HIV infection in the penitentiaries of Ukraine

In connection with a sharp increase of the number of HIV-infected persons in the Ukraine the natural growth of the number of such persons in penitentiary institutions was registered, starting from 1995 (455 persons in 1995, 2,937 persons in 1996, 2,779 persons in 1997 and 173 persons during 5 months of 1998). 83% of HIV infection persons were drug addicts introducing drugs intravenously. In 1997 the strategy of decreasing the risk of infection in penitentiary institutions was worked out in collaboration with UNAIDS experts: repressive and isolation measures were replaced with measures aimed at the "decrease of harm". Special attention is given to circumstances aggravating the epidemic situation in HIV infection, and particularly at the sharp growth of morbidity in tuberculosis and syphilis (10.6 and 10.3 times respectively in 1997 in comparison with 1993). In addition, in 1997 the number of person having drug addiction was noted to increase 2.3 times in comparison with 1993. The necessity of taking constant information and educational measures aimed at decreasing the risk of the spread of HIV infection is emphasized.     

Radiodiagnosis of traumatic injuries of the kidneys in children

Altogether 35 children (21 boys and 14 girls) with traumatic renal lesions ages 5 to 14 were examined, of them 23 were subjected to operation 2-13 h after injury, 12 patients received conservative therapy. The patients were divided into 3 groups with relation to a degree of severity of injury: mild (12 patients), moderate (20 patients) and grave (3 patients). All the children were given combined clinical, x-ray and radiological examination. Normally the most informative diagnostic method was excretory urography, particularly its infusion variant. Renography, renoscanning or dynamic renoscintigraphy were employed for observation over time to reduce radiation exposure.     

Psychological impact of traumatic injuries: what the surgeon can do.

In their treatment of accident and assault victims, plastic surgeons have unique opportunities to identify and refer patients with posttraumatic stress symptoms. This article describes brief assessments that surgeons or their clinic staff can use to evaluate traumatically injured adults and children for trauma-related psychological symptoms. An immediate postinjury evaluation (within 10 days of the trauma) consists of 11 questions to determine the presence of the following risk factors for posttrauma maladjustment: panic during or immediately after the trauma, reexperiencing symptoms, avoidance, sleep disturbance, injury from an assault, previous trauma and psychiatric history, and blaming someone else for the injury. The seven follow-up interview questions assess reexperiencing symptoms, avoidance, trauma-related phobias, depression, irritability, and increased substance use, all of which, if present, suggest psychological impairment. Questions recommended for the evaluation of younger children assess changes in play and recreational activity, sleep disturbance, night terror, aggression, irritability, avoidance, emergence of new fears, and loss of recently acquired developmental skills. The assessments require less than 2 minutes and are easily integrated into the hospital or clinic examinations of these patients.     

Review of 1,000 major facial fractures and associated injuries.

The records of 1,020 major facial fractures were reviewed, and it was found that the occurrence of life-threatening associated injuries was highly predictable on the basis of the pattern of facial fractures and the circumstances of the injury. Certain groups of patients have a high probability of associated serious injuries of the central nervous system, the trunk, or the extremities. Probably these patients should be primarily under the care of a surgeon who is capable of the diagnosis and emergency therapy of these associated injuries, as well as the facial injuries, so that appropriate priorities can be established and put in effect.     

区域生态效率研究进展

作为指示可持续发展水平的重要指标,区域生态效率定量表征了区域发展过程中社会经济和生态环境的协调水平,能够为生态文明建设提供重要科学依据。在对生态效率概念内涵进行系统梳理的基础上,重点探讨了区域生态效率研究的近今进展：研究方法从单一比值到模型模拟、研究对象从静态评估到时空动态、研究内容从效率测度到机理认知。最后,提出区域生态效率研究的重点方向,即地理大数据的时空分析、多要素集成的模型研发、区域城市化的重点关注、面向可持续的区域管治等4个方面。     

Classifying mild traumatic brain injuries with functional network analysis

Background

Traumatic brain injury (TBI) represents a critical health problem of which timely diagnosis and treatment remain challenging. TBI is a result of an external force damaging brain tissue, accompanied by delayed pathogenic events which aggravate the injury. Molecular responses to different mild TBI subtypes have not been well characterized. TBI subtype classification is an important step towards the development and application of novel treatments. The computational systems biology approach is proved to be a promising tool in biomarker discovery for central nervous system injury.

Results

In this study, we have performed a network-based analysis on gene expression profiles to identify functional gene subnetworks. The gene expression profiles were obtained from two experimental models of injury in rats: the controlled cortical impact and the fluid percussion injury. Our method integrates protein interaction information with gene expression profiles to identify subnetworks of genes as biomarkers. We have demonstrated that the selected gene subnetworks are more accurate to classify the heterogeneous responses to different injury models, compared to conventional analysis using individual marker genes selected without network information.

