ESIN in Femur Fractures: Exact Technique Is Important!

Abstract : Background and Purpose: : Elastic stable intramedullary nailing (ESIN) is gaining increasing popularity, but studies with high case loads are rare. It was the aim of four experienced pediatric trauma centers to give an update of indications for ESIN, postoperative management, and complications. Patients and Methods: : Data of the last 100 ESIN cases of each department before June 30, 2003 were collected by reviewing the charts and X-rays. Among these 400 collected ESINs 65 femoral shaft fractures (16%) were found. The patients' age ranged between 23/4 and 151/4 years. The middle third of the shaft was affected 42 times (65%), 13 fractures (20%) were in the proximal third of the diaphysis, and ten (15%) in the distal part of the femur, five dia- and five metaphyseal. Mainly transverse fractures were treated (52%), followed by 38% oblique or spiral fractures and 10% wedge or comminuted fractures. Two open reductions were required. Median hospitalization time was 6 days. Nails were extracted after a mean of 178 days. Results: : Six skin irritations (wound infections, hematoma, seroma), one patient with myositis ossificans and one with constant pain at too long nail end were found. Three cosmetically relevant scarrings were observed during follow-up. Relevant axial deviations at fracture healing in two and shortening in one fracture could be seen, all caused by technical failure. Conclusion: : ESIN meets all demands for an optimal fracture healing in children. Still, a considerable percentage of complications is observed, mainly caused by the surgeon himself, which can be avoided by exact indication and technique. Postoperative management has yet to be standardize

IWIN: the Isfjorden Weather Information Network

In an effort led by the University Centre in Svalbard (UNIS), with support from the Norwegian Meteorological Institute (MET Norway), the Isfjorden Weather Information Network (IWIN) is under development in the Isfjorden region in central Svalbard. The network substantially expands upon the relatively sparse existing operational network of weather stations and consists of compact and cost-efficient all-in-one weather stations permanently installed at lighthouses around Isfjorden and on board small tourist cruise ships trafficking the fjord from spring to autumn. All data from the network until June 2023, as presented in this paper, can be found at https://doi.org/10.5281/zenodo.8137588 (Frank et al., 2023b). New data become freely available in near-real time via MET Norway's data portals (https://doi.org/10.21343/ebrw-w846, Frank et al., 2023a). The IWIN data are highly valuable for scientific purposes such as atmospheric boundary layer research, the validation and development of numerical weather prediction models, and assimilation in these, as well as the planning and safe conduction of outdoor activities in the region.publishedVersio

IWIN: the Isfjorden Weather Information Network

In an effort led by the University Centre in Svalbard (UNIS), with support from the Norwegian Meteorological Institute (MET Norway), the Isfjorden Weather Information Network (IWIN) is under development in the Isfjorden region in central Svalbard. The network substantially expands upon the relatively sparse existing operational network of weather stations and consists of compact and cost-efficient all-in-one weather stations permanently installed at lighthouses around Isfjorden and on board small tourist cruise ships trafficking the fjord from spring to autumn. All data from the network until June 2023, as presented in this paper, can be found at https://doi.org/10.5281/zenodo.8137588 (Frank et al., 2023b). New data become freely available in near-real time via MET Norway's data portals (https://doi.org/10.21343/ebrw-w846, Frank et al., 2023a). The IWIN data are highly valuable for scientific purposes such as atmospheric boundary layer research, the validation and development of numerical weather prediction models, and assimilation in these, as well as the planning and safe conduction of outdoor activities in the region.</p

Coming in from the cold: Addressing the challenges experienced by women conducting remote polar fieldwork

Remote fieldwork is an important component of polar research across both physical and social sciences. There is increasing recognition that the inherent logistical, physical, psychological, and interpersonal challenges of remote polar fieldwork are not felt equally across the polar research community, with minority groups often disproportionately affected. Although historically lacking diversity, the demographics of polar researchers have shifted, and the way polar research is conducted has been changing in response. However, there are still barriers to equal participation. Removing these barriers would attract scientists from more diverse backgrounds and improve scientific outcomes. We explored the lived experiences of those who identify as women in polar fieldwork through a review of current literature and an anonymous survey, using existing networks to connect with women working in polar research. We synthesised survey responses with regards to topics such as harassment, hygiene, inefficient communication, gendered work expectations and responsibilities to form a holistic understanding of the key fieldwork challenges faced by women. The majority of survey respondents (79%, n = 320) had encountered negative experiences during fieldwork, with the most common and impactful issues relating to field team dynamics and communication, sexism, rest, and weather. Many other issues including fieldwork preparation, work expectations, harassment, and personal space and privacy were also raised by respondents. We identify critical points of action from the survey results and in literature and propose strategies to remove barriers to participation and improve the experiences of women in polar fieldwork. These include individual- and organisational-level strategies for pre, during, and post fieldwork. A diverse polar research community is imperative in order to address the challenges presented by current unprecedented climate change. Though this study focussed on women’s experiences, we seek to advance the discourse on challenges faced by all minorities in polar research

Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report

<p>Abstract</p> <p>Introduction</p> <p>A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury.</p> <p>Case presentation</p> <p>A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder.</p> <p>Conclusion</p> <p>There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.</p

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods - We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland. Patient charts were retrospectively reviewed. Results - More lower extremity fractures occurred in boys (62%, n = 341). Of 548 fractured long bones in the lower extremity, 25% involved the femur and 75% the lower leg. The older the patients, the more combined fractures of the tibia and fibula were sustained (adolescents: 50%, 61 of 123). Salter-Harris (SH) fracture patterns represented 66% of single epiphyseal fractures (83 of 126). Overall, 74 of the 83 SH patterns occurred in the distal epiphysis. Of all the metaphyseal fractures, 74 of 79 were classified as incomplete or complete. Complete oblique spiral fractures accounted for 57% of diaphyseal fractures (120 of 211). Of all fractures, 7% (40 of 548) were classified in the category "other", including 29 fractures that were identified as toddler's fractures. 5 combined lower leg fractures were reported in the proximal metaphysis, 40 in the diaphysis, 26 in the distal metaphysis, and 8 in the distal epiphysis. Interpretation - The PCCF allows classification of lower extremity fracture patterns in the clinical setting. Re-introduction of a specific code for toddler's fractures in the PCCF should be considered

Abscess formation of a spherical-shape duplication in the splenic flexure of the colon: case report and review of the literature

Gastrointestinal tract duplications are rare congenital malformations that may occur anywhere in the alimentary tract from the mouth to the anus, and vary greatly in presentation, size, location, and especially in symptoms. We present a case of an infected spherical colonic duplication, in a 20-day-old baby, located at the splenic flexure of the colon. The prominent symptom was acute abdomen, accompanied by bilious vomiting, intestinal obstruction, and high fever. We present this case, due to atypical clinical presentation and the inability of the imaging modality to establish the diagnosis preoperatively

An investigation into the prevalence of dog bites to primary school children in Trinidad

<p>Abstract</p> <p>Background</p> <p>To estimate the prevalence of dog bites to primary school children between the ages of 8–12 years using a semi-structured interview process. With the increase in the pet population and popularity of dangerous breeds of dog and a high stray dog population combined with a dearth of information on the risk of dog attacks to children in Trinidad, a semi-structured interview process was used to determine risk factors associated with dog attacks.</p> <p>Methods</p> <p>A questionnaire survey of 1109 primary school children between the ages of 8–12 years was conducted in Trinidad from November 2002 to September 2003. The survey was conducted to determine the risk factors such as age, gender, size of dog and relationship of dog and victim, in dog bite incidents. The chi-square statistic and odds ratios were used to estimate risk factors for a bite incident.</p> <p>Results</p> <p>Twenty-eight percent of children were bitten at least once by a dog. Gender (male) and owning a dog were statistically significant risk factors (p = 0.003 and 0.008 respectively, χ²<it>df</it>, 95% confidence). Most attacks occurred outside of the home (58.0%) followed by the victims' home (42.0%) and were by a dog known but not owned (54.6%) by the victim. Many victims (33.0%) were bitten without having any interaction with the dog and the majority (61.9%) of victims did not receive professional medical assistance. Overall, the lower leg or foot was most often injured (39.3%).</p> <p>Conclusion</p> <p>A public educational campaign is needed on responsible pet ownership. In addition, children must be taught effective ways of avoiding attacks or reducing injury in the event of a dog attack. The Dangerous dogs Act 2000 must be proclaimed in parliament by the Government of Trinidad and Tobago to exert more pressure on pet owners to safeguard the public from the menace of dog attacks.</p