Resuscitation with hydroxyethyl starch improves renal function and lactate clearance in penetrating trauma in a randomized controlled study: the FIRST trial (Fluids in Resuscitation of Severe Trauma).

Background: The role of fluids in trauma resuscitation is controversial. We compared resuscitation with 0.9% saline vs hydroxyethyl starch, HES 130/0.

Clinical evaluation of autologous gamma delta T cell-based immunotherapy for metastatic solid tumours.

Background: Adoptive transfer of ex vivo expanded autologous Vγ9Vδ2 T cells may be of therapeutic benefit for cancer because of their potent direct cytotoxicity towards tumour cells, synergistic cytotoxicity when combined with aminobisphosphonates and enhancement of antibody-dependent cell-mediated cytotoxicity.

Methods: To determine the feasibility and clinical safety of therapy with ex vivo expanded, activated Vγ9Vδ2 T cells in combination with zoledronate, we enrolled 18 subjects with advanced solid tumours into a phase I clinical study. Administered indium(111)-oxine-labelled Vγ9Vδ2 T cells were tracked in a cohort of patients.

Learning alters theta amplitude, theta-gamma coupling and neuronal synchronization in inferotemporal cortex.

Background: How oscillatory brain rhythms alone, or in combination, influence cortical information processing to support learning has yet to be fully established. Local field potential and multi-unit neuronal activity recordings were made from 64-electrode arrays in the inferotemporal cortex of conscious sheep during and after visual discrimination learning of face or object pairs. A neural network model has been developed to simulate and aid functional interpretation of learning-evoked changes.

Comparison of clinical and immunological effects of intravenous and intradermal administration of α-galactosylceramide (KRN7000)-pulsed dendritic cells.

Purpose: Human Vα24+Vβ11+ natural killer T-cells (NKT cells) have antitumor activity via direct cytotoxicity and by induction of antitumor actions of T and NK cells. Activation of NKT cells is crucial for their antitumor activity and is induced by α-galactosylceramide (α-GalCer, KRN7000) presented by CD1d on dendritic cells (DC). We conducted a phase I clinical trial of therapy with α-GalCer-pulsed DC to determine safety, tolerability, immune effects and an optimal dose, and administration route.

EAO summer camp: a facilitated sharing experience.

Aim: The purpose of the EAO summer camp was to create visions and ideas for future developments in the field of implant dentistry. An additional goal was the installation of a young, strong and enduring network for scientific exchange among participants. SUMMER CAMP ACTIVITY: Forty participants younger than 40 years of age, from 16 different European countries, discussed potential future developments of implant dentistry in a professionally moderated workshop.

The biomechanical functional demand placed on knee and hip muscles of older adults during stair ascent and descent.

Age-related decline in physical capabilities may lead to older adults experiencing difficulty in performing everyday activities due to high demands placed on the muscles of their lower extremity. This study aimed to determine the biomechanical functional demand in terms of joint moments and maximal muscle capabilities at the knee and hip joints while older adults performed stair ascent (SA) and stair descent (SD). Eighty-four healthy older adults aged 60-88 years were tested.

Pancreatic injuries after blunt abdominal trauma: an analysis of 110 patients treated at a level 1 trauma centre.

Background And Objective: Injuries to the pancreas are uncommon, but may result in considerable morbidity and mortality. This study evaluated the management of blunt pancreatic injuries using a previously defined protocol to determine which factors predicted morbidity and mortality.

Methods: The study design was a retrospective chart review of all adult patients with blunt pancreatic injuries treated at a level 1 trauma centre between March 1981 and June 2009.

Civilian penetrating axillary artery injuries.

Background: The surgical management and outcome of penetrating axillary artery (AA) injuries is presented.

Patients And Methods: Patients presenting to Groote Schuur Hospital with penetrating AA injuries from January 2003 to December 2009 were reviewed. Demographic data, mechanism of injury, associated injuries, angiographic findings, surgical treatment, complications, and mortality were noted.

Practical matters for the control of contamination in a nuclear medicine department.

A practicable and safe methodology is required for the control of contamination arising due to work in nuclear medicine departments, taking account of the range of radionuclides used for diagnostic and therapeutic procedures. A method for categorising radionuclides is proposed, based on their contamination derived limits. The categories utilised are: low energy gamma, imaging gamma, high energy gamma with beta, low energy beta, high energy beta and (51)Cr.

A comparison of two interventions designed to promote neutral wrist postures during simple computer operations.

Objective: To compare two postural interventions, a wrist splint and a Wrist Alignment Device (WAD) with a biofeedback mechanism.

Participants: Nine right-handed healthy individuals participated in the study.

Methods: Using both hands independently a 30-minute office-activity-experiment was performed that consisted of data entry, mouse clicking, text dragging, and mouse scrolling executed one after the other.

Collecting injury surveillance data in low- and middle-income countries: the Cape Town Trauma Registry pilot.

Injury is a major public health issue, responsible for 5 million deaths each year, equivalent to the total mortality caused by HIV, malaria and tuberculosis combined. The World Health Organisation estimates that of the total worldwide deaths due to injury, more than 90% occur in low- and middle-income countries (LMIC). Despite the burden of injury sustained by LMIC, there are few continuing injury surveillance systems for collection and analysis of injury data.

Nonoperative management of pelvic gunshot wounds.

