Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Low severity neck injuries.
Статті в журналах з теми "Low severity neck injuries"
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 статей у журналах для дослідження на тему "Low severity neck injuries".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте статті в журналах для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Putra, I. Putu A., Johan Iraeus, Fusako Sato, Mats Y. Svensson, Astrid Linder, and Robert Thomson. "Optimization of Female Head–Neck Model with Active Reflexive Cervical Muscles in Low Severity Rear Impact Collisions." Annals of Biomedical Engineering 49, no. 1 (April 24, 2020): 115–28. http://dx.doi.org/10.1007/s10439-020-02512-1.
Повний текст джерелаАнотація:
AbstractViVA Open Human Body Model (HBM) is an open-source human body model that was developed to fill the gap of currently available models that lacked the average female size. In this study, the head–neck model of ViVA OpenHBM was further developed by adding active muscle controllers for the cervical muscles to represent the human neck muscle reflex system as studies have shown that cervical muscles influence head–neck kinematics during impacts. The muscle controller was calibrated by conducting optimization-based parameter identification of published-volunteer data. The effects of different calibration objectives to head–neck kinematics were analyzed and compared. In general, a model with active neck muscles improved the head–neck kinematics agreement with volunteer responses. The current study highlights the importance of including active muscle response to mimic the volunteer’s kinematics. A simple PD controller has found to be able to represent the behavior of the neck muscle reflex system. The optimum gains that defined the muscle controllers in the present study were able to be identified using optimizations. The present study provides a basis for describing an active muscle controller that can be used in future studies to investigate whiplash injuries in rear impacts
2
Kokubun, Brent, and Motasem Refaat. "An Unusual Inverted Talar Neck Fracture–Dislocation." Case Reports in Orthopedics 2022 (December 5, 2022): 1–6. http://dx.doi.org/10.1155/2022/8014529.
Повний текст джерелаАнотація:
Talar neck fractures occur on a continuum of injury severity. Hawkins classification, later modified by Canale, is the gold standard method of describing talar neck fractures by the degree of dislocation. It has proven to be clinically relevant in predicting risk of osteonecrosis. Despite its merits, talar neck fractures present on a wide spectrum of involvement of the body and neck, dislocation, and concomitant injuries, making every situation a challenge in treatment. We present a unique case of a talar neck fracture in which the talar dome had dislocated and inverted 180°, which is not described in the widely used Hawkins classification. We recommend urgent open reduction, low threshold for use of a transcalcaneal traction pin and dual incisions, and guarded prognosis of osteonecrosis and posttraumatic arthritis.
3
Lang, M., MH Moen, T. van Roy, and E. Verhagen. "Injuries and Illness in Elite Equestrian Athletes: A Two-Season Prospective Study." Deutsche Zeitschrift für Sportmedizin/German Journal of Sports Medicine 72, no. 4 (June 20, 2021): 181–88. http://dx.doi.org/10.5960/dzsm.2021.481.
Повний текст джерелаАнотація:
Problem/Intro: Epidemiological data of injuries and illnesses in equestrian athletes are limited. The objective of this study was to describe the incidence, prevalence, and severity of health Problems among a cohort of elite riders. Methods: We conducted a prospective cohort study with 38 elite equestrian athletes over a two-year follow-up period. Health Problems were recorded weekly with the Oslo Sports Trauma Research Center Questionnaire on health problems and subsequently categorized into illnesses and injuries according to the recently published International Olympic Committee guidelines. Based on the athlete’s weekly responses, we calculated health Problem prevalence, incidence and severity. Results: A total of 93 health problems were reported including 30 illnesses and 63 injuries resulting in a weekly prevalence of 12.1% (95% CI: 10.5-13.7) for all health problems. For acute injuries, the chest, lumbosacral region, and neck were the most commonly reported body locations. The lumbosacral Region was the most commonly reported repetitive injury mechanism body region. Illnesses most often affected the upper respiratory and gastrointestinal body systems. Conclusion: There was a low prevalence of injuries among this cohort of elite athletes. Future efforts that further improve athlete safety should focus on repetitive mechanism injuries and implementation and scale-up of preventive equipment to the broader equestrian population.
4
Kozachenko, Ihor. "Nonfatal air gun shot trauma: structural analysis and morphological features injuries." Forensic-medical examination, no. 2 (December 30, 2016): 47–51. http://dx.doi.org/10.24061/2707-8728.2.2016.10.
Повний текст джерелаАнотація:
In practical activities of the Ukrainian bureau of forensic we increasingly come across cases of nonfatal air gun injuries. However, experts lack a common methodological approaches for forensic evaluation of injuries, particularly during the examination of living people. An earlier analysis of nonfatal air gun injuries made on materials of only two regional bureau of forensic medical examination, a purely local nature used on a small number of cases using some general parameters can provide processing methodology study of air gun injuries and practical recommendations for the implementation of forensic medical examinations. 127 cases of «Expert’s conclusions» and «Acts of the forensic examination» were investigated, taken from 21 bureaus all regions of Ukraine during the period of 2006-2015, in which was performed forensic medical examinations in cases nonfatal air guns injuries.Discussion. The main causes of nonfatal air gun injuries are named as hooliganism, domestic conflicts, careless handling of weapons and robbery. Among the injured men is 86 %, women – 14 %. Injuries made mostly of air pistols and rifles, caliber 4.5mm. Among the weapons 8 models applied rifles large and extra large capacity. Most commonlywounded parts were head (38 %), chest (17,3 %) and lower limbs (16 %), less common – upper limbs (10,2 %) and neck (3,9 %). Input air gun injuries are mainly wounds (74 %), sometimes abrasions (23 %) and bruising (3 %). The nature and volume air gun injuries primarily dependent on the power of the applied weapon and the affected areas of the body, penetrating wounds from shots of powerful guns are accompanied by injuries of the brain and spinal cord, internal organsof the chest and abdomen bleedings, fractures of the skull, vertebrae, ribs and scapula; of shots from pistols and rifles low penetrating injuries were observed only in the cranial cavity, mostly after bullet passing an eyeball.Conclusions:1. The main causes of nonfatal air gun shot trauma were hooliganism, domestic violence, accidents and robberies. Among the casualties men is 86 %, women – 14 %.2. Injuries made mostly of air pistols and rifles, caliber 4.5mm including extra large power rifles.3. Most cases provided head, chest and lower limbs wounds, fewer cases of upper limbs and neck injuries were observed.4. High and extra large power rifles more caused penetrating air gunshot wounds of major body cavities with injury to the brain and spinal cord, internal organs with hemorrhages and bone fractures. Pistols and low power rifles caused penetrating injuries only in the cranial cavity, commonly after passing projectile eyeball.5. The majority of wounds are defined as minor injuries. Injuries of moderate severity made up only 2%. Serious injuries attributed to 13% according hazard to life and complete loss of sight.
5
Seyedi, MohammadReza, and Sungmoon Jung. "Numerical assessment of occupant responses during the bus rollover test: A finite element parametric study." Proceedings of the Institution of Mechanical Engineers, Part D: Journal of Automobile Engineering 234, no. 8 (December 26, 2019): 2195–215. http://dx.doi.org/10.1177/0954407019894425.
Повний текст джерелаАнотація:
Rollover crashes of buses are usually associated with multiple impacts that can result in complex interactions between passengers and a bus superstructure. Although there have been a few field data studies that provide some insights into occupant injuries (e.g. severity and distribution of injuries) during the real-world bus rollover crash, because they had used post-crash data, the occupant kinematics and injury mechanisms were not completely detailed in their results. Based on a literature review, available numerical and experimental studies on a bus rollover safety have mainly focused on structural integrity rather than considering occupant responses in their assessment. In addition, their results about occupant responses in bus rollover crashes show some discrepancies in terms of the estimated injury distribution, severity, and causes. Therefore, the main objective of this study was to provide a more detailed understanding of the occupant kinematics and associated injury risk during the ECE R66 tilt table bus rollover test using validated finite element (FE) models. The ECE R66 tilt table rollover was simulated using a full finite element model of the bus. A 50th percentile male Hybrid III Anthropomorphic test device (ATD) and EuroSID-2re FE models were selected to simulate the occupant’s motion. Each ATD was seated adjacent to the impacted side wall and restrained with a 2-point seatbelt. Simulation parameters included two impact surface friction values and different side window conditions. The results indicated that both ATD estimated the highest injury risk when the partial ejection occurred. They predicted a similar injury risk for the head and thorax. The ES-2re estimated a very low risk of neck injury in all simulations, whereas the Hybrid III estimated the high risk of a neck injury. Finally, recommendations to potentially reduce the injuries were provided and possible future works were suggested.
6
Lemus, Mario Cahueque, Enrique Vargas Uribe, and José María Jiménez Avila. "Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report." Coluna/Columna 14, no. 1 (March 2015): 53–55. http://dx.doi.org/10.1590/s1808-1851201514010r129.
Повний текст джерелаАнотація:
Cervical spine injuries are often described as catastrophic events in neurological terms, with very low survival rate. Lesions to C3-C7 segment are the most common (about 80%) followed by segment C1-C2 (20%). The cervical spine injuries are of great importance, both by severity as the neurological implications. It is important to consider that among cervical traumas that do not present neurological damage at the time of the accident, 10% have deficits later, so all cervical trauma should be considered as potential spinal cord traumas, until the evolution of the case shows that definitively there is no spinal cord or nerve root damage. Cases have been reported with both atlantooccipital and atlantoaxial dislocations without neurological deficit, so these lesions went unnoticed in the emergency services. Some of the events to be considered at the time of the accident are suboccipital pain on axial skull pressure and spontaneous stiffness of the patient's neck. Dysphagia, pain on palpation of the anterior neck and a visible increase of prepharyngeal mass can also be observed, which is why it is important to keep the suspicion of craniocervical trauma in all patients who have these symptoms and carry out the relevant tests. This paper presents a case of post-traumatic atlantoaxial dislocation, which showed no neurological deficit at the time of the accident, but was later presented, as well as the surgical procedure carried out.
