Academic literature on the topic 'The last injury'
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Journal articles on the topic "The last injury"
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Delahunt, Charles B., Pedro D. Maia, and J. Nathan Kutz. "Built to Last: Functional and Structural Mechanisms in the Moth Olfactory Network Mitigate Effects of Neural Injury." Brain Sciences 11, no. 4 (2021): 462. http://dx.doi.org/10.3390/brainsci11040462.
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Most organisms suffer neuronal damage throughout their lives, which can impair performance of core behaviors. Their neural circuits need to maintain function despite injury, which in particular requires preserving key system outputs. In this work, we explore whether and how certain structural and functional neuronal network motifs act as injury mitigation mechanisms. Specifically, we examine how (i) Hebbian learning, (ii) high levels of noise, and (iii) parallel inhibitory and excitatory connections contribute to the robustness of the olfactory system in the Manduca sexta moth. We simulate injuries on a detailed computational model of the moth olfactory network calibrated to data. The injuries are modeled on focal axonal swellings, a ubiquitous form of axonal pathology observed in traumatic brain injuries and other brain disorders. Axonal swellings effectively compromise spike train propagation along the axon, reducing the effective neural firing rate delivered to downstream neurons. All three of the network motifs examined significantly mitigate the effects of injury on readout neurons, either by reducing injury’s impact on readout neuron responses or by restoring these responses to pre-injury levels. These motifs may thus be partially explained by their value as adaptive mechanisms to minimize the functional effects of neural injury. More generally, robustness to injury is a vital design principle to consider when analyzing neural systems.
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Carrotte, Peter. "When Did Your Practice Last Have a Needle-Stick Injury?" Dental Update 28, no. 10 (2001): 514. http://dx.doi.org/10.12968/denu.2001.28.10.514a.
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Kawamata, Tatsuro, and Yoichi Katayama. "Management of Severe Head Injury : Changes in the Last Decade." Japanese Journal of Neurosurgery 15, no. 7 (2006): 491–97. http://dx.doi.org/10.7887/jcns.15.491.
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Sethi, Sidharth K., Timothy Bunchman, Ronith Chakraborty, and Rupesh Raina. "Pediatric acute kidney injury: new advances in the last decade." Kidney Research and Clinical Practice 40, no. 1 (2021): 40–51. http://dx.doi.org/10.23876/j.krcp.20.074.
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Houston, Megan N., Johanna M. Hoch, Bonnie L. Van Lunen, and Matthew C. Hoch. "The Impact of Injury on Health-Related Quality of Life in College Athletes." Journal of Sport Rehabilitation 26, no. 5 (2017): 365–75. http://dx.doi.org/10.1123/jsr.2016-0011.
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Context:Health-related quality of life (HRQOL) is a broad term for the impact of injury or illness on physical, psychological, and social health dimensions. Injury has been associated with decreased HRQOL in athletes. However, the influence of injury history, participation status, time since last injury, and injury severity on HRQOL remains unclear.Objective:To compare HRQOL in collegiate athletes based on injury history, participation status, time since last injury, and injury severity and to examine relationships between HRQOL outcomes.Design:Cross-sectional.Setting:3 National Collegiate Athletic Association (NCAA) institutions.Participants:467 collegiate athletes (199 males, 268 females; 19.5 ± 1.3 y, 173.9 ± 10.5 cm, 71.9 ± 13.6 kg) were recruited from NCAA Division I (n = 299) and Division III (n = 168) institutions. Athletes were included regardless of participation status, which created a diverse sample of current and past injury histories.Main Outcome Measures:During a single session, participants completed an injury history form, the Disablement in the Physically Active Scale (DPA), and the Fear-Avoidance Beliefs Questionnaire (FABQ). Dependent variables included DPA-Physical Summary Component (DPA-PSC), DPA-Mental Summary Component (DPA-MSC), and FABQ Scores.Results:HRQOL differences were detected between groups based on injury history, participation status, and time since last injury. No differences were detected for injury severity. A moderate correlation was identified between the DPA-PSC and FABQ (rs = 0.503, P < .001) and a weak relationship was identified between the DPA-MSC and FABQ (rs = 0.266, P < .001).Conclusions:Injury negatively influenced HRQOL in athletes with a current injury. While those individuals participating injured reported better HRQOL than the athletes sidelined due to injury, deficits were still present and should be monitored to ensure a complete recovery. Identifying the patient’s perception of impairment will help facilitate evidencebased treatment and rehabilitation strategies that target the physical and psychosocial aspects of health.
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Agarwal, P. "Thermal injury in pregnancy: predicting maternal and fetal outcome." Indian Journal of Plastic Surgery 38, no. 02 (2005): 95–99. http://dx.doi.org/10.4103/0970-0358.19774.
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ABSTRACTThis study was undertaken to assess the parameters that may predict maternal and foetal outcome in 49 thermally injured pregnant women in a Plastic surgery unit in tertiary referral center in the last five years. There were 33 maternal deaths and 34 fetal deaths. In general, pregnancy as such does not influence maternal outcome after thermal injury. In first and second trimester best chance for foetal survival is to ensure maternal survival and in the last trimester fetal survival depends upon fetal maturity. Maternal survival is less likely if the burn wound exceeds 50% total body surface area. Thermal injury does increase the risk of spontaneous abortion and premature labour. Early obstetric intervention is indicated in patients with fatal burn and complications.
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Pujol, Nicolas, Marie Philippe Rousseaux Blanchi, and Pierre Chambat. "The Incidence of Anterior Cruciate Ligament Injuries among Competitive Alpine Skiers." American Journal of Sports Medicine 35, no. 7 (2007): 1070–74. http://dx.doi.org/10.1177/0363546507301083.
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Background Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design Descriptive epidemiology study. Methods Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.
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Lau, Simon C. P., Nathan G. Myhill, Rekha Ganeshalingam, and Gerald M. Y. Quan. "Cervical Spinal Cord Injury at the Victorian Spinal Cord Injury Service: Epidemiology of the Last Decade." Clinical Medicine Insights: Trauma and Intensive Medicine 5 (January 2014): CMTIM.S12939. http://dx.doi.org/10.4137/cmtim.s12939.
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Introduction Cervical spinal cord injury (CSCI) is a significant medical and socioeconomic problem. In Victoria, Australia, there has been limited research into the incidence of CSCI. The Austin Hospital's Victorian Spinal Cord Injury Service (VSCIS) is a tertiary referral hospital that accepts referrals for surgical management and ongoing neurological rehabilitation for south eastern Australia. The aim of this study was to characterise the epidemiology of CSCI managed operatively at the VSCIS over the last decade, in order to help fashion public health campaigns. Methods This was a retrospective review of medical records from January 2000 to December 2009 of all patients who underwent surgical management of acute CSCI in the VSCIS catchment region. Patients treated non-operatively were excluded. Outcome measures included: demographics, mechanism of injury and associated factors (like alcohol) and patient neurological status. Results Men were much more likely to have CSCI than women, with a 4:1 ratio, and the highest incidence of CSCI for men was in their 20s (39%). The most common cause of CSCI was transport related (52%), followed by falls (23%) and water-related incidents (16%). Falls were more prevalent among those >50 years. Alcohol was associated in 22% of all CSCIs, including 42% of water-related injuries. Discussion Our retrospective epidemiological study identified at-risk groups presenting to our spinal injury service. Young males in their 20s were associated with an increased risk of transport-related accidents, water-related incidents in the summer months and accidents associated with alcohol. Another high risk group were men >50 years who suffer falls, both from standing and from greater heights. Public awareness campaigns should target these groups to lower incidence of CSCI.
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Chowdhury, Md Shahabul Huda, Md Nazmul Karim, Md Ridwanur Rahman, Md Abul Faiz, Farhana Ahmed, and Shahjada Selim. "An epidemiological study of injury in a rural community in Bangladesh." Bangladesh Medical Research Council Bulletin 41, no. 1 (2016): 46–51. http://dx.doi.org/10.3329/bmrcb.v41i1.30318.
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Injuries are a focus of public health practice because they pose a serious health threat, occur frequently and are preventable. The evidence regarding injury, its contributing factor and its consequence in rural population of Bangladesh is scarce. Present study aimed to assess the epidemiology of injury in a rural area. The study was conducted in the Bairag Union of Anwara upazilla in Chittagong district of Bangladesh. Data of 6256 individuals were collected from 1016 households. Three structured and standardized questionnaires were used for data collection. The questionnaires were pretested and validated prior to final survey. Severity of injury was assessed based on the number of days with restricted activity and consequences of injury were considered as a measure of severity of injury. A total of 6 people died due to injury in last one year in the survey, the death tolls to 0.096% (95% CI 0.037%-0.199%). A total of 392 experienced an injury that at least hampered one days routine activity. Crude prevalence of injury over last one year is calculated to be 6.27% (95% CI 5.69%-6.89%). Of injured subjects majority (77.2%) were aged between 10 to 59 years, 73% were male, 55.6% were of lower class and among them 7.9 % suffered multiple injuries. More than 80% of the incident leading to injury happened during the day, (8 am to 6 pm). Daytime injury mostly occurs in afternoon. The mechanism of injury of 30% subjects were road accident, of 29.5% subjects was slip, trip or fall. In 17.9 % victims mechanism of injury was collision with a person or object. Around 10% had deep cut, 1.4% had superficial cut, and 3.3 % patient had burn through contact with heat. Among the injured only 19.2% escaped any physical consequence, 27.2% suffered from decrease in work capacity, 48.1% developed temporary disability, 3.8% developed permanent disability, and 1.2% suffered disfiguration.
