1/79. An unusual stingray injury--the skindiver at risk.Serious abdominal injury following a stingray attack on a skindiver is described. knowledge of the creature's habits and the avoidance of swimming along the seabed are recommended as precautionary measures against such an injury.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/79. Risk to tourists posed by wild mammals in south africa.BACKGROUND: One of south africa's principal tourist attractions is the opportunity to encounter Africa's large mammals in the wild. Attacks by these mammals can be exceptionally newsworthy with potentially deleterious effects on tourism. Little is known about the risk of injury and death caused by wild mammals to visitors to south africa's nature reserves. The aim of this study was to determine the incidence of fatal and nonfatal attacks on tourists by wild mammals in south africa and to ascertain avoidable factors, if any. methods: Commercial press records covering all South African newspapers archived at the Independent newspapers' central library were systematically reviewed for a 10-year period, January 1988 to December 1997 inclusive, to identify all deaths and injuries to domestic and international tourists resulting from encounters with wild mammals in south africa. All of these incidents were analyzed to ascertain avoidable factors. RESULTS: During the review period seven tourists, including two students from thailand and a German traveler, were killed by wild mammals in south africa. Three of the four deaths ascribed to lions resulted from tourists carelessly approaching prides on foot in lion reserves. A judicial inquiry found that the management of a KwaZulu-Natal Reserve was culpable for the remaining death. Tourist ignorance of animal behavior and flagrant disregard of rules contributed to the two fatalities involving hippopotami. The unusual behavior manifested by the bull elephant responsible for the final death, resulted from discomfort caused by a dental problem to this pachyderm. During the same period there were 14 nonfatal attacks on tourists, including five by hippo, three by buffalo, two by rhino, and one each by a lion, leopard, zebra and musth elephant. Only the latter occurred while the visitor was in a motor vehicle. Tourist ethological naivete and failure to determine the experience of trail guides prior to travel, resulted in inadvertent agonistic behavior, unnecessary risk-taking and avoidable injury. CONCLUSIONS: This retrospective study has shown that attacks on tourists by wild mammals in south africa are an uncommon cause of injury and death. Sensible precautions to minimize this risk include remaining in a secure motor vehicle or adequately fenced precincts while in the vicinity of large mammals, rigidly observing nature reserve instructions, never approaching animals that appear ill, malnourished, displaying aggressive behavior traits or female wild mammals with young, and demanding adequately trained and experienced game rangers when embarking on walking trails. Any behavior that might be construed as antagonistic and which could provoke an attack by large mammals should be avoided (e.g., driving directly at a lion). Visitors need to be informed of classic signs of aggression, in particular in elephants, which will allow timely avoidance measures to be taken. The risk-enhancing effect of excessive alcohol intake is undesirable in the game reserve setting, as is driving at high speed after dusk in areas where hippos graze. Local advice on personal safety in wildlife reserves and the credentials of trail guides should be obtained from lodge or reserve management, tourism authorities or the travel industry prior to travel to game reserves.- - - - - - - - - - ranking = 0.5keywords = injury (Clic here for more details about this article) |
3/79. penis wound by scorpion sting.CONTEXT: The majority of scorpion stings are oligosymptomatic, occurring mainly on the hands and feet. Fatality is rare. CASE REPORT: A 33-year old man suffered a severe sting on his penis from a scorpion of the species Tytius trivittatus. Alcohol and salt were used without success in an effort to relieve pain. Medical assistance was sought 4 hours after the event, at which time diffuse erythema, edema and punctiform injury on the glans penis were observed, with no systemic manifestation. Intravenous meperidine was administered with immediate relief of the pain. The local signs disappeared within 48 hours, with the patient remaining asymptomatic.- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
4/79. Smitten by a kitten.Mammalian bite wounds are commonly encountered in the emergency department. When patients come early (<8 hours after injury), local infection is not usually evident. At this stage, the issue of providing prophylactic antibiotic therapy arises. We report a complication of a cat bite to the hand in a previously healthy 32-year-old man. This patient did not seek medical treatment immediately after the cat bite, and distinct local infection did not develop. Nevertheless, his course was complicated with acute staphylococcus aureus endocarditis. We discuss the common pathogens involved in a cat bite infection, including S aureus, and delineate the indications for prophylactic antibiotic therapy after a mammalian bite wound.- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
5/79. Unusual injury pattern in a case of postmortem animal depredation by a domestic German shepherd.A case is presented of a 38-year-old woman with skeletization of the head, neck, and collar region and a circumscribed 26-cm x 19-cm defect on the left chest with sole removal of the heart through the opened pericardium but undamaged mediastinum and lungs. The injuries showed V-shaped puncture wounds and superficial claw-induced scratches adjacent to the wound margins that have been described as typical for postmortem animal depredation of carnivore origin and derived from postmortem animal damage by the woman's domestic German shepherd. The circumscribed destruction of the left chest with unusual opening of the pericardium is explained by the physiognomy of the muzzle of the German shepherd and differs from previous reports. Any case presented as postmortem animal mutilation should be viewed with skepticism and undergo a full autopsy.- - - - - - - - - - ranking = 0.66674016578581keywords = injury, chest (Clic here for more details about this article) |
