It became possible to put forward air easily.

Dr. Mathura PN * Dr. SainiO. P. *, Dr Mathura BB * Dr. Sayini PC * Dr. Gahlot LCD **

* Department of Forensic Medicine and lasix generic side effects Toxicology Tuberculosis and Chest Diseases, SP Medical College, Bikaner, Rajasthan . Department of Forensic Medicine and ** Toxicology, CMC Ludhiana, Punjab

Report on two cases, as the ceremony subcutaneous emphysema of the chest without pneumothorax or bony injury blunt chest impenetrable objects. In one case the statement was made by the accused entered the air syringe. To verify the application of air was introduced with 50 ml syringe in dead bodies subcutaneously in chest emphysema can be produced quickly. In the second case was extensive surgical emphysema without pneumothorax or bony injury of the chest. We can conclude that subcutaneous emphysema can occur without bone damage breast, and it can be obtained artificially, but it requires further validation experiments on living. Keywords: subcutaneous emphysema, trauma

39 years old, the injured man was seen by medical staff after in the government hospital with a suspected history of attacking a blunt object, the day of the incident. According to the report injury was diffuse tumor on the left side of the chest on the left forearm. X-ray report showed subcutaneous emphysema of the chest on the left side without bone damage and rib fracture ulna. The doctor received an opinion of the surgeon to know the causes of subcutaneous emphysema. The surgeon opined that subcutaneous emphysema was associated with injury and the doctor suggested that chest trauma life threatening, so serious in nature. The accused complained to the court that the honorable air injection syringe was artificially subcutaneous emphysema and requested the victim to be reviewed with the medical commission. On the order of the court Honorary Medical Board was established and a panel of three doctors examined the patient about the last 2 months. Group of doctors again advised X-ray chest, as in X-Ray reports, there was no bone injury. Medical Board advised bone scan, but no bone injury was found. Medical Board referred the case to the cardio-thoracic surgeon, who also opined that subcutaneous emphysema due to trauma. Looking for adoption ready emphysema was decided to introduce air into the syringe in dead bodies. It became possible to put forward air easily. Thus, emphysema can be done by entering the air but this should be confirmed by experiments in life. At the fifty-five sick man presented as a case of assault with a history of punch in the fall. He was placed in the surgical department. Injured was reviewed medical legitimate aim, as in the report of an injury he had abrasions on the left parietal region, left forearm below the front and back of the left shoulder from behind with subcutaneous emphysema on face neck, shoulders, upper chest. X-Ray chest is showing no bone damage, pneumothorax haemopneumothorax. Repeated X-Ray also advised, but no bone injury was seen. CT scan revealed extensive surgical emphysema from pnevmomediastinuma. However, pneumothorax or chest bone damage can be assessed in CT too. It was in referovanyh breast specialist who also opined that subcutaneous emphysema associated with trauma. Several reductions were made for the treatment of subcutaneous emphysema. Subcutaneous emphysema of the chest after blunt chest trauma in the absence of wounds or injuries bone, usually secondary to pnevmomediastinuma may occur after alveolar rupture. In this case air tracks along the implementation and maintenance of vascular tissue until it reaches the mediastinum. From the mediastinum it is in the subcutaneous tissue neck, chest and forearm. The air can be released directly into the