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Biomedical subjects

A Leopold

Publications and source records attributed to A Leopold.

8 recordsLinked to original sources
PubMed2006

[Blast injuries of the hands. Patterns of trauma and plastic surgical treatment].

BACKGROUND: Blast injuries of the hand represent a demanding surgical emergency for the reconstructive hand surgeon. Commercially available fireworks are often regarded as less dangerous compared to combat ammunition, but the following examples demonstrate their real potential for devastating hand injuries. Some of the closed injuries can represent a pitfall for correct assessment of trauma severity. PATIENTS AND METHODS: Fifty patients who were seen after fireworks explosions from December 1995 until April 2005 were analyzed in respect to their patterns of injury and their subsequent surgical treatment. The severity was graded using the Hand Injury Severity Score (HISS). The majority of patients were injured during the New Year's day celebrations and presented with complex blast injuries due to commercially available, CE-certified fireworks. RESULTS: Depending on the size of the explosives comparable patterns of injury were seen. Larger shells led to traumatic subtotal amputations of the exposed fifth finger ray and thenar ray. Complex destructions with multiple fractures and avulsions of the midhand were also present. Smaller explosives caused multiple lacerations in the palm of the hand, subcutaneous flexor tendon ruptures, and closed fingertip fractures. DISCUSSION: Acute neurapraxias and neural compartment syndromes were clinically present. All patients (50) had to be operated primarily, and subsequent operations were necessary in 19 cases (number of operations 1-4, med. 1). In the HISS grading, 18 "minor" (HISS <20), 16 "moderate" (HISS 21-50), 7 "severe" (HISS 51-100), and 9 "major" (HISS >100) explosion injuries were present (range: 2-155, med. 47). CONCLUSION: Blast injuries of the hand need a fast, strategically planned surgical approach. This is also true for presumably harmless, CE-certified fireworks. In a multiple patient scenario, triage based on surgical urgency may be necessary. A detailed clinical examination and surgical exploration is mandatory to avoid possible pitfalls like in closed injuries. Profound skills in reconstructive and microvascular hand surgery are essential to achieve an optimal clinical outcome.

Adolescent↗
PubMed2005

Case Study Part 1: How to calculate appropriate deterministic long-term toxicity to exposure ratios (TERs) for birds and mammals.

In the European Union, first-tier assessment of the long-term risk to birds and mammals from pesticides is based on calculation of a deterministic long-term toxicity/exposure ratio (TER(lt)). The ratio is developed from generic herbivores and insectivores and applied to all species. This paper describes two case studies that implement proposed improvements to the way long-term risk is assessed. These refined methods require calculation of a TER for each of five identified phases of reproduction (phase-specific TERs) and use of adjusted No Observed Effect Levels (NOELs) to incorporate variation in species sensitivity to pesticides. They also involve progressive refinement of the exposure estimate so that it applies to particular species, rather than generic indicators, and relates spraying date to onset of reproduction. The effect of using these new methods on the assessment of risk is described. Each refinement did not necessarily alter the calculated TER value in a way that was either predictable or consistent across both case studies. However, use of adjusted NOELs always reduced TERs, and relating spraying date to onset of reproduction increased most phase-specific TERs. The case studies suggested that the current first-tier TER(lt )assessment may underestimate risk in some circumstances and that phase-specific assessments can help identify appropriate risk-reduction measures. The way in which deterministic phase-specific assessments can currently be implemented to enhance first-tier assessment is outlined.

Animals↗
PubMed2005

Case Study Part 2: Probabilistic modelling of long-term effects of pesticides on individual breeding success in birds and mammals.

Long term exposure of skylarks to a fictitious insecticide and of wood mice to a fictitious fungicide were modelled probabilistically in a Monte Carlo simulation. Within the same simulation the consequences of exposure to pesticides on reproductive success were modelled using the toxicity-exposure-linking rules developed by R.S. Bennet et al. (2005) and the interspecies extrapolation factors suggested by R. Luttik et al. (2005). We built models to reflect a range of scenarios and as a result were able to show how exposure to pesticide might alter the number of individuals engaged in any given phase of the breeding cycle at any given time and predict the numbers of new adults at the season's end.

Animals↗
PubMed2005

A new interpretation of avian and Mammalian reproduction toxicity test data in ecological risk assessment.

The long-term risks of pesticides to wildlife in the EU currently are assessed by comparing the lowest no-observed-effect concentration (NOEC) determined from the suite of endpoints measured in existing avian and mammalian laboratory reproduction tests with estimated exposure concentrations by calculating Toxicity to Exposure Ratios (TERs). Regulatory authorities experience difficulties when assessing long-term risks because of the lack of accepted methods to improve the ecological realism of exposure and toxicity estimates and understand risks at a population level. This paper describes an approach for interpreting existing avian and mammalian toxicity test data that divides breeding cycles into several discrete phases and identifies specific test endpoints as indicators of direct pesticide effects possible at each phase. Based on the distribution of breeding initiation dates for a species of concern and the dates of pesticide applications, this approach compares the phase-specific toxicity endpoint with the expected pesticide exposure levels during each of the breeding phases. The fate of each breeding attempt is determined through a series of decision points. The cumulative reproductive response of individuals in a breeding population based on this decision framework provides a means of examining the estimated risks over the course of the breeding season and deriving an overall metric of the impact of the pesticide on reproduction. Research needed to further improve the approach is discussed.

Animals↗
PubMed1988

[Skin changes in syringomyelia].

Asymmetric anonychia, skin edema, and painless ulceration of the fingers may be the first symptoms of syringomyelia. Neurologic examination of the patient leads to the diagnosis, which can be proved by the demonstration of the cavity in the central spinal cord. Prophylactic dermatologic treatment may prevent the progression of the skin lesions.

Biopsy↗