7
Lee, Christine, Ekaterina Tiourin, Sawyer Schuljak, Jonathan Phan, Theodore Heyming, John Schomberg, Elizabeth Wallace, Yigit Guner, and Raj Vyas. "Surgical Treatment of Pediatric Dog-bite Wounds: A 5-year Retrospective Review." Western Journal of Emergency Medicine 22, no. 6 (October 27, 2021): 1301–10. http://dx.doi.org/10.5811/westjem.2021.9.52235.
Повний текст джерелаАнотація:
Introduction: Dog bites are a significant health concern in the pediatric population. Few studies published to date have stratified the injuries caused by dog bites based on surgical severity to elucidate the contributing risk factors. Methods: We used an electronic hospital database to identify all patients ≤17 years of age treated for dog bites from 2013–2018. Data related to patient demographics, injury type, intervention, dog breed, and payer source were collected. We extracted socioeconomic data from the American Community Survey. Data related to dog breed was obtained from public records on dog licenses. We calculated descriptive statistics as well as relative risk of dog bite by breed. Results: Of 1,252 injuries identified in 967 pediatric patients, 17.1% required consultation with a surgical specialist for repair. Bites affecting the head/neck region were most common (61.7%) and most likely to require operating room intervention (P = 0.002). The relative risk of a patient being bitten in a low-income area was 2.24, compared with 0.46 in a high-income area. Among cases where the breed of dog responsible for the bite was known, the dog breed most commonly associated with severe bites was the pit bull (relative risk vs German shepherd 8.53, relative risk vs unknown, 3.28). Conclusion: The majority of injuries did not require repair and were sufficiently handled by an emergency physician. Repair by a surgical specialist was required <20% of the time, usually for bites affecting the head/neck region. Disparities in the frequency and characteristics of dog bites across socioeconomic levels and dog breeds suggest that public education efforts may decrease the incidence of pediatric dog bites.
8
Temizel, Selin, Robert Wunderlich, and Mats Leifels. "Characteristics and Injury Patterns of Road Traffic Injuries in Urban and Rural Uganda—A Retrospective Medical Record Review Study in Two Hospitals." International Journal of Environmental Research and Public Health 18, no. 14 (July 19, 2021): 7663. http://dx.doi.org/10.3390/ijerph18147663.
Повний текст джерелаАнотація:
In the ongoing Second Decade of Action for Road Safety, road traffic crashes pose a considerable threat especially in low-income countries. Uganda shows a vast burden of non-fatal injuries and resides at the top range of countries with the highest death rates due to unsafe roads. However, little is known about the differences in road traffic associated injuries between urban and rural areas and potential influence factors. Here, we used a cross-sectional study conducted by a retrospective medical record review from trauma cases admitted in 2016 to hospitals in rural and urban areas in Uganda. Injury severity scores were calculated and descriptive analysis was carried out while multivariate logistic regression was applied to assess significant covariates. According to the 1683 medical records reviewed, the mean age of trauma patients in the dataset under investigation was 30.8 years with 74% male. The trauma in-hospital mortality was 4% while prevalence of traumatic injuries is 56.4%. Motorcycle users (49.6%) and pedestrians (33.7%) were identified as the most vulnerable groups in both urban and rural setting while mild injuries of extremities (61.6%) and the head/neck-region (42.0%) were registered most. The frequency of road traffic injuries was homogenous in the urban and rural hospitals investigated in this study; interventions should therefore be intensified ubiquitously. The identification of significant differences in road traffic crash and injury characteristics provides the opportunity for specific programmes to decrease the socio-economic and health burden of unsafe roads. In addition to law enforcement and introduction of a Systems Thinking approach to road safety including infrastructural and educational concepts, the strengthening of trauma care and health resources is recommended.
9
Del Ciampo, Luiz Antonio, Ivan Savioli Ferraz, Maria Tazima, Letícia Graziela Bachette, Karla Ishikawa, and Rodrigo Paixão. "Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo." Sao Paulo Medical Journal 130, no. 1 (2012): 27–31. http://dx.doi.org/10.1590/s1516-31802012000100005.
Повний текст джерелаАнотація:
CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8%) were boys and 74 (41.1%) were girls. Their ages were: 10 to 12 (66/36.6%), 12 to 14 (60/33.3%) and 14 to 16 years (54/30%). The injuries had occurred in public places (47.7%) and at home (21.1%). The main types were bruises (45.1%) and falls (39.2%), involving upper limbs (46.1%), lower limbs (31%) and head/neck (13.1%). The injuries occurred in the afternoon (44.4%) and morning (30%), on Mondays (17.7%) and Thursdays (16.6%). Radiological examinations were performed on 53.8%. At the time of injury, 76.1% of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4%. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.
10
Rau, Cheng-Shyuan, Hang-Tsung Liu, Shiun-Yuan Hsu, Tzu-Yu Cho, and Ching-Hua Hsieh. "Alcohol-related hospitalisations of trauma patients in Southern Taiwan: a cross-sectional study based on a trauma registry system." BMJ Open 4, no. 10 (October 2014): e005947. http://dx.doi.org/10.1136/bmjopen-2014-005947.
Повний текст джерелаАнотація:
ObjectivesTo provide an overview of the demographic characteristics of patients with positive blood alcohol concentration (BAC) and to investigate the performance of brain CT scans in these patients.DesignCross-sectional study.SettingTaiwan.Participants2192 patients who had undergone a test for blood alcohol of 13 233 patients registered in the Trauma Registry System between 1 January 2009 and 31 December 2012. A BAC level of 50 mg/dL was defined as the cut-off value. Detailed information was retrieved from the patients with positive BAC (n=793) and was compared with information from those with a negative BAC (n=1399).Main outcome measuresGlasgow Coma Scale (GCS) and Injury Severity Score (ISS) as well as the performance and findings of obtained brain CT scans.ResultsPatients with positive BAC had a higher rate of face injury, but a lower GCS score, a lower rate of head and neck injury, a lower ISS and New Injury Severity Score. Alcohol use was associated with a shorter length of hospital stay (8.6 vs 11.4 days, p=0.000) in patients with an ISS of <16. Of 496 patients with positive BAC who underwent brain CT, 164 (33.1%) showed positive findings on CT scan. In contrast, of 891 patients with negative BAC who underwent brain CT, 389 (43.7%) had positive findings on CT scan. The lower percentage of positive CT scan findings in patients with positive BAC was particularly evident in patients with an ISS <16 (18.0% vs 28.8%, p=0.001).ConclusionsPatients who consumed alcohol tended to have a low GCS score and injuries that were less severe. However, given the significantly low percentage of positive findings, brain CT might be overused in these patients with less severe injuries.
11
Pham, Linda, Jaclyn N. Portelli Tremont, Adam Bruderick, John Nazarian, Pascal Osita Udekwu, Edmund J. Rutherford, and Scott M. Moore. "Post-Mortem CT Delivers Fast and Accurate Injury Identification in Trauma Patients." American Surgeon 88, no. 5 (March 20, 2022): 973–80. http://dx.doi.org/10.1177/00031348221078985.
Повний текст джерелаАнотація:
Background Accurate and timely injury identification is critical but difficult to achieve in trauma patients who die shortly after arrival to the hospital. Autopsy has historically been used to detect injuries, but few undergo formal autopsy. This study investigates the utility of post-mortem computed tomography (PMCT) for injury identification in a diverse trauma population. Methods Cross-sectional study of adult trauma patients who died within 24 hours of arrival to a Level I trauma center were included. Among patients with PMCT, injury severity score (ISS) and number of injuries (NOI) were calculated either from physical exam alone (pre-PMCT) or exam and imaging (post-PMCT). ISS and NOI before and after PMCT were compared. A cause of death analysis was performed for patients who underwent comprehensive (ie, head, neck, and torso) PMCT. Non-parametric repeated measures tests were used, as appropriate. Results 7.3% (N = 28) of patients received PMCT. Compared to pre-PMCT, median ISS (21 vs 3.5) and NOI (5 vs 2) were greater post-PMCT ( P < .001, respectively). Autopsy rate was 13.2% overall; 82.5% of autopsies were due to a penetrating mechanism, and median time to autopsy reporting was 38.5 days. Among 17 patients who received comprehensive PMCT, 64.7% had a single cause of death identified, and the remaining were classified as either multiple potential contributors or unknown. Discussion PMCT is a readily available method to identify injuries in trauma patients who expire shortly upon presentation. Given the low autopsy rate for blunt trauma and delay in reporting, PMCT is an important adjunct for trauma providers.
12
Infinger, Allison E., and Jonathan R. Studnek. "An Assessment of Pain Management Among Patients Presenting to Emergency Medical Services After Suffering a Fall." Prehospital and Disaster Medicine 29, no. 4 (June 19, 2014): 344–49. http://dx.doi.org/10.1017/s1049023x14000594.
