidioidomycosis is a rare complication of pulmonary coccidioidomycosis that remains incompletely characterized, and its histopathologic features have not been systematically evaluated. All skeletal coccidioidal infections (2000 to 2012) were retrieved from the University of Arizona and Mayo Clinic in Arizona pathology archives. Clinical history and histologic features were reviewed. Among 25 patients (median age 40 y; 17 men), infections involved bones (2 cases), joints (6), or both (17), usually in the distal extremities (68%), especially the wrist (32%). History included previously documented coccidioidomycosis (13), autoimmune disease (8), diabetes (6), malignancy (4), and iatrogenic immunosuppression (10). Common symptoms (median 3 mo) included pain/arthralgia (21) and swelling (10). Cultures and serology were positive in 15 of 17 (88%) and 19 of 22 patients (86%), respectively. Treatment included surgical debridement(s) and chronic antifungal medication(s). Histologic review showed granulomas in all cases, ranging from poorly to well formed, with or without necrosis. Spherule density varied widely (mean 4.8/HPF; range <0.1 to 13.5/HPF). Composition of inflammatory infiltrates, degree of necrosis, and extent of fibrosis did not significantly differ between immunocompetent and immunocompromised patients. Eosinophils were only seen in one third of cases; when present, eosinophils were almost always rare. 10 patients experienced recurrent infection, 8 of whom were immunocompromised; the remaining patients recovered. In conclusion, distal extremities are the most common sites of skeletal coccidioidomycosis encountered by surgical pathologists. This condition is strongly associated with autoimmune disorders and immunosuppression. Spherules are sometimes rare, and multiple modalities including serology, culture, and histology may be required for diagnosis.

  12. Aggressive dogs: assessment and treatment considerations.

    PubMed

    Crowell-Davis, Sharon L

    2008-05-01

    The question of what to do with an aggressive dog involves clinical, legal, and ethical considerations. This first column on the subject addresses the clinical aspects from the standpoint of the general veterinarian. PMID:18581290

  13. Human Aggression Linked to Chemical Balance

    ERIC Educational Resources Information Center

    Science News, 1978

    1978-01-01

    Recent studies done by federal researchers indicate that human aggression may be affected by a critical balance of two or three key brain chemical neurotransmitters. Results of this study with human beings are included in this article. (MA)

  14. Breast Cancers Between Mammograms Have Aggressive Features

    Cancer.gov

    Breast cancers that are discovered in the period between regular screening mammograms—known as interval cancers—are more likely to have features associated with aggressive behavior and a poor prognosis than cancers found via screening mammograms.

  15. Behavioral and Pharmacogenetics of Aggressive Behavior

    PubMed Central

    Takahashi, Aki; Quadros, Isabel M.; de Almeida, Rosa M. M.; Miczek, Klaus A.

    2013-01-01

    Serotonin (5-HT) has long been considered as a key transmitter in the neurocircuitry controlling aggression. Impaired regulation of each subtype of 5-HT receptor, 5-HT transporter, synthetic and metabolic enzymes has been linked particularly to impulsive aggression. The current summary focuses mostly on recent findings from pharmacological and genetic studies. The pharmacological treatments and genetic manipulations or polymorphisms of a specific target (e.g., 5-HT1A receptor) can often result in inconsistent results on aggression, due to “phasic” effects of pharmacological agents vs “trait”-like effects of genetic manipulations. Also, the local administration of a drug using the intracranial microinjection technique has shown that activation of specific subtypes of 5-HT receptors (5-HT1A and 5-HT1B) in mesocorticolimbic areas can reduce species-typical and other aggressive behaviors, but the same receptors in the medial prefrontal cortex or septal area promote escalated forms of aggression. Thus, there are receptor populations in specific brain regions that preferentially modulate specific types of aggression. Genetic studies have shown important gene × environment interactions; it is likely that the polymorphisms in the genes of 5-HT transporters (e.g., MAO A) or rate-limiting synthetic and metabolic enzymes of 5-HT determine the vulnerability to adverse environmental factors that escalate aggression. We also discuss the interaction between the 5-HT system and other systems. Modulation of 5-HT neurons in the dorsal raphe nucleus by GABA, glutamate, and CRF profoundly regulate aggressive behaviors. Also, interactions of the 5-HT system with other neuropeptides (arginine vasopressin, oxytocin, neuropeptide Y, opioid) have emerged as important neurobiological determinants of aggression. Studies of aggression in genetically modified mice identified several molecules that affect the 5-HT system directly (e.g., Tph2, 5-HT1B, 5-HT transporter, Pet1, MAOA) or

  16. Androgen receptors, sex behavior, and aggression.

    PubMed

    Cunningham, Rebecca L; Lumia, Augustus R; McGinnis, Marilyn Y

    2012-01-01

    Androgens are intricately involved in reproductive and aggressive behaviors, but the role of the androgen receptor in mediating these behaviors is less defined. Further, activity of the hypothalamic-pituitary-gonadal axis and hypothalamic-pituitary-adrenal axis can influence each other at the level of the androgen receptor. Knowledge of the mechanisms for androgens' effects on behaviors through the androgen receptor will guide future studies in elucidating male reproductive and aggressive behavior repertoires.

  17. Risk factors for aggressive recurrent respiratory papillomatosis in adults and juveniles.

    PubMed

    Omland, Turid; Akre, Harriet; Lie, Kathrine A; Jebsen, Peter; Sandvik, Leiv; Brøndbo, Kjell

    2014-01-01

    In this cohort study we examined whether gender, age at onset, observation time or human papillomavirus (HPV) genotype are risk factors for an aggressive clinical course in Recurrent Respiratory Papillomatosis (RRP). Clinical data from patient records comprised gender, age at onset, date of first endolaryngeal procedure with biopsy, date of last follow-up, total number of endolaryngeal procedures, and complications during the observation period. Disease was defined as juvenile (JoRRP) or adult onset (AoRRP) according to whether the disease was acquired before or after the age of 18. Aggressive disease was defined as distal spread, tracheostomy, four surgical operations annually or >10 surgeries in total. DNA was extracted from formalin-fixed paraffin-embedded tissue. HPV genotyping was performed by quantitative PCR assay identifying 15 HPV genotypes. The study included 224 patients. The majority were males (141/174 in AoRRPs and 31/50 in JoRRPs; p = 0.005). The median follow-up from initial diagnosis was 12.0 years (IQR 3.7-32.9) for JoRRPs and 4.0 years (IQR 0.8-11.7) for AoRRPs. The disease was more aggressive in juveniles than adults (p<0.001), a difference that disappeared after 10 years' observation. JoRRPs with aggressive disease were younger at onset (mean difference 4.6 years, 95%CI [2.4, 6.8], p = 0.009). HPV6 or -11 was present in all HPV-positive papillomas. HPV11 was more prevalent in aggressive disease, and HPV6 in non-aggressive disease (p<0.001). Multiple logistic regression revealed that only age at onset (OR = 0.69, 95% CI [0.53, 0.88], p = 0.003) was associated with aggressive disease in juveniles, while HPV11 (OR = 3.74, 95% CI [1.40, 9.97], p = 0.008) and observation time >10 years (OR = 13.41, 95% CI [5.46, 32.99[, p<001) were risk factors in adults. In conclusion, the only significant risk factor for developing aggressive disease in JoRRPs was age at onset, but both HPV11 and observation time >10 years were risk factors for an aggressive

  18. Psychoanalytic views of aggression: some theoretical problems.

    PubMed

    Pedder, J

    1992-06-01

    Various problems in relation to psychoanalytic theories of aggression are considered in a review which is by no means exhaustive but includes areas which have puzzled and interested the author. First to be considered is why the concept of aggression as a major drive was a relative late-comer in psychoanalysis; next the contentious concept of a 'death instinct' and some of the factors in Freud's lifetime which may have contributed to both. Then it is suggested that we seem to have theories of aggression which might be called primary or secondary in two different senses. First is the question whether aggression is innate or secondary to frustration. In another sense, primary and secondary theories of aggression seem to survive paralleling Freud's original primary and secondary theories of anxiety. In this sense the primary theory survives as an explanation of psychosomatic disorder. Lastly, the link between suicide and murder is considered and the turning of aggression against the self in depression and self-destructive attacks. PMID:1633126

  19. Female competition and aggression: interdisciplinary perspectives

    PubMed Central

    Stockley, Paula; Campbell, Anne

    2013-01-01

    This paper introduces a Theme Issue combining interdisciplinary perspectives in the study of female competition and aggression. Despite a history of being largely overlooked, evidence is now accumulating for the widespread evolutionary significance of female competition. Here, we provide a synthesis of contributions to this Theme Issue on humans and other vertebrates, and highlight directions for future research. Females compete for resources needed to survive and reproduce, and for preferred mates. Although female aggression takes diverse forms, under most circumstances relatively low-risk competitive strategies are favoured, most probably due to constraints of offspring production and care. In social species, dominance relationships and threats of punishment can resolve social conflict without resort to direct aggression, and coalitions or alliances may reduce risk of retaliation. Consistent with these trends, indirect aggression is a low cost but effective form of competition among young women. Costs are also minimized by flexibility in expression of competitive traits, with aggressive behaviour and competitive signalling tailored to social and ecological conditions. Future research on female competition and the proximate mediators of female aggression will be greatly enhanced by opportunities for interdisciplinary exchange, as evidenced by contributions to this Theme Issue. PMID:24167303

  20. Neural mechanisms of predatory aggression in rats-implications for abnormal intraspecific aggression.

    PubMed

    Tulogdi, Aron; Biro, Laszlo; Barsvari, Beata; Stankovic, Mona; Haller, Jozsef; Toth, Mate

    2015-04-15

    Our recent studies showed that brain areas that are activated in a model of escalated aggression overlap with those that promote predatory aggression in cats. This finding raised the interesting possibility that the brain mechanisms that control certain types of abnormal aggression include those involved in predation. However, the mechanisms of predatory aggression are poorly known in rats, a species that is in many respects different from cats. To get more insights into such mechanisms, here we studied the brain activation patterns associated with spontaneous muricide in rats. Subjects not exposed to mice, and those which did not show muricide were used as controls. We found that muricide increased the activation of the central and basolateral amygdala, and lateral hypothalamus as compared to both controls; in addition, a ventral shift in periaqueductal gray activation was observed. Interestingly, these are the brain regions from where predatory aggression can be elicited, or enhanced by electrical stimulation in cats. The analysis of more than 10 other brain regions showed that brain areas that inhibited (or were neutral to) cat predatory aggression were not affected by muricide. Brain activation patterns partly overlapped with those seen earlier in the cockroach hunting model of rat predatory aggression, and were highly similar with those observed in the glucocorticoid dysfunction model of escalated aggression. These findings show that the brain mechanisms underlying predation are evolutionarily conservative, and indirectly support our earlier assumption regarding the involvement of predation-related brain mechanisms in certain forms of escalated social aggression in rats.