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Miller, John. "Trends in Personal Injury Litigation: the 1990s." Victoria University of Wellington Law Review 34, no. 2 (2003): 407. http://dx.doi.org/10.26686/vuwlr.v34i2.5782.
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Just as Accident Compensation did not exist in a political or social vacuum, it also did not exist in a legal vacuum. One of the remarkable features of the last decade has been the resurgence of personal injury actions, partially as a response to the scheme being perceived as less generous. John Miller details case law development over the last decade or so.
Dissertations / Theses on the topic "The last injury"
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Papassoni, João Paulo. "Uma perpétua lida: estudo sobre A derradeira injúria, de Machado de Assis." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/8/8149/tde-13082018-181212/.
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A dissertação faz um estudo que contempla pesquisa e análise do conjunto de sonetos intitulado A derradeira injúria, composto por Machado de Assis para o livro O Marquês de Pombal: obra comemorativa do centenário da sua morte, publicado em 1885 e editado pelo Club de Regatas Guanabarense. A partir da pesquisa, foi possível resgatar registros e dados sobre a publicação, bem como o contexto social e cultural em que o poema foi escrito. A partir da análise, procurou-se compreender questões formais e interpretativas relativas à poesia que ilustram não apenas essa peça literária específica, como também se relaciona a questões abrangentes e pertinentes à obra poética machadiana.<br>The dissertation makes a study that includes research and analysis of the set of sonnets entitled A derradeira injúria, composed by Machado de Assis for the book O Marquês de Pombal: obra comemorativa do centenário da sua morte, published in 1885 and edited by the Club de Regatas Guanabarense. From the research, it was possible to retrieve records and data about the publication, as well as the social and cultural context in which the poem was written. From the analysis, it sought to understand formal and interpretative questions related to poetry that illustrate not only this specific literary piece, but also relates to comprehensive questions pertinent to Machado\'s poetic work.
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Ma, Feifei. "Dual role of matrix metalloproteinases in brain injury and neurorepair after cerebral ischemia." Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/377444.
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L'ictus isquèmic és una de les principals causes de mortalitat, discapacitat de llarg termini i de morbiditat al món. Actualment, els únics tractaments eficaços són el tractament trombolític intravenós amb activador del plasminogen tissular (tPA) i les novedoses trombectomies intra-arterials, que requereixen ser administrades en la fase hiperaguda de la malaltia (<4,5 hores per al tractament amb tPA i <6 hores per les emergents la teràpies endovasculars). Per tant, és necessari investigar noves teràpies que podrien ser utilitzades per tractar un gran nombre de pacients en una fase posterior de la malaltia per reparar el teixit danyat. Alguns enfocaments terapèutics apunten que per assolir aquest objectiu és necessari potenciar la remodelació vascular i la neurogènesi en el cervell isquèmic.
L'objectiu d'aquesta tesi és l'estudi de la modulació de la metaloproteinasa de matriu-13 (MMP-13) en la neurorreparación i el d’investigar diverses MMPs com a biomarcadors que serveixin per monitoritzar la millora de la funció motora durant la teràpia neuro-rehabilitadora. Utilitzant un model d’isquèmia cerebral per oclusió de l’arteria cerebral mitja en ratolins, es va trobar que expressió de la MMP-13 està implicada en el dany i en mecanismes de reparació post-isquèmia. Després de la isquèmia-reperfusió, la deficiència en MMP-13 redueix la mida de l'infart, millora l’estatus funcional en la fase més aguda i protegeix de l’aparició de transformacions hemorràgiques, però interfereix negativament en la recuperació del teixit cortical mitjançant la reducció en la migració neuroblast en proliferació, en el remodelat vascular i en un microambient amb factors tròfics reduïts. Al mateix temps les cèl·lules endotelials progenitores amb un silenciament transitori de l’expressió de MMP-13 presenten una funció aberrant en assajos de tubulogènesis, in vitro.
Com que la deficiència de MMP-13 protegia del dany cerebral en el model animal d’isquèmia al temps que participava en la recuperació del teixit en fases de reparació, aquesta tesi també estudia el perfil temporal dels nivells plasmàtics de MMP-3, MMP-12 i MMP-13 durant la teràpia neuro-rehabilitadora per investigar el seu paper com a potencials biomarcadors del teixit en recuperació. Els nostres resultats mostren que alts nivells de plasma MMP-13, així com MMP-12, estan fortament associats amb la severitat i extensió de la isquèmia, però no els de MMP-3. Curiosament, els pacients amb un millor status en la funció motora durant la rehabilitació presenten els nivells més elevats de MMP-3 i reduïts de MMP-12 / -13. També, els valors de MMP-3 estan estretament associats amb la millor recuperació motora després de l'accident cerebrovascular, el que indica el seu potencial com a biomarcador de la millora en la funció motora. Aquests resultats són importants per imaginar el futur ús d'un biomarcador per tal de poder ajustar, personalitzar i modular teràpies de neuro-rehabilitació d'acord a les necessitats dels pacients.
En conclusió aquesta tesi mostra el paper de les MMPs en el dany i reparació de teixits després de l'ictus isquèmic i ressalta la importància de monitoritzar i modular aquestes proteases en favor de la recuperació dels pacients.<br>Ischemic stroke is a leading cause of mortality, long-time disability and morbidity in the world. Currently, the only effective treatments are the intravenous thrombolytic therapy with tissue plasminogen activator (tPA) and the new emerging intra-arterial thrombectomies, which require to be administered in the hyperacute phase of stroke (<4.5 hours for tPA treatment and <6 hours for endovascular therapy). Therefore, it is necessary to investigate new therapies that could be used to treat a large number of patients in a later phase to repair and rewire the damaged tissue. One approach to achieve these objectives is to enhance vascular remodeling and neurogenesis in the ischemic brain.
The aim of this thesis is to study the modulation of extracellular matrix metalloproteinase-13 (MMP-13) in brain injury and neurorepair and to investigate several MMPs as serving biomarkers to monitor motor and functional improvement during neurorehabilitation therapy.
Using a distal middle cerebral artery occlusion model of ischemia in mice, we found that the modulation of MMP-13 is involved in ischemic damage and repair mechanisms. After ischemia-reperfusion, MMP-13 deficiency reduces infarct size, improves functional outcome and protects from hemorrhagic transformation, but impairs cortical tissue recovery by reducing proliferating neuroblast migration and vessel remodelling in a microenvironment with reduced trophic factors. At the same time MMP-13-silenced endothelial progenitor cells present an aberrant in vitro tubulogenesis function.
As MMP-13 deficiency protects brain injury acutely and participates in post-stroke tissue recovery, this thesis also studies the temporal profile of plasma MMP-3, MMP-12 and MMP-13 during rehabilitation therapy to investigate their potential role as biomarkers of tissue recovery. Our results show that high levels of plasma MMP-13, as well as MMP-12, are strongly associated with stroke severity acutely, but not MMP-3. Interestingly, those patients with a better motor outcome during rehabilitation present elevated MMP-3 and decreased MMP-12/-13 levels. MMP-3 is closely associated with the better post-stroke motor recovery, indicating the potential as a biomarker of final functional improvement. These are important results that envision the use of biomarkers that could help to adjust, personalize and modulate neurorehabilitation therapies according to patients’ needs.
In conclusion this thesis shows the role of MMPs in tissue injury and repair after stroke and the importance to monitor and modulate these proteases in favor of patients’ recovery.
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Castro, González Lidia. "Estudio de las subunidades reguladas por SUR1 (Kir6.2 y TRPM4) en las contusiones cerebrales traumáticas y la isquemia cerebral focal. Desarrollo de un modelo animal de infarto maligno en cerdo." Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/668009.
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El traumatismo craneoencefálico (TCE) tiene un gran impacto socio-económico y sanitario en todo el mundo, y es una de las principales causas de mortalidad y discapacidad entre la población adulta menor de 40 años. El infarto cerebral maligno, es un tipo de infarto cerebral isquémico, que tiene una mortalidad de alrededor del 80%, y su incidencia aumenta con la edad del paciente. Ambas patologías se caracterizan porque su evolución puede provocar graves desequilibrios iónicos a nivel de las neuronas y de las células gliales, con el consecuente arrastre osmótico de agua y la formación de edema citotóxico. El edema puede evolucionar provocando un efecto de masa que causa la compresión, deformación y herniación de las estructuras cerebrales, pudiendo provocar la muerte del paciente, debido entre otras cosas al aumento de la presión intracraneal (PIC). Los TCEs y los infartos malignos se abordan siguiendo las mismas estrategias de tratamiento, que pasan por el seguimiento de la evolución de la lesión, la monitorización multimodal del paciente, y en último caso su intervención quirúrgica.
