The use vacuum therapy in wound healing after fasciotomy in compartment syndrome — case report and literature review

Fasciotomy (opening of the fascial compartments) is one of the main and most effective methods used for emergency treatment of compartment syndrome. Post-fasciotomy wounds may be the cause of the patient’s prolonging hospitalization and may be a challenge in terms of their treatment. In order to avoid potential complications, the wound should be closed as quickly as possible — once the compartment’s pressure on the muscle has been relieved. A large size of the surgical wounds constitutes a significant care problem as it may substantially prolong their healing period and increase infection risk. The use of skin transplants may lead to complications and rigid scars both in the place of harvest and the post-fasciotomy wound; therefore immediate wound closure to allow healing by primary intention is a better option for the patient. This technique allows limiting complications and gives better aesthetic effects; however, it may often be difficult to apply due to the significant limb swelling and shrinking or necrosis of the wound edges. In this paper the authors present a case of a 58-year-old man after the open fasciotomy for whom Negative Pressure Wound Therapy (NPWT) was applied as a method auxiliary to compartment syndrome treatment and shortening wound healing period. In the summary, the use of NPWT in facilitating the treatment of compartment syndrome and healing of fasciotomy wound was discussed briefly, based on the literature review

Beyond technology: A research agenda for social sciences and humanities research on renewable energy in Europe

This article enriches the existing literature on the importance and role of the social sciences and humanities (SSH) in renewable energy sources research by providing a novel approach to instigating the future research agenda in this field. Employing a series of in-depth interviews, deliberative focus group workshops and a systematic horizon scanning process, which utilised the expert knowledge of 85 researchers from the field with diverse disciplinary backgrounds and expertise, the paper develops a set of 100 priority questions for future research within SSH scholarship on renewable energy sources. These questions were aggregated into four main directions: (i) deep transformations and connections to the broader economic system (i.e. radical ways of (re)arranging socio-technical, political and economic relations), (ii) cultural and geographical diversity (i.e. contextual cultural, historical, political and socio-economic factors influencing citizen support for energy transitions), (iii) complexifying energy governance (i.e. understanding energy systems from a systems dynamics perspective) and (iv) shifting from instrumental acceptance to value-based objectives (i.e. public support for energy transitions as a normative notion linked to trust-building and citizen engagement). While this agenda is not intended to be—and cannot be—exhaustive or exclusive, we argue that it advances the understanding of SSH research on renewable energy sources and may have important value in the prioritisation of SSH themes needed to enrich dialogues between policymakers, funding institutions and researchers. SSH scholarship should not be treated as instrumental to other research on renewable energy but as intrinsic and of the same hierarchical importance.acceptedVersio

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present — ‘D’, either elevated blood glucose levels or a family history of diabetes mellitus; ‘K’, the presence of high urinary or blood ketoacids; and ‘A’, a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. The mainstays of treatment include restoration of circulating volume, insulin therapy, electrolyte replacement and treatment of any underlying precipitating event. Without optimal treatment, DKA remains a condition with appreciable, although largely preventable, morbidity and mortality. In this Primer, we discuss the epidemiology, pathogenesis, risk factors and diagnosis of DKA and provide practical recommendations for the management of DKA in adults and children

Epileptogenesis following Kainic Acid-Induced Status Epilepticus in Cyclin D2 Knock-Out Mice with Diminished Adult Neurogenesis.

The goal of this study was to determine whether a substantial decrease in adult neurogenesis influences epileptogenesis evoked by the intra-amygdala injection of kainic acid (KA). Cyclin D2 knockout (cD2 KO) mice, which lack adult neurogenesis almost entirely, were used as a model. First, we examined whether status epilepticus (SE) evoked by an intra-amygdala injection of KA induces cell proliferation in cD2 KO mice. On the day after SE, we injected BrdU into mice for 5 days and evaluated the number of DCX- and DCX/BrdU-immunopositive cells 3 days later. In cD2 KO control animals, only a small number of DCX+ cells was observed. The number of DCX+ and DCX/BrdU+ cells/mm of subgranular layer in cD2 KO mice increased significantly following SE (p<0.05). However, the number of newly born cells was very low and was significantly lower than in KA-treated wild type (wt) mice. To evaluate the impact of diminished neurogenesis on epileptogenesis and early epilepsy, we performed video-EEG monitoring of wt and cD2 KO mice for 16 days following SE. The number of animals with seizures did not differ between wt (11 out of 15) and cD2 KO (9 out of 12) mice. The median latency to the first spontaneous seizure was 4 days (range 2-10 days) in wt mice and 8 days (range 2-16 days) in cD2 KO mice and did not differ significantly between groups. Similarly, no differences were observed in median seizure frequency (wt: 1.23, range 0.1-3.4; cD2 KO: 0.57, range 0.1-2.0 seizures/day) or median seizure duration (wt: 51 s, range 23-103; cD2 KO: 51 s, range 23-103). Our results indicate that SE-induced epileptogenesis is not disrupted in mice with markedly reduced adult neurogenesis. However, we cannot exclude the contribution of reduced neurogenesis to the chronic epileptic state