Повний текст джерелаАнотація:
AbstractIntroductionEmergency Medical Services (EMS) professionals frequently care for patients experiencing acute pain. Analgesics are critical in patient comfort and satisfaction levels during the treatment of acute pain. The objective of this study was to assess the frequency of pain management in patients suffering a fall, the documented pain score, and the location of their injuries. It was hypothesized that the frequency of analgesia administration was low and would be associated with injury location.MethodsThis was a retrospective review of patients presenting with a complaint of an injury from a fall transported by a single municipal EMS system. Administration of analgesia was the primary outcome variable, with pain severity, injury location, age, gender, race, and distance of fall the independent variables of interest. Pain severity was assessed using a 0-10 scale. Injury location was defined as head/neck, extremities, back, and hip. Patients were deemed ineligible for analgesia, according to local protocol, if they reported chest or abdominal pain, or were hemodynamically unstable as determined by an assessment of pulse and blood pressure.ResultsThere were 1,200 patients who were classified as having injuries suffered from a fall, with 76 (6.3%) ineligible for analgesia. Ninety-two (8.2%) patients received analgesia, and they had a mean recorded pain score of 9.1 (95% CI, 8.7-9.5), which was higher than those who did not receive analgesia (5.8; 95% CI, 5.5-6.2). Analgesia administration was associated with injury location; patients experiencing an extremity injury (OR = 13.23; 95% CI, 5.58-31.36; P < .001) or hip injury (OR = 11.65; 95% CI, 4.64-29.24; P < .001) had increased odds of analgesia administration compared to those with head/neck injury. The odds of analgesia administration were decreased for black patients (OR = 0.19; 95% CI, 0.08-0.44; P < .001) when compared to white patients.ConclusionAnalgesia administration was provided to 10% of eligible patients, and was associated with injury location. Of concern was the number of patients who suffered a fall and did not receive a documented pain score. The results from this study indicated a need for education relating to pain management in patients suffering a fall.InfingerAE, StudnekJR. An assessment of pain management among patients presenting to Emergency Medical Services after suffering a fall. Prehosp Disaster Med. 2014;29(4):1-6.
13
Sultan, Amina. "Paediatric Dentist's Proactiveness in Understanding and Managing Child Abuse and Neglect (CAN)." Journal of Indo Pacific Academy of Forensic Odontology. 10, no. 01 (May 25, 2020): 5–14. http://dx.doi.org/10.53275/inapfo.2231-1092-2231-15721012.
Повний текст джерелаАнотація:
Child abuse and Neglect (CAN), is now a centre of public attention after prolonged neglect by both society and medical professionals. Child neglect is a form of child maltreatment. There is evidence in the literature that 50% of all injuries involve the head and neck region, which places dentists particularly paediatric dentist at the forefront of abuse detection. Based on available records, the majority of dentists confirm that they can recognize abuse, strangely, a great number of them shows reluctance in reporting to appropriate authorities. The reporting is required not only for ethical reasons but also Section 21(1) of the Protection of Children from Sexual Offences (POCSO) Act, 2012 has made it compulsory to inform about and incidents of child sexual abuse to the law enforcement jurisdiction. This applies to everyone including parents, medical professionals, and school authorities. If suspicion of abuse occurs, all valid information must be documented with radiographs, photographs and impressions. A comprehensive report should be made in the dental chart concerning the presence, site, severity and distribution of the injuries
14
Mersky, A., M. Eberhardt, P. Overfield, S. Melanson, J. Stoltzfus, and J. Prestosh. "301: The Effect of the Repeal of the Pennsylvania Helmet Law on the Severity of Head and Neck Injuries Sustained in Motorcycle Accidents." Annals of Emergency Medicine 54, no. 3 (September 2009): S94. http://dx.doi.org/10.1016/j.annemergmed.2009.06.332.
Повний текст джерела
15
Fredriksen, Torbjørn A., Harald Hovdal, and Ottar Sjaastad. "“Cervicogenic Headache”: Clinical Manifestation." Cephalalgia 7, no. 2 (June 1987): 147–60. http://dx.doi.org/10.1046/j.1468-2982.1987.0702147.x.
Повний текст джерелаАнотація:
The main criteria of “cervicogenic headache” are considered to be as follows: relatively rare and long-lasting unilateral attacks of severe headache, although seemingly of a non-excruciating character, signs of neck involvement, and lack of “cluster pattern”. In the present communication, the clinical manifestations in 11 patients fulfilling these criteria are described. All 11 patients selected in accordance with these criteria proved to be females, the age at onset ranging from 6 to 40 years (mean, 30 years). The mean duration of symptoms was 13 years. Six patients had had previous head/neck injuries. All patients had pain periorbitally, in the temporal region, and in the low occipital region (nape of the neck); less frequent were frontal, parietal, and facial pain and pain in the upper part of the occipital region. The duration of attacks was from 3 h to 3 weeks, and the interval between attacks lasted from 2 days to 2 months. The commonest accompanying phenomena were phonophobia, dizziness, ipsilateral eyelid edema, ipsilaterally blurred vision, and irritability. Some of the patients also had nausea ( n = 7) and vomiting ( n = 6). On physical examination, slight to moderate reduction of movements in the neck was noted, and five patients had ipsilaterally reduced sensation for touch in the trigeminal area. All the patients except one were severely afflicted. Attacks could, in addition to occurring spontaneously, be precipitated in all patients by head movements or by pressure at specific points in the neck.
16
Kulas, M., L. Brueton-Campbell, E. Weldon, N. McDonald, and R. Pryce. "MP14: Quantification of head-neck motion in trauma patients in the emergency department under spinal motion restriction: a prospective observational study." CJEM 22, S1 (May 2020): S47. http://dx.doi.org/10.1017/cem.2020.162.
Повний текст джерелаАнотація:
Introduction: This was a prospective observational study involving a convenience sample of low-risk trauma patients presenting to a Level 1 Trauma Centre under spinal motion restriction (SMR). To our knowledge no prior studies have objectively measured head-neck (H-N) motion in trauma patients with suspected spine injuries during emergency department (ED) care. The goal was to establish the feasibility of deploying non-invasive motion sensors on trauma patients in the ED and to provide initial estimates for H-N kinematics under SMR during different phases of treatment. Methods: Low-risk adult patients treated by Winnipeg Fire Paramedic Service who sustained non-life threatening trauma with the potential for spine injury were eligible for inclusion. Participants received usual pre-hospital care; application of spine board and/or cervical collar, as determined by local practice protocol. Inertial measurement units (IMUs) were placed on participant's forehead, sternum and stretcher upon arrival to the ED. Data was collected during three phases of care: patient handling (log rolls, transfers, clothing removal); stretcher movement (to imaging, etc); stretcher stationary. IMUs were removed upon disposition decision by the attending physician. IMUs yielded data on H-N motion in terms of linear acceleration (resultant) and angular displacement (rotation + flexion-extension + side-flexion = total). Peak (M +/- SE) displacements and accelerations are reported, with comparisons across treatment phases using repeated measures ANOVA. Results: Eleven patients were enrolled in the study (age: 49 +/- 16 years; Injury Severity Score 13.4 +/- 9.9; female = 2). Substantial H-N motion was observed during ED care. Total H-N displacement (28.6 +/- 3.6 deg) and acceleration (7.8 +/- 1.0 m/s2) were higher during patient handling compared to stretcher moving (13.0 +/- 2.5 deg; 4.6 +/- 0.9 m/s2; p < .05) but not while the stretcher was stationary (18.9 +/- 3.4 deg; 5.4 +/- 1.2 m/s2; p > .06). Similar differences were detected for side-flexion and flexion-extension (p < .05), with peak displacements of 11.4+/-1.5 deg and 14.6 +/- 2.2 deg during patient handling, respectively. Conclusion: IMU use on trauma patients safely described H-N motion kinematics in a small sample of patients with different spectrums of illness during their care in the ED. Future studies utilizing IMUs could inform ED spine motion restriction protocols and compare movement of patients in specific subsets (intoxicated, spinal tenderness, injury severity etc.).
17
Cheng, CH, WT Yim, NK Cheung, JHH Yeung, CY Man, CA Graham, and TH Rainer. "Differences in Injury Pattern and Mortality between Hong Kong Elderly and Younger Patients." Hong Kong Journal of Emergency Medicine 16, no. 4 (October 2009): 224–32. http://dx.doi.org/10.1177/102490790901600405.
Повний текст джерелаАнотація:
Background The rapidly aging population in Hong Kong is causing an impact on our health care system. In Hong Kong, 16.5% of emergency department trauma patients are aged ≥65 years. Objective We aim to compare factors associated with trauma and differences in trauma mortality between elderly (≥65 years) and younger adult patients (15 to 64 years) in Hong Kong. Methods A retrospective observational study was performed using trauma registry data from the Prince of Wales Hospital, a 1200–bed acute hospital which is a regional trauma centre. Results A total of 2172 patients (331 [15.2%] elderly and 1841 [84.8%] younger) were included. Male patients predominated in the younger adult group but not in the elderly group. Compared with younger patients, elderly patients had more low falls and pedestrian-vehicle crashes and sustained injuries to the head, neck and extremities more frequently. The odds ratio (OR) for death following trauma was 5.5 in the elderly group (95% confidence interval [CI] 3.4–8.9, p>0.0001). Mortality rates increased progressively with age (p>0.0001) and were higher in the elderly at all levels of Injury Severity Score (ISS). Age ≥65 years independently predicted mortality (OR=5.7, 95% CI 3.5–9.3, p>0.0001). The elderly had a higher co-morbidity rate (58.6% vs. 14.1%; p>0.01). There was a lower proportion of trauma call activations for the elderly group (38.6% vs. 53.3%; p>0.01). Conclusion Elderly trauma patients differ from younger adult trauma patients in injury patterns, modes of presentation of significant injuries and mortality rates. In particular, the high mortality of elderly trauma requires renewed prevention efforts and aggressive trauma care to maximise the chance of survival.
18
Shahsavarinia, Kavous, Hassan Soleimanpour, Sepideh Harzand Jadidi, Mohammad Saadati, Aida Javanmardi, and Gilani Neda. "Determinants of Hospital Length of Stay among Burn Patients Using Quantile Regression." Depiction of Health 12, no. 3 (February 13, 2021): 262–72. http://dx.doi.org/10.34172/doh.2021.26.