Background: The nonoperative management (NOM) of abdominal gunshot injuries is gradually becoming the standard of care. Patients with pelvic gunshot injuries constitute a subgroup of patients at high risk of visceral injury. The aim of this study was to assess the feasibility and safety of the selective NOM of pelvic gunshot injuries.

Strong inverse correlation between microRNA-125b and human papillomavirus DNA in productive infection.

Infection by the human papillomavirus (HPV) is a cause of cervical intraepithelial neoplasia (CIN) and cancer. microRNA (miRNA) in situ analysis of the transformation zone epithelia, the site of initial cervical HPV infection, showed that miRNAs let-7c, -99a, 26a, and 125b were the most abundantly expressed. In situ testing of CIN 1 showed a dramatic reduction in miR-125b expression in the koilocytes, the cytologic marker of productive HPV infection.

The utility of in situ detection, including RT in situ PCR, of viral nucleic acid and the co-localization of the cytokine response to the study of viral pathogenesis.

This manuscript focuses on the detection of viral nucleic acids by in situ based methodologies. The optimal protocol depends on the virus. We will describe protocols for viral RNA detection by reverse transcriptase (RT) in situ PCR.

Rugby union injuries in Scottish schools.

Background: Rugby union is the most popular worldwide collision sport, yet concerns have been raised regarding the safety of the sport due to the physical, high impact nature and an increasing number of injuries.

Methods: A prospective, cohort study of the incidence, pattern and severity of injuries in rugby players in six Scottish schools during the second half of the 2008-09 season. Definition of injury and severity of injury were taken from International Rugby Board (IRB) consensus guidelines.

Predicting mortality in damage control surgery for major abdominal trauma.

Background: Damage control surgery (DCS) has become well established in the past decade as the surgical strategy to be employed in the unstable trauma patient. The aim of this study was to determine which factors played a predictive role in determining mortality in patients undergoing a damage control laparotomy.

Materials And Methods: A retrospective review of all patients undergoing a laparotomy and DCS in a level 1 trauma centre over a 3-year period was performed.

Measuring the positional accuracy of computer assisted surgical tracking systems.

Computer Assisted Orthopaedic Surgery (CAOS) technology is constantly evolving with support from a growing number of clinical trials. In contrast, reports of technical accuracy are scarce, with there being no recognized guidelines for independent measurement of the basic static performance of computer assisted systems. To address this problem, a group of surgeons, academics and manufacturers involved in the field of CAOS collaborated with the American Society for Testing and Materials (ASTM) International and drafted a set of standards for measuring and reporting the technical performance of such systems.

Management of the retained knife blade.

Background: The retained knife blade is an unusual and spectacular injury. The aim of this study was to review our experience with the management of such injuries.

Methods: A retrospective chart review of patients with retained knife blades treated at Groote Schuur Hospital Trauma Centre from January 1996 to December 2007 was undertaken.

A summary of the 25th International Papillomavirus Conference 2009: vaccines, screening, epidemiology and therapeutics.

The 25th International Papillomavirus Conference was held in Malmo, Sweden, on May 8-14, 2009. The conference encompassed all areas of papillomavirus (PV) research, from clinical vaccinology to molecular biology. This review highlights some of the 237 presentations and 887 abstracts which were presented and summarizes sessions on prophylactic vaccines, screening, epidemiology and therapeutics.

Pneumocephalus following gunshot injury to the thoracic vertebral column: a case report.

Subarachnoid pleural fistula (SPF) following injury to the vertebral column is an extremely rare complication and is usually described after blunt trauma. We report the first case of SPF with pneumocephalus due to a gunshot wound to the spine.

Local risk factors for implant therapy.

Purpose: The aim of this review was to determine the effect of several potential local risk factors on implant survival and success (primary outcomes) as well as on mucosal recession, bleeding on probing, and proximal marginal bone loss (secondary outcomes).

Materials And Methods: A comprehensive review of the literature was conducted. The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by three reviewers.

An analysis of 50 surgically managed penetrating subclavian artery injuries.

Objectives: The surgical management and outcome of penetrating subclavian artery (SCA) injuries is presented in this article.

Design: A retrospective chart review is used to detail the management and outcome of penetrating SCA injuries.

Patients And Methods: Patients with penetrating SCA injuries presenting to the Groote Schuur Hospital from January 1997 to December 2007 were reviewed.

A three-dimensional finite element model of maximal grip loading in the human wrist.

The aim of this work was to create an anatomically accurate three-dimensional finite element model of the wrist, applying subject-specific loading and quantifying the internal load transfer through the joint during maximal grip. For three subjects, representing the anatomical variation at the wrist, loading on each digit was measured during a maximal grip strength test with simultaneous motion capture. The internal metacarpophalangeal joint load was calculated using a biomechanical model.

Endoscopic treatment of persistent thoracobiliary fistulae after penetrating liver trauma.

Background: This study evaluated the outcomes of patients with complex or persistent thoracobiliary fistulae following penetrating liver trauma, who underwent endoscopic biliary intervention at a tertiary referral centre.

Methods: All patients who underwent endoscopic retrograde cholangiography (ERC) and endoscopic biliary intervention for traumatic thoracobiliary fistulae between 1992 and 2008 were evaluated. Bile duct injuries were classified according to their biliary anatomic location on cholangiography and type of pulmonary communication.