  1. Hormone-dependent aggression in female rats: testosterone implants attenuate the decline in aggression following ovariectomy.

    PubMed

    Albert, D J; Jonik, R H; Walsh, M L

    1990-04-01

    Female rats were individually housed with a sterile male for a 4- to 5-week period. Each female was then tested for aggression toward an unfamiliar female intruder at weekly intervals. Those females that displayed a high level of aggression on each of three weekly tests were ovariectomized and given subcutaneous implants of testosterone-filled tubes, ovariectomized and given subcutaneous implants of empty tubes, or sham-ovariectomized and implanted with empty tubes. These implants should produce a serum testosterone concentration of about 0.6 ng/ml, compared to 0.17 ng/ml in intact females. Beginning 1 week postoperatively, the aggression of each female was tested weekly for 4 weeks. Ovariectomized females with testosterone implants displayed a level of aggression significantly higher than that of ovariectomized females with empty implants on 3 of 4 weekly tests. The level of aggression by females with testosterone implants was not significantly different from that of sham-ovariectomized females on the first postoperative test. Additional observations showed that testosterone implants did not produce an increase in aggression in females whose preoperative level of aggression was low. Further, Silastic implants containing estrogen (1 to 2 mm long) sufficient to maintain a serum estrogen level of 20 to 30 pg/ml also attenuated the decline of aggression following ovariectomy. These results suggest that testosterone and estrogen may both contribute to the biological substrate of hormone-dependent aggression in female rats.

  2. Comparative Evaluation of Platelet-Rich Fibrin Biomaterial and Open Flap Debridement in the Treatment of Two and Three Wall Intrabony Defects

    PubMed Central

    Ajwani, Himanshu; Shetty, Sharath; Gopalakrishnan, Dharmarajan; Kathariya, Rahul; Kulloli, Anita; Dolas, R S; Pradeep, A R

    2015-01-01

    Background: Platelet-rich concentrates are the most widely used regenerative biomaterials. Stimulation and acceleration of soft and hard tissue healing are due to local and continuous delivery of growth factors and proteins, mimicking the needs of the physiological wound healing and reparative tissue processes. This article aims to evaluate the clinical efficacy of open flap debridement (OFD) with or without platelet-rich fibrin (PRF) in the treatment of intrabony defects. Materials and Methods: Twenty subjects with forty intrabony defects were treated with either autologous PRF with open-flap debridement (test, n = 20) or open-flap debridement alone (control, n = 20). Soft tissue parameters included: Plaque index, sulcus bleeding index, probing depth, relative attachment level and gingival marginal level (GML). The hard tissue parameters included-distances from: Cement enamel junction to the base of the defect (CEJ-BOD): Alveolar crest to the base of the defect (AC-BOD): And CEJ to AC. The parameters were recorded at baseline and at 9 months postoperatively calculated using standardized radiographs by image-analysis software. Results: Statistically significant (0.005*) intragroup improvements were seen with all the hard and soft parameters in both test and control groups, except for GML. Statistically significant improvements were seen with the mean defect fill (CEJ-BOD and AC-BOD) (P = 0.003*) when intergroup comparisons were made. Conclusions: Adjunctive use of PRF with OFD significantly improves defect fill when compared to OFD alone. PRF has consistently been showing regenerative potential; it is simple, easy and inexpensive biomaterial compared with bone grafts. PMID:25954068

  3. Impact on Neurological Recovery of Transforaminal Debridement and Interbody Fusion versus Transpedicular Decompression in Combination with Pedicle Screw Instrumentation for Treating Thoracic and Lumbar Spinal Tuberculosis

    PubMed Central

    Choovongkomol, Kongtush; Piyapromdee, Urawit; Leownorasate, Manoon

    2016-01-01

    Study Design Retrospective study. Purpose To compare the neurological outcome of transforaminal debridement and interbody fusion with transpedicular decompression for treatment of thoracic and lumbar spinal tuberculosis. Overview of Literature Few articles have addressed the impact of neurological recovery in patients with tuberculosis who were treated by two different operative methods via the posterior-only approach. Methods Clinical and radiographic results of one-stage posterior instrumented spinal fusion for treatment of tuberculous spondylodiscitis with neurological deficits were reviewed and analyzed from 2009 to 2013. The extensive (E) group consisted of patients who received transforaminal debridement and interbody fusion, whereas transpedicular decompression was performed on limited (L) group. Rapid recovery was improvement of at least one Frankel grade within 6 weeks after operation. Otherwise, it was slow recovery. Results All 39 patients had improved neurological signs. The median follow-up period was 24 months. Proportionately younger patients (under 65 years of age) received extensive surgery (15 of 18, 83.3% vs. 11 of 21, 52.4%; p=0.04). The mean operative time and blood loss in the group E were higher than in the group L (both p<0.01). With regard to type of procedure, especially at thoracic and thoracolumbar spine, patients who underwent extensive surgery had rapid neurological recovery significantly different from those of limited surgery (p=0.01; Relative Risk, 3.06; 95% Confidence Interval, 1.13 to 8.29). Conclusions Transforaminal debridement and interbody fusion provides more rapid neurological recovery in patients with thoracic and thoracolumbar spinal tuberculosis compared to transpedicular decompression. PMID:27340536

  4. Through Knee Amputation: Technique Modifications and Surgical Outcomes

    PubMed Central

    Albino, Frank P; Seidel, Rachel; Brown, Benjamin J; Crone, Charles G

    2014-01-01

    Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four trans-femoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown. PMID:25276650

  5. Surgical treatment of 724 carcinomas of the gallbladder. Results of the French Surgical Association Survey.

    PubMed Central

    Cubertafond, P; Gainant, A; Cucchiaro, G

    1994-01-01

    OBJECTIVE: The objective of this study was to evaluate the benefit of an aggressive approach to gallbladder carcinoma on long-term survival. SUMMARY BACKGROUND DATA: Recent studies have shown that an aggressive surgical treatment of bile duct carcinoma can be associated with a surprising long-term survival. However, recent data on gallbladder carcinoma are not available. METHODS: Data were obtained from a questionnaire sent to 73 institutions in France, Europe, and overseas, and they were analyzed retrospectively. The review included an analysis of patient sex and age, associated hepatobiliary diseases, symptoms and signs, diagnostic tests, operative management, pathology reports, and survival. RESULTS: Seventy-eight per cent of the patients were women, and 22% were men (p < 0.001). Gallstones were present in 86% of the cases. Four per cent of the patients had Tis stage lesions, 11% had T1 to T2 stage lesions, and 85% had T3 to T4 stage lesions (p < 0.001). Pain was the most frequent symptom (77%). Twenty-three per cent of the patients underwent curative operations, and 77% had a palliative treatment (25% of the patients underwent exploratory laparotomy). Exploratory laparotomy was followed by the highest mortality rate (66%), and older patients (> 70 years) had a higher operative risk (p < 0.04). The overall median survival was 3 months, and long-term survival correlated with the cancer stage (Tis, > 60 months; T1 to T2, > 22 months, and T3 to T4, 2 to 8 months). No differences were observed among the different surgical procedures adopted. CONCLUSIONS: No progress has been made in the last 10 years in the treatment of gallbladder malignancies. PMID:8147608

  6. Perpetration and Victimization of Intimate Partner Aggression Among Rural Mothers

    PubMed Central

    Schwab Reese, Laura M.; Harland, Karisa; Smithart, Kelsey

    2015-01-01

    Abstract Intimate partner aggression is a leading cause of injury among women of child-bearing age. Research suggests that pregnancy and the postpartum period are times of increased vulnerability to aggression. Since rural women are at an increased risk of intimate partner aggression, research is needed to examine the role of pregnancy and the presence of children on intimate partner aggression among this vulnerable population. The purpose of this study is to examine the association between young children and intimate partner aggression victimization and perpetration among a rural sample. This analysis utilized data from biologic females of child-bearing age from the Keokuk County Rural Health Study, a cohort study of over 1,000 rural families conducted from 1994 to 2011. Crude and adjusted logistic regression was used to determine the relationship between having a young child and experiencing four forms of intimate partner aggression: verbal aggression perpetration, verbal aggression victimization, physical aggression perpetration, and physical aggression victimization. Having young children was significantly associated with increased odds of perpetrating verbal aggression but not victimization of verbal aggression or perpetration and victimization of physical aggression. This significant relationship persisted after adjustment for education, employment, or location of residence but not age or marital status. The increased odds of perpetrating verbal aggression among mothers in a rural area highlight the need for interventions designed for rural parents. One method of reducing intimate partner aggression may be to incorporate intimate partner aggression prevention activities into existing child abuse intervention activities.

  7. Relational Aggression and Academic Performance in Elementary School

    ERIC Educational Resources Information Center

    Risser, Scott D.

    2013-01-01

    To investigate the relationship between relational aggression and school performance, this study examined the relative and combined associations among relational aggression, overt aggression, and victimization and children's academic performance. Additionally this study examined the relative associations among relational and overt aggression and…

  8. The dopaminergic system and aggression in laying hens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The dopaminergic system regulates aggression in humans and other mammals. To investigate if birds with genetic propensity for high and low aggressiveness may exhibit distinctly different aggressive mediation via dopamine (DA) D1 and D2 receptor pathways, two high aggressive (DXL and LGPS) and one lo...

  9. Relational Aggression in Middle Childhood: Predictors and Adolescent Outcomes

    ERIC Educational Resources Information Center

    Spieker, Susan J.; Campbell, Susan B.; Vandergrift, Nathan; Pierce, Kim M.; Cauffman, Elizabeth; Susman, Elizabeth J.; Roisman, Glenn I.

    2012-01-01

    This study examined gender differences in the level and developmental course of relational aggression in middle childhood, as well as early predictors and outcomes of relational aggression, after controlling for concurrent physical aggression. Relational (RAgg) and Physical aggression (PAgg) scores for 558 boys and 545 girls at the ages of eight…

  10. Frontoethmoid osteoma with pneumocephalus: options for surgical management.

    PubMed

    Harasaki, Yasu; Pettijohn, Kelly J; Waziri, Allen; Ramakrishnan, Vijay R

    2013-05-01

    Pneumocephalus is an exceedingly rare complication associated with neurological deficit in cases of frontoethmoid osteoma. The overarching management strategy for affected patients remains undefined. We describe the case of a 61-year-old female patient presenting with frontoethmoid osteoma manifesting as profound intraparenchymal pneumocephalus and associated neurological deficit, treated through a minimally invasive combined surgical strategy involving image-guided burr hole decompression of the pneumocephalus followed by transnasal endoscopic removal of the tumor. Using this approach, the patient rapidly recovered full neurologic function. We review the existing literature and, given the likely intraparenchymal location of pneumocephalus associated with these lesions with the potential of rapid clinical deterioration, recommend aggressive surgical management. Although these lesions can be removed from a purely endoscopic approach, we recommend burr-hole decompression of the pneumocephalus as an adjunct to ensure prompt resolution of the neurologic symptoms.