Повний текст джерелаАнотація:
Background and Objectives Burns is one of the most common and potentially dangerous public health problems. Burn patients' hospitalization facilitates the provision of medical services. However, prolonging the length of hospital stay can not only impose an economic cost, but also cause various infections in patients. Various factors affect patients’ hospitalization length including patients age and gender, burn cause, anatomic place and its severity. Identifying and considering these factors will reduce burn patient’s hospitalization and its consequences. The aim of this study was to evaluate the factors affecting hospitalization length in burn patients admitted to Sina Hospital as burn referral hospital in Northwest of Iran. Material and Methods In this cross-sectional study, the medical records of burn patients who were admitted to Sina Hospital in Tabriz during 2018, were included. Data collection was performed using a goal-based researcher data collection form. The form included patient’s demographics (age, gende, marital status, education level, occupation, comorbidity) and Status of vital signs at admission including respiratory rate, heart rate, body temperature, Glasgow Coma Scale score (less than 12 moderate injuries, 13 and 14 mild injuries, 15 or more normal) and systolic and diastolic blood pressure, burn place, date, cause, TBSA, burn severity, length of stay and outcome. Data were analyzed using Stata 16 software and through quantile regression modeling. Data normality was evaluated using Kolmogorov-Smirnov test, skewness and kurtosis. Due to the skewness of the hospitalization variable distribution (hospitalization length was a non-negative variable with right skew and skewness coefficient of 4.72 and kurtosis coefficient equal to 6.53), to obtain a complete picture of how the conditioned distribution of the response variable changes from variables Independently, Quantile regression was used for modeling with a significance level of P <0.05. Results The total number of hospitalized burn patients was 1586 of whom 998 (62.3%) were male. The mean age of the patients was 25.5 ± 22.9 years. Most of the patients were in age-group 0-5 years. About 22.3% of patients were in Tachypnea situation and 33.3% had low blood pressure. Based on Glasgow score, 0.3% of patients were with moderate and 2.2% with low injury. Only 15.4% of patients were with more than 20% burn in their body. Burn degree III was the most prevalent injury (35.1%). Upper limbs (62.9%) were the most anatomic sections injured in burn. Totally 94 patients (5.9%) were died due to burn injuries. Burns occurred more often in summer (30.5%) and at home (n=1246, 78.6%). The median length of hospitalization was 8 days (95% CI: 7.34-8.57). Single (P = 0.010) and illiterate patients (P = 0.022) had a longer hospitalization length. The lower the Glasgow coma score at admission, resulted in longer hospital stay (P = 0.034). Patients with burn on face (P = 0.037), head and neck (P <0.001) and back of the trunk (P = 0.031) had longer hospital stay, respectively. The higher the percentage of burns, the longer the hospital stay (P <0.001) and the presence of concurrent trauma also increased the length of hospital stay (P <0.001). Conclusion Glasgow coma score, burns on the face, neck and back were identified as effective clinical signs on hospitalization length of stay amongst burn patients. Considering these factors in the triage of burn patients, providing quality treatment and care services to manage these symptoms can reduce the length of hospital stay and ultimately lead to a reduction in social and economic costs for patients and society. Extended Abstract Background and Objectives Burns is one of the most common and potentially dangerous public health problems. Burn patients' hospitalization facilitates the provision of medical services. However, prolonging the length of hospital stay can not only impose an economic cost, but also cause various infections in patients. Various factors affect patients’ hospitalization length including patients age and gender, burn cause, anatomic place and its severity. Identifying and considering these factors will reduce burn patient’s hospitalization and its consequences. The aim of this study was to evaluate the factors affecting hospitalization length in burn patients admitted to Sina Hospital as burn referral hospital in Northwest of Iran. Material and Methods In this cross-sectional study, the medical records of burn patients who were admitted to Sina Hospital in Tabriz during 2018, were included. Data collection was performed using a goal-based researcher data collection form. The form included patient’s demographics (age, gende, marital status, education level, occupation, comorbidity) and Status of vital signs at admission including respiratory rate, heart rate, body temperature, Glasgow Coma Scale score (less than 12 moderate injuries, 13 and 14 mild injuries, 15 or more normal) and systolic and diastolic blood pressure, burn place, date, cause, TBSA, burn severity, length of stay and outcome. Data were analyzed using Stata 16 software and through quantile regression modeling. Data normality was evaluated using Kolmogorov-Smirnov test, skewness and kurtosis. Due to the skewness of the hospitalization variable distribution (hospitalization length was a non-negative variable with right skew and skewness coefficient of 4.72 and kurtosis coefficient equal to 6.53), to obtain a complete picture of how the conditioned distribution of the response variable changes from variables Independently, Quantile regression was used for modeling with a significance level of P <0.05. Results The total number of hospitalized burn patients was 1586 of whom 998 (62.3%) were male. The mean age of the patients was 25.5 ± 22.9 years. Most of the patients were in age-group 0-5 years. About 22.3% of patients were in Tachypnea situation and 33.3% had low blood pressure.Based on Glasgow score, 0.3% of patients were with moderate and 2.2% with low injury. Only 15.4% of patients were with more than 20% burn in their body. Burn degree III was the most prevalent injury (35.1%). Upper limbs (62.9%) were the most anatomic sections injured in burn. Totally 94 patients (5.9%) were died due to burn injuries.Burns occurred more often in summer (30.5%) and at home (n=1246, 78.6%). The median length of hospitalization was 8 days (95% CI: 7.34-8.57). Single (P = 0.010) and illiterate patients (P = 0.022) had a longer hospitalization length. The lower the Glasgow coma score at admission, resulted in longer hospital stay (P = 0.034). Patients with burn on face (P = 0.037), head and neck (P <0.001) and back of the trunk (P = 0.031) had longer hospital stay, respectively. The higher the percentage of burns, the longer the hospital stay (P <0.001) and the presence of concurrent trauma also increased the length of hospital stay (P <0.001). Conclusion Glasgow coma score, burns on the face, neck and back were identified as effective clinical signs on hospitalization length of stay amongst burn patients. Considering these factors in the triage of burn patients, providing quality treatment and care services to manage these symptoms can reduce the length of hospital stay and ultimately lead to a reduction in social and economic costs for patients and society. Practical implications of research Paying attention to the effective symptoms during the stay of burn patients during triage of these patients and providing quality treatment and care services to manage these symptoms can reduce the length of hospital stay and ultimately lead to a reduction in its social and economic costs. For patients and the community. Ethical considerations This research was carried out after the approval of the Ethics Committee of the Vice Chancellor for Research of Tabriz Azad University of Medical Sciences, as a dissertation for general medicine. Data related to patients with burn injuries admitted to Sina Hospital in 1397 were coded in the form of data registration without name and information. Also, all patient information was kept completely confidential and the information obtained from the study was used for research purposes only. Conflict of interest The authors state that there is no conflict of interest in publishing this article. Acknowledgement The present article is taken from the dissertation of General Doctor of Medicine. The authors consider it necessary to express their gratitude to the Vice Chancellor for Research and Technology of Tabriz Azad University of Medical Sciences and the director of Sina Hospital and the people participating in the research.
19
Ali, Nadir, Sadaf Sajid, Fatima Arshad, Usama Ahmad, and Humza Naveed. "Motorization Rate Resulting in a Road Traffic Accident an Epidemiological Audit of Injuries and Factors in the Medium-Scaled Cities of Punjab, Pakistan." Pakistan Journal of Medical and Health Sciences 16, no. 7 (July 30, 2022): 347–50. http://dx.doi.org/10.53350/pjmhs22167347.
Повний текст джерелаАнотація:
Background: Motor vehicles are increasing exponentially day by day all over the world with a global increasing prevalence of road traffic accidents. This situation of mass motorization has affected developing countries like Pakistan as well. Due to a lack of popper legislation and implementation of the law, the RTA situation is worse and requires proper research of epidemiological factors and medico-legal evaluation of injuries. Purpose: To see the pattern of RTA injuries and various epidemiological factors influencing them in the medium-scaled city like Sargodha, Gujranwala, Sialkot, and Gujarat Punjab, Pakistan. Study design: It is a retrospective study to evaluate and assess the pattern, severity, and epidemiological factors concerning RTA injuries and their medico-legal relationship during four years period from 2016 to 2019 in the medium-scaled cities of Punjab, Pakistan. Nearly 300 cases were selected to get information on predesigned Performa from Hospital records of DHQ Teaching Hospitals of Sargodha, Gujranwala, Sialkot, and Gujarat. Method and materials: After collecting data on designed Performa, the information was collected about epidemiological factors, type of injuries, the pattern of injury, outcome of injury, and medico-legal outcome for furthering justice. A descriptive statistical method was applied for the analysis and evaluation of collected data. Furthermore, standard deviation, F-statistics, and Chitest p-value were also applied to see the association of epidemiological factors with RTA injuries. Results: In a total of 300 cases of road traffic accidents, the average age was found 28.5years of age with gender male in most of the cases (86%). The 15-35 years age group was identified in more than 70 % of cases with the majority of accidents being motorcyclists with pillion riders and pedestrians. The majority of victims suffered RTA injuries while crossing the roads and constituted 30.66 % of all the cases followed by the victims passing by the side of roads with 24 %. The head and neck injuries were the most affected in most of these cases followed by extremities injuries. Conclusion: Motorcyclists with pillion riders were mostly involved in road traffic accidents. Males in the age group 20-30 years were the most affected victims being the socially active age group involved in motoring. The grievous and life-threatening injuries are increasing resulting in a very high rate of mortality and morbidity in society. The study suggests strict legislation and proper implementation of health and safety measures to avoid high RTA rates. Keywords: Motorization, RTA, automobile accidents, grievous injuries, health & safety measures.