Entender los procesos implicados en la patofisiología del TCE y del infarto, es esencial para su correcto tratamiento. Muchos de los estudios actuales, dirigen su atención a los mecanismos implicados en la formación del edema citotóxico inicial, y en concreto al estudio de un nuevo canal iónico involucrado en su progresión. Este canal está formado por una subunidad reguladora que recibe el nombre de receptor de sulfonilurea 1 (SUR1) y una subunidad formadora de poro, el receptor de potencial transitorio de la melastatina 4 (TRPM4). Juntos constituyen el canal SUR1-TRPM4, que ha demostrado estar sobre-expresado en pacientes y modelos animales de TCE e infarto cerebral, entre otras patologías. El bloqueo de este canal con fármacos como la glibenclamida (un inhibidor de sulfonilureas), ha demostrado mejorar el pronóstico neurológico en modelos animales de roedores y estudios clínicos con pacientes. La subunidad reguladora SUR1, además de asociarse con TRPM4, también regula la apertura de canales de potasio dependientes de adenosín trifosfato (ATP)(KATPs), entre los que se encuentra el canal iónico rectificador de entrada de potasio 6.2 (Kir6.2). El canal SUR1-Kir6.2 ha sido estudiado ampliamente en células del páncreas y cardiomiocitos, entre otros. Sin embargo, la expresión de este canal no ha sido estudiada en profundidad a nivel cerebral en humanos. Este canal acopla el metabolismo de la célula a la actividad eléctrica, mediante la regulación del flujo de K+ a través de la membrana celular. Se considera que tiene una función neuroprotectora, induciendo la hiperpolarización celular durante episodios de hipoxia y/o isquemia.
Lo que esta tesis pretende es, en primer lugar, el desarrollo de un nuevo modelo animal de isquemia regional en cerdo común, que sea estable y reproducible. Este modelo permitirá una mejor comprensión de los procesos isquémicos que tienen lugar en pacientes que han sufrido un infarto cerebral maligno, para poder extrapolarlos en un segundo paso a las lesiones cerebrales traumáticas. El uso de modelos animales es esencial para conseguir una mejor comprensión de los mecanismos implicados en cualquier patología, así como para poder desarrollar nuevas estrategias protectoras contra esta. En segundo lugar, se pretende profundizar en el estudio de los canales regulados por SUR1, en concreto Kir6.2, el menos estudiado a nivel del SNC en humanos hasta la fecha. Para ello, se estudió su expresión en tejido pericontusional cerebral de humanos con la pretensión de conocer mejor su función en este tipo de patologías.<br>Traumatic brain injury (TBI) has a great socio-economic and sanitary impact in the whole world and is one of the leading causes of mortality and disability in adult population with less than 40 years. Malignant cerebral infarction is a type of ischemic cerebral infarct that has an elevated mortality of around 80%, and its incidence increases with the age of the patient. The evolution of both pathologies can lead to severe ionic disarrangements in neurons and glial cells, osmotic water displacement and cytotoxic edema formation. Edema can evolve causing a mass effect that leads to compression, deformation and herniation of the cerebral structures that can result in patient’s death, due to the increase of the intracranial pressure (ICP), among other causes. TBIs and malignant infarcts are treated following the same strategies, which are the monitoring of lesion evolution, multimodal monitoring of the patient and as a last resort, surgical intervention.
Understanding the processes involved in the pathophysiology of the TBI and cerebral infarct, is essential for their correct treatment. Many of the current studies, focus their attention on the mechanisms involved in the formation of the initial cytotoxic edema and specially, in the study of a new ionic channel that is related to the progression of the edema. This channel is constituted by a regulator subunit named sulfonylurea receptor 1 (SUR1) and a pore forming subunit called transient receptor potential melastatin 4 (TRPM4). Both subunits together form the channel SUR1-TRPM4 that is overexpressed in patients and in animal models of TBI and cerebral infarct, among other pathologies. The blockage of this channel with drugs like glibenclamide (an inhibitor of sulfonylureas), has demonstrated to improve neurological outcome in rodent animal models and also in clinical assays with patients. Regulator subunit SUR1 is not only associated to TRPM4, but also regulates the opening of adenosine phosphate (ATP)-sensitive potassium channels (KATPs), which include the inwardly rectifier potassium ion channel 6.2 (Kir6.2). The channel SUR1-Kir6.2 has been well studied in pancreatic and cardiac cells, among others. However, the expression of this channel has not been deeply studied in the human brain. This channel couples cell metabolism to electric activity, regulating the K+ flux through the cell membrane. It is considered that it has a neuroprotective function, inducing the cell hyperpolarization during hypoxic and/or ischemic episodes.
The aim of this doctoral thesis is, first of all, the development of a new animal model of regional ischemia in common pig, stable and reproducible. This model will allow a better understanding of the ischemic processes that occur in patients with a malignant cerebral infarction, to extrapolate it in second place to traumatic brain lesions. The use of animal models is essential to achieve a better understanding of the mechanisms involved in any pathology, and to develop new treatment strategies. The aim of the second part of this thesis was to study in detail the channels regulated by SUR1, and especially Kir6.2 channel, the less studied in human brain to the date. For this purpose, Kir6.2 expression was studied in human pericontusional brain tissue, with the aim to achieve a better understanding of its function in this kind of pathologies.
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Alabau, Rodríguez Sergi. "Relación entre las contracturas glenohumerales y la funcionalidad en pacientes afectos de parálisis braquial obstétrica." Doctoral thesis, Universitat Autònoma de Barcelona, 2020. http://hdl.handle.net/10803/670323.
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La paràlisi braquial obstètrica (PBO) és una patologia prevalent i amb grans repercussions funcionals en la qualitat de vida dels nens afectats. La pèrdua de la mobilitat de l'articulació glenohumeral que pateixen aquests pacients es deu a la combinació de la lesió nerviosa inicial, al desenvolupament anormal de la musculatura i a un patró de moviment restringit, compensat per l'articulació escapulotorácica en la majoria de pacients. I tot això tradueix a l'aparició de contractures articulars glenohumerales en la majoria dels pacients, tant operats com no operats, fins i tot en aquells amb recuperació motora completa. Per això, la prevenció de la contractura glenohumeral és un dels pilars fonamentals en el tractament de la PBO.
La majoria d'autors fa referència a l'aparició de contractures de l'espatlla en rotació interna. En canvi, molt pocs autors han estudiat les contractures glenohumerales en adducció, abducció i rotació externa. A més, no hi ha sèries publicades que avaluïn la prevalença ni que caracteritzin la deformitat de les contractures, el grau d'afectació ni la seva repercussió funcional. Un altre problema que es presenta a l'estudiar les contractures glenohumerales és el mètode de medició, obtenint-se una gran variabilitat en els resultats. A més, no existeix un mètode fàcil i reproduïble que permeti determinar la mobilitat activa i passiva de l'articulació glenohumeral independentment de l'escapulotoràcica.
En aquesta tesi doctoral s'ha avaluat, en una població de més de dos-cents pacients afectats de PBO, la prevalença de contractures articulars glenohumerales en adducció, abducció i rotació externa, evidenciant que són molt freqüents en la majoria dels pacients, fins i tot apareixent de forma combinada (contractures multidireccionals). Per realitzar totes les medicions del balanç articular glenohumeral s'ha descrit un nou mètode de mediciót, utilitzant l'espina escapular com a referència durant l'exploració clínica en la consulta externa. Es tracta d'un mètode fàcil, reproduïble i econòmic que permet objectivar la disfunció glenohumeral independentment de l'escapulotoràcica. Per validar la seva utilitat, s'ha realitzat un estudi de variabilitat intra i interobservador en una subpoblació de vint i cinc pacients amb PBO que ha mostrat una excel·lent fiabilitat de la tècnica de medició. A més s'ha caracteritzat cada contractura i s'ha detallat per primera vegada el valor mitjà i la desviació estàndard de la mobilitat glenohumeral per a cada tipus de contractura. Finalment, s'han realitzat estudis comparatius de cada tipus de contractura amb la funcionalitat de l'extremitat mitjançant l'escala de Mallet modificada, evidenciant que les contractures glenohumerales inferiors generen una important limitació en l'abducció activa (abduction lag) i passiva de l'espatlla; les posteriors provoquen una limitació de la rotació interna de l'espatlla i, com a conseqüència, una limitació cap a la línia mitja; mentre que les contractures superiors no provoquen una limitació funcional tant important, tot i que poden provocar un problema estètic. Totes aquestes troballes ajuden a comprendre millor les seqüeles funcionals dels pacients amb PBO i, en definitiva, a millorar el seu tractament, tant a nivell quirúrgic com rehabilitador.<br>La parálisis braquial obstétrica (PBO) es una patología prevalente y con grandes repercusiones funcionales en la calidad de vida de los niños afectados. La pérdida de la movilidad de la articulación glenohumeral que padecen los pacientes se debe a la combinación de la lesión nerviosa inicial, al desarrollo anormal de la musculatura y a un patrón de movimiento restringido, compensado por la articulación escapulotorácica en la mayoría de los pacientes. Y todo traduce a la aparición de contracturas articulares glenohumerales en la mayoría de los pacientes, tanto operados cómo no operados, incluso en aquellos con recuperación motora completa. Por esto, la prevención de la contractura glenohumeral es uno de los pilares fundamentales en el tratamiento de la PBO.