  11. Apicotomy: surgical management of maxillary dilacerated or ankylosed canines.

    PubMed

    Araújo, Eustáquio A; Araújo, Cristiana V; Tanaka, Orlando M

    2013-12-01

    This clinical article reports a technique, apicotomy, for managing dilacerated or ankylosed canines. The records of 3 patients successfully treated with apicotomy are presented. Orthodontists observe clinically significant incidences of impacted maxillary canines in their daily practices. Several procedures have been described to bring an ankylosed, impacted tooth into occlusion. Luxation is the most widely used solution, but there are risks involved with that approach, and the success rate is low. Surgical repositioning has also been used, but morbidity is high, and the aggressiveness of the procedure might also contraindicate it. Ankylosis might be related to the anatomic position of the canine's root apex and its adjacent anatomic structures. Apicotomy is a guided fracture of a canine root apex, followed by its orthodontic traction. It is a conservative surgical alternative for treating impacted canines with dilacerations or apical root ankylosis.

  12. Duodenal adenocarcinoma: Advances in diagnosis and surgical management

    PubMed Central

    Cloyd, Jordan M; George, Elizabeth; Visser, Brendan C

    2016-01-01

    Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma (DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multi-institutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles. PMID:27022448

  13. Surgical castration of the male common hippopotamus (Hippopotamus amphibius).

    PubMed

    Walzer, Chris; Petit, Thierry; Stalder, Gabrielle L; Horowitz, Igal; Saragusty, Joseph; Hermes, Robert

    2014-02-01

    In a prospective, clinical, surgery study we report here for the first time, in detail, on the surgical castration of 10 captive adult male common hippopotami (Hippopotamus amphibius). The successful procedures, a species-specific modification of standard equine castration techniques, provide valuable insight into the spatially dynamic nature of the common hippopotamus testis. The use of ultrasonography to locate the testis before and during the procedures and species-specific positioning during surgery greatly facilitated this distinctive procedure. Additionally, this surgical method provides an important additional tool for captive management of the common hippopotamus. Castration of individual males not only facilitates population control but can potentially also be employed to limit intermale aggression.

  14. Surgical castration of the male common hippopotamus (Hippopotamus amphibius).

    PubMed

    Walzer, Chris; Petit, Thierry; Stalder, Gabrielle L; Horowitz, Igal; Saragusty, Joseph; Hermes, Robert

    2014-02-01

    In a prospective, clinical, surgery study we report here for the first time, in detail, on the surgical castration of 10 captive adult male common hippopotami (Hippopotamus amphibius). The successful procedures, a species-specific modification of standard equine castration techniques, provide valuable insight into the spatially dynamic nature of the common hippopotamus testis. The use of ultrasonography to locate the testis before and during the procedures and species-specific positioning during surgery greatly facilitated this distinctive procedure. Additionally, this surgical method provides an important additional tool for captive management of the common hippopotamus. Castration of individual males not only facilitates population control but can potentially also be employed to limit intermale aggression. PMID:24246424

  15. Apicotomy: surgical management of maxillary dilacerated or ankylosed canines.

    PubMed

    Araújo, Eustáquio A; Araújo, Cristiana V; Tanaka, Orlando M

    2013-12-01

    This clinical article reports a technique, apicotomy, for managing dilacerated or ankylosed canines. The records of 3 patients successfully treated with apicotomy are presented. Orthodontists observe clinically significant incidences of impacted maxillary canines in their daily practices. Several procedures have been described to bring an ankylosed, impacted tooth into occlusion. Luxation is the most widely used solution, but there are risks involved with that approach, and the success rate is low. Surgical repositioning has also been used, but morbidity is high, and the aggressiveness of the procedure might also contraindicate it. Ankylosis might be related to the anatomic position of the canine's root apex and its adjacent anatomic structures. Apicotomy is a guided fracture of a canine root apex, followed by its orthodontic traction. It is a conservative surgical alternative for treating impacted canines with dilacerations or apical root ankylosis. PMID:24286914

  16. Surgical treatment approaches and reimbursement costs of surgical site infections post hip arthroplasty in Australia: a retrospective analysis

    PubMed Central

    2013-01-01

    Background The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. Methods Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. Results A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following ‘failed DAIR’ cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. Conclusions As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings. PMID:23497364

  17. Psychosis, aggression, and self-destructive behavior in hospitalized adolescents.

    PubMed

    Delga, I; Heinssen, R K; Fritsch, R C; Goodrich, W; Yates, B T

    1989-04-01

    The authors studied the history of aggressive and self-destructive behaviors in psychotic and nonpsychotic hospitalized adolescents (N = 137). A multidimensional measure of self- and other-directed aggression was retrospectively applied to each patient's social and developmental history. Nonsignificant gender and diagnostic differences were obtained on ratings of violence and suicide. Broader definitions of internal and external aggression yielded nonsignificant diagnostic differences, but gender differences were observed on both internal and external aggression measures. Females displayed greater internal aggression, and males reported higher external aggression scores. These results, compared to those of other investigators, suggest the importance of social and cultural variables in understanding adolescent psychosis and aggression.

  18. A review of the surgical management of heel pressure ulcers in the 21st century.

    PubMed

    Bosanquet, David C; Wright, Ann M; White, Richard D; Williams, Ian M

    2016-02-01

    Heel ulceration, most frequently the result of prolonged pressure because of patient immobility, can range from the trivial to the life threatening. Whilst the vast majority of heel pressure ulcers (PUs) are superficial and involve the skin (stages I and II) or underlying fat (stage III), between 10% and 20% will involve deeper tissues, either muscle, tendon or bone (stage IV). These stage IV heel PUs represent a major health and economic burden and can be difficult to treat. The worst outcomes are seen in those with large ulcers, compromised peripheral arterial supply, osteomyelitis and associated comorbidities. Whilst the mainstay of management of stage I-III heel pressure ulceration centres on offloading and appropriate wound care, successful healing in stage IV PUs is often only possible with surgical intervention. Such intervention includes simple debridement, partial or total calcanectomy, arterial revascularisation in the context of coexisting peripheral vascular disease or using free tissue flaps. Amputation may be required for failed surgical intervention, or as a definitive first-line procedure in certain high-risk or poor prognosis patient groups. This review provides an overview of heel PUs, alongside a comprehensive literature review detailing the surgical interventions available when managing such patients.

  19. Levels of Aggression among Turkish Adolescents and Factors Leading to Aggression.

    PubMed

    Avci, Dilek; Kilic, Mahmut; Tari Selcuk, Kevser; Uzuncakmak, Tugba

    2016-07-01

    Aggression, an increasing problem among adolescents, is a potential threat to public health as it can lead to violence. Determining the factors causing aggression plays an important role in taking measures to reduce violence. This study aimed at determining the level of aggression among adolescents and at identifying the factors associated with high levels of aggression. This cross-sectional study was conducted with 2,409 Turkish adolescents. Data were collected with the Socio-demographic Questionnaire, Aggression Scale, Perceived Social Support Scale, and Communication Skills Attitude Scale. Data were analyzed using descriptive statistics, the chi-square test, t-test, and logistic regression. The participants' mean aggression score was 91.83 ± 24.05, and 24.0% of the adolescents' aggression levels rated high. According to the logistic regression model, aggression was 1.26 times higher among males, 1.92 times higher among those who perceived their mental health as poor, 1.58 times higher among those with suicidal ideation, 1.29 times higher among those who did not get prepared for university entrance exams, and 1.62 times higher among those who perceived their school performance as poor. Perceived family social support was a protective factor against high aggression. Approximately one out of every four adolescents in the two Turkish high schools where the study was conducted was determined to display high levels of aggression. Therefore, in order to reduce aggression among adolescents, programs such as coping management and coping with anger should be applied by nurses. Programs should include not only students but also families. PMID:27111434

  20. Levels of Aggression among Turkish Adolescents and Factors Leading to Aggression.

    PubMed

    Avci, Dilek; Kilic, Mahmut; Tari Selcuk, Kevser; Uzuncakmak, Tugba

    2016-07-01

    Aggression, an increasing problem among adolescents, is a potential threat to public health as it can lead to violence. Determining the factors causing aggression plays an important role in taking measures to reduce violence. This study aimed at determining the level of aggression among adolescents and at identifying the factors associated with high levels of aggression. This cross-sectional study was conducted with 2,409 Turkish adolescents. Data were collected with the Socio-demographic Questionnaire, Aggression Scale, Perceived Social Support Scale, and Communication Skills Attitude Scale. Data were analyzed using descriptive statistics, the chi-square test, t-test, and logistic regression. The participants' mean aggression score was 91.83 ± 24.05, and 24.0% of the adolescents' aggression levels rated high. According to the logistic regression model, aggression was 1.26 times higher among males, 1.92 times higher among those who perceived their mental health as poor, 1.58 times higher among those with suicidal ideation, 1.29 times higher among those who did not get prepared for university entrance exams, and 1.62 times higher among those who perceived their school performance as poor. Perceived family social support was a protective factor against high aggression. Approximately one out of every four adolescents in the two Turkish high schools where the study was conducted was determined to display high levels of aggression. Therefore, in order to reduce aggression among adolescents, programs such as coping management and coping with anger should be applied by nurses. Programs should include not only students but also families.

  1. Normative influences on aggression in urban elementary school classrooms.

    PubMed

    Henry, D; Guerra, N; Huesmann, R; Tolan, P; VanAcker, R; Eron, L

    2000-02-01

    We report a study aimed at understanding the effects of classroom normative influences on individual aggressive behavior, using samples of 614 and 427 urban elementary school children. Participants were assessed with measures of aggressive behavior and normative beliefs about aggression. We tested hypotheses related to the effects of personal normative beliefs, descriptive classroom norms (the central tendency of classmates' aggressive behavior), injunctive classroom normative beliefs (classmates' beliefs about the acceptability of aggression), and norm salience (student and teacher sanctions against aggression) on longitudinal changes in aggressive behavior and beliefs. injunctive norms affected individual normative beliefs and aggression, but descriptive norms had no effect on either. In classrooms where students and teachers made norms against aggression salient, aggressive behavior diminished over time. Implications for classroom behavior management and further research are discussed.