20
Bhanushali, Riya. "Regeneration Potential of Stem Cell in the Treatment of IVD." International Journal for Research in Applied Science and Engineering Technology 9, no. 8 (August 31, 2021): 3022–36. http://dx.doi.org/10.22214/ijraset.2021.37908.
Повний текст джерелаАнотація:
Abstract: Degenerative disc disease is a prevalent musculoskeletal disorder in which damaged spinal discs cause pain upon aging, accidental injuries. Spinal discs connect adjacent vertebrae and help in maintaining mobility, flexibility and rotation of spinal cord. Spinal discs also act as shock absorbers. Intervertebral disc (IVD) degeneration is often associated with low back and neck pain, which accounts for disability worldwide. Physical therapy, spinal fusion surgeries reduce severity and symptoms of degenerative disc disease but they are not complete cure for this disease. Current preclinical studies show that mesenchymal stem cells have the capacity to repair degenerative disks by differentiation to chondrocyte-like cells, which produce proteoglycans and type II collagen. Mesenchymal stem cells (MSCs) isolated from bone marrow (BM-MSCs), adipose tissue (AD-MSCs) and umbilical cord (UC-MSCs) show potential use in cartilage and intervertebral disc (IVD) repair. Regenerative medicine and stem cell therapy hold great promise for treatment of intervertebral disc (IVD) disease. This review discusses about progression of degenerative disc disease, various types of stem cells, potential use of mesenchymal stem cells (MSCs) and embryonic stem cells (ESCs) for the treatment of degenerative disc disease. This review also focuses upon challenges encountered by the application of stem cell therapy for treating degenerative disc disease as well as future perspectives. Keywords: IVD, Stem cell therapy, AF & NP cells, MSCs, Scaffolds, Cell therapy
21
Farooqi, Iqra N., and Anupa Sharma. "Unusual Case of Pelvic Osteomyelitis Revealing Osteoporosis." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A230—A231. http://dx.doi.org/10.1210/jendso/bvab048.468.
Повний текст джерелаАнотація:
Abstract Pelvic osteomyelitis is an uncommon and challenging condition to treat. Pressure ulcers, spinal injuries, contiguous sources of tracking infections, pelvic surgical procedures, traumatic injuries and open fractures all serve as nidi for developing pelvic osteomyelitis. We present a case of pelvic osteomyelitis suspected to be caused by insufficiency fractures due to osteoporosis in an anorexic adult.51 year old postmenopausal Caucasian female with undiagnosed anorexia presented to the hospital for severe right-sided pelvic pain and nausea. She denied fevers, vomiting, trauma, surgical procedures, history of pelvic infections, abnormal vaginal discharge, travel, prolonged steroid therapy. She disclosed a strict vegetarian diet, excessive daily exercise, low dairy intake and over 100lb intentional weight loss over the past 30 years. She reported normal menses, used oral contraceptives between ages of 25 to 30, and reached menopause at 49 years. For many years, she denied medical care including age-appropriate cancer screenings. She is employed in academia and denies tobacco, alcohol or drug use. On admission, height 153cm and weight 43kg, BMI 16.7kg/m2. Examination was notable for frail body habitus, moderate RLQ and pelvic tenderness, prominent PSIS and SI joints with decreased RLE range of motion. Laboratory results showed calcium 9.5mg/dL (n 8.6–10.4), phosphorus 4.1mg/dL (2.5–4.5), ALP 181IU/L (45–115), PTH 23pg/dL (n 9–76), Vitamin D 35ng/dL (n 25–80), 24-hour urinary calcium 285mg/24h (n 50–400). Abdominopelvic CT scan showed chronic right pubic ramus and bilateral sacral insufficiency fractures confirmed on MRI with septic arthritis of the pubic symphysis, osteomyelitis of pubic bodies and intramuscular abscess extending to the right adductor muscle. Wound culture was positive for Streptococcus viridans and pelvic bone biopsy showed degenerative changes. The patient completed IV Ceftriaxone therapy and underwent DXA scan confirming osteoporosis (T-scores:-3.8 lumbar spine L1-L4, -3.6 left femoral neck, -3.3 right femoral neck). Alendronate 10mg daily and calcium citrate-vitamin D 1000mg-800IU twice daily was prescribed. Diagnostic workup for secondary causes of severe osteoporosis was unremarkable except for hypercalciuria, for which calcium supplement was held with a plan to repeat in the future. Concern for her cachectic appearance and severity of her illness also elicited a dietician referral. Pelvic osteomyelitis and septic arthritis are seldom found without inciting insults. We report an atypical cause of presumed anorexia induced osteoporosis resulting in pelvic osteomyelitis. Untreated osteoporosis may lead to fracture, resulting in inflammation and predisposing patients to infections. Thus, early recognition and evaluation of osteoporosis in patients at high risk for fracture, such as patients with anorexia, is critical for prevention.
22
Rhee, John, Lindsay A. Tetreault, Jens R. Chapman, Jefferson R. Wilson, Justin S. Smith, Allan R. Martin, Joseph R. Dettori, and Michael G. Fehlings. "Nonoperative Versus Operative Management for the Treatment Degenerative Cervical Myelopathy: An Updated Systematic Review." Global Spine Journal 7, no. 3_suppl (September 2017): 35S—41S. http://dx.doi.org/10.1177/2192568217703083.
Повний текст джерелаАнотація:
Study Design: Systematic review (update). Objective: Degenerative cervical myelopathy (DCM) is a progressive degenerative spine disease that is increasingly managed surgically. The objective of this study is to determine the role of nonoperative treatment in the management of DCM by updating a systematic review published by Rhee and colleagues in 2013. The specific aims of this review were (1) to determine the comparative efficacy, effectiveness, and safety of nonoperative and surgical treatment; (2) to assess whether myelopathy severity differentially affects outcomes of nonoperative treatment; and (3) to evaluate whether activities or minor injuries are associated with neurological deterioration. Methods: Methods from the original review were used to search for new literature published between July 20, 2012, and February 12, 2015. Results: The updated search yielded 2 additional citations that met inclusion criteria and compared the efficacy of conservative management and surgical treatment. Based on a single retrospective cohort, there were no significant differences in posttreatment Japanese Orthopaedic Association (JOA) or Neck Disability Index scores or JOA recovery ratios between patients treated nonoperatively versus operatively. A second retrospective study indicated that the incidence rate of hospitalization for spinal cord injury was 13.9 per 1000 person-years in a nonoperative group compared with 9.4 per 1000 person-years in a surgical group (adjusted hazard ratio = 1.57; 95% confidence interval = 1.11-2.22; P = .011). Conclusion: Nonoperative management results in similar outcomes as surgical treatment in patients with a modified JOA ≥ 13, single-level myelopathy and intramedullary signal change on T2-weighted magnetic resonance imaging. Furthermore, patients managed nonoperatively for DCM have higher rates of hospitalization for spinal cord injury than those treated surgically. The overall level of evidence for these findings was rated as low.
23
Hameed, Abdul. "Traumatic brain injury of childhood." Journal of Fatima Jinnah Medical University 15, no. 2 (December 6, 2021): 52–53. http://dx.doi.org/10.37018/zncr2683.
Повний текст джерелаАнотація:
It is a common observation, and very unfortunate one, that only the driver wears or “bears” helmets on motorbikes. None of the other passengers, especially children, are supposed to be protected against head injury. The same callous attitude is observed in cars where children are sometimes sitting in the lap of the front seater without tightening with the seat belt. Kids are thrown in the air to recatch them for pleasure or shaken severely. At times intentionally or unintentionally abused and hit or slapped on head or face without understanding how much harm is posed to them psychologically and physically. “Children are not mini-adults.” Their unique unprotected anatomy and premature physiology make them vulnerable to catastrophic permanent damage and even death.
Traumatic brain injury (TBI) frequently occurs in young people. It remains the most common cause of disability and death between the ages 1 and 45.1 TBI cases are increasing rapidly in Pakistan with the increase in population and poor domestic, road, and sports safety considerations.1,2 Falls from height remain on top while reviewing the modes of injury followed by road traffic accidents. Child abuse is increasingly observed important reason for a head injury, especially in infants and young children, as they are more vulnerable and dependent on adults.2 Abusive head trauma (AHT) is unfortunately common in children up to two years. These children may appear with drowsiness, delayed milestones, seizures, and intracranial traumas of different stages of healing. Other associated injuries may be retinal bleeds, multiple rib fractures, and long bone fractures of different stages of recovery. Child abuse should be promptly identified and appropriately reported.
Children are different from adults and more vulnerable to traumatic brain injuries because of their proportionately larger head, low blood circulating volume, and thin osteo-fibrous non-rigid skull. More watery and less myelinated brain, non-aerated paranasal sinuses, and less CSF cushion to protect shaking and damage. Children are also vulnerable to TBI during the birth process. During normal delivery and especially
DOI: https://doi.org/10.37018/ZNCR2683
difficult instrument-assisted births neonates are left with various types of intracranial hemorrhages. Cephalic and subgaleal hematomas are not uncommonly seen. This is due to increased flexibility or decreased rigidity of the neonatal skull. This increased elasticity of premature skull caused some degree of skull deformation in small children when they are shacked. The irregular base of the skull, especially in the anterior and middle cranial fossa, and the absence of adequate CSF cushion and watery consistency of the brain make it vulnerable to “shaken baby syndrome.” When a child is severely shacked, stretching and shearing forces may tear vessels and cause contusions in brain parenchyma. It may end up in subdural hematomas and intraparenchymal contusions.