La mayoría de autores hace referencia a la aparición de contracturas del hombro en rotación interna. En cambio, muy pocos autores han estudiado las contracturas glenohumerales en aducción, abducción y rotación externa. Además, no existen series publicadas que evalúen la prevalencia ni que caractericen la deformidad de las contracturas, el grado de afectación ni su repercusión funcional. Otro problema que se presenta al estudiar las contracturas glenohumerales es el método de medición, existiendo una alta variabilidad en los resultados obtenidos. Además, no existe un método fácil y reproducible que permita determinar la movilidad activa y pasiva de la articulación glenohumeral independientemente de la escapulotorácica.
En esta tesis doctoral se ha evaluado, en una población de mas de dos-cientos pacientes afectados de PBO, la prevalencia de contracturas articulares glenohumerales en aducción, abducción y rotación externa, evidenciándose que son muy frecuentes en la mayoría de los pacientes, incluso apareciendo de forma combinada (contracturas multidireccionales). Para realizar todas las mediciones del balance articular glenohumeral se ha descrito un nuevo método de medición, utilizando la espina escapular cómo referencia durante la exploración clínica en la consulta externa. Se trata de un método fácil, reproducible y económico que permite objetivar la disfunción glenohumeral independientemente de la escapulotorácica. Para validar su utilidad, se ha realizado un estudio de variabilidad intra e interobservador en una subpoblación de veinticinco pacientes con PBO que ha mostrado una excelente fiabilidad de la técnica de medición. Además se ha caracterizado cada contractura y se ha detallado por primera vez el valor promedio y la desviación estándar del rango de movilidad glenohumeral para cada tipo de contractura. Por último, se han realizado estudios comparativos de cada tipo de contractura con la funcionalidad de la extremidad mediante la escala de Mallet modificada, evidenciando que las contracturas glenohumerales inferiores generan una importante limitación en la abducción activa (abduction lag) y pasiva del hombro; las posteriores provocan una limitación de la rotación interna del hombro y, como consecuencia, una limitación hacia la línea media; mientras que las contracturas superiores no provocan una importante limitación funcional importante, aunque pueden provocar un problema estético. Todos estos hallazgos ayudan a comprender mejor las secuelas funcionales de los pacientes con PBO y, en definitiva, a mejorar su tratamiento, tanto a nivel quirúrgico cómo rehabilitador.<br>Neonatal brachial plexus injury (NBPI) is a prevalent pathology with great functional repercussions on the quality of life of affected children. The loss of mobility of the glenohumeral joint suffered by these patients is due to the combination of the initial nerve injury, the abnormal development of the musculature and a restricted movement pattern, compensated by the scapulothoracic joint in most patients. All these changes translate into the appearance of glenohumeral joint contractures in most patients, both operated and non-operated, even in those with complete motor recovery. For this reason, the prevention of GH contracture is one of the fundamental pillars in the treatment of PBO.
Most authors refer to the appearance of internally rotating shoulder contractures. In contrast, very few authors have studied glenohumeral contractures in adduction, abduction, and external rotation. Furthermore, there are no published series that evaluate the prevalence or characterize the deformity of contractures, the degree of involvement and their functional impact. Another problem that occurs when studying glenohumeral contractures is the measurement method, with high variability in the results. Furthermore, there is no easy and reproducible method to determine the active and passive mobility of the glenohumeral joint independently of the scapulothoracic joint.
In this doctoral thesis, the prevalence of glenohumeral joint contractures in adduction, abduction, and external rotation has been evaluated in a population of more than two hundred patients affected with PBO, showing that they are very frequent in the majority of patients, even appearing in combination (multidirectional contractures). To perform all the measurements of glenohumeral joint balance, a new measurement method has been described, using the scapular spine as a reference during the clinical examination in the outpatient clinic. It is an easy, reproducible, and inexpensive method that allows glenohumeral dysfunction to be objectified independently of scapulothoracic. To validate its usefulness, an intra and inter-observer variability study was performed in a subpopulation of twenty-five patients with NBPI, which has shown excellent reliability of the measurement technique. Furthermore, each contracture has been characterized and the average value and standard deviation of the range of glenohumeral motion for each type of contracture have been detailed for the first time. Finally, comparative studies of each type of contracture with the functionality of the extremity have been performed using the modified Mallet scale, showing that the inferior glenohumeral contracture generate an important limitation in active (abduction lag) and passive shoulder abduction; the posterior one cause a limitation of the internal rotation of the shoulder and, as a consequence, a limitation towards the midline; while the superior contracture do not cause a significant functional limitation, although they can cause an aesthetic problem. All these findings help to better understand the functional sequelae of patients with NBPI and, ultimately, to improve their treatment, both at the surgical and rehabilitative levels.
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Delmuns, Carvajal Salvio Fernando. "Estudio de las lesiones y análisis electromiográfico de la actividad muscular de los brazos en niños que practican karting de competición." Doctoral thesis, Universitat Ramon Llull, 2021. http://hdl.handle.net/10803/672065.
Full textAbstract:
Hi ha pocs estudis centrats en el kàrting de competició a diferència del "go kart" modalitat d'oci. Aquesta tesi s’ha plantejat els següents objectius: conèixer les lesions i el seu impacte en el kàrting de competició, així com conèixer l'activitat muscular dels braços en l'acció de pilotatge d'aquests karts. Es va realitzar un estudi epidemiològic retrospectiu a pilots de 7 a 15 anys que van participar als campionats dels anys 2005-2009,analitzant les diferents lesions en base a la categoria, número de participacions i circuit. Així mateix, es van explorar els factors de risc de patir lesions i vàrem suggerir mesures correctives per reduir el nombre de lesions i la seva gravetat. El segon estudi es va centrar en l'ús d’electromiografia de superfície (EMGS) a una selecció de músculs de les extremitats superiors, mentre es pilotaven karts de competició en pista. Tretze pilots de la categoria sènior van participar voluntàriament en aquest estudi i es va analitzar l'activitat muscular: (a) en el nombre de voltes realitzades, (b) en ambdós braços, (c) segons les característiques del traçat, i (d) segons el tipus de kart (amb o sense marxes). En el primer estudi es van analitzar 334 pilots que van completar un total de 445.590,8 km de competició. Un total de 38 pilots va patir lesions durant els 5 anys de l'estudi. Les lesions corporals es van localitzar principalment a les mans i canells (42,1%). El segon estudi, es van trobar diferències significatives entre l'activitat muscular en relació al tipus de kart (p <0.0001). Els resultats també mostren que hi ha una interacció significativa entre el tipus de kart i el braç dominant (p = 0.021), amb diferències significatives entre els dos tipus de kart per a cada braç dominant (p <0.0001). L'activitat muscular augmenta més significativament en el braç del mateix sentit de la corba per sobre del braç dominant.<br>Hay pocos estudios centrados en el karting de competición a diferencia del “go kart” modalidad de ocio. Esta tesis se ha planteado los siguientes objetivos: conocer las lesiones y su impacto en el karting de competición, así como conocer la actividad muscular de los brazos en la acción de pilotaje de estos karts. Se realizó un estudio epidemiológico retrospectivo en pilotos de 7 a 15 años que participaron en los campeonatos de los años 2005-2009, analizando las diferentes lesiones en base a la categoría, número de participaciones y circuito. Así mismo, se exploraron los factores de riesgo de sufrir lesiones y se sugirieron medidas correctivas para reducir el número de lesiones y su gravedad. El segundo estudio se centró en el uso de electromiografía de superficie (EMGS) en una selección de músculos de las extremidades superiores, mientras se pilotaban karts de competición en pista. Trece pilotos de la categoría senior participaron voluntariamente en este estudio y se analizó la actividad muscular: (a) en el número de vueltas realizadas, (b) en ambos brazos, (c) según las características del trazado, y (d) según el tipo de kart (con o sin marchas). En el primer estudio se analizaron 334 pilotos que completaron un total de 445.590,8 km de competición. Un total de 38 pilotos sufrió lesiones durante los 5 años del estudio. Las lesiones corporales se localizaron principalmente en manos y muñecas (42,1%). En el segundo estudio, se encontraron diferencias significativas entre la actividad muscular en relación al tipo de kart (p<0.0001). Los resultados también muestran que hay una interacción significativa entre el tipo de kart y el brazo dominante (p= 0.021), con diferencias significativas entre los dos tipos de kart para cada brazo dominante (p< 0.0001). La actividad muscular aumenta más significativamente en el brazo del mismo sentido de la curva por encima del lado dominante.<br>There are few studies focused on competitive karting as opposed to the “go kart” leisure type. The main objectives of this thesis were to analyze the injuries and their impact on competitive karting, as well as to assess the muscular activity of the arms in the driving action of these karts in children. A retrospective epidemiological study was carried out in pilots between 7 and 15 years old who participated in the championships of the years 2005-2009, analyzing the different injuries based on the category, number of participations and circuit. Risk factors for injury were also explored and we suggested corrective measures to reduce the number and severity of injuries. The second study focused on the use of surface electromyography (EMGS) on a selection of muscles of the upper extremities, while driving competitive karts on track. Thirteen pilots of the senior category volunteered to participate in this study and we analyzed the muscle activity based on: (a) the number of laps performed, (b) both arms, (c) the characteristics of the track, and (d) the type of kart (with or without gears). The first study included 334 pilots who completed a total of 445,590.8 km of competition. A total of 38 pilots suffered injuries during the 5 years of the study. Bodily injuries were mainly located in the hands and wrists (42.1%). In the second study, significant differences were found between muscle activity in relation to the type of kart (p <0.0001). The results also showed that there was a significant interaction between the type of kart and the dominant arm (p = 0.021), with significant differences between the two types of kart for each dominant arm (p <0.0001). Muscle activity increased more significantly in the arm located in the same direction of the curve than the dominant side.