  2. Surgical treatment for septic arthritis of the knee joint in elderly patients: a 10-year retrospective clinical study.

    PubMed

    Chen, Chao-Ming; Lin, Hsi-Hsien; Hung, Shih-Chieh; Huang, Tung-Fu; Chen, Wei-Ming; Liu, Chien-Lin; Chen, Tain-Hsiung

    2013-04-01

    Septic arthritis is the most rapidly destructive joint disease, but its early diagnosis remains challenging; delayed or inadequate treatment, even by expert physicians, can lead to irreversible joint destruction. Between 25% and 50% of patients develop irreversible loss of joint function, which is especially concerning in elderly patients. To understand the factors influencing the outcome of septic arthritis, the authors reviewed patients aged older than 50 years who had undergone debridement surgery for primary septic arthritis at their institution between 1998 and 2008. Ninety-two patients (92 knees) were enrolled in the study; 14 did not meet inclusion criteria and were excluded from the final analysis. Of the 78 included patients, 7 underwent arthrodesis, 22 underwent total knee arthroplasty, 19 were indicated for total knee arthroplasty for severe knee joint osteoarthritis but did not undergo surgery by the end of this study, and the remaining 30 had no or mild symptoms of osteoarthrosis and did not receive any surgical procedure. Staphylococcus aureus was the most common pathogenic agent (38%), followed by mixed bacterial infection (10%). Several factors negatively influenced the final clinical outcome, including delayed treatment, advanced macroscopic staging made during debridement surgery, performing multiple debridement surgeries, and a larger Lysholm score difference pre- and posttreatment. More antibiotics administered, longer duration of antibiotic treatment, and more pathogenic agents present were also significantly correlated with poor outcome. These findings shed new light on the management of septic arthritis. Accurate diagnoses and effective treatments are important for the clinical outcome of knee joint bacterial infection in elderly patients.

  3. Surgical treatment of osteomyelitis.

    PubMed

    Cierny, George

    2011-01-01

    Chronic osteomyelitis is refractory to nonsurgical treatment due to a resilient, infective nidus that harbors sessile, matrix-protected pathogens bound to substrate surfaces within the wound. Curative treatment mandates physical (surgical) removal of the biofilm colony, adjunctive use of antibiotics to eliminate residual phenotypes, and efforts to optimize the host response throughout therapy. Patient selection, therapeutic options, and the treatment format are determined by the Cierny/Mader staging system, while reconstruction is governed by the integrity/stability of the affected bone(s) and quality/quantity parameters of the soft-tissue envelope.

  4. Chronic Post Surgical Pain

    PubMed Central

    2011-01-01

    Chronic post-surgical pain (CPSP) is a recognised adverse consequence of surgery; surgery is common, therefore the population at risk is considerable. Putative risk factors for CPSP include genetic predisposition, demographic, clinical (pain history, type of surgery, anaesthesia, acute pain severity), and psychological factors (vulnerability vs resilience). Evidence of prevention is limited: long-term benefit from pre-emptive/perioperative analgesia has not been demonstrated consistently. Large scale prospective studies with detailed pre, intra and postoperative multifactorial assessments are required to refine understanding of the aetiology and prognosis of CPSP. PMID:26526062

  5. [Surgical approaches in rhinoplasty].

    PubMed

    Nguyen, P S; Duron, J-B; Bardot, J; Levet, Y; Aiach, G

    2014-12-01

    In the first step of rhinoplasty, the surgical approach will expose through different types of incisions and dissection planes the osteocartilaginous framework of the nasal pyramid prior to performing actions to reduce or increase the latter. This exposure can be performed by a closed approach or by an external approach--the choice depends on the type of nose and the habits of the surgeon. Far from being opposites, closed and external approaches are complementary and should be known and mastered by surgeons performing rhinoplasty.

  6. FAM5C Contributes to Aggressive Periodontitis

    PubMed Central

    Carvalho, Flavia M.; Tinoco, Eduardo M. B.; Deeley, Kathleen; Duarte, Poliana M.; Faveri, Marcelo; Marques, Marcelo R.; Mendonça, Adriana C.; Wang, Xiaojing; Cuenco, Karen; Menezes, Renato; Garlet, Gustavo P.; Vieira, Alexandre R.

    2010-01-01

    Aggressive periodontitis is characterized by a rapid and severe periodontal destruction in young systemically healthy subjects. A greater prevalence is reported in Africans and African descendent groups than in Caucasians and Hispanics. We first fine mapped the interval 1q24.2 to 1q31.3 suggested as containing an aggressive periodontitis locus. Three hundred and eighty-nine subjects from 55 pedigrees were studied. Saliva samples were collected from all subjects, and DNA was extracted. Twenty-one single nucleotide polymorphisms were selected and analyzed by standard polymerase chain reaction using TaqMan chemistry. Non-parametric linkage and transmission distortion analyses were performed. Although linkage results were negative, statistically significant association between two markers, rs1935881 and rs1342913, in the FAM5C gene and aggressive periodontitis (p = 0.03) was found. Haplotype analysis showed an association between aggressive periodontitis and the haplotype A-G (rs1935881-rs1342913; p = 0.009). Sequence analysis of FAM5C coding regions did not disclose any mutations, but two variants in conserved intronic regions of FAM5C, rs57694932 and rs10494634, were found. However, these two variants are not associated with aggressive periodontitis. Secondly, we investigated the pattern of FAM5C expression in aggressive periodontitis lesions and its possible correlations with inflammatory/immunological factors and pathogens commonly associated with periodontal diseases. FAM5C mRNA expression was significantly higher in diseased versus healthy sites, and was found to be correlated to the IL-1β, IL-17A, IL-4 and RANKL mRNA levels. No correlations were found between FAM5C levels and the presence and load of red complex periodontopathogens or Aggregatibacter actinomycetemcomitans. This study provides evidence that FAM5C contributes to aggressive periodontitis. PMID:20383335

  7. 6-hydroxydopamine and aggression in cats.

    PubMed

    Beleslin, D B; Samardzić, R; Stefanović-Denić, K

    1981-01-01

    The effect of 6-hydroxydopamine (6-OHDA) injected into the cerebral ventricles on behaviour of singly- and group-housed cats was investigated. 6-OHDA in doses of 0.5, 1 and 2 mg was administered every morning for 5 to 8 days. In small doses 6-OHDA in singly- and group-housed cats evoked motor phenomena such as tremor, ataxia, rigidity, weakness and sometimes clonic-tonic convulsions. Occasionally restlessness, irritability and rage were observed. Large doses of 6-OHDA in group-housed cats, after a short latent period (2-3 days) produced aggression which intensified on subsequent injections, and thereafter, on repeated administrations, no longer occurred. The aggression consisted of restlessness, irritability, anger, rage, apprehension, threat, attack, fighting, flight and crying. Of autonomic phenomena mydriasis, dyspnea and sometimes piloerection were observed. The aggression was initiated by the most restless cat, or by disturbing the animals, such as by moving the cage. When 6-OHDA no longer produced aggressive behaviour, motor changes such as tremor, ataxia, rigidity, walking on broad base, weakness with adynamia and clonic-tonic convulsions developed. These latter symptoms were produced by large doses of 6-OHDA in singly-housed cats. In these animals spontaneous signs of aggressive behaviour usually were not observed, although if handled they showed rage, snarling and hissing. When singly-housed cats were kept in the same cage with group-housed animals, the singly-housed cats usually became aggressive. It appears that hyperactivity induced aggression in 6-OHDA-treated cats. PMID:7195585

  8. Cruel Intentions on Television and in Real Life: Can Viewing Indirect Aggression Increase Viewers' Subsequent Indirect Aggression?

    ERIC Educational Resources Information Center

    Coyne, Sarah M.; Archer, John; Eslea, Mike

    2004-01-01

    Numerous studies have shown that viewing violence in the media can influence an individual's subsequent aggression, but none have examined the effect of viewing indirect aggression. This study examines the immediate effect of viewing indirect and direct aggression on subsequent indirect aggression among 199 children ages 11 to 14 years. They were…

  9. Popular and Nonpopular Subtypes of Physically Aggressive Preadolescents: Continuity of Aggression and Peer Mechanisms during the Transition to Middle School

    ERIC Educational Resources Information Center

    Shi, Bing; Xie, Hongling

    2012-01-01

    Using peer nominations of physical aggression and perceived popularity in the spring semester of fifth grade, we identified 54 popular aggressive and 42 nonpopular aggressive preadolescents in a diverse sample of 318 participants recruited from an urban school district. Physical aggression in the spring semester of sixth grade was included to…

  10. Effects of Viewing Relational Aggression on Television on Aggressive Behavior in Adolescents: A Three-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Coyne, Sarah M.

    2016-01-01

    Most researchers on media and aggression have examined the behavioral effects of viewing physical aggression in the media. Conversely, in the current study, I examined longitudinal associations between viewing "relational aggression" on TV and subsequent aggressive behavior. Participants included 467 adolescents who completed a number of…

  11. Aggressive and Nonaggressive Children's Moral Judgments and Moral Emotion Attributions in Situations Involving Retaliation and Unprovoked Aggression

    ERIC Educational Resources Information Center

    Gasser, Luciano; Malti, Tina; Gutzwiller-Helfenfinger, Eveline

    2012-01-01

    The authors investigated 7- and 9-year-old children's moral understanding of retaliation as compared to unprovoked aggression with regard to their aggressive behavior status. Based on peer ratings, 48 children were selected as overtly aggressive and 91 as nonaggressive. Their moral understanding of retaliation and unprovoked aggression was…

  12. Brief report: the adolescent Child-to-Parent Aggression Questionnaire: an examination of aggressions against parents in Spanish adolescents.

    PubMed

    Calvete, E; Gamez-Guadix, M; Orue, I; Gonzalez-Diez, Z; Lopez de Arroyabe, E; Sampedro, R; Pereira, R; Zubizarreta, A; Borrajo, E

    2013-12-01

    The objective of this study was to develop a questionnaire to assess child-to-parent aggression in adolescents and to document the extent of the problem. The questionnaire developed in this study, the Child-to-Parent Aggression Questionnaire (CPAQ), includes forms of physical and psychological aggression directed at both the mother and the father. It also includes open questions about the reasons for the aggressive acts. The CPAQ was completed by a sample of 2719 adolescents (age range: 13-18 years old, 51.4% girls). Confirmatory factor analysis supported a four-factor correlated structure (physical aggression against mother, physical aggression against father, psychological aggression against mother, and psychological aggression against father). Psychological and physical aggression against the mother was more frequent than against the father. However, there were no differences with regard to severe forms of aggression. Girls scored significantly higher on all indicators of psychological aggression, including severe psychological aggression. Nevertheless, except for the prevalence of physical aggression against mothers, which was higher in females, there were no significant differences in physical aggression against parents. Finally, the reasons provided by the adolescents for the aggression included both instrumental (e.g., to obtain permission to get home late and to access their computers) and reactive reasons (e.g., anger and self-defense). These findings highlight the complexity of child-to-parent aggression in adolescence.