mediastinum after tracheal, bronchial and esophageal rupture due to trauma-1 breast. In our case subcutaneous emphysema after blunt chest trauma in the absence of chest wound or bone injury shows that the subcutaneous emphysema was secondary to pnevmomediastinuma as seen on CT in case 2. If a CT scan was done, and sometimes pnevmomediastinuma can be seen on plain x-rays. In these cases there was no evidence of injury to the trachea, bronchi and esophagus. In both cases there was no pneumothorax and bone injuries. When subcutaneous emphysema hand and forearm due to the high pressure air 2 and the other part numbers because of existing puncture wound 3 hectares have been described in literature. Physical examination is sufficient to diagnose fractures of the ribs almost all conscious patients. In addition, because of difficulties in obtaining good radiographic views of all 30-50% rib fractures may be missed by radiological examination 4. Delayed films 3-6 weeks may show kallusoobrazovaniya place of fracture. Rib fractures occur in about 85% of impenetrable injury 5. Fractures cartilage is difficult to differentiate radiographically, although the films showing fractured sternum indicate the presence of associated cartilage injury, and if its not in the union or false joint developing of X-rays can be helpful. If the report does not. An X-ray examination was done again in about two and a half months, so the formation of bone callus should be obvious, or have missed destruction through poor vision in the previous radiographic films. Second, in this case, bone scans to exclude evidence of bone injury. Similarly in the second report of the CT of the chest was made also possible bone and cartilage injury. In this case, appears to be injury of the lungs, pleura, trachea, bronchi and subsequent subcutaneous emphysema of the edges of the cracks. Losses in bone or soft tissues of the chest may be mistakenly interpreted as representing thoracic disease and the most important diagnostic feature. Subcutaneous emphysema may be more apparent than primary pneumothorax. Two muscles are usually visualized. Anterior axillary fold is formed by the pectoral muscles seen curved medially and downwards from the armpit to the chest. In muscle men, big chest look like a continuation of the anterior axillary time, passing obliquely both lungs. This muscle is responsible for increased surveillance of the middle and upper lung. In the absence of this region will lead to increased transparency in the lungs and misleading impression of emphysema 7, but in both cases, the muscle was present. It seems that it is reasonable to conclude that subcutaneous emphysema can be obtained by introducing air through a syringe, but this requires confirmation by further experiments in life. Needle puncture marks can be detected by careful study, but difficult to detect, if examined after a long time, as seen on occasion 1. In all such cases, the CT / MRI should be encouraged, as is the case 2. Pseudomediastinum indicate injury can be assessed only after CT. A. Crofton and Douglas. Respiratory disease. Volume 2, 5th ed. 2000, pp1204-5. 2. Klein M, Szkrabko S, Rodriguez MJ, Payaslian S. Subcutaneous emphysema hand and forearm due to the high pressure injection of air. Medicine 2003, 63: 721-3. 3. Please BC, A. Subcutaneous emphysema noise figure over the existing puncture wound. Br J Plast Surg 1999 52: 505-6. 4. Trunkey DD. Injury management. Volume 3, New York, Theime 1986. 5. Cohn I., Hardy JD, Sayin WR, Nettervile RE. Thoracic trauma analysis of 1022 cases. J Trauma 1963 3: 22-40. 6. Vij K. Textbook of Forensic Medicine and Toxicology. 3rd ed. V. Churchill, N-Delhi, 2005. 7. PJ Morris, tree WC (editor). Oxford textbook of surgery. 2nd ed. Oxford. London, 2000. .