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Callohuari, Quispe Rosalía. "Actividad gastroprotectora del extracto acuoso de las vainas de Caesalpinia spinosa (Molina) Kuntze "tara" frente a la injuria aguda inducida en ratas." Master's thesis, Universidad Nacional Mayor de San Marcos, 2018. https://hdl.handle.net/20.500.12672/8641.
Full textAbstract:
Evalúa la actividad gastroprotectora del extracto acuoso de las vainas de Caesalpinia spinosa (Molina) Kuntze “tara” (EAVT), frente a la injuria aguda inducida en ratas. El extracto acuoso se prepara a partir de vainas secas molidas (1:4 p/v) a 65°C por 1 hora. Se realiza la marcha fitoquímica, el contenido de fenoles, la actividad antioxidante (DPPH) y la toxicidad aguda a dosis límite (2 000 mg/kg) del EAVT. Los ensayos para evaluar la actividad gastroprotectora del EAVT son: Lesión gástrica inducida por etanol 70% (Robert et al.,1979), 36 especímenes son distribuidas aleatoriamente en 6 grupos (n=6): I (SSF-SSF), II (SSF-EtOH), III (EAVT 100 mg/kg-EtOH), IV (EAVT 400 mg/kg-EtOH), V (EAVT 800 mg/kg-EtOH) y VI (antiácido 500 mg/kg-EtOH); y ligadura pilórica (método modificado por Sandoval et al.,2002), 30 ratas son distribuidas aleatoriamente en 5 grupos (n=6): I (SSF), II (EAVT 100 mg/kg), III (EAVT 400 mg/kg), IV (EAVT 800 mg/kg) y V (antiácido 500 mg/kg). Los metabolitos secundarios presentes en el EAVT son: compuestos fenólicos, taninos y flavonoides. El contenido de fenoles totales es de 383,76 mg EAG/g EAVT. La capacidad antioxidante del extracto se clasifica como de buena actividad (IC50 = 1,12±0,04 µg/mL). No se observan signos de toxicidad aguda. El EAVT muestra actividad gastroprotectora de manera dosis dependiente contra la injuria aguda inducida por el etanol, siendo significativos (p<0,01) a las dosis de 400 y 800 mg/kg, lo cual es confirmado por el análisis histo-patológico. El EAVT a dosis de 400 mg/kg incrementa significativamente (p<0,05) la producción de mucus comparado con el grupo control, sin guardar una protección dependiente de la dosis, el contenido MDA disminuyó significativamente (p<0,05) de manera dosis dependiente, sin embargo, presenta depleción de GS-NP siendo significativa (p<0,05) a la dosis de 800 mg/kg y no presenta actividad antisecretora. Concluye que el EAVT tiene buena actividad antioxidante por su alto contenido en taninos y polifenoles, su efecto gastroprotector está relacionado con el incremento del porcentaje de mucus y reducción de MDA, y el mecanismo por el cual el extracto protege la mucosa gástrica no implica inhibición de la secreción de ácido.<br>Tesis
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Nasi, Medeot Lucía. "Hiponutrición perinatal y depresión: estudio de la reversión de las conductas depresivas facilitadas por la injuria nutricional temprana." Bachelor's thesis, 2017. http://hdl.handle.net/11086/5538.
Full textAbstract:
Tesina (Grado en Ciencias Biológicas)--Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Lugar de Trabajo: Departamento de Farmacología. Facultad de Ciencias Químicas. U.N.C. 2017.
31 h.; grafs.; tabls. Contiene Referencia Bibliográfica.<br>El objetivo del presente proyecto es estudiar la participación del factor neurotrófico BDNF en la facilitación de las conductas depresivas inducidas por el déficit nutricional temprano.
El estudio de la reversión de la anhedonia y la depresión del humor facilitada por la malnutrición temprana luego del tratamiento crónico con desipramina.
Evaluación de la reversión de la depresión del humor facilitada por la malnutrición temprana luego de la administración repetida del gangliosido GM1.
Books on the topic "The last injury"
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Whittle, Ian. Head injury. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569381.003.0589.
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Head injury or traumatic brain injury is a ubiquitous phenomenon in all societies and affects up to 2 per cent of the population per year (Bullock et al. 2006). Although the causes of head injury and its distribution within populations vary, it can have devastating consequences both for the patient and family (Tagliaferri et al. 2006). In some countries severe traumatic brain injury is the commonest cause of death in people under 40 years (Lee et al. 2006), and it is estimated that the sequelae of head injury cost societies billions of dollars per year. Understanding of the pathophysiology, diagnosis, and management have all improved dramatically in the last few decades (Steudel et al. 2005). However within western society, perhaps one of the greatest benefits has been the reduction in severe craniocerebral injuries following motor vehicle accidents. This has arisen because of increased safety in car design, seat-belt legislation, the introduction of air-bags, enforcement of speed limits, and the societal conformity to drink-driving legislation. For instance, because of these changes, in the last 15 years the number of severe head injuries managed in the Clinical Neuroscience unit in Edinburgh has decreased by around 66 per cent. Unfortunately in some developing countries one legacy of increased traffic, particularly of motor cycles, is an epidemic of head injuries amongst young adults (Lee et al. 2006). With the number of severe head injuries declining in many countries the challenge will be to provide better care for patients with minor head injury, about 10 times more common than severe injury (Steudel et al. 2005).Ageing patients who tend to fall over, falls associated with increased alcohol consumption, and domestic or social assaults probably now contribute to the majority of head injuries (Flanagan et al. 2005; Steudel et al. 2005; Tagliaferri et al. 2006). Sporting injuries are fortunately uncommon as a cause of severe craniocerebral injury, although horse riding accidents can sometimes be devastating particularly in teenage girls. In some countries injuries from hand guns and other missiles are common (Aryan et al. 2005), but in European countries many such injuries are self-inflicted. Prompt management of intracranial haematoma, which occurs in 25–45 per cent of severe head injuries, 3–12 per cent of moderate injuries, and 0.2 per cent of minor injuries, and the rehabilitation of patients with head injury are now important areas in clinical neuroscience (Flanagan et al. 2005; Bullock et al. 2006b, c).
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Andrews, Peter J. D., and Jonathan K. J. Rhodes. Assessment of traumatic brain injury. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0342.
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Traumatic brain injury (TBI) accounts for the majority of traumatic deaths and most disability due to trauma in people aged less than 40 years old. Current trends suggest this burden of disease will increase dramatically over the next 20 years. Successful management of patients after traumatic brain injury requires recognition of patients at risk of deterioration, appropriate investigation, including imaging, and prevention of systemic and intracranial secondary injury processes. Unlike trauma affecting other body systems, outcome from TBI has not improved in the last 10–15 years. Assessment of a patient with traumatic brain injury includes clinical examination and diagnostic imaging both of which can be quantified or graded using scores such as the Glasgow Coma Score (GCS) and the Marshall score for grading cranial computed tomographic (CT) scans. Clinical examination and diagnostic imaging can both aid in prognostication (http://www.crash.lshtm.ac.uk/Risk%20calculator/).
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Brown, Jeremiah R., and Chirag R. Parikh. Cardiovascular surgery and acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0245.
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Over the last decade, cardiac surgery-associated acute kidney injury (AKI) has been recognized as a frequent adverse event following cardiac surgery. In this clinical context and others, AKI has been strongly associated with increased morbidity, mortality, and length of hospitalization. These adverse events that accompany AKI have been shown to be directly proportional to the magnitude of the peak rise in serum creatinine and the duration of AKI making AKI a costly complication and a target for prevention in hospitalized patients around the world. This chapter discusses the subsequent healthcare costs, utilization, mortality, and morbidity that follow subtle changes in serum creatinine known as AKI in the perioperative setting of cardiac surgery.
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Covington, Laura S. Psychological Aspects of Infertility Post-Injury. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190461508.003.0010.