  13. Aggression in humans: what is its biological foundation?

    PubMed

    Albert, D J; Walsh, M L; Jonik, R H

    1993-01-01

    Although human aggression is frequently inferred to parallel aggression based on testosterone in nonprimate mammals, there is little concrete support for this position. High- and low-aggression individuals do not consistently differ in serum testosterone. Aggression does not change at puberty when testosterone levels increase. Aggression does not increase in hypogonadal males (or females) when exogenous testosterone is administered to support sexual activity. Similarly, there are no reports that aggression increases in hirsute females even though testosterone levels may rise to 200% above normal. Conversely, castration or antiandrogen administration to human males is not associated with a consistent decrease in aggression. Finally, changes in human aggression associated with neuropathology are not consistent with current knowledge of the neural basis of testosterone-dependent aggression. In contrast, human aggression does have a substantial number of features in common with defensive aggression seen in nonprimate mammals. It is present at all age levels, is displayed by both males and females, is directed at both males and females, and is not dependent on seasonal changes in hormone levels or experiential events such as sexual activity. As would be expected from current knowledge of the neural system controlling defensive aggression, aggression in humans increases with tumors in the medial hypothalamus and septal region, and with seizure activity in the amygdala. It decreases with lesions in the amygdala. The inference that human aggression has its roots in the defensive aggression of nonprimate mammals is in general agreement with evidence on the consistency of human aggressiveness over age, with similarities in male and female aggressiveness in laboratory studies, and with observations that some neurological disturbances contribute to criminal violence. This evidence suggests that human aggression has its biological roots in the defensive aggression of nonprimate

  14. 'Salvage Treatment' of Aggressive Giant Cell Tumor of Bones with Denosumab

    PubMed Central

    Vaishya, Raju; Vijay, Vipul

    2015-01-01

    Giant cell tumor of the bone (GCTB) presents as a lytic lesion of epiphyseometaphyseal regions of the long bones usually during the second to the fourth decade with female predilection. Histologically, they are formed of neoplastic mononuclear cells with a higher receptor activator of nuclear factor kappa-B ligand (RANKL) expression responsible for the aggressive osteolytic nature of the tumour. RANKL helps in the formation and functioning of osteoclasts. A newer molecule, Denosumab, is a monoclonal antibody directed against RANKL and thus prevents the formation and function of osteoclasts. Management of refractory, multicentric, recurrent, or metastatic GCTB remains challenging as achieving a tumor-free margin surgically is not always possible. Denosumab may play a crucial role, especially in the management of such difficult lesions. We present three cases of locally aggressive GCTB (involving proximal humerus, sacrum, and proximal femur) that were treated and responded very well to Denosumab therapy. PMID:26251767

  15. The Aggression-Inhibiting and Aggression-Facilitating Influence of Heightened Sexual Arousal.

    ERIC Educational Resources Information Center

    Baron, Robert A.; Bell, Paul A.

    Eighty-six undergraduate males participated in an experiment designed to investigate the impact of various types of erotic stimuli upon aggression. On the basis of previous research, it was hypothesized that exposure to mild erotic stimuli would tend to inhibit subsequent aggression, while exposure to more arousing stimuli of this type would…

  16. Witnessed aggression: influence of an observer's sex and values on aggressive responding.

    PubMed

    Borden, R J

    1975-03-01

    Two experiments investigated the effects of the presence of an observer on aggressive responding. In one experiment, male subjects observed by a male aggressed more than those observed by a female. When the male observer was removed from the situation, subjects' level of aggressiveness more closely matched the level manifested by the opponent. The removal of the female observer had little effect on the subjects' behavior. In the second experiment, the male or female observer of the subject's behavior was disguised as a member of an organization with explicit values (aggressive or pacifistic) regarding the use of aggression. In this case, significant differences in aggression were associated with the observer's values but not the observer's sex. Following the departure of the observer, the shock settings of subjects in the two aggressive-value observer groups showed a signifcant decrease. The average shock setting of subjects in the two pacifistic-value observer groups remained at about the same level. In sum, the results indicated that the subjects' aggressive behavior was apparently a function of their expectations of approval for such behavior, based on the inferred or explicit values of the observer. The results were further discussed in terms of social learning theory.

  17. The Relationship between Unstable Self-Esteem and Aggression: Differences in Reactive and Proactive Aggression

    ERIC Educational Resources Information Center

    Lee, Eunju J.

    2014-01-01

    This study examines whether the instability of self-esteem (i.e., a high intraindividual variability in self-esteem) is differentially associated with different types of aggressive behavior by using a sample of 235 preadolescent children. Self-esteem was measured four times for four consecutive days, and proactive and reactive aggressive behaviors…

  18. The impact of classroom aggression on the development of aggressive behavior problems in children.

    PubMed

    Thomas, Duane E; Bierman, Karen L

    2006-01-01

    Prior research suggests that exposure to elementary classrooms characterized by high levels of student aggression may contribute to the development of child aggressive behavior problems. To explore this process in more detail, this study followed a longitudinal sample of 4,907 children and examined demographic factors associated with exposure to high-aggression classrooms, including school context factors (school size, student poverty levels, and rural vs. urban location) and child ethnicity (African American, European American). The developmental impact of different temporal patterns of exposure (e.g., primacy, recency, chronicity) to high-aggression classrooms was evaluated on child aggression. Analyses revealed that African American children attending large, urban schools that served socioeconomically disadvantaged students were more likely than other students to be exposed to high-aggressive classroom contexts. Hierarchical regressions demonstrated cumulative effects for temporal exposure, whereby children with multiple years of exposure showed higher levels of aggressive behavior after 3 years than children with primacy, less recent, and less chronic exposure, controlling for initial levels of aggression. Implications are discussed for developmental research and preventive interventions.

  19. Intra- Versus Intersex Aggression: Testing Theories of Sex Differences Using Aggression Networks.

    PubMed

    Wölfer, Ralf; Hewstone, Miles

    2015-08-01

    Two theories offer competing explanations of sex differences in aggressive behavior: sexual-selection theory and social-role theory. While each theory has specific strengths and limitations depending on the victim's sex, research hardly differentiates between intrasex and intersex aggression. In the present study, 11,307 students (mean age = 14.96 years; 50% girls, 50% boys) from 597 school classes provided social-network data (aggression and friendship networks) as well as physical (body mass index) and psychosocial (gender and masculinity norms) information. Aggression networks were used to disentangle intra- and intersex aggression, whereas their class-aggregated sex differences were analyzed using contextual predictors derived from sexual-selection and social-role theories. As expected, results revealed that sexual-selection theory predicted male-biased sex differences in intrasex aggression, whereas social-role theory predicted male-biased sex differences in intersex aggression. Findings suggest the value of explaining sex differences separately for intra- and intersex aggression with a dual-theory framework covering both evolutionary and normative components.

  20. Beliefs about Aggression and Submissiveness: A Comparison of Aggressive and Nonaggressive Individuals with Mild Intellectual Disability

    ERIC Educational Resources Information Center

    Kirk, Jamie; Jahoda, Andrew; Pert, Carol

    2008-01-01

    Recent research has examined the relevance of the social information processing model of aggression to individuals with intellectual disability (ID). This study investigated the "response access" and "response decision" steps of this model. Photo stories were used to compare aggressive and nonaggressive individuals' beliefs about the outcomes of…

  1. Gentian Violet and Methylene Blue Polyvinyl Alcohol Foam Antibacterial Dressing as a Viable Form of Autolytic Debridement in the Wound Bed.

    PubMed

    Applewhite, Andrew Joseph; Attar, Paul; Liden, Brock; Stevenson, Quyen

    2015-05-01

    The objective of this article is to describe the results of a comparative porcine study that evaluated the effectiveness of a gentian violet and methylene blue (GV/MB) polyvinyl alcohol (PVA) antibacterial foam dressing in debriding eschar. The authors performed an in vivo, preclinical study on eschar-covered porcine wounds. Two clinical case studies are also included. Test products, GV/MB antibacterial foam dressing, collagenase ointment, collagenase ointment plus GV/MB antibacterial foam dressing, medical-grade honey, and moist gauze dressing (control), were applied to porcine wounds using a split-back study design. The percent of eschar removal and wound closure were measured and recorded at time points up to 14 days. Statistically significant reduction in eschar was observed with GV/MB dressing and with GV/MB dressing with collagenase. By day 14, the wounds with GV/MB dressing alone and GV/MB dressing with collagenase had eschar covering less than 25% of the wound bed area compared with collagenase alone, medical grade honey, or moist gauze control, which showed eschar still covering over 75% of the wound bed area. Autolytic debridement activity of GV/MB foam dressings was evident in the porcine eschar study, as well as in the cases described.

  2. Gentian Violet and Methylene Blue Polyvinyl Alcohol Foam Antibacterial Dressing as a Viable Form of Autolytic Debridement in the Wound Bed.

    PubMed

    Applewhite, Andrew Joseph; Attar, Paul; Liden, Brock; Stevenson, Quyen

    2015-05-01

    The objective of this article is to describe the results of a comparative porcine study that evaluated the effectiveness of a gentian violet and methylene blue (GV/MB) polyvinyl alcohol (PVA) antibacterial foam dressing in debriding eschar. The authors performed an in vivo, preclinical study on eschar-covered porcine wounds. Two clinical case studies are also included. Test products, GV/MB antibacterial foam dressing, collagenase ointment, collagenase ointment plus GV/MB antibacterial foam dressing, medical-grade honey, and moist gauze dressing (control), were applied to porcine wounds using a split-back study design. The percent of eschar removal and wound closure were measured and recorded at time points up to 14 days. Statistically significant reduction in eschar was observed with GV/MB dressing and with GV/MB dressing with collagenase. By day 14, the wounds with GV/MB dressing alone and GV/MB dressing with collagenase had eschar covering less than 25% of the wound bed area compared with collagenase alone, medical grade honey, or moist gauze control, which showed eschar still covering over 75% of the wound bed area. Autolytic debridement activity of GV/MB foam dressings was evident in the porcine eschar study, as well as in the cases described. PMID:26054993

  3. Surgical treatment and outcomes of temporal bone chondroblastoma.

    PubMed

    Moon, In Seok; Kim, Jin; Lee, Ho-Ki; Lee, Won-Sang

    2008-12-01

    Chondroblastoma is an uncommon primary benign bone tumor that usually arises in the epiphyses of the long bones. Temporal bone chondroblastoma is a rare primary bone tumor that affects the floor of the middle cranial fossa and temporomandibular joint (TMJ). The biological nature of temporal bone chondroblastoma is occasionally aggressive because of local invasion and is known to have a high recurrence after curettage. Therefore, complete resection is recommended. However, the literature provides little information regarding long-term surgical outcomes and complications after surgical resection. The authors have retrospectively analyzed four cases of temporal bone chondroblastoma that had been completely excised by a single surgeon with an eventual long-term follow-up. A single surgeon operated on four patients, two males and two females, with a mean age of 34 years, at the Department of Otorhinolaryngology, Severance Hospital. In all cases, the tumor involved the middle cranial fossa dura and the mandibular fossa with variable degree of infiltration. All patients have had no tumor recurrence to date (mean follow-up period of 5 years). Complete surgical resection of the temporal bone chondroblastoma is the gold standard for treatment. Precise preoperative image evaluation of tumor extension and proper management of the dura mater and temporomandibular joint (TMJ) are the major important features in complete surgical removal that minimize complications in temporal bone chondroblastoma treatment.