Prevention of bone begins with birth and ...

According to the report published in October 2004, a doctor named bone health and osteoporosis,

report of Surgeon General, an estimated 44 million men and women aged over 50 or have a low

bone mass and osteoporosis. Now about the price in the U.S. in direct medical costs of treating fractures

by osteoporosis in the range of $ 12. 2 to $ 17. 9000000000 a year in 2002 dollars. Left untamed, bone health of Americans will only get worse, mainly because of aging

population. In fact, the prevalence of osteoporosis and fractures caused by them related increase

much if the basic health of the bones of American sister greatly improved. By 2010, about

12 million people over age 50 should have osteoporosis and another 40 million have low bone mass

(National Osteoporosis Foundation, 2002). Much of this significant load can be prevented. Evidence clearly shows that people can do much to strengthen

your bone health. Prevention of bone begins with birth and lifelong problems. Choosing

engage in regular exercise, keep bones healthy diet and avoid behaviors such as smoking, that

may cause damage to bones, people can improve their bone health throughout life. You lasix 40 mg are never too old or too young to improve your bone health. For more information about bone health, osteoporosis prevention, call the Florida and educational programs

Department of Health Bureau of Family Health and Community by calling (850) 245-4455. There is also information >> << online at WWW. Ministry of Health. condition. temperature. us / family / bone / index. HTML or visit the National Osteoporosis Foundation in the WWW >>. << Nof. Surgeon General of the organization or site http://www. surgeongeneral. GOV / index. HTML

Florida Ministry of Health formed a partnership with ten (), the county health departments and concerned citizens

of osteoporosis educational programs for adults and children. In addition,

The program provides activities to inform the public of the State for distribution of educational materials and

participate in the (May) activities. Prevention of osteoporosis and curriculum educational program designed to build large >> << family foundation for a healthy lifestyle by raising awareness about the benefits of physical >> << activity, healthy eating, and not smoke and drink alcohol in order to create and maintain healthy

bones, muscles and joints throughout life. Families strengthen bones - Education for adults interactive educational program designed to teach adults to risk factors, prevention,

diagnosis and treatment of osteoporosis. Special attention is given to families to strengthen bones. You are never too young or too old to improve your bone health. Food for thought - the secondary schools use in life-size skeletons, students study the impact of food on their bodies, muscles and bones. In two parts, the program includes a segment of anorexia and bulimia. Students discuss body image, public

pressure, the importance of a balanced diet, good self-esteem and the importance of a strong >> << bones and organs, emphasizing the importance of calcium in the diet and exercise weight bearing. Set for Life - Middle School has an interactive program that focuses on the importance of physical fitness, good nutrition and prevention of osteoporosis

. The curriculum provides examples of calcium-rich foods includes three

three-dimensional models showing the muscles and organs of the human body, food diary exercise, and after

measures to enhance the experience. Bone Zone - educational program of children's interaction program designed to provide information about the health of children, osteoporosis and healthy life >>. << The program provides children with fun ways to learn about osteoporosis and what they can do now

to keep their bones healthy and prevent osteoporosis in my adult life. The program has colorful >> << displays, songs and shouts, and life-size skeleton children together one bone at a time. Prevention of osteoporosis will include both professional and public education. Department

Health is committed to providing osteoporosis education for all >> << Florida on how to build and maintain strong bones as part of lifelong health and independence

. .

Calcitonin.

Biphosphonates. This type of treatment used to stop the progress of osteoporosis >> << and even turn it back. They encourage the setting of calcium in the bones. One of them is also used when people should be on long term steroids. Strontium ranelate (Protelos or Protos) is sometimes used if bisphosphonates

can not be accepted. Calcitonin. This hormone, which used to be given, by injection, for a limited >> << for a few weeks, but now available as a nasal spray that is used in the long run. Calcium. Make sure you have enough in your diet, but your doctor may also

want you to supplements. Chewable and effervescent forms assimilated

better body than direct tablets. Vitamin D and calcium, sometimes useful, especially in >> << elderly. Fluoride is used in some countries, as it appears to increase bone mass, but

there does not seem to be conclusive evidence that it prevents fractures. Anesthesia. You may lasix without a prescription have quite painkillers (analgesics) for quite some time >> << if osteoporosis fractures. Hormone therapy is no longer recommended for treatment of osteoporosis, the risks

, thought outweigh the benefits. Your doctor may refer you to a specialist. You are likely in these tests, bone density >> << to monitor progress while in treatment. .

Next we consider the stimulation of division ...