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This chapter explores how service members with injuries that damage sexual and reproductive functioning may experience the psychosocial implications of impaired fertility. It addresses a general overview of infertility and then describes the experience within the military context. Infertility can be an invisible, secondary wound that is not felt until one considers procreation and that may last for many years. Further, infertility is an injury that affects not only the service member but also his or her partner. Many ethical considerations and barriers, including limited insurance coverage and accessibility for treatment, make it difficult to access technologies for reproduction. Fertility preservation and sperm harvesting should be considered as options by service members before deployment. While advances in technologies can help injured service members to procreate, the challenges and emotional fallout are significant and need to be addressed in treatment, counseling, and public policy.
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Chamberlen, Anastasia. Self-Harming and Prison Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198749240.003.0007.
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This chapter develops the links between coping and painful emotions in prison, by looking at self-injury practices as one particularly problematic form of coping that is both common among women prisoners, and increasingly more prominent in English prisons overall. This last substantive chapter of the book uses self-injury as a case study through which to explore an application of the book’s main arguments, findings, and implications, examining the participants’ explanations of why they self-injured during and after custody. In doing so, it advocates for an embodied perspective to the study of emotions, identity, and survival in prison, and challenges the prison’s rehabilitative potential.
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Mundy, Anthony R., and Daniela E. Andrich. Upper urinary tract trauma. Edited by Anthony R. Mundy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0051.
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Of all the major urological injuries, injury to the kidney is the most common. Indeed it is the most commonly injured intra-abdominal organ. Blunt or penetrating external injury is almost always the cause. The diagnosis and treatment of renal trauma has changed dramatically in the last 30 years or so reflecting the development of CT scanning for diagnosis and of endovascular interventional radiological techniques for treatment, at the expense of intravenous urography and surgery, respectively. Complications can be divided into early and late. The commonest early complications are bleeding and extravasation of urine, which may in turn lead to a urinoma, infection, and abscess formation. The best way of handling bleeding is by selective microembolization or surgery if necessary, which is usually only when embolization fails. A urinoma can usually be drained percutaneously through the flank, but may require surgery occasionally.
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Longo, Umile Giuseppe, and Nicola Maffulli. Lower limb injuries. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0045.
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Physical activity plays a significant role in the well-being of a child. Long-term health benefits depend on continuation of physical activity, which enhances well-being and favours balanced development. Injuries can counter the beneficial effects of sports participation, especially if a child is unable to continue participating because of any residual effects of injury. Prevention of sports injuries has been largely implemented in the last few years. This chapter reviews common lower limb injuries in children with an emphasis on injury management. Sports-related injuries of the lower limb in children mostly cover ligament injuries, fractures, epiphyseal injuries, and apophysitis. It also cover the most frequent approaches for the management of these injuries, including conservative management for undisplaced fractures or partial ligamentous ruptures. Surgery is recommended for displaced fractures or complete ligamentous injuries.
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Suffredini, Anthony F., and J. Perren Cobb. Genetic and molecular expression patterns in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0031.
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Investigators who study RNA, proteins, or metabolites use analytic platforms that simultaneously measure changes in the relative abundance of thousands of molecules in a single biological sample. Over the last decade, the application of these high-throughput, genome-wide platforms to study critical illness and injury has generated huge quantities of data that require specialized computational skills for analysis. These investigations hold promise for improving our understanding of the host response, thereby transforming the practice of intensive care. This chapter summarizes recent technological and computational approaches used in genomics, proteomics, and metabolomics. While major advances have been made with these approaches when applied to chronic diseases, the acute nature of critical illness and injury has unique challenges. The rapidity of initiating events, the trajectory of inflammation that follows injury or infection and the interplay of host responses to a replicating infection, all have major effects on changes in gene and molecular expression. This complexity is further accentuated by measurement that may vary with the timing and type of tissue sampled after the critical event. In addition, the hunt for novel molecular markers holds promise for identifying patients at risk for severe illness and for enabling more individualized therapy.
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Vimalesvaran, Kavitha, and Michael Marber. Myocardial Remodelling after Myocardial Infarction. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0031.
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This chapter focuses on myocardial remodelling, a process that affects the heart’s shape, structure, and function, following myocardial injury (MI). Post-MI remodelling can be divided into three phases, with the first phase 0–72 hours beginning at the time of ischaemic injury, the second phase 72 hours to 6 weeks, and the third and last phase 6 weeks and beyond. During post-infarction remodelling, hypertrophy is an adaptive response that compensates for the increased load, reduces the effect of progressive dilatation, and balances contractile function. The chapter discusses the factors involved in ventricular remodelling and its association with heart failure progression. The effects of therapies designed to prevent or attenuate post-infarction left ventricular remodelling, with reference to the pathophysiological mechanisms involved, are then considered. Therapies specifically discussed include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β-adrenoreceptor blockers, and aldosterone receptor antagonists.
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Laffey, John G., and Brian P. Kavanagh. Hypercapnia in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0086.
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Hypercapnia is a central component of current ‘protective’ ventilator management. Hypercapnia, and the associated acidosis, has potentially important biologic effects on immune responses, injury and repair. Arterial carbon dioxide tension PaCO2 is tightly governed under physiological conditions and small elevations rapidly increase spontaneous minute ventilation. In the mechanically-ventilated patient, elevated PaCO2 usually reflects reduced elimination. This can be because tidal volume or respiratory rate delivered by the ventilator are reduced, or because of the diseased lung per se. Hypercapnia has many effects that are clinically obvious, but research over the last decade reveals important consequences on inflammatory and cellular mechanisms that are not apparent at the bedside.
Book chapters on the topic "The last injury"
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Longo, Dario Livio, Pietro Irrera, Lorena Consolino, Phillip Zhe Sun, and Michael T. McMahon. "Renal pH Imaging Using Chemical Exchange Saturation Transfer (CEST) MRI: Basic Concept." In Methods in Molecular Biology. Springer US, 2021. http://dx.doi.org/10.1007/978-1-0716-0978-1_14.
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AbstractMagnetic Resonance Imaging (MRI) has been actively explored in the last several decades for assessing renal function by providing several physiological information, including glomerular filtration rate, renal plasma flow, tissue oxygenation and water diffusion. Within MRI, the developing field of chemical exchange saturation transfer (CEST) has potential to provide further functional information for diagnosing kidney diseases. Both endogenous produced molecules as well as exogenously administered CEST agents have been exploited for providing functional information related to kidney diseases in preclinical studies. In particular, CEST MRI has been exploited for assessing the acid-base homeostasis in the kidney and for monitoring pH changes in several disease models. This review summarizes several CEST MRI procedures for assessing kidney functionality and pH, for monitoring renal pH changes in different kidney injury models and for evaluating renal allograft rejection.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by two separate chapters describing the experimental procedure and data analysis.
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"Breakthroughs of the Last Twenty Years." In Essentials of Spinal Cord Injury, edited by Michael G. Fehlings, Maxwell Boakye, John F. Ditunno Jr., Alexander R. Vaccaro, Serge Rossignol, and Anthony S. Burns. Georg Thieme Verlag, 2013. http://dx.doi.org/10.1055/b-0034-83896.
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Pabla, Navjot, Yogesh Scindia, Joseph Gigliotti, and Amandeep Bajwa. "Mouse Models of Acute Kidney Injury." In Animal Models in Medicine and Biology [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.97523.
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Acute Kidney Injury (AKI) is a poor prognosis in hospitalized patients that is associated with high degree of mortality. AKI is also a major risk factor for development of chronic kidney disease. Despite these serious complications associated with AKI there has not been a great amount of progress made over the last half-century. Here we have outlined and provided details on variety of mouse models of AKI. Some of the mouse models of AKI are renal pedicle clamping (ischemia reperfusion injury), Cisplatin induced nephrotoxicity, sepsis (LPS, cecal slurry, and cecal ligation and puncture), folic acid, and rhabdomyolysis. In this chapter we describe in detail the protocols that are used in our laboratories.
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"Trauma." In Congress of Neurological Surgeons Essent, edited by Jamie S. Ullman. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780197534342.003.0005.
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This chapter discusses traumatic spinal cord and brain injuries. The first three studies review the background and key findings of the third National Acute Spinal Cord Injury Study (NASCIS) trial, examine the efficacy of the Canadian C-Spine Rule in the evaluation of cervical spine injuries in alert and stable trauma patients; and describe the development of the Thoracolumbar Injury Classification and Severity Score (TLICS) classification system. The next two studies assess the effect of early surgical decompression in patients with traumatic cervical spinal cord injury and delineate the role of secondary brain injury in determining patient outcome in severe traumatic brain injury. The following set of four studies evaluates the efficacy of phenytoin in preventing posttraumatic seizures, as well as the efficacy of intracranial pressure monitoring, induction of hypothermia, and decompressive craniectomy for severe traumatic brain injury. The last study, which is of historical value, identifies predictors of outcome in comatose patients with traumatic acute subdural hematoma.
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Frigieri, Gustavo, Nicollas Nunes Rabelo, Ricardo de Carvalho Nogueira, and Sérgio Brasil. "Management of Patients with Brain Injury Using Noninvasive Methods." In Advancement and New Understanding in Brain Injury [Working Title]. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.94143.