  4. Maternal Depression and Childhood Aggression: Literature Review

    PubMed Central

    Hendricks, Katherine; Liu, Jianghong

    2012-01-01

    Introduction Childbearing depression (CBD) and childhood aggression are serious and international problems that encumber public health. Although maternal depression has received much attention in the literature in the last three decades, clinically it remains under-diagnosed and under-treated, especially during pregnancy. As a result, many mothers and families are left to suffer its long-lasting physical and psychosocial effects. This article's aim is to review the current literature on whether CBD increases the likelihood of childhood aggression in children ages six years and younger. Methods Using keywords, an electronic search was performed using Cumulative Index of Nursing and Allied Health, PsycINFO, and PubMed databases. Search limits included the following: 2000-2010, English, peer-review, human, All Child: 0-18. From more than 2,000 search results, 13 articles were reviewed based on relevance to paper's inquiry and sample size greater than 50. Results In all, the articles agreed that depression in women increases the likelihood of early childhood aggression by causing negative parenting behaviors. However, this finding is tempered by a number of weaknesses in the quality of articles reviewed and by the complexity of the topic. Conclusion More research is needed to determine the etiology and interplay of mediating factors between CBD and childhood aggression. This could inform the study and implementation of effective and early prevention, screening, and treatment measures and programs for maternal depression and childhood aggression. PMID:22739482

  5. Predicting hospital aggression in secure psychiatric care

    PubMed Central

    Priday, Lee J.; Ireland, Carol A.; Chu, Simon; Kilcoyne, Jennifer; Mulligan, Caroline

    2016-01-01

    Background Risk assessment instruments have become a preferred means for predicting future aggression, claiming to predict long-term aggression risk. Aims To investigate the predictive value over 12 months and 4 years of two commonly applied instruments (Historical, Clinical and Risk Management - 20 (HCR-20) and Violence Risk Appraisal Guide (VRAG)). Method Participants were adult male psychiatric patients detained in a high secure hospital. All had a diagnosis of personality disorder. The focus was on aggression in hospital. Results The actuarial risk assessment (VRAG) was generally performing better than the structured risk assessment (HCR-20), although neither approach performed particularly well overall. Any value in their predictive potential appeared focused on the longer time period under study (4 years) and was specific to certain types of aggression. Conclusions The value of these instruments for assessing aggression in hospital among patients with personality disorder in a high secure psychiatric setting is considered. Declaration of interest J.L.I., C.A.M. and J.K. are employed by the trust where the data were collected. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703760

  6. Surgical Scar Revision: An Overview

    PubMed Central

    Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

    2014-01-01

    Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods. PMID:24761092

  7. Digit ratio (2D:4D), aggression, and testosterone in men exposed to an aggressive video stimulus.

    PubMed

    Kilduff, Liam P; Hopp, Renato N; Cook, Christian J; Crewther, Blair T; Manning, John T

    2013-01-01

    The relative lengths of the 2(nd) and 4(th) digits (2D:4D) is a negative biomarker for prenatal testosterone, and low 2D:4D may be associated with aggression. However, the evidence for a 2D:4D-aggression association is mixed. Here we test the hypothesis that 2D:4D is robustly linked to aggression in "challenge" situations in which testosterone is increased. Participants were exposed to an aggressive video and a control video. Aggression was measured after each video and salivary free testosterone levels before and after each video. Compared to the control video, the aggressive video was associated with raised aggression responses and a marginally significant increase in testosterone. Left 2D:4D was negatively correlated with aggression after the aggressive video and the strength of the correlation was higher in those participants who showed the greatest increases in testosterone. Left 2D:4D was also negatively correlated to the difference between aggression scores in the aggressive and control conditions. The control video did not influence testosterone concentrations and there were no associations between 2D:4D and aggression. We conclude that 2D:4D moderates the impact of an aggressive stimulus on aggression, such that an increase in testosterone resulting from a "challenge" is associated with a negative correlation between 2D:4D and aggression.

  8. The socializing effect of classroom aggression on the development of aggression and social rejection: A two-wave multilevel analysis.

    PubMed

    Rohlf, Helena; Krahé, Barbara; Busching, Robert

    2016-10-01

    The current study examined the moderating effect of classroom aggression on the development of individual aggression and on the path from individual aggression to social rejection over time. The study included 1,284 elementary school children and consisted of two data waves 10months apart. At both time points, teachers assessed the children's physical and relational aggression and their social rejection status. Multi-level analyses revealed that the classroom level of relational aggression moderated the link between individual relational aggression at T1 and T2 (b=-0.18, 95% CI [-0.32, -0.05], p<.01) and the link between T1 relational aggression and T2 social rejection (b=-0.12, 95% CI [-0.23, -0.003], p<.01). Being in a classroom where relational aggression was prevalent increased relational aggression among children with a low level of relational aggression at T1. Furthermore, a high individual level of relational aggression predicted greater social rejection in classrooms with a low level of relational aggression. Children were mainly influenced by their same-gender peers. Boys as a group had a greater influence than girls on their peers of either gender in the domain of relational aggression, whereas girls as a group had a greater influence in the domain of physical aggression. The contributions of analyzing cross-level interaction to understanding the developmental patterns of aggression and social rejection in middle childhood are discussed.

  9. The socializing effect of classroom aggression on the development of aggression and social rejection: A two-wave multilevel analysis.

    PubMed

    Rohlf, Helena; Krahé, Barbara; Busching, Robert

    2016-10-01

    The current study examined the moderating effect of classroom aggression on the development of individual aggression and on the path from individual aggression to social rejection over time. The study included 1,284 elementary school children and consisted of two data waves 10months apart. At both time points, teachers assessed the children's physical and relational aggression and their social rejection status. Multi-level analyses revealed that the classroom level of relational aggression moderated the link between individual relational aggression at T1 and T2 (b=-0.18, 95% CI [-0.32, -0.05], p<.01) and the link between T1 relational aggression and T2 social rejection (b=-0.12, 95% CI [-0.23, -0.003], p<.01). Being in a classroom where relational aggression was prevalent increased relational aggression among children with a low level of relational aggression at T1. Furthermore, a high individual level of relational aggression predicted greater social rejection in classrooms with a low level of relational aggression. Children were mainly influenced by their same-gender peers. Boys as a group had a greater influence than girls on their peers of either gender in the domain of relational aggression, whereas girls as a group had a greater influence in the domain of physical aggression. The contributions of analyzing cross-level interaction to understanding the developmental patterns of aggression and social rejection in middle childhood are discussed. PMID:27586070

  10. [Transsexualism: indication and surgical treatment].

    PubMed

    Biemer, E; Kockott, G; Hartung, R

    1979-09-01

    After the diagnosis of transsexuality is well definated and recognized in most western countries, the surgical transformation of the genital area is performed. Before surgical treatment an exact psychiatric clarification is absolutely essential. The operation is the last part of a long treatment. The surgical result in the more common female transsexual is quite reasonable. The treatment of the fewer male transsexuals is not solved completely, especially the reliable techniques for penis reconstructions are not very sufficient.

  11. Pilomatrixoma of the breast in a patient with type 1 myotonic dystrophy: successful surgical approach.

    PubMed

    Fama', F; Ieni, A; Tchernev, G; Chokoeva, A A; Maximov, G K; Wollina, U; Lotti, T; Patterson, J W; Fioranelli, M; Roccia, M G; Guarneri, C; Gioffre-Florio, M

    2016-01-01

    Malherbe’s calcifying epithelioma is an uncommon cutaneous tumour that originates from the matrix cells of hair follicle. It was initially described by Malherbe as a benign calcifying epithelioma. Several ultra-structural and electron-microscopic studies later demonstrated its origin from matrix cells and the term pilomatrixoma was introduced. The treatment of this tumour remains mainly surgical. Malignant cases with post-surgical recurrences have been described in literature and recurrences have been related to an incomplete surgical treatment or tumour aggressiveness. We present the case of 31-year-old female patient with pilomatrixoma of the breast, which was very similar to fibroadenoma, in terms of size and other clinical features. We successfully treated this patient surgically, and the aesthetic results were good, despite the proximity of the tumour to the areola-nipple complex. Fifteen months later, the patient is doing well, free of any clinical local recurrence. PMID:27373126

  12. Spines of Steel: A Case of Surgical Enthusiasm in Cold War America.

    PubMed

    Linker, Beth

    2016-01-01

    Just as the prevalence of scoliosis began to decline precipitously after World War II, American orthopedic surgeon Dr. Paul R. Harrington devised a new, invasive surgical system whereby implantable prosthetic metal rods and hooks were used to straighten curved backs. By the 1970s, "Harrington rods" had become the gold standard of surgical scoliosis care in the United States, replacing more conventional methods of exercise, bracing, and casting. This article situates the success of Harrington rods within a much larger and historically longer debate about why, when compared to those in other nations, American surgeons appear to be "more aggressive" and "knife-happy." Using Harrington's papers and correspondence, I argue that patients played a vital role in the rise of spinal surgery. As such, this article examines not only how surgical enthusiasm has been historically measured, defined, and morally evaluated, but also how scoliosis became classified as a debility in need of surgical management.