Head size in the pediatric age group is proportionately larger than the body, making the head a bigger target for trauma. A thin neck also accompanies this with weak neck muscles, and it increases the chances of neck trauma and cervical spinal cord injury in children. It is mandatory to inspect and rule out any spinal injury with head trauma. Children have not yet developed paranasal air sinuses that could absorb force of direct impact on the skull and hence the brain. It makes the brain less protected from trauma. Children also have less circulating volume, so lacerating scalp wounds, contrary to adults, may be cause of hypovolemic shock and death in children.
Skull fractures and the resulting severity of TBI in children are similar to in adults.1-3 Child may come with huge linear fractures spanning over parietal, occipital, temporal, and frontal bones. These may or may not be associated with dural tears and CSF leaks. Most fractures may not need surgical treatment. There are two types of fractures specific for the early age group. A greenstick ping pong ball fracture occurs when a parietal eminence strikes over or is hit upon. It usually is associated with falls from the bed over a hard surface. Spontaneous resolution is observed in early neonates, but in toddlers, it may need surgical elevation if untreated is a potential cause of seizure activity of the brain in the future. Growing skull fracture of neonates and children younger than two years is earlier a linear fracture that grows due to pulsatile leptomeningeal or brain herniation through free edges of fracture and separating these edges apart. It should be treated surgically. Epidural hematomas in children are primarily venous sinus hemorrhages when fracture line runs over and tears the venous sinuses. Arterial causes of epidural hematoma are also possible. Indications for surgery in symptomatic patients are the same as in adults. Most non-symptomatic hematomas may resolve spontaneously by seepage through overlying skull fractures and absorption in subgaleal space.3
Goals and means of treatment of traumatic brain injury are similar in children as in adults.3,4 Primary goal of treatment is to identify primary brain insults and prevent their conversion into secondary brain injure. Secondary brain injury is a result of an ongoing increase in brain oedema and reduction in cerebral perfusion. Resulting brain ischemia may cause death or irreversible mental damage. This can be achieved, stepwise, by elevation of the head by 30 degrees to facilitate CSF and venous drainage out of intracranial compartment while keeping airway patent, oxygenation, use of osmotic diuretics, external ventricular drainage of CSF, evacuation of intracranial hematomas, elective ventilation and barbiturate coma, hyperventilation with targets of CO2 between 30 and 35, decompressive craniotomies and hypothermia as a last resort. The goal of all these measures is to decrease intracranial pressure and increase cerebral perfusion. Patients with a low Glasgow Coma Scale at arrival, like 3 or 4, have very few chances of surviving one year after trauma. General school-going toddlers with mild traumatic brain injury have good outcomes. These children may need prolonged psychological assistance to transition from preschool to school life.1-4
Particular attention should be given to children who tolerate abusive head trauma. These children are under constant torture from their caregivers. So prompt identification and reporting to the concerned government department is the health caregiver's moral and legal obligation. Transport rules should be made and implemented for safety measures in motorbikes and an unrestrained car traveling.
24
Wróble, R. R., and J. P. Albright. "Neck and Low Back Injuries in Wrestling." Clinics in Sports Medicine 5, no. 2 (April 1986): 295–325. http://dx.doi.org/10.1016/s0278-5919(20)31133-9.
Повний текст джерела
25
Teitz, Carol C., and Diane M. Cook. "Rehabilitation of Neck and Low Back Injuries." Clinics in Sports Medicine 4, no. 3 (July 1985): 455–76. http://dx.doi.org/10.1016/s0278-5919(20)31208-4.
Повний текст джерела
26
Youn, ghan. "Neck injuries in low speed frontal collisions." International Journal of Vehicle Design 32, no. 1/2 (2003): 84. http://dx.doi.org/10.1504/ijvd.2003.003238.
Повний текст джерела
27
Al-Ali, Mohamed A., Ashraf F. Hefny, and Fikri M. Abu-Zidan. "Head, face and neck camel-related injuries: Biomechanics and severity." Injury 50, no. 1 (January 2019): 210–14. http://dx.doi.org/10.1016/j.injury.2018.11.029.
Повний текст джерела
28
Gewiess, Jan, Christoph Emanuel Albers, Hans-Christoph Pape, Hannes Bangerter, Wolf-Dieter Zech, Marius Johann Baptist Keel, and Johannes Dominik Bastian. "Characteristics of Prehospital Death in Trauma Victims." Journal of Clinical Medicine 10, no. 20 (October 18, 2021): 4765. http://dx.doi.org/10.3390/jcm10204765.
Повний текст джерелаАнотація:
Background: Using Injury Severity Score (ISS) data, this study aimed to give an overview of trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims. Methods: Age, gender, trauma mechanism, cause of death, and ISS data were recorded regarding forensic autopsies and whole-body postmortem CT. Characteristics were analyzed for injuries considered potentially survivable at cutoffs of (I) ISS ≤ 75 vs. ISS = 75, (II) ISS ≤ 49 vs. ISS ≥ 50, and (III) ISS < lethal dose 50% (LD50) vs. ISS > LD50 according to Bull’s probit model. Results: In n = 130 prehospital trauma victims (45.3 ± 19.5 years), median ISS was 66. Severity of injuries to the head/neck and chest was greater compared to other regions (p < 0.001). 52% died from central nervous system (CNS) injury. Increasing injury severity in head/neck region was associated with CNS-injury related death (odds ratio (OR) 2.7, confidence interval (CI) 1.8–4.4). Potentially survivable trauma was identified in (I) 56%, (II) 22%, and (III) 9%. Victims with ISS ≤ 75, ISS ≤ 49, and ISS < LD50 had lower injury severity across most ISS body regions compared to their respective counterparts (p < 0.05). Conclusion: In prehospital trauma victims, injury severity is high. Lethal injuries predominate in the head/neck and chest regions and are associated with CNS-related death. The appreciable amount (9–56%) of victims dying at presumably survivable injury severity encourages perpetual efforts for improvement in the rescue of highly traumatized patients.
29
Syzyi, M. Yu. "TREATMENT-DIAGNOSTIC MEASURES FOR INJURY OF THE NECK." Kharkiv Surgical School, no. 3-4 (December 20, 2019): 123–25. http://dx.doi.org/10.37699/2308-7005.3-4.2019.28.
Повний текст джерелаАнотація:
Summary. The article is devoted to the study of the urgent problem of neck injury and medical diagnostic tactics. Externally, a small wound on the neck can hide serious damage to deep structures and adjacent anatomical areas. In peacetime during neck injuries, it is necessary stick to the basic principles of surgery: all wounds are subject to primary surgical treatment with a thorough revision of the wound canal. The algorithm of therapeutic and diagnostic measures depends on the nature and severity of the damage, clinical symptoms, and related injuries that are life-threatening.
30
Vick, Laura R., and Saleem Islam. "Adding Insult to Injury: Neck Exploration for Penetrating Pediatric Neck Trauma." American Surgeon 74, no. 11 (November 2008): 1104–6. http://dx.doi.org/10.1177/000313480807401113.
Повний текст джерелаАнотація:
Penetrating neck injuries are uncommon in children, and management involves mandatory exploration of the neck. This results in a number of unnecessary operations. Adult experience is moving towards selective exploration. A retrospective review was performed on all trauma patients presenting over the past 10 years. Pediatric patients with penetrating neck injury were selected and data were collected and analyzed. Out of a total of 19,363 trauma patients over the study period, we identified 39 children with 42 penetrating neck injuries. The average age was 13 years, and 56 per cent of cases were male. A large proportion (72%) was African-American. Over half of the injuries (63%) were from projectiles, including gun shot wounds (59%), which tended to be in the older children, whereas animal bites (5) were noted as a predominant cause in the younger ones. Six patients underwent exploration without any preoperative imaging due to penetration of the platysma, and four of these were nontherapeutic. Eighteen patients with platysma penetration underwent directed preoperative imaging, and 15 avoided operative exploration. CT scans were the most common imaging modality (68%). The median injury severity score was 11. The hospital length of stay was longer in the patients who underwent exploration. Mandatory exploration of the neck in children should not be performed unless clinically indicated. Preoperative imaging should be used liberally to limit nontherapeutic explorations, improve diagnostic accuracy, and reduce morbidity.
31
Voss, JanOliver, Nadine Thieme, Christian Doll, Stefan Hartwig, Nicolai Adolphs, Max Heiland, and Jan-Dirk Raguse. "Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge." Craniomaxillofacial Trauma & Reconstruction 11, no. 3 (September 2018): 172–82. http://dx.doi.org/10.1055/s-0038-1642035.
Повний текст джерелаАнотація:
Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.
32
Barmparas, G., P. H. Navsaria, D. Serna-Gallegos, A. J. Nicol, S. Edu, A. A. Sayari, D. R. Margulies, and E. J. Ley. "Blunt Pharyngoesophageal Injuries: Current Management Strategies." Scandinavian Journal of Surgery 107, no. 4 (April 9, 2018): 336–44. http://dx.doi.org/10.1177/1457496918766692.
Повний текст джерелаАнотація:
Background: Blunt pharyngoesophageal injuries pose a management challenge to the trauma surgeon. The purpose of this study was to explore whether these injuries can be managed expectantly without neck exploration. Methods: The National Trauma Databank datasets 2007–2011 were reviewed for blunt trauma patients who sustained a pharyngeal injury, including an injury to the cervical esophagus. Patients who survived over 24 h and were not transferred from other institutions were divided into two groups based on whether a neck exploration was performed. Outcomes included mortality and hospital stay. Results: A total of 545 (0.02%) patients were identified. The median age was 18 years and 69% were male. Facial fractures were found in 16%, while 13% had an associated traumatic brain injury. Of the 284 patients who survived over 24 h and were not transferred from another institution, 65 (23%) underwent a neck exploration. The injury burden was significantly higher in this group as indicated by the higher median Injury Severity Score (17 vs 10, p < 0.01) and need for intensive care unit admission (75% vs 31%, p < 0.01). The overall mortality was 2%: 3.1% for neck explorations versus 1.6% for conservative management (adjusted p = 0.54). Neck exploration patients were more likely to remain longer in the hospital (median 13 vs 10 days, adjusted p = 0.03). Conclusion: Pharyngoesophageal injuries are rare following blunt trauma. Only a quarter require a neck exploration and this decision appears to be dictated by the injury burden. Selective non-operative management based on clinical status seems to be feasible and is not associated with increased mortality.