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In the last decades, the development of new noninvasive technologies in critical care allowed physicians to continuously monitor clinical parameters, aggregating important information that has been previously inaccessible or restricted due to the invasiveness of the existing techniques. The aim of this chapter is to present noninvasive methods in use on intensive care units (ICU) for brain injured patients monitoring, collaborating to the diagnosis and follow-up, aiding medical teams to achieve better outcomes.
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Brooks, Peter. "Burns itch." In Burns (OSH Surgery). Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780199699537.003.0036.
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Post-burns itch, or pruritus, is one of the most common and distressing complications of burn injury. It typically begins in the first two weeks after the injury, and may last for several years. Post-burn pruritus can interfere with daily activities, and also complicate healing when scratched. This chapter outlines the causes, epidemiology, and biology of itching then provides an overview of therapies available. Assessment scales and the classification of types of pruritus are also outlined.
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Homaifar, Beeta Y., Melodi Billera, Sean M. Barnes, Nazanin Bahraini, and Lisa A. Brenner. "Understanding Traumatic Brain Injury and Suicide Through the Lens of Executive Dysfunction." In Handbook of Military and Veteran Suicide. Oxford University Press, 2017. http://dx.doi.org/10.1093/med:psych/9780199873616.003.0015.
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The care and study of patients with traumatic brain injury (TBI) and suicidal ideation/behavior presents unique challenges to both clinicians and researchers. In this chapter, background information regarding TBI (i.e., definition, severity classifications, epidemiology, assessment, and common postinjury sequelae/psychiatric disorders) are presented to provide context for a discussion of the complicated relationships between brain injury and suicidal thoughts and behaviors. The potential contribution of executive dysfunction (e.g., impairment in reasoning and/or decision-making) is reviewed. In addition, the idea that propensity toward or against engaging in risky behavior can be used to increase understanding regarding the relationship between TBI and suicidal ideation and behaviors is discussed. Last, clinical challenges and future research directions are presented.
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Mitra, Kaushik. "Progress of derisking strategies for drug-induced liver injury (DILI) in the last two decades." In Identification and Quantification of Drugs, Metabolites, Drug Metabolizing Enzymes, and Transporters. Elsevier, 2020. http://dx.doi.org/10.1016/b978-0-12-820018-6.00017-x.
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Frigieri, Gustavo, Cintya Yukie Hayashi, Nícollas Nunes Rabelo, and Sérgio Brasil. "Intracranial Pressure Waveform: History, Fundamentals and Applications in Brain Injuries." In Advancement and New Understanding in Brain Injury [Working Title]. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.94077.
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Intracranial pressure (ICP) can be analyzed for its absolute value, usually in mmHg or cmH2O, its tendency over time and the waveform of its pulse. This chapter will focus on the waveform of the ICP pulse (ICPwf), already observed since 1881, and for a long time not understood. Studies conducted in recent decades show the correlation between the ICPwf and intracranial compliance (ICC), another important clinical parameter added to the practice in the second half of the last century. ICC allows physicians early analyzing patients’ neurological conditions related to disorders resulting from variations in cerebrospinal fluid (CSF), blood and intracranial tissue volumes. This chapter is an invitation to dive into the history and development of ICPwf analysis, clinical uses already adopted and others still under study.
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Chihi, Mehdi, Ulrich Sure, and Ramazan Jabbarli. "Demographic, Clinical, and Radiographic Characteristics of Cerebral Aneurysms in Tuberous Sclerosis Complex." In Advancement and New Understanding in Brain Injury [Working Title]. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.93802.
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To date, little is known on the prevalence, incidence, and characteristics of intracranial aneurysms (IA) in patients with tuberous sclerosis complex (TSC). Based on our recent systematic review and two cases treated in our institute, we summarize the current evidence concerning the distinct characteristics of these aneurysms. In contrast to saccular IA in healthy adults, IA in TSC present commonly with large or even giant sac size and fusiform configuration, location predilection on the internal carotid artery remote from the branching zones, remarkable higher prevalence of pediatric cases, inverted sex-ratio, and suspected rapid growth. Although the pathogenesis of IA in TSC is still unclear, all these features might point to the crucial role a congenital defect in the development of IA rather than extrinsic or environmental factors. Furthermore, we discuss the enhancement of the regular magnetic resonance (MR) imaging screening suggested by the last recommendations of the 2012 International TSC Consensus Conference with cranial time-of-flight MR angiography in order to enable timely identification and treatment of frequently complex IA in TSC.
Conference papers on the topic "The last injury"
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Przekwas, Andrzej, V. C. Chancey, X. G. Tan, et al. "Development of Physics-Based Model and Experimental Validation of Helmet Performance in Blast Wave TBI." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206839.
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Explosive devices are the main weapon of terrorist attacks and a cause of major injuries to Soldiers and civilians. Recent military medical statistics show that a significant percentage of Soldiers injured in explosion events endures blast wave traumatic brain injury (BW-TBI). In the last few years, better understandings of BW-TBI mechanisms and of improved injury protection have become of paramount importance. Most studies have taken the conventional approach of animal testing, in vitro brain tissue study, and analysis of clinical data. These, while useful and necessary, are slow, expensive, and often non-conclusive. Physiology-based mathematical modeling tools of blast wave brain injury will provide a complementary capability to study both BW-TBI mechanisms and the effectiveness of protective armor.
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van Esch, Bart. "Injury and Mortality to Fish Passing Through Pumping Stations." In ASME-JSME-KSME 2011 Joint Fluids Engineering Conference. ASMEDC, 2011. http://dx.doi.org/10.1115/ajk2011-06015.
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An unwanted side effect of pumping stations is that fish suffer from injury and mortality when passing through the pumps and that fish migration is hampered. In recent years, the development of so-called “fish-friendly pumping stations” is becoming a hot topic among European governmental institutions and pump manufacturers. In the Netherlands, many field studies have been conducted over the last decade, to assess the chances of survival for fish passing through pumps. However, a clear correlation between observed injury or mortality and (for example) flow rate, shaft speed or pump type could not be established. This paper presents a new analysis of the above mentioned field studies. It makes use of American studies on the biological criteria for fish injury, the most important of which are pressure changes, shear forces, and mechanical injury. A blade strike model was adapted to fish passing through centrifugal pumps of radial, mixed-flow, and axial type. It reveals the relation between fish injury and the type of pump, its size, shaft speed, and pressure head. The results correlate well with experiments. The flow through a typical mixed-flow pump is calculated using CFD. The results show that pressure fluctuations and shear forces are not likely to add to fish mortality. The paper concludes with guidelines for the design and selection of “fish-friendly pumps” in pumping stations.
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Chen, C. T. Christopher, Alexandra DiTullio, and Xianghua Deng. "Gelatinase B (MMP-9) Modulates Joint Inflammation and Cartilage Degradation After Overload Injury." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176466.
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Osteoarthritis is the leading cause for disability in the U.S. Primary osteoarthritis occurs progressively with age due to a variety of factors, while secondary osteoarthritis is usually the result of a sports or accident-related joint injury. Several recent studies found that degraded matrix in synovial fluid was surged within days after initial injury along with the elevation of matrix degradative enzymes, including matrix metalloproteinases (MMPs) and aggrecanases [1]. The elevation of degraded matrix could last for up to a decade, although it is not clear whether these degradative events are related to joint inflammation, the chronic presence of which is the hallmark of rheumatoid arthritis and often leads to joint degeneration.
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Smith, Katisha D., and Liang Zhu. "Theoretical Evaluation of a Simple Cooling Pad Inducing Hypothermia in the Spinal Cord Following Traumatic Injury." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206190.
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Although significant damage is caused by the mechanics of the traumatic spinal cord injury (SCI), secondary injury that follows is often times even more dangerous. It occurs within the first 12–24 hours following the injury and can last up to 5–10 days, depending on the severity of the injury [1]. Secondary injury causes physiological disturbances that disrupt the body’s homeostasis like initiating a cellular inflammatory response at the injury site and increasing the release of free radicals. An overabundance of free radicals contributes to tissue ischemia, cerebral edema, and disruption of the spine-blood barrier. The use of hypothermia (<35°C) as a therapeutic agent has been shown effective in providing neuroprotection from secondary injury [2]. Research has shown the benefits of hypothermia include decreasing oxygen consumption, free radical generation, neurotransmitter release, inflammation, and metabolic demands [3–5]. Even a temperature decrease of 1–2°C can be beneficial at the cellular level [4,6]. However, these studies use techniques that can be invasive. This research evaluates the effectiveness of using a non-invasive cooling pad on the torso to reduce the spinal cord temperature by at least 2°C.
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Mohammed, Obaidur Rahman, D. V. Suresh, and Hamid M. Lankarani. "Computational Modelling and Simulation of Pedestrian Subsystem Impactor With Sedan Vehicle and Truck Model." In ASME 2020 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/imece2020-24372.