Figure 5

.. quite large (green line) or experience exponential growth (black dotted line). If the population of cells becomes more other factors change the rate of growth, such as feedback from inflammation and tolerance mechanisms schematically in red. DOI: 10. 1371/journal. Thu. 0,009,648. g005

likely scenario will be the first autoreaktivnyh cells escape negative selection, do not feel it yourself and the environment as antigens of immature cells. This cell maturation is naive in the population where it can be stimulated by self antigen or allergen. Antigenic stimulation causes the cells multiply in a little autoreaktivnyh memory cells. These autoreaktivnyh memory cell may still require survival factors survival or rapid reproduction. If so, increased competition for survival factors can suppress this cell clone, and thus prevent the disease. Suppression autoreaktivnyh cells thus accompanied by passive depletion of the memory population. Large values ​​of attrition, and leads to more rapid loss of immunological memory. On the other hand, long-term stable population of memory should be low value of attrition, and so people with greater ranger of values ​​

will grow. Inequality in the formula. 6 defines the boundary between the suppression and the spread, which is a function of rate of infection. shows the pedagogical example. The value

, usually property environment. To clone autoreaktivnyh cells limit determines the minimum flow of infection need to suppress that clone lasix 12.5mg. For clones with large values ​​

large enough to suppress them. Similarly it is possible that all >> << value below a certain threshold can be suppressed homeostatic sources of attrition, although this is not a common feature of all niches. Conversely, if we consider the external environment, which is well characterized by a specific value, the border in the figure defines the lower limit autoreactivities we are likely to find in this environment. Low cost >> << related BЂњfilthyBЂ Wednesday ". The following subsections we approach curve data for human and mouse CD

T-cell memory to make quantitative predictions for these borders. We can find the asymptotics of passive depletion autoreaktivnyh suppression in the limit of rare infections, i. e low. Balance the total number of memory cells for a given rate of infection is given. This is simply the value

, for which the right side of the equation. 1 is equal to zero, the homeostatic balance. If we consider the case when the level of contamination is small enough that the amendment K. In this limit equation. 7 is reduced to the form obtained by Anti et al. etc.

As seen from this equation, clones with

). is zero and there is no lower limit on the ability autoreaktivnyh cells to proliferate in sterile conditions. Asymptotics of the border that divides the field stop and be present around the curve. This asymptotic behavior can be seen an inch, and that it is a common feature of homeostatic regulation. For large values ​​>> << it may not be possible to satisfy the equation. 6. This is demonstrated and discussed in the following subsections, where we model cell homeostasis in IL-15 regulated niche (CD

T-cell memory) cells and IL-7 niche (CD

and naive T cells), respectively. There we also give quantitative predictions for the speed range of antigenic stimulation. pool of memory T cells. These cells differ from effector memory, the presence of a high level of CD122 on the cell surface. CD122 protein is part of the receptor for IL-15. In the absence of IL-15 CD

memory T cells can not survive. Other cell types usually has no effect on IL-15 knockout mouse

shows that the niche is not universal and that competition between cells that niche for IL-15 should have little impact on other cell types. We also know that sterile environment memory population in this niche is stable yield. In the homeostatic equilibrium total number of cells remains constant. Since there is no homeostatic influx of new cells in this pool (

) as homeostatic division rate

ago level. With CSFE staining and other methods was noted in mice that homeostatic division rate of about once every 2BЂ "3 weeks, meaning. To distinguish whether IL-15 inhibits apoptosis and stimulates the division, consider two possible cases separately. Suppression of apoptosis is described:

is a population, the first term on the right side represents the population growth by division, and the second is reduced by apoptosis. Number. Judge et al. Memory T cells in IL-15, a saturated solution. In saturated environments might be expected, if the equation. 11 were correct description we see the proliferation rate of the population level. Instead of the population was observed twice in less than three days, excluding the equation. 11, is really a model. From this we conclude that IL-15 not only inhibit apoptosis. Next we consider the stimulation of division by IL-15, described by the equation, and increasing growth. Another experiment Judge et al. Memory T cells in IL-15 in mice. In the absence of IL-15 and stimulating antigen, Equation 12 predicts the collapse of the number of cells with speed. Observed decline was approximately 2 weeks

according to the model. This means that in first approximation, IL-15 stimulates the division. We can compare the homeostasis is expressed in the formula. 12 of our general model to obtain the asymptotic limit of the suppression that separates from the suppression of proliferation described by the equation. 6. Our previous requirement that requires that

also generally reduced. Physically, this corresponds to concentrations >> << be less than a few cells are competing for it. This gives us (in formula 6). Conditions for the suppression. Physically, this corresponds to cells that can support the number of antigenic stimulation alone (characterized by large

) and do not require homeostatic signals for survival. The condition for suppression autoreaktivnyh cells, and requires that. This asymptote is drawn explicitly >> << and occurs in areas. .