33
Teng, Tso Liang, Cho Chung Liang, Hung Yu Huang, and You Lin Chen. "Effect of Vehicle Seat on Neck Injury in Rear Impact." Advanced Materials Research 538-541 (June 2012): 2995–98. http://dx.doi.org/10.4028/www.scientific.net/amr.538-541.2995.
Повний текст джерелаАнотація:
Seat is a main part of vehicle to contact with occupant in rear impact and chiefly concern with the severity of neck injuries. Therefore, improvement in seat design can effectively reduce the neck injuries of occupant. For designing an effective vehicle seat to protect occupant, this study develops the numerical model of sled test by using MADYMO software and discusses the relevance between the seat parameters and occupant’s neck based on the validated numerical model. The seat parameters include the stiffness of seat angle device, seat friction and angle of head restraint. The discussion of influencing factors of seat can be referred for designing a safety seat. The occupant neck then can be protected in rear impact accidents.
34
Lanigan, Alexander, Brentley Lindsey, Stephen Maturo, Joseph Brennan, and Adrienne Laury. "The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan: 2011-2016." Otolaryngology–Head and Neck Surgery 157, no. 4 (August 22, 2017): 602–7. http://dx.doi.org/10.1177/0194599817725713.
Повний текст джерелаАнотація:
Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.
35
Yetiser, Sertac, and Mustafa Kahramanyol. "High-Velocity Gunshot Wounds to the Head and Neck: A Review of Wound Ballistics." Military Medicine 163, no. 5 (May 1, 1998): 346–51. http://dx.doi.org/10.1093/milmed/163.5.346.
Повний текст джерелаАнотація:
Abstract Patients who sustain gunshot injuries to the head and neck face heavy tissue damage and eventually life-threatening conditions. A very significant factor that determines the degree of injury is the course and extent of the missile track. The missile track is well correlated with bullet structure, size, and velocity, which have distinct features in civilian and military firearm injuries. The missile entrance or exit wound may be out of sight in some injuries, and often it is difficult to predict the severity of the injury in the chaotic circumstances of the battlefield. We studied the wound ballistics in five soldiers who suffered penetrating cranial and cervical firearm injuries.
36
Travenko, E. N., V. A. Porodenko, S. A. Anuprienko, A. V. Аshkhotov, and A. S. Penkin. "Forensic evaluation of cervical spine distortion injuries in non-fatal road traffic accidents: An observational study." Kuban Scientific Medical Bulletin 29, no. 3 (June 28, 2022): 76–88. http://dx.doi.org/10.25207/1608-6228-2022-29-3-76-88.
Повний текст джерелаАнотація:
Background. The study relevance is substantiated by the growing numbers of road vehicles and cervical spine traumas occurring among all spinal injuries. Currently, there is no common vision of the cervical trauma pathogenesis, diagnostic algorithm or treatment, which stipulates difficulties in the forensic evaluation of soft tissue injuries of the neck, especially combined with the head or spine traumas around neck, as well as certain diseases.Objectives. A study of the incidence of cervical spine distortion injuries and their clinical and forensic assessment for severity to human health.Methods. A retrospective selective single-stage trial and analysis of 32 forensic medical reports on road accident and physical injury administrative cases in 2017 (single year) have been conducted. Normally distributed data are presented as mean (M), standard deviation (SD) and percent shares. The significance of inter-share variation was estimated with Student’s t-test.Results. Cervical spine distortion injuries more frequently associated with traumas to drivers than passengers inside the salon (81.2%), especially in passenger vehicles, with front-seat travellers inflicted most often (60.0%). Cases of independent pathology were very rare. The most common were combinations with soft tissue injuries, combined blunt trauma to the head, torso and limbs, with craniocerebral or maxillofacial trauma. Cervical osteochondrosis was revealed in 18% cases. Primary diagnosis predominantly grounded on complaints and history (67%), with only 12% cases using a comprehensive neurological examination or instrumental methods. The severity was assessed in the context of concomitant injuries. Acute and moderate severity had equal rates of 6.2%, light severity — 37.5%, no damage — 9.3%. Non-qualified remained 39.8% cases due to a lack of full clinical and instrumental examination (66.7%) or the victim’s failure to appear (13.3%); 20% cases were expert-reported as uncertain for trauma circumstances and mechanism.Conclusion. Further research and systematisation of the data accumulated are necessary. The following clinical and forensic evaluation, as well as statistical analyses will facilitate common diagnostic and severity assessment algorithms to develop for mechanical soft tissue and ligament injuries of the cervical spine.
37
de S Nogueira, Lilia, Cristiane de A Domingues, and Ane KS Bonfim. "Alcoholic Beverage and Traffic Accidents: Impact of the Drunk-Driving Law in Severity and Mortality of Victims." Panamerican Journal of Trauma, Critical Care & Emergency Surgery 6, no. 1 (2017): 17–24. http://dx.doi.org/10.5005/jp-journals-10030-1167.
Повний текст джерелаАнотація:
ABSTRACT Objectives To analyze the impact of the Drunk-Driving Law on the characteristics and severity of traffic accident victims and to identify risk factors for mortality before and after law enforcement. Materials and methods A retrospective, quantitative study that analyzed victims of traffic accidents attended at a hospital in São Paulo, Brazil, between 2006 and 2010, through the analysis of medical records. The Drunk-Driving Law was considered the time frame of this research, and the victims were distributed in two groups: Before the law (January 2006 to June 2008) and after the law (July 2008 to December 2010). Pearson chi-square, Mann–Whitney, and multiple logistic regression tests were used, with a significance level of 5%. Results The sample consisted of 1,405 victims, the majority being males (78.01%), with a mean age of 37.39 years. In the group comparison (before and after the Drunk-Driving Law), there was a significant difference related to the external cause, admission to the ICU, and discharge conditions. Factors associated with prelaw mortality were age, number of injured body regions, and New Injury Severity Score. The length of hospital stay and the Revised Trauma Score were considered as protective factors for this outcome. After the validity of the law, in addition to the variables described earlier, the head/neck and abdomen regions most severely injured were added as risk factors for mortality. Conclusion The impact of the Drunk-Driving Law set a positive outcome in the survival of the victims. However, when it comes to the statistics and severity of the trauma, it is necessary to sustain the law with reinforcement of the inspection so that more lives are saved. Clinical significance The results of this study provide support to managers on the importance of sustaining the law and the need of implementing new trauma prevention strategies. How to cite this article Bonfim AKS, Nogueira LS, Domingues CA. Alcoholic Beverage and Traffic Accidents: Impact of the Drunk-Driving Law in Severity and Mortality of Victims. Panam J Trauma Crit Care Emerg Surg 2017;6(1):17-24.
38
Rueda-Arreguín, José Luis, Marco Ceccarelli, and Christopher René Torres-SanMiguel. "Design of an Articulated Neck to Assess Impact Head-Neck Injuries." Life 12, no. 2 (February 19, 2022): 313. http://dx.doi.org/10.3390/life12020313.
Повний текст джерелаАнотація:
This paper describes a new solution for an articulated low-cost artificial neck with sensors to assess the effects of head impacts. This prototype is designed as a new solution to evaluate the neck’s response after suffering the head impact. An overview of existing solutions is reported to evaluate the advantages and disadvantages of each one briefly. Problems and requirements for prototype design are outlined to guide to a solution with commercial components. A prototype is developed, and its operating performance is evaluated through a lab test. Several tests are worked out considering the biomechanics involved in the most common accidents of head-neck impacts. Results show a response on the prototype similar to an actual human neck. Future improvements are also outlined for better accurate responses considering the results from the lab test.
39
Passmore, David, Chungil Chae, Victoria Borkovskaya, Rose Baker, and Jeong-Ha Yim. "Severity of U.S. Construction Worker Injuries, 2015-2017." E3S Web of Conferences 97 (2019): 06038. http://dx.doi.org/10.1051/e3sconf/20199706038.
Повний текст джерелаАнотація:
Workers in the U.S. construction industry experience workplace hazards that can lead to work-related injuries that sometimes are fatal. Reported in this paper is a case-control study of risks factors associated with 4,845 injured workers and their work environments that led to fatal rather than nonfatal injuries during 2015-2017. These injury data originally were assembled from information collected by the U.S. Bureau of Labor Statistics that were used in a machine learning competition, but were repurposed for this secondary analysis of injury risks. Sixty-one percent of workers recorded in this dataset were injured fatally. Multiple logistic regression was applied to model the probability of a fatal injury as a function of the nature of the injury, part of body injured, human factors involved, whether the injured worker was carrying out a regularly assigned task at the time of the injury, and the manner in which the injury was inflicted. Related positively, relative to benchmarks, to the probability of a fatality injury were: falls and strikes; electrocution; asphyxiation and drowning; injury to the head and neck; and working at a task not regularly assigned. Negatively related to the probability of a fatal injury were: chemical/temperature burns; amputation and crushing; fractures and dislocations; injuries to fingers, hands, wrists, and other extremities; and falls from an elevation or to the same level, although this last negative relationship is anomalous in the light of independent research findings. Findings of this study do not necessarily culpable causes of work-related death. Rather these findings identify risk factors that might prove fruitful for further analysis of the incidence, severity, and costs of construction injuries.
