2,280 research outputs found

    Evolving frontiers in severe polytrauma management: refining the essential principles

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    This editorial aims to refine the severe polytrauma management principles. While keeping ABCDE priorities, the termination of futile resuscitation and the early use of tourniquet to stop exsanguinating limb bleeding are crucial. Difficult-airway-management (DAM) is by a structured 5-level approach. The computerised tomography (CT) scanner is the tunnel to death for hemodynamically unstable patients. Focused Abdominal Sonography for Trauma-Ultrasonography (FAST USG) has replaced diagnostic peritoneal lavage (DPL) and is expanding to USG life support. Direct whole-body multidetector-row computed tomography (MDCT) expedites diagnosis & treatment. Non-operative management is a viable option in rapid responders in shock. Damage control resuscitation comprising of permissive hypotension, hemostatic resuscitation & damage control surgery (DCS) help prevent the lethal triad of trauma. Massive transfusion protocol reduces mortality and decreases the blood requirement. DCS attains rapid correction of the deranged physiology. Mortality reduction in major pelvic disruption requires a multi-disciplinary protocol, the novel pre-peritoneal pelvic packing and the angio-embolization. When operation is the definitive treatment for injury, prevention is best therapy. © Penerbit Universiti Sains Malaysia, 2013.published_or_final_versio

    Patterns, aetiology and risk factors of intimate partner violence-related injuries to head, neck and face in Chinese women

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    Nasopharyngeal carcinoma: time lapse before diagnosis and treatment

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    This is a descriptive study of 168 patients with nasopharyngeal carcinoma who were referred to public oncology departments for primary treatment between July and September 1996. The mean duration from the onset of the symptoms to histological diagnosis was 5.0 months; the duration ranged from 6.1 months (for patients presenting with nasal symptoms) to 1.8 months (for those with cranial nerve dysfunction). The mean period between the onset of symptoms and the seeking of medical advice was 2.9months. For 54% of the patients, there was a further delay of up to 2.4 months between the initial medical consultation and referral to the appropriate specialist. The majority (84%) of patients attended public institutions for histological confirmation. The mean total time taken from the onset of symptoms to the commencement of radiotherapy was 6.5 months (range, 1.3-74.0 months)---45% of the delay was attributed to the patient, 20% to initial consultations, 14% to diagnostic arrangement, and 21% to preparation for radiotherapy. Concerted efforts are needed to minimise further the time between the onset of symptoms and treatment. A substantial reduction in this delay can be achieved if both public and primary care doctors were made more aware of the significance of relevant symptoms.published_or_final_versio

    Book Reviews

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    Catherine Stonehouse and Scottie MayListening to Children on the Spiritual Journey: Guidance for Those Who Teach and Nurture2010. Grand Rapids, MI: Baker AcademicReviewed by Desiree Segura-April Dyron B. DaughrityThe Changing World of Christianity: The Global History of a Borderless Religion2010. New York: Peter LangReviewed by Meesaeng Lee Choi Derek TidballThe Message of Holiness: Restoring God\u27s Masterpiece2010. Downers Grove, IL Inter-Varsity, PressReviewed by Joseph R. Dongell Accordance. Scholars CollectionDVD-ROM and CD-ROM, version 82008. OakTree Software, Inc.Reviewed by Michael D. Matlock and Jason R. Jackson Paul L. Gavrilyuk, Douglas M. Koskela, Jason E. Vickers, Eds.Immersed in the Life of God: The Healing Resources of the Christian Faith2008. Grand Rapids: William B. Eerdmans Publishing Co.Reviewed by Stephen Seamands Thomas Jay OordThe Nature of Love: A TheologySt. Louis, MO: Chalice Press, 2010Reviewed by Wm. Andrew Schwartz James R. PaytonGetting the Reformation Wrong. Correcting some MisunderstandingsDowners Grove: InterVarsity Press, 2010, 240 pages, $23Reviewed by Ben Witherington Kenneth Cain KinghornThe Story of Asbury Theological Seminary2010. Published by Emeth PressReviewed by Laurence W. Woo

    A novel psittacine adenovirus identified during an outbreak of avian chlamydiosis and human psittacosis: zoonosis associated with virus-bacterium coinfection in birds

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    Chlamydophila psittaci is found worldwide, but is particularly common among psittacine birds in tropical and subtropical regions. While investigating a human psittacosis outbreak that was associated with avian chlamydiosis in Hong Kong, we identified a novel adenovirus in epidemiologically linked Mealy Parrots, which was not present in healthy birds unrelated to the outbreak or in other animals. The novel adenovirus (tentatively named Psittacine adenovirus HKU1) was most closely related to Duck adenovirus A in the Atadenovirus genus. Sequencing showed that the Psittacine adenovirus HKU1 genome consists of 31,735 nucleotides. Comparative genome analysis showed that the Psittacine adenovirus HKU1 genome contains 23 open reading frames (ORFs) with sequence similarity to known adenoviral genes, and six additional ORFs at the 3′ end of the genome. Similar to Duck adenovirus A, the novel adenovirus lacks LH1, LH2 and LH3, which distinguishes it from other viruses in the Atadenovirus genus. Notably, fiber-2 protein, which is present in Aviadenovirus but not Atadenovirus, is also present in Psittacine adenovirus HKU1. Psittacine adenovirus HKU1 had pairwise amino acid sequence identities of 50.3–54.0% for the DNA polymerase, 64.6–70.7% for the penton protein, and 66.1–74.0% for the hexon protein with other Atadenovirus. The C. psittaci bacterial load was positively correlated with adenovirus viral load in the lung. Immunostaining for fiber protein expression was positive in lung and liver tissue cells of affected parrots, confirming active viral replication. No other viruses were found. This is the first documentation of an adenovirus-C. psittaci co-infection in an avian species that was associated with a human outbreak of psittacosis. Viral-bacterial co-infection often increases disease severity in both humans and animals. The role of viral-bacterial co-infection in animal-to-human transmission of infectious agents has not received sufficient attention and should be emphasized in the investigation of disease outbreaks in human and animals. © 2014 To et al.published_or_final_versio
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