Many patients will benefit from working with ...

The importance of exercise to combat osteoporosis can not be underestimated. Lack of regular exercise can make good changes in diet have little effect on bone mass. Since the right kind of exercise in combination with other preventive measures, as appropriate calcium intake may help in the creation of bone mass, particularly at high risk of fracture sites, such as hands, hips and spine. The key here is weight bearing exercises BЂ "meaning of a person does while on his feet that works bones and muscles against gravity. Most forms of weight bearing exercises include:

Some weight lifting / resistance exercises (eg squats)

special form of exercise will depend lasix drug interactions on the general physical health personBЂ ™, the degree of bone loss, and whether the person is regularly engaged in physical activity. We recommend that people talk to your doctor about appropriate types of exercises to include in your plan of treatment of osteoporosis, especially people who have been sedentary most of his adult life or are diagnosed with low bone mass (called BЂњosteopeniaBЂ ") or osteoporosis. Some movements, like those that require twisting of the spine or bending forward from the waist (like squats or toe applicable), and most high-impact exercise may put some people at risk of fractures and should be avoided. Recommendations on frequency of exercise required to increase bone density changes. Depending on the diagnosis oneBЂ ™ and doctor-recommended activity restrictions, specific procedures for exercises that are recommended can range from:

20-30 minutes of aerobic exercise 3 to 4 times a week to

30 minutes of moderate physical activity every day, plus weight training 2 to 3 times a week. Many patients benefit from working with exercise specialist (training in exercise physiology, physical education, physical therapy, or a similar specialty) to find the correct progress of exercise, how to stretch and strengthen muscles safely, and how to correct bad habits posture. This is especially true for those of advanced osteoporosis (facing the highest risk of fractures) and those who are beginning a new exercise program. Implementation of a specialist should be familiar with the special needs of people with osteoporosis. .

Common causes of .

Subcutaneous emphysema subcutaneous emphysema (SCE) refers to under the skin. It exists in a layer of the skin subcutaneously. The status is also sometimes referred to as tissue. Subcutaneous emphysema Alternative names: crepitus, subcutaneous air, tissue >> << Definition ... Subcutaneous emphysema can often be seen as a smooth bulging of the skin. When health care provider feels (palpates) the skin, it produces an unusual crackling buy lasix sensation as the gas is pushed through the fabric. Common causes of ... Subcutaneous emphysema perforation of the esophagus (hollow, muscular tube used in swallowing), trachea (windpipe), or large blood vessels of the heart - a rare ... Subcutaneous emphysema swallowing pain or burning ... The air under the skin (subcutaneous emphysema drainage from the tissues, stinking brown-red or bloody fluid (

Increased heart rate (moderate to high ... Early complications associated with surgical procedures and insertion traheostomycheskoy tubes include infection ,

(), and leakage of air into the breast tissue or neck (

subcutaneous emphysema). Although mediastinal or subcutaneous emphysema usually passes spontaneously

may need special treatment to remove. air and reinflate the lungs Complications include bleeding, subcutaneous emphysema

, and various commercial products allow quick surgical access to the ring area and provide pipe that allows an adequate oxygenation and ventilation - air .. is caught in a trap in the pleural space causing a slight subcutaneous emphysema - air under skin ... Mattox KL, Allen K. A systematic approach, hemotoraks,