  13. Spines of Steel: A Case of Surgical Enthusiasm in Cold War America.

    PubMed

    Linker, Beth

    2016-01-01

    Just as the prevalence of scoliosis began to decline precipitously after World War II, American orthopedic surgeon Dr. Paul R. Harrington devised a new, invasive surgical system whereby implantable prosthetic metal rods and hooks were used to straighten curved backs. By the 1970s, "Harrington rods" had become the gold standard of surgical scoliosis care in the United States, replacing more conventional methods of exercise, bracing, and casting. This article situates the success of Harrington rods within a much larger and historically longer debate about why, when compared to those in other nations, American surgeons appear to be "more aggressive" and "knife-happy." Using Harrington's papers and correspondence, I argue that patients played a vital role in the rise of spinal surgery. As such, this article examines not only how surgical enthusiasm has been historically measured, defined, and morally evaluated, but also how scoliosis became classified as a debility in need of surgical management. PMID:27374847

  14. [Self aggressive-behaviours in prison].

    PubMed

    Ammar, Malek M; Borras, L; Eytan, A

    2008-01-01

    Suicide among prisoners is a relatively well documented public health issue. On the other hand, data about self-aggressive behaviours in prisons are scarce, despite the fact that this problem seems to be highly prevalent. We conducted a retrospective study over a fifteen months period in a remand prison situated in the French speaking area of Switzerland. During this time period, 161 self-aggressive behaviours were recorded, corresponding to 80 inmates. The most frequent acts were self-cuttings and self-mutilations, followed by strangulations. All these patients were male and their mean age was 25. Some of these behaviours (ingesting cutting objects and sewing of the lips) were specific to some ethno-cultural groups. Copycat behaviours play a significant role in closed communities such as prisons. These results underline the necessity of taking into account self-aggressive behaviours in penitentiary institutions. PMID:19024369

  15. Sun-induced frowning fosters aggressive feelings.

    PubMed

    Marzoli, Daniele; Custodero, Mariagrazia; Pagliara, Alessandra; Tommasi, Luca

    2013-01-01

    We tested whether aggressiveness can be triggered by the involuntary frowning that occurs when people face the sun, due to the fact that sun-induced frowning involves the same pattern of facial muscle activation as in the expression of anger (interestingly, Charles Darwin remarked on the sunshade-like nature of frowning). In line with data showing that experimentally and unobtrusively induced facial and body displays facilitate congruent feelings, we found that participants walking against the sun without sunglasses scored higher in a self-report measure of anger and aggression compared to those walking with the sun behind and/or wearing sunglasses. We also suggest that frowning at the sun affects mood very quickly, because we did not find any effect of walking time on self-reported aggressiveness. Our results provide the first evidence of the ecological validity of the facial feedback hypothesis.

  16. Surgical treatment of selected patients with multilevel contiguous thoracolumbar spinal tuberculosis by only posterior instrumentation without any bone fusion.

    PubMed

    Shen, Xiongjie; Huang, Xiangwang; Xiao, Sheng; Liu, Hongzhe; Zhang, Yi; Xiang, Tiecheng; Wang, Guoping; Sheng, Bin; Huang, Shu; Liu, Xiangyang

    2015-01-01

    The retrospective clinical study is to determine the feasibility and efficacy of surgical management of multilevel contiguous thoracolumbar spinal tuberculosis (MCTLST) by only posterior instrumentation without posterior or anterior bone fusion and without anterior fixation in the study of eleven selected cases. Eleven selected cases with MCTLST were treated with combined posterior instrumentation and debridement and/or decompression without any bone fusion. The mean follow-up was 33.1 months (range 20-48 months). The kyphosis angle ranged from 9.2 to 40.4° before operation, 27.8° in average. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocytesedimentationrate (ESR) used to judge the activity of tuberculosis, which were collected at certain time. Spinal tuberculosis (STB) was completely cured in all eleven patients. There was no recurrent tuberculosis infection. The postoperative kyphosis angle was 7.1° to 12.5°, 9.6° in average and there was no significant loss of the correction at the final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. In conclusions, combined posterior instrumentation and debridement and/or decompression without any bone fusion can be a feasible and effective method in treatment of patients with MCTLST. However, the strict selection of patients was the critical of the surgery success.

  17. Surgical treatment of selected patients with multilevel contiguous thoracolumbar spinal tuberculosis by only posterior instrumentation without any bone fusion

    PubMed Central

    Shen, Xiongjie; Huang, Xiangwang; Xiao, Sheng; Liu, Hongzhe; Zhang, Yi; Xiang, Tiecheng; Wang, Guoping; Sheng, Bin; Huang, Shu; Liu, Xiangyang

    2015-01-01

    The retrospective clinical study is to determine the feasibility and efficacy of surgical management of multilevel contiguous thoracolumbar spinal tuberculosis (MCTLST) by only posterior instrumentation without posterior or anterior bone fusion and without anterior fixation in the study of eleven selected cases. Eleven selected cases with MCTLST were treated with combined posterior instrumentation and debridement and/or decompression without any bone fusion. The mean follow-up was 33.1 months (range 20-48 months). The kyphosis angle ranged from 9.2 to 40.4° before operation, 27.8° in average. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocytesedimentationrate (ESR) used to judge the activity of tuberculosis, which were collected at certain time. Spinal tuberculosis (STB) was completely cured in all eleven patients. There was no recurrent tuberculosis infection. The postoperative kyphosis angle was 7.1° to 12.5°, 9.6° in average and there was no significant loss of the correction at the final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. In conclusions, combined posterior instrumentation and debridement and/or decompression without any bone fusion can be a feasible and effective method in treatment of patients with MCTLST. However, the strict selection of patients was the critical of the surgery success. PMID:26770474

  18. Proactive and reactive aggression in referred children and adolescents.

    PubMed

    Connor, Daniel F; Steingard, Ronald J; Cunningham, Julie A; Anderson, Jennifer J; Melloni, Richard H

    2004-04-01

    Investigating different types of aggression is important to facilitate a better understanding of excessive maladaptive aggression in referred youth. Using regression analysis, the authors investigated demographic, historical, diagnostic, and treatment correlates of proactive aggression and reactive aggression in a heterogeneous population (N = 323) of psychiatrically referred youths. Ratings of proactive and reactive aggression significantly correlated with more established measures of aggression. Results suggest the importance of hyperactive/impulsive behavior, disruptive behavior disorders, and self-reported hostility in youths with both reactive and proactive aggression. Substance use disorders, a family history of substance abuse, and family violence were specifically associated with proactive aggression. Younger age and a history of abuse were correlated with reactive aggression. Implications for clinical interventions and future research are discussed. PMID:15113242

  19. Intergenerational Transmission of Relationship Aggression: A Prospective Longitudinal Study

    PubMed Central

    Cui, Ming; Durtschi, Jared A.; Donnellan, M. Brent; Lorenz, Frederick O.; Conger, Rand D.

    2012-01-01

    The present study examined whether physical and verbal aggression in the family of origin were associated with similar patterns of aggression in young adult couples. Hypotheses were tested using a sample of 213 focal individuals who were followed from adolescence to adulthood. Results suggested that aggression in the family when focal participants were adolescents predicted aggression with romantic partners when participants were adults. The association between interparental aggression and later aggression in adult romantic unions was partially mediated through parents’ aggression to focal participants when they were adolescents. Both physical and verbal aggression revealed the same pattern of findings. All together, these findings are consistent with a developmental-interactional perspective (Capaldi & Gorman-Smith, 2003) concerning the developmental origins of aggression in intimate relationships. PMID:21171767

  20. Validation of a laboratory play measure of child aggression.

    PubMed

    Johnston, A; DeLuca, D; Murtaugh, K; Deiner, E

    1977-03-01

    The validity of laboratory play measures of aggression has been called into question. Critics have charged that laboratory findings on childhood aggression cannot be generalized to everyday aggression. In the present study, the validity of striking a Bobo clown as a measure of aggression was assessed by correlating the rate of this behavior with peer ratings, teaching ratings, and self-ratings of aggressiveness in a preschool. Laboratory aggression correlated significantly with both peer ratings, r = .76, p less than .01, and teacher ratings, r = .57, p less than .05, but not with self-ratings, r = .36. Laboratory aggression correlated more highly with aggression ratings for males (N = 9) than for females (N = 9), but not significantly so. The findings support the use of laboratory play as a valid measure of aggression in children.

  1. Clinical assessment and management of psychiatric patients' violent and aggressive behaviors in general hospital.

    PubMed

    Bernstein, Kunsook Song; Saladino, Joseph P

    2007-10-01

    Patients with co-morbid psychiatric disorders exhibiting violent and aggressive behaviors can be a challenge for nurses in medical-surgical units. They can deliver effective, safe care by assessing risk and building a rapport with the patient during the admission process; utilizing crisis prevention strategies, including appropriate medication administration, environmental, psychobiological, counseling, and health teaching interventions; and employing conflict resolution technique. Utilizing the nursing process, the nurse can provide effective therapeutic interventions to promote safety for both the patient and the nurse. PMID:18072668

  2. Aggressive Surgery in Palliative Setting of Lung Cancer: Is it Helpful?

    PubMed Central

    Byregowda, Suman; Prabhash, Kumar; Puri, Ajay; Joshi, Amit; Noronha, Vanita; Patil, Vijay M; Panda, Pankaj Kumar; Gulia, Ashish

    2016-01-01

    With increase in survival and progression-free survival in the advanced metastatic cancers, the expectation of quality of life (QOL) has increased dramatically. Palliative care plays a vital role in the management of these advanced cancer patients. At present scenario, palliative care in advanced cancer has seen a completely different approach. Aggressive surgical procedures have been performed to improve the QOL in the advanced cancer patients. We report a case of advanced lung cancer with pathological femur fracture, treated with extensive total femur replacement surgery to provide better QOL. PMID:27803575

  3. Boys’ and Girls’ Relational and Physical Aggression in Nine Countries

    PubMed Central

    Lansford, Jennifer E.; Skinner, Ann T.; Sorbring, Emma; Di Giunta, Laura; Deater-Deckard, Kirby; Dodge, Kenneth A.; Malone, Patrick S.; Oburu, Paul; Pastorelli, Concetta; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Al-Hassan, Suha M.; Alampay, Liane Peña; Bacchini, Dario; Bombi, Anna Silvia; Bornstein, Marc H.; Chang, Lei

    2012-01-01

    Distinguishing between relational and physical aggression has become a key feature of many developmental studies in North America and Western Europe, but very little information is available on relational aggression in more diverse cultural contexts. This study examined the factor structure of, gender differences in, and associations between relational and physical aggression in China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Children ages 7 to 10 years (N = 1410) reported on their relationally and physically aggressive behavior. Relational and physical aggression shared a common factor structure across countries. Unsurprisingly, boys reported being more physically aggressive than girls across all nine countries; surprisingly, there were no significant gender differences in relational aggression. In all nine countries, relational and physical aggression were significantly correlated (average r = .49). The countries differed significantly in the mean levels of both relational and physical aggression that children reported using and with respect to whether children reported using more physical than relational aggression or more relational than physical aggression. Despite mean level differences in relational and physical aggression across countries, the findings provided support for cross-country similarities in associations between relational and physical aggression, as well as links between gender and aggression. PMID:23935227

  4. Neuronavigation. Principles. Surgical technique.

    PubMed

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  5. Surgical education in Mexico.

