Heart trauma. Penetrating wounds

The article presents the definition of penetrating heart injury, mechanisms of its occurrence, clinical forms, approaches to urgent diagnostics and main therapeutic strategies. The article will be useful for cardiologists, doctors of the emergency departments.

Results of treatment of penetrating wounds of the eyeball

Actuality. Trauma of the organ of vision still has been one of the most frequent causes of disability due to visual disorders leading to blindness, which determines the high socio-economic significance of this problem. In the structure of eye trauma, penetrating wounds make up from 67 to 84%. Timely and fully performed primary surgical treatment in combination with modern vitreoretinal surgery, according to indications, allows preserving the eyeball and even obtaining good functional results. Purpose. The aim of this work is to analyze the structure and outcomes of penetrating eye injuries in patients treated at the N.A. Semashko for 2015-2020. Material and methods. We carried out a retrospective analysis of the medical records of patients with penetrating wounds for 2015-2020. For five years in the regional clinical hospital named after N.A. Semashko, Ryazan, 142 patients aged 19 to 82 were hospitalized. Results. In the first hours after admission primary surgical debridement was done to 100% of patients. Also all patients were immediately started systemic and local detoxification and antibiotic therapy. Against the background of the treatment, the inflammatory process was arrested in 95.8% of patients, the average hospital stay was 6.8±2.5 days. An improvement in visual functions was observed in 52.1% of cases (74 eyes), visual acuity remained the same in 47 eyes (33.1%), and deterioration, up to complete loss of vision, in 21 eyes (14.8%). Conclusion. The results of the treatment of penetrating wounds depend both on the time and amount of care provided, and on the patient's age, the presence of complications and concomitant diseases, on the localization of the inlet, on the depth of penetration of a foreign body, and on many other factors. Key words: penetrating wound, vitrectomy, phacoemulsification, intraocular foreign body.

Clinical Characteristics and Visual Outcomes in Patients with Intralenticular Foreign Bodies with Self-Sealing Corneal Penetrating Wounds

Purpose. Siderosis bulbi may occur as a result of retained intralenticular foreign bodies (ILFBs) that were missed during examination in patients with self-sealing wounds and without a significant decrease in visual acuity. This study aimed to explore the clinical characteristics and visual outcomes of ILFBs with self-sealing corneal penetrating wounds. Methods. Fifteen eyes of 15 patients with ILFBs and self-sealing corneal penetrating wounds, seen between October 2014 and September 2019, were retrospectively analyzed. Data regarding the patient demographics, clinical features, surgical procedure, and initial and final best-corrected visual acuity (BCVA) were analyzed. Results. All patients were male with a mean age of 41 years. The foreign bodies passed through the cornea, sometimes through the iris, through the anterior capsule, and finally localized in the lens. All ILFBs were pointed and metallic objects and were successfully removed with phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Anterior capsule violation was found in three eyes, but no posterior capsule rupture was found. The IOL was placed in a capsule bag in all the cases. The BCVA ranged from 20/200 to 20/25 preoperatively and improved to between 20/32 and 20/20 at the last follow-up visit. The IOLs were well-centered. Apart from posterior capsule opacity in four eyes, no other postoperative complications were found. Conclusions. In patients with a pointed metallic ILFB and self-sealing corneal penetrating wounds (with or without cataracts), early diagnosis and removal of the metallic ILFB combined with lens removal and IOL implantation may avoid late complications and achieve good visual outcomes.

Tetanus in Animals — Summary of Knowledge

Tetanus is a neurologic non-transmissible disease (often fatal) of humans and other animals with a worldwide occurrence. Clostridium tetani is the spore producing bacillus which causes the bacterial disease. In deep penetrating wounds the spores germinate and produce a toxin called tetanospasmin. The main characteristic sign of tetanus is a spastic paralysis. A diagnosis is usually based on the clinical signs because the detection in the wound and the cultivation of C. tetani is very difficult. Between animal species there is considerable variability in the susceptibility to the bacillus. The most sensitive animal species to the neurotoxin are horses. Sheep and cattle are less sensitive and tetanus in these animal species are less common. Tetanus in cats and dogs are rare and dogs are less sensitive than cats. Clinically two forms of tetanus have been recognized, i. e. localized and generalized. The available treatment is not specific because the toxin in neuronal cells cannot be accessed by antitoxin antibodies. The aim of the therapy is to: neutralise the unbound neurotoxin, inhibit C. tetani growth in the wound, and provide supportive care to mitigate the effects of the neurotoxin. The treatment is difficult with an unclear prognosis.

Penetrating Cervical Neck Injuries in Children: About a Case

Penetrating wounds of the neck are rare traumas in children, providers of mortality and high morbidity due to the density of the vital structures of this region and the lack of protection. Their management, a real challenge for the surgeon, has evolved over the years, going from systematic exploration to more selective management. We report the case of an 8-year-old child, victim of a penetrating cervical trauma after falling on a stick to the partner, who was successfully treated at the Rabat Children's Hospital. We will also discuss the emergency management methods for these cervical injuries.

A View from the Beginning of Magnetoencephalography

This chapter examines the author’s work on visually evoked field (VEF) experiments. After their first VEF experiment, the author and other researchers thought that it may well be possible to use magnetoencephalography (MEG) to noninvasively map primary projection areas of several sensory pathways on the cerebral cortex. The importance of such a task lay partly in the fact that an enormous amount of information about these areas already existed. This information was gained in part by studying patients with penetrating wounds of their brains. Other studies applied electric stimuli during brain surgery to exposed brain tissue. Even if the researchers could not add anything of value to this knowledge base, they may still be able to verify MEG’s ostensible potential for locating specific functional areas noninvasively. Ultimately, this became one of the more valuable potential applications before brain surgery. The chapter then suggests some research projects that may accelerate progress in MEG.