6/79. Sea urchin puncture resulting in PIP joint synovial arthritis: case report and MRI study.Of the 600 species of sea urchins, approximately 80 may be venomous to humans. The long spined or black sea urchin, Diadema setosum may cause damage by the breaking off of its brittle spines after they penetrate the skin. synovitis followed by arthritis may be an unusual but apparently not a rare sequel to such injury, when implantation occurs near a joint. In this case report, osseous changes were not seen by plain x-rays. magnetic resonance imaging (MRI) was used to expose the more salient features of both soft tissue and bone changes of black sea urchin puncture injury 30 months after penetration. In all likelihood, this type of injury may be more common than the existing literature at present suggests. It is believed to be the first reported case in this part of the world as well as the first MRI study describing this type of joint pathology. Local and systemic reactions to puncture injuries from sea urchin spines have been described previously. These may range from mild, local irritation lasting a few days to granuloma formation, infection and on occasions systemic illness. The sea urchin spines are composed of calcium carbonate with proteinaceous covering. The covering tends to cause immune reactions of variable presentation. There are only a handful of reported cases with sea urchin stings on record, none of them from the Red Sea. However, this condition is probably more common than is thought and can present difficulty in diagnosis. In this case report, the inflammation responded well to heat treatment, mobilization and manipulation of the joint in its post acute and chronic stages. As some subtle changes in soft tissues and the changes in bone were not seen either on plain x-rays or ultrasound scan, gadolinium-enhanced MRI was used to unveil the marked changes in the joint.- - - - - - - - - - ranking = 0.5keywords = injury (Clic here for more details about this article) |
7/79. Injuries to avian researchers at Palmer Station, Antarctica from penguins, giant petrels, and skuas.This paper describes 5 cases of injury to seabird researchers between 1996 and 1999 at Palmer Station, Antarctica. The injuries were inflicted by 3 seabird species: the Adelie penguin (Pygoscelis adeliae); the southern giant petrel (Macronectes giganteus); and the brown skua (Catharacta lonnbergi). All injured parties were biologic researchers with previous field experience working under National science Foundation research grants; all sought medical evaluation and treatment voluntarily. The nature and frequency of such injuries seems not to have been greatly reported in the medical literature. Although these cases were largely soft tissue injuries that healed without serious complications, the possibility of exotic infections is considered. We have dubbed this constellation of injuries AVES (Antarctic Vogel [German for bird] Encounter syndrome).- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
8/79. Acute renal failure after a sea anemone sting.A 27-year-old man suffering from severe swelling and pain in his right arm was referred to our hospital. He showed signs of acute renal failure (ARF) with severe dermatitis of his right arm. Three days before being admitted, he accidentally touched some kind of marine organism with his right hand while snorkeling in the Sulu Sea around Cebu Island. Within a few minutes, he was experiencing severe pain in his right hand. Then his right hand gradually became swollen. The marine creature responsible for this injury was thought to have been a sea anemone, which is a type of coelenterate. Histologic findings of a renal biopsy indicated that acute tubular necrosis (ATN) had caused ARF in this patient's case. Supportive therapies improved renal function of this patient, and steroid pulse therapy attenuated the severe skin discoloration. The ATN was thought to have been caused by the poison from a sea anemone because there were no other conceivable reasons for the patient's condition. This is the first time that a marine envenomation case has been reported in which the sting of a sea anemone has caused ATN without the failure of any other organs.- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
9/79. A stingray injury in a devotee of aquarium fishes.The stingray is one of the most dangerous fishes for man. The sting is poisonous and causes a painful wound. Fatalities are reported. Most injuries due to stingrays occur in coast regions of the tropics and subtropics. Therefore, physicians in countries with a moderate climate are less informed about the management about these kinds of injuries. The characteristics, treatment and prevention are discussed in connection with a case that occurred in belgium in a devotee of aquarium fishes.- - - - - - - - - - ranking = 0.66666666666667keywords = injury (Clic here for more details about this article) |
10/79. Pathologic features of fatal shark attacks.To examine the pattern of injuries in cases of fatal shark attack in South Australian waters, the authors examined the files of their institution for all cases of shark attack in which full autopsies had been performed over the past 25 years, from 1974 to 1998. Of the seven deaths attributed to shark attack during this period, full autopsies were performed in only two cases. In the remaining five cases, bodies either had not been found or were incomplete. Case 1 was a 27-year-old male surfer who had been attacked by a shark. At autopsy, the main areas of injury involved the right thigh, which displayed characteristic teeth marks, extensive soft tissue damage, and incision of the femoral artery. There were also incised wounds of the right wrist. Bony injury was minimal, and no shark teeth were recovered. Case 2 was a 26-year-old male diver who had been attacked by a shark. At autopsy, the main areas of injury involved the left thigh and lower leg, which displayed characteristic teeth marks, extensive soft tissue damage, and incised wounds of the femoral artery and vein. There was also soft tissue trauma to the left wrist, with transection of the radial artery and vein. Bony injury was minimal, and no shark teeth were recovered. In both cases, death resulted from exsanguination following a similar pattern of soft tissue and vascular damage to a leg and arm. This type of injury is in keeping with predator attack from underneath or behind, with the most severe injuries involving one leg. Less severe injuries to the arms may have occurred during the ensuing struggle. Reconstruction of the damaged limb in case 2 by sewing together skin, soft tissue, and muscle bundles not only revealed that no soft tissue was missing but also gave a clearer picture of the pattern of teeth marks, direction of the attack, and species of predator.- - - - - - - - - - ranking = 0.83333333333333keywords = injury (Clic here for more details about this article) |
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