    PubMed

    Cervantes, Jorge

    2010-05-01

    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital. PMID:19603225

  6. Neuronavigation. Principles. Surgical technique.

    PubMed

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques. PMID:20108488

  7. [Managing aggression and violence associated with psychosis].

    PubMed

    Hallikainen, Tero; Repo-Tiihonen, Eila

    2015-01-01

    Risk for violence in psychosis is associated with the subject's history of early-onset antisocial behavior, substance abuse, suicidal ideation, lack of insight, and non-adherence to antipsychotic medication. These risk factors can be managed by effective treatment for psychosis, with the exception of predatory antisocial aggression. Generally, this group of patients is at considerable risk for untreated conditions. There is, however, no pharmacological treatment indicated solely for aggression. Physical violence can often be avoided by alertness and risk monitoring, and by attentive customer service skills. Safety at work is our shared responsibility. PMID:26427235

  8. [Treatment of aggressive non-Hodgkin's lymphomas].

    PubMed

    Moreno Nogueira, J A; Ruiz Borrego, M; Pérez Valderrama, B; Valero Azbiru, M

    2009-02-01

    Aggressive non-Hodgkin's lymphomas (NHL) in localized stages I and II, without bulky areas and a fair International Prognostic Factor (IPI) (30% of all cases) have high possibilities of cure (80%) when treated with combined chemotherapy, CHOP or CHOP-like (3-4 courses) followed by locoregional radiation therapy. Localized aggressive non-Hodgkin's lymphomas with signs of poor prognosis or advanced stages (III and IV) must be treated with rituximab-containing immunochemotherapy. As second line in responding patients (DHAP, ESHAP, MINE, VIM, DICE, etc., and rituximab) high doses chemotherapy with hematopoietic growth factor support should be considered, although not in refractory patients.

  9. Application of Silver Sulfadiazine Cream With Early Surgical Intervention in Patients Suffering From Combined Burn-Blast Injury Facial Tattoos

    PubMed Central

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention. PMID:24829894

  10. Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos.

    PubMed

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

  11. [Effect of sodium valproate on aggressive behavior of male mice with various aggression experience].

    PubMed

    Smagin, D A; Bondar', N P; Kudriavtseva, N N

    2010-01-01

    Sector of Social Behavior Neurogenetics, Institute of Cytology and Genetics, Siberian Branch, Effects of sodium valproate on the aggressive behavior of male mice with 2- and 20-day positive fighting experience have been studied. It is established that valproate administered in a singe dose of 100 mg/kg has no effect on the behavior of male mice with a 2-day experience of aggression. The treatment of mice with 300 mg/kg of valproate significantly decreased the level of aggressive motivation and the percentage of animals demonstrating attacks and threats. In male mice with a 20-day experience of aggression, valproate decreased the time of hostile behavior in a dose-dependent manner. Valproate in a single dose of 300 mg/kg significantly decreased the level of aggressive motivation, but also produced a toxic effect, whereby 73% of aggressive males demonstrated long-term immobility and 45% exhibited movement abnormalities (falls) upon the treatment. It is suggested that changes in the brain neurochemical activity, which are caused by a prolonged experience of aggression, modify the effects of sodium valproate.

  12. Disentangling impulsiveness, aggressiveness and impulsive aggression: an empirical approach using self-report measures.

    PubMed

    García-Forero, Carlos; Gallardo-Pujol, David; Maydeu-Olivares, Alberto; Andrés-Pueyo, Antonio

    2009-06-30

    There is confusion in the literature concerning the concept of impulsive aggression. Based on previous research, we hypothesize that impulsivity and aggression may be related, though not as closely as to consider them the same construct. So, our aim was to provide empirical evidence of the relationship between the impulsivity and aggressiveness constructs when considered as traits. Two widely used questionnaires [Barratt's Impulsiveness Scale (BIS) and Aggression Questionnaire-Refined (AQ-R)] were administered to 768 healthy respondents. Product-moment and canonical correlations were then calculated. In addition, a principal components analysis was conducted to explore whether impulsive aggression can be defined phenotypically as the expression of a single trait. The common variance between impulsivity and aggressiveness was never higher than 42%. The principal components analysis reveals that one component is not enough to represent all the variables. In conclusion, our results show that impulsivity and aggressiveness are two separate, although related constructs. This is particularly important in view of the misconceptions in the literature.

  13. Minimally invasive corticotomy in orthodontics: a new technique using a CAD/CAM surgical template.

    PubMed

    Cassetta, M; Pandolfi, S; Giansanti, M

    2015-07-01

    Accelerating orthodontic tooth movement is a topical issue. Despite the different techniques described in the literature, the corticotomy is the only effective and safe means of accelerating orthodontic tooth movement. Although effective, the corticotomy presents significant postoperative discomfort. The aggressive nature of these particular methods, related to the elevation of mucoperiosteal flaps and to the length of the surgery, has resulted in reluctance to proceed with this technique among both patients and the dental community. To overcome the disadvantages of the corticotomy, this technical note describes an innovative, minimally invasive, flapless procedure combining piezoelectric surgical cortical micro-incisions with the use of a 3D Printed CAD/CAM surgical guide.

  14. [Denosumab may be a supplement to the surgical treatment of giant cell tumours of bone].

    PubMed

    Sørensen, Anna Lynge; Hansen, Rehne Lessmann; Jørgensen, Peter Holmberg

    2016-09-01

    Giant cell tumour of bone (GCTB) is an aggressive bone tumour causing bone destruction. GCTB requires surgical treatment, and severe cases have a high risk of functional morbidity. GCTB consists of receptor activator of nuclear factor kappa-B (RANK)-positive osteoclast-like giant cells. The formation and activity of these cells are mediated by the interaction with RANK ligand (RANKL) released from neoplastic stromal cells. Denosumab is a human monoclonal antibody which inhibits RANKL and impairs the growth of the GCTB. Several studies have described the ability of denosumab to downgrade the extent of surgical treatment and improve the functional outcome. PMID:27593237

  15. Early surgical intervention and optimal medical treatment for Candida parapsilosis endocarditis.

    PubMed

    Toyoda, Shigeru; Tajima, Emi; Fukuda, Reiko; Masawa, Taito; Inami, Shu; Amano, Hirohisa; Arikawa, Takuo; Yoshida, Atsushi; Hishinuma, Akira; Inoue, Teruo

    2015-01-01

    We herein report the case of a 72-year-old man with endocarditis of the aortic valve who underwent urgent aortic valve replacement 36 hours after admission due to an aggravation of aortic valve regurgitation. Postoperative cultures of the blood and site of valve vegetation identified Candida parapsilosis as a pathogen. Antifungal therapy with amphotericin B and fluconazole was initiated after surgical treatment. Thereafter, the patient displayed a favorable clinical course. Candida parapsilosis endocarditis involving the native valves is extremely rare and associated with a very high mortality rate. Prompt surgical treatment and the aggressive use of antifungal agents are required to save the patient's life.

  16. Complications of surgical extraction of ankylosed primary teeth and distal shoe space maintainers.

    PubMed

    Kirshenblatt, S; Kulkarni, G V

    2011-01-01

    The purpose of this report was to present the iatrogenic complications that may result from the management of ankylosed primary teeth as well as describe the case of a patient with an ankylosed primary mandibular left second molar which was surgically extracted and an adjacent primary first molar that was cemented with a distal shoe space maintainer. Aggressive surgical removal of the ankylosed tooth caused damage to the developing crown of the successor. Improper placement of the appliance caused perforation of the developing tooth follicle. Orthodontic therapy and a polycarbonate temporary crown were used to restore occlusion. Nonsurgical extractions and alternative appliances should be considered when treating patients with ankylosed primary second molars.

  17. Isolated cleft lip with generalized aggressive periodontitis: A rare entity

    PubMed Central

    Metgud, Renuka; Kumar, Ajay; Bhat, Kishore

    2015-01-01

    Oro-facial clefts are one of the most common birth defects and may be associated with other genetic anomalies. Aggressive periodontitis is a rare condition that progresses rapidly, but affects only a small percentage of the population. Most of the cases of aggressive periodontitis are familial. Even though, literature has documented the association of various genetic disorders with aggressive periodontitis, the aggressive periodontitis in patients with isolated cleft lip (CL) have never been addressed. Here, we report a rare case of isolated CL with generalized aggressive periodontitis. The concomitant presentation of isolated CL with aggressive periodontitis in an individual has clinical significance for multi-disciplinary care. PMID:25810600

  18. Child abuse and aggression among seriously emotionally disturbed children.

    PubMed

    Ford, Julian D; Fraleigh, Lisa A; Connor, Daniel F

    2010-01-01

    Abused children may be at risk for problems with aggression. In a sample of 397 seriously emotionally disturbed children, reactive aggression was associated with documented history of physical abuse but not sexual abuse. Girls were equally likely to be classified as reactively aggressive regardless of physical abuse history, but boys with physical abuse histories were 50% more likely to be classified as reactively aggressive than boys with no physical abuse history. Proactive aggression was unrelated to physical or sexual abuse history. The association of physical abuse and reactive aggression warrants further scientific study and attention in clinical assessment and treatment with seriously emotionally disturbed children.

  19. Aggressive and nonaggressive children's moral judgments and moral emotion attributions in situations involving retaliation and unprovoked aggression.

    PubMed

    Gasser, Luciano; Malti, Tina; Gutzwiller-Helfenfinger, Eveline

    2012-01-01

    The authors investigated 7- and 9-year-old children's moral understanding of retaliation as compared to unprovoked aggression with regard to their aggressive behavior status. Based on peer ratings, 48 children were selected as overtly aggressive and 91 as nonaggressive. Their moral understanding of retaliation and unprovoked aggression was assessed by an interview including questions about their moral judgments and emotion attributions. Aggressive children judged retaliations as less serious than did nonaggressive children. They also referred less often to the harmful consequences of retaliation and were more likely to excuse the retaliation because of the provocation. In unprovoked aggressive situations younger aggressive children, compared with the younger nonaggressive children, attributed more happiness to transgressors, more anger to victims, and less sadness to transgressors and victims. The results are discussed in terms of previous research on aggressive children's moral understanding of retaliation and unprovoked aggression.

  20. When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists.

    PubMed

    Long, Kristin; Talley, Cynthia; Yarrison, Rebecca B; Bernard, Andrew

    2015-01-01

    Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible. PMID:26078909