Epileptogenesis in wt and cD2 KO mice following intra-amygdala kainic acid injection.

<p><b>(A)</b> Neurodegeneration in CA3 of the hippocampus at 8 d after KA-induced status epilepticus. <b>(B)</b> Duration of status epilepticus, <b>(C)</b> percent of animals developing epilepsy, <b>(D)</b> latency to the first spontaneous seizure, <b>(E)</b> seizure frequency in epileptic mice and <b>(F)</b> average spontaneous seizure duration in wt and cD2 KO mice following intra-amygdala kainic acid injection. <b>(G)</b> An example of an electrographic seizure detected in a cD2 KO animal. Arrows in A indicate the area of neuronal loss. Each circle in B and D-F represents one animal, and horizontal bars indicate mean (B) or median (D-F) values; cx—cortex, KO—knock-out, SE—status epilepticus, wt—wild type.</p

Distribution and characteristics of COPD phenotypes &ndash; results from the Polish sub-cohort of the POPE study

Aleksander Kania,1 Rafał Krenke,2 Krzysztof Kuziemski,3 Małgorzata Czajkowska-Malinowska,4 Natalia Celejewska-W&oacute;jcik,1 Barbara Kuźnar-Kamińska,5 Małgorzata Farnik,6 Juliusz Bokiej,7 Marta Miszczuk,2 Iwona Damps-Konstańska,3 Marcin Grabicki,5 Marzena Trzaska-Sobczak,6 Krzysztof Sładek,1 Halina Batura-Gabryel,5 Adam Barczyk6 1Department of Pulmonology, II Chair of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Krak&oacute;w, Poland; 2Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland; 3Department of Allergology and Pneumonology, Medical University of Gdańsk, Gdańsk, Poland; 4Department of Lung Diseases and Respiratory Failure, Regional Center of Pulmonology, Bydgoszcz, Poland; 5Department of Pulmonology, Allergology and Respiratory Oncology, Poznań University of Medical Sciences, Poznań, Poland; 6Department of Pneumology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland; 7Department of Lung Diseases, Regional Hospital Center Jelenia G&oacute;ra, Jelenia G&oacute;ra, Poland Background: This study aimed to examine the distribution of predefined phenotypes, demographic data, clinical outcomes, and treatment of patients who were included in the Polish cohort of the Phenotypes of COPD in Central and Eastern Europe (POPE) study. Patients and methods: This was a sub-analysis of the data from the Polish cohort of the POPE study, an international, multicenter, observational cross-sectional survey of COPD patients in Central and Eastern European countries. The study included patients aged .40 years, with a confirmed diagnosis of COPD, and absence of exacerbation for at least 4 weeks before study inclusion. A total of seven Polish centers participated in the study. Results: Among the 430 Polish COPD patients enrolled in the study, 61.6% were non-exacerbators (NON-AE), 25.3% were frequent exacerbators with chronic bronchitis (AE CB), 7.9% were frequent exacerbators without chronic bronchitis (AE NON-CB), and 5.1% met the definition of asthma-COPD overlap syndrome (ACOS). There were statistically significant differences among these phenotypes in terms of symptom load, lung function, comorbidities, and treatment. Patients with the AE CB phenotype were most symptomatic with worse lung function, and more frequently reported anxiety and depression. Patients with the ACOS phenotype were significantly younger and were diagnosed with COPD earlier than those with other COPD phenotypes; those with the ACOS phenotype were also more often atopic and obese. Conclusion: There is significant heterogeneity among COPD patients in the Polish population in terms of phenotype and clinical outcome. The non-exacerbator phenotype is observed most frequently in Poland, while the frequent exacerbator with chronic bronchitis phenotype is the most symptomatic. Keywords: chronic obstructive pulmonary disease, asthma-COPD overlap syndrome, phenotype