, and subcutaneous emphysema .. September 1986, 17 (5) :309-12 [Medline ..]. conditions that cause swelling of the face, including possible medical causes of disease ... eye swelling face .. burns. Subcutaneous emphysema, ... Full article ... if it led to the penetration of air into the subcutaneous tissue neck and chest, prognosis depends mainly on the disease, in which run into difficulties.

presence of subcutaneous emphysema is ... can lead to sudden pain in the side of the lungs and shortness of breath. condition can also put pressure on the lungs and cause it. Subcutaneous emphysema (sub-ku-TA-no-la We-Fi-SE-ma). These cocaine will complain of sharp, often worse with deep breathing is difficult or pain when swallowing, and the air under the skin in the neck that feels like Rice Krispies under the skin when touched (

subcutaneous emphysema). P2 receptors purynerhichni, Children's Hospital, Perry, Postinfectious, bleomitsyn B (2), refraction, eye, sabeus, Cercopithecus, Sak, yolk, division, immunomahnitnyh Cell, spectrometry, Gamma,

subcutaneous emphysema of ... See also:,,,,

Women are much more prone to this disease

Skeletal structure of the body is very important for the conservation and of the human body. Without these important structures, people can not move and even think and enjoy many fun life. Thus, any defects or irregularities in the structure of the human skeleton can cause disability, pain, injury and sometimes death. One such disease is osteoporosis or disease that makes bones fragile and very weak, which makes them overly prone to breakage and fracture. Strength and bone density in osteoporosis caused also becomes easier, which makes them easy to break as glass. This disease affects any type of bone, but it is more common along the spine and hip bones. Women are much more prone to this disease than men, because of the fact that, when reached menopause, estrogen production - a key hormone that makes bones absorb minerals like calcium properly - stop. Causes Because osteoporosis affects women much more than the opposite sex, sex is one of the possible causes of the disease. Other causes are prolonged use of steroids, patients who have had their uterus or cervix removed (hysterectomy), genetic predisposition, especially if both parents have the disease of bone, advanced age, sedentary lifestyle, excessive smoking and drinking, and lack of testosterone levels in men lasix drug reactions. Unfortunately, the disease attacks silently skeletal system, as bone weakness does not show any serious symptoms until the patient does not feel related to osteoporosis fractures. However, patients should visit a doctor if they experience the following - sudden back pain, reduced growth and curvature of the spine kyphosis is due to bone damage. When a person suffers from osteoporosis, the bones of this man became so fragile that even a small sneeze can cause serious fractures. There are many diseases that currently have no definitive treatment and, unfortunately, osteoporosis is one of them. Although no treatment that can restore lost bone density does not exist, there are many drugs and treatments for those causes of osteoporosis. Examples of such procedures are those with biphosphonates, which may help keep calcium minerals in the bones of the skeleton, causing the patient more resistant to bone loss and bone density breakage. For men who have low level of testosterone, they can be injected with these hormones to help them get bone strength and reduce the chances of getting fractures. Therapy that replaces the female hormones given to patients with osteoporosis. In the long-term hormone replacement therapy or HRT can prevent lower bone density. In patients with osteoporosis fractures, can be given painkillers to relieve pain associated with injuries. This disease, though not completely curable, can be easily prevented. The way to stop the advance of osteoporosis should eat foods and drink beverages that are rich in calcium minerals and vitamins D - the substance that makes bones absorb the necessary amount of calcium. If these minerals and vitamins that are not available due to natural sources, additives recommended. Since the disease does not show any serious symptoms, undergo tests that measure bone density is recommended for those at least 50 to 60 years and above as older bone is generally weaker. Maintaining a healthy and active lifestyle can also help reduce the risk of osteoporosis. Doing exercise can make bones more resistant to damage and subsequent damage. To avoid breakage of bones, avoid lifting heavy objects as this can lead to injuries weak skeletal system. In addition, smoking and drinking habits should be limited, as these items are always risk factors for many types of diseases. .