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Abstract The increase in public transportation in the last decade has resulted in a larger pedestrian population and hence a larger number of pedestrian collisions. In the past, car-pedestrian accident prevention had been a challenge for automotive and transport safety members. Recent reports in car-pedestrian accidents have influenced many improvements to prioritize pedestrian protection for automotive industries. The number of pedestrian fatalities in U.S has raised in last decade proportionally, Car manufacturers, and transport investigation teams are implementing new product designs and adding new development methods to reduce the risk of pedestrian collisions. In this study, adult headform and upper legform is tested with a finite element vehicle model to examine the simulation results and injury behavior during impact. All finite element simulation tests are produced under Euro-NCAP Committee regulations. Finite element models are configured as per the regulation’s and testing criteria. Both upper legform impactor and adult headform finite simulation results are tested with assessing criteria limits. Finite simulation tests are carried on the LS-DYNA – Code platform. This comparative study between sedan and pickup finite vehicle models gives an injury risk prediction of pedestrian safety and assesses design parameters of automotive industries.
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Berrones Sanz, Luis David, and Victoria Alejandra Muro Báez. "Accidentes viales de los motociclistas en México: subgrupos y factores de riesgo." In CIT2016. Congreso de Ingeniería del Transporte. Universitat Politècnica València, 2016. http://dx.doi.org/10.4995/cit2016.2016.2172.
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Motorcycling as a means of transportation has grown rapidly in Mexico. In the last decade, the number of motorcycles increased 338.05%, which means that motorbikes represent 5.97% of the total number of vehicles in the country. During this period, however, the annual average shows that 3.16% of motorcyclists had an accident, which is proof that motorcycle riders are vulnerable users with high risks in terms of road safety. The objective of this research is to identify the subgroups of motorcyclers with higher accident risks and to identify risk factors. The sample for the quantitative study included all motorbike riders who died or were injured as a result of a reported road accident, between 2000 and 2014. The sample was obtained using the database at the National Institute for Statistics and Geography and the General Direction of Health Information. Descriptive variables were determined for all the categories and were matched to the death cause to find statistical correlation. These systems of information registrered, during 2014 in Mexico, more than 41,881 accidents and 826 deaths caused by motorcycle accident. The highest number of accidents involved men (P&lt;0.001) between 20 and 30 years old, where 20.55% had head injuries and only 16.59% of bikers were wearing a helmet at the time of the accident. This combination – age 20-30, male gender and not wearing a helmet – seems to be a powerful risk factor. However, accidents are largely underreported due to the fact that the format used to receive attention after suffering a violent attack or injury (SIS-SS-127-P) does not include the motorcycle as an agent of injury. For this reason, it is of the utmost importance to create a reliable statistical system and promote a good road safety culture together with protective factors and safety equipment.DOI: http://dx.doi.org/10.4995/CIT2016.2016.2172
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Schneider, Charles M., Ajay K. Verma, Tamanna T. K. Munia, Mark Romanick, Kouhyar Tavakolian, and Reza Fazel-Rezai. "Analysis of Postural Stability After Concussion Using Empirical Mode Decomposition: A Pilot Study." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3541.
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Maintaining upright stance is a complex process, it requires appropriate functioning of a postural control system which consists of inputs from somatosensory, vestibular, musculoskeletal, and proprioceptive systems as well as from several brain regions [1–4]. A concussion is defined as a brain injury caused due to unexpected acceleration/deceleration of the head causing temporary alteration of brain function and it is a prevalent source of injury to football athletes [1]. With the altered function of the brain, the ability to maintain postural equilibrium becomes challenging due to the inability of individuals to respond promptly to stressors, thus, making maintenance of postural equilibrium rather difficult for individuals with a concussion. Effects of concussion on postural ability are shown to last up to three days post injury [5]. Postural stability test, therefore, can be performed to make a valid return to play (RTP) decision, pre-mature RTP is shown to have been catastrophic due to its potential to permanently impair previously affected region/functioning [1,5]. Postural sway data (center of pressure, COP) is traditionally analyzed to study the postural control. Therefore, COP can provide critical information regarding individual’s ability to maintain upright stance post injury. A more sensitive concussion assessment tool based on electroencephalogram (EEG) is used to accurately track effects of concussion [6]. However, sophisticated electrode placement requirement inhibits its immediate applicability. In current preliminary research, we attempt to differentiate athletes with a history of concussion (experimental) from healthy (control) using postural data. In order to do so, a concept of empirical mode decomposition (EMD) was adopted. EMD has shown evidence in the literature to infer vital information pertaining to the complex underlying physiological phenomenon [4, 7–8]. In the current research, the resultant COP (COPr) was decomposed into its finite set of band-limited signals termed as intrinsic mode functions (IMFs) [8], a set of linear and nonlinear features were extracted from COPr and its IMfs. Lastly, a test of significance was conducted to infer the potential of postural data for differentiating concussed from healthy athletes.
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Wirth, Sean, Ruben Montes, Susan Bell, and Michael Saltzman. "Engineering Out the Hazards of a Machine Shop." In ASME 2011 International Mechanical Engineering Congress and Exposition. ASMEDC, 2011. http://dx.doi.org/10.1115/imece2011-63072.
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A machine shop environment presents a high potential for occupational injuries and fatalities. A combination of rotating spindle, coolant spatter, cutting tool activity, and sharp airborne chips, occurring during the metal cutting process, creates a significant hazard for equipment operators. The danger of working in this environment is reflective in industry TRIRs (Total Recordable Incident Rate) which fall between 2.7 (Oil and Gas Manufacturing) and 5.5 (Metal Manufacturing) based on the latest USA Industry and Illness Data. This case study highlights how the Navigation Manufacturing facility (500 employees, 100 CNC machines) — identified numerous safety issues in its machine shop environment and processes, and undertook a three-step program for “engineering out” those hazards. 1. The first step involved modifying machinery guarding and improving the internal visibility of parts during machine operation. 2. The second step took traditional secondary process tasks performed manually outside the machine — de-burring, marking, cleaning — and incorporated these tasks into the machining effort to reduce potential operator hand injuries that could occur during interaction with the part. 3. Thirdly, the handling of production parts was improved with the use of parts catchers, modified forklifts, and new safer material lifting devices, further reducing the likelihood of other bodily injury. Implementation of “hands-free” machine and equipment improvements and enhanced process practices has allowed the facility to achieve over two million hours without a Recordable Injury (TRIR), over 9 million hours without a Days Away from Work Case (DAFWC), and a TRIR of less than 0.4 for the last 5 years.
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Brakefield, Timothy, Thomas Burkhardt, Andrew Meehan, Gregory Nemunaitis, Mohamed Samir Hefzy, and Mehdi Pourazady. "Gurney Mattress Redesign." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80036.
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One of the most devastating yet survivable injuries today is trauma to the spinal cord. Often times this injury results in the inability of the patient to move and feel below the neck. When transporting these individuals on a gurney to perform routine tests, they are prone to excessive pressures over long periods of time that may result in the breakdown of skin, muscle and other tissues over pressure sensitive areas resulting in the formation of pressure ulcers [1]. The financial burden to treat pressure ulcers is high. The cost to heal a single complex full-thickness pressure ulcer has been estimated to be $70,000 [2] and the total economic burden of treating all pressure ulcers was estimated to be as high as $1.335 billion per year [3]. These costs not only load society with an enormous financial burden, but the patient must undergo a series of treatments that may last for months which will remove them from productive activities.
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Thorbole, Chandrashekhar K., Mary Aitken, James Graham, Beverly Miller, and Samantha Hope Mullins. "Assessment of the Dynamic Behavior of a Single Person ATV in Presence of a Passenger: Outcome on the Rider and Passenger Crash Impact Kinematics Using Computational Model." In ASME 2012 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/imece2012-86164.
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An ATV (All-terrain vehicle) is a gasoline powered, fast moving off road vehicle often used for farming and industrial activities as well as recreational activities. The popularity of this type of vehicle has increased over the last decade with more than 10 million in use today. Most ATVs are designed for only single rider even though the seat of the ATV may appear big enough to carry a passenger. The presence of an additional person on a single person ATV greatly affects its dynamic handling characteristics. This change increases the risk of a crash and subsequent injuries to both riders. ATV crashes involving climbing and descending on steep hills are common. Lateral rollover crashes are often the result of riding an ATV at a high speed on uneven terrain. The presence of passenger on a single person ATV during these conditions changes the rider impact kinematics and resulting injury outcome, as the ATV behaves differently in the presence of an additional person. The computational model of a single person, adult-sized ATV, as developed previously for the study of child injury prevention, was used for this study. The multi-body computational model of this ATV was developed using biodynamic code MADYMO. This computational model was validated against the laboratory test for its dynamic and suspension characteristics. The tilt table test and the drop test were employed to compare the computational model result. This computer model was used to simulate the crash mechanism involving climbing and descending steep hills with two people on the ATV. This model was also used to simulate the lateral rollover of ATV with two people. The rider and the additional passenger on this single rider ATV were modeled using a 50th percentile male and a 5th percentile female. The two rider simulation was compared with single rider simulation for similar terrain and ATV speed to gain insight about the influence of this additional passenger weight on the crash kinematics of the ATV and the rider. These simulations will also be used in the future to generate more visually dramatic videos for educational intervention for ATV safety programs and other injury prevention activities.