Conclusions

The systems approach can lead to a better understanding of the underlying complexities of the molecular responses after TBI and the identified subnetworks will have important prognostic functions for patients who sustain mild TBIs.

     

Risks of acute traumatic intracranial haematoma in children and adults: implications for managing head injuries.

OBJECTIVE--To determine the factors influencing the risk of an acute traumatic intracranial haematoma in children and adults with a recent head injury. DESIGN--Prospective study of incidence of risk factors in samples of patients attending accident and emergency departments and in all patients having an acute traumatic intracranial haematoma evacuated in one regional neurosurgical unit during 11 years. SETTING--Accident and emergency departments in Scotland or Teesside and regional neurosurgical centre in Glasgow. PATIENTS--8406 Adults and children (less than or equal to 14 years) who attended accident and emergency departments and 1007 consecutive patients who had an operation for an acute traumatic intracranial haematoma. Data were complete in 8366 and 960 patients respectively. RESULTS--Overall, children were less at risk than adults (one in 2100 v one in 348 respectively). In both age groups the presence of a skull fracture and changes in conscious level permitted identification of subgroups of patients with widely differing degrees of risk. In children the absolute risk ranged from one in almost 13,000 without a fracture or altered conscious level to one in 12 for a child in a coma and with a fracture; the pattern was similar in adults, the risks in corresponding groups ranging from one in almost 7900 to one in four. CONCLUSIONS--Although children attending hospital after a head injury have a lower overall risk of a traumatic haematoma, the main indicators of risk, a skull fracture and conscious level, are the same as in adults, and the pattern of their combined effect is similar. Guidelines for managing adults with recent head injury may therefore be applied safely to children; with the increasing provision of facilities for computed tomography they should be revised to ensure early scanning of more patients with head injury.     

Stimulation of the spinal cord in the treatment of traumatic injuries of cervical spine

Since 1974, clinical experiments have been conducted at the Rehabilitation Clinic in Konstancin (Poland) on the effects of electrostimulation on the damaged spinal cord. 30 patients with stimulation after injury to the cervical spinal cord are reported. Patients with complete and incomplete cervical cord injury were compared. The patients were treated by surgical decompression with simultaneous implantation of stimulating electrodes in contact with the spinal cord. The control group of patients were operated upon in the same period for similar injuries, but had no stimulators implanted. Neurological improvement was better in the stimulated compared to the nonstimulated patients, both as regards number of neurological improvements as well as quality of neurological function. The comparison also confirmed a favorable effect of spinal cord stimulation on the development of bladder automatism.     

Psychological adjustment in children after traumatic disfiguring injuries: a 12-month follow-up

The psychological adjustment of 57 children (age range, 3 to 12 years) who sustained mutilating traumatic injuries to the face or upper or lower extremities was assessed over a 12-month interval. The injuries had occurred as a result of boating, lawn mower, or home accidents or dog bites. Within 5 days of the traumatic event, 98 percent of the children were symptomatic for posttraumatic stress disorder, depression, or anxiety. One month after the injury, 82 percent were symptomatic. Symptom frequency had declined by the time of the 3-month and 6-month evaluations, but 44 percent of the children continued to report symptoms at 12-month follow-up visits, and 21 percent met the diagnostic criteria for posttraumatic stress disorder. Typical symptoms included flashbacks, fear of re-injury, mood disorders, body-image changes secondary to disfigurement, sleep disturbances, and anxiety. These findings support the importance of psychological evaluation and treatment of children who suffer mutilating injuries that require the attention of plastic surgeons.     

区域生态环境脆弱性评价方法研究综述

随着社会经济的快速发展以及人口压力的不断增长,人类活动正越来越强烈地影响着地球的生态系统平衡,导致当前生态环境的脆弱性进一步加剧,生态环境问题越来越突出。通过对区域生态环境脆弱性评价研究相关文献资料整理,认为生态环境脆弱性是个相对的概念,受到自然地理条件因素、系统自身恢复能力、人为活动干扰因素等多重影响,是自然因素和人为因素共同作用的结果。结合生态环境脆弱性内涵表征及其评价的主要内容、评价指标选取及体系构建、评价方法及分析模型等方面的研究,分析了生态脆弱性评价研究领域的发展状况及其不同区域指标体系和评价方法的差异,讨论了在研究理论方法的创新、评价指标体系及计算模型的构建、自然因素和人为因素评判的定量分析描述、评价结果的应用研究等方面仍存在一些问题,并结合评价模型构建、数据处理分析的有效性、评价结果应用等方面分析了生态环境脆弱性评价研究的发展趋势。总体认为,区域生态环境脆弱性评价在未来研究中:研究思路需要进一步突出综合系统性;数据处理需要进一步突出时空动态性;研究方法需要进一步突出学科融合性;研究结果需要进一步突出实践应用性。