40
McKinlay, J., and JE Smith. "Penetrating brain injury: a case of survival following blast fragmentation injuries to the head." Journal of The Royal Naval Medical Service 99, no. 2 (June 2013): 55–56. http://dx.doi.org/10.1136/jrnms-99-55.
Повний текст джерелаАнотація:
AbstractWe present a case of penetrating head injuries caused by blast fragmentation, along with other serious injuries (including to the arms, face and neck), where a good recovery was made despite an Injury Severity Score (ISS) of 75. We suggest that survival and outcome are reliant on several factors and cannot be predicted from ISS, velocity of penetrating injury or presenting Glasgow Coma Scale (GCS) alone.
41
McArthur, Katherine, Darcy Jorgensen, Mike Climstein, and James Furness. "Epidemiology of Acute Injuries in Surfing: Type, Location, Mechanism, Severity, and Incidence: A Systematic Review." Sports 8, no. 2 (February 20, 2020): 25. http://dx.doi.org/10.3390/sports8020025.
Повний текст джерелаАнотація:
Prospective and retrospective studies have examined traumatic injuries within competitive and recreational surfers worldwide using online surveys and health care facility (HCF; e.g., hospital, emergency department, medical record) data. However, few studies have provided a synthesis of all available literature. The purpose of this study was to obtain, critique and synthesise all literature specific to acute surfing injuries, and evaluate differences in injury type, mechanism and location between HCF and survey data. A systematic literature review design was used to identify relevant articles from three major databases. Peer-reviewed epidemiological studies of musculoskeletal surfing injuries were included. A modified AXIS tool was used for critical appraisal, and objective data was extracted and synthesized by lead researchers. Overall frequencies for injury location, type and mechanism were calculated from raw injury data. A total of 19 cross-sectional articles of fair to good quality (Modified AXIS 54.2–83.3%) were included in this study; 17 were National Health and Medical Research Council (NHMRC) level III-2 (retrospective) and two were level II (prospective). Articles examined competitive, recreational and combined populations. Injury data from Australia, Brazil, UK, USA, Portugal, Japan, Norway, and worldwide were represented. Skin (46.0%; HCF 50.1%, survey 43.8%) and being struck by own surfboard (38.6%; HCF 73.4%, survey 36.7%) were the most common injury type and mechanism. Head, face and neck injuries were most common in HCF (43.1%) versus lower limb injuries (36.4%) in survey data. Incidence proportion was highest in aerialists (0.48). Incidence rate (number of injuries per 1000 h) ranged from 0.74 in Australian surfers (Melbourne) to 6.6 in international contest surfers from medical record data. This review highlights the prevalence of skin, board-related, head, face and neck, and lower limb surfing injuries across available literature. Proposed use of protective equipment and foam-based surfboards in dangerous or crowded surf locations may reduce injury risk.
42
Haar, Rohini J., Vincent Iacopino, Nikhil Ranadive, Madhavi Dandu, and Sheri D. Weiser. "Death, injury and disability from kinetic impact projectiles in crowd-control settings: a systematic review." BMJ Open 7, no. 12 (December 2017): e018154. http://dx.doi.org/10.1136/bmjopen-2017-018154.
Повний текст джерелаАнотація:
ObjectiveWe conducted a systematic review of the available literature on deaths, injuries and permanent disability from rubber and plastic bullets, as well as from bean bag rounds, shot pellets and other projectiles used in arrests, protests and other contexts from 1 January 1990 until 1 June 2017.Data sourcesPubMed, Scopus, JSTOR and grey literature.Data synthesisWe report on descriptive statistics as well as data on injury severity, permanent disability and death. We analysed potential risk factors for injury severity, including the site of impact, firing distance and access to medical care.ResultsOf 3228 identified articles, 26 articles met inclusion criteria. These articles included injury data on 1984 people, 53 of whom died as a result of their injuries. 300 people suffered permanent disability. Deaths and permanent disability often resulted from strikes to the head and neck (49.1% of deaths and 82.6% of permanent disabilities). Of the 2135 injuries in those who survived their injuries, 71% were severe, injuries to the skin and to the extremities were most frequent. Anatomical site of impact, firing distance and timely access to medical care were correlated with injury severity and risk of disability.ConclusionsKinetic impact projectiles (KIPs), often called rubber or plastic bullets, are used commonly in crowd-control settings. We find that these projectiles have caused significant morbidity and mortality during the past 27 years, much of it from penetrative injuries and head, neck and torso trauma. Given their inherent inaccuracy, potential for misuse and associated health consequences of severe injury, disability and death, KIPs do not appear to be appropriate weapons for use in crowd-control settings. There is an urgent need to establish international guidelines on the use of crowd-control weapons to prevent unnecessary injuries and deaths.
43
Thompson, Daniel C., R. J. Crooks, J. C. Clasper, A. Lupu, S. A. Stapley, and D. J. Cloke. "The pattern of paediatric blast injury in Afghanistan." BMJ Military Health 166, no. 3 (October 21, 2017): 151–55. http://dx.doi.org/10.1136/jramc-2017-000795.
Повний текст джерелаАнотація:
IntroductionBetween 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults.MethodA retrospective analysis was undertaken of prospectively collected data derived from the UK Joint Theatre Trauma Registry of ambulant paediatric (aged 2–15 years) admissions with blast injuries at the Role 3 Field Hospital, Camp Bastion from June 2006 to March 2013. The data set included demographic information, injury profile and severity (New Injury Severity Score) and operative findings. The pattern of injuries were investigated by looking at trends in the number and severity of injuries sustained by each body region.ResultsDuring this period, 295 admissions were identified, 76% of whom were male, with an overall mortality rate of 18.5%. The most common blast mechanism was an IED (68%) causing 80% of fatalities. The lower extremities were the most commonly injured body region, accounting for 31% of total injuries and occurring in 62% of cases. 24.3% of children between 2 and 7 years suffered severe head or neck injuries compared with 19.8% of children aged between 8 and 15 years. 34% of head injuries were rated unsurvivable and accounted for 88% of fatalities. 77% of cases required an operation with a mean operating time of 125 min. The most common first operations were debridement of soft tissues (50%), laparotomy (16%) and lower limb amputation (11%).ConclusionAlthough paediatric blast casualties represented a small percentage of the overall workload at Camp Bastion Role 3 Medical Facility, the pattern of injuries seen suggests that children are more likely to sustain severe head, face and neck injuries than adults.
44
Ivancic, Paul C. "Biomechanics of Sports-Induced Axial-Compression Injuries of the Neck." Journal of Athletic Training 47, no. 5 (September 1, 2012): 489–97. http://dx.doi.org/10.4085/1062-6050-47.4.06.
Повний текст джерелаАнотація:
ContextHead-first sports-induced impacts cause cervical fractures and dislocations and spinal cord lesions. In previous biomechanical studies, researchers have vertically dropped human cadavers, head-neck specimens, or surrogate models in inverted postures.ObjectiveTo develop a cadaveric neck model to simulate horizontally aligned, head-first impacts with a straightened neck and to use the model to investigate biomechanical responses and failure mechanisms.DesignDescriptive laboratory study.SettingBiomechanics research laboratory.Patients or Other ParticipantsFive human cadaveric cervical spine specimens.Intervention(s)The model consisted of the neck specimen mounted horizontally to a torso-equivalent mass on a sled and carrying a surrogate head. Head-first impacts were simulated at 4.1 m/s into a padded, deformable barrier.Main Outcome Measure(s)Time-history responses were determined for head and neck loads, accelerations, and motions. Average occurrence times of the compression force peaks at the impact barrier, occipital condyles, and neck were compared.ResultsThe first local compression force peaks at the impact barrier (3070.0 ± 168.0 N at 18.8 milliseconds), occipital condyles (2868.1 ± 732.4 N at 19.6 milliseconds), and neck (2884.6 ± 910.7 N at 25.0 milliseconds) occurred earlier than all global compression peaks, which reached 7531.6 N in the neck at 46.6 milliseconds (P < .001). Average peak head motions relative to the torso were 6.0 cm in compression, 2.4 cm in posterior shear, and 6.4° in flexion. Neck compression fractures included occipital condyle, atlas, odontoid, and subaxial comminuted burst and facet fractures.ConclusionsNeck injuries due to excessive axial compression occurred within 20 milliseconds of impact and were caused by abrupt deceleration of the head and continued forward torso momentum before simultaneous rebound of the head and torso. Improved understanding of neck injury mechanisms during sports-induced impacts will increase clinical awareness and immediate care and ultimately lead to improved protective equipment, reducing the frequency and severity of neck injuries and their associated societal costs.
45
Chiaviello, Christine T., Richard A. Christoph, and G. Randall Bond. "Infant Walker-Related Injuries: A Prospective Study of Severity and Incidence." Pediatrics 93, no. 6 (June 1, 1994): 974–76. http://dx.doi.org/10.1542/peds.93.6.974.
Повний текст джерелаАнотація:
Objective. To determine the incidence and significance of walker-related injuries in infants. Methods. During a 3-year, 8-month period, all infants who were brought to the University of Virginia Pediatric Emergency Department with a walker-related injury were prospectively studied. During the emergency department visit demographic and epidemiologic information were recorded. The annual incidence of walker-related injuries occurring in infants <1 year of age that resulted in a hospital emergency department visit was calculated from the home zip codes of the injured patients and from the population of infants <1 year of age living in Charlottesville and in Albemarle County. Results. Sixty-five patients were enrolled in the study. The age distribution ranged from 3 months to 17 months, with 95% younger <1 year old. Mechanisms associated with walker-related injuries included stairway falls in 46 infants (71%), tip-overs in 14 infants (21%), falls from a porch in 2 infants (3%), and burns in 3 infants (5%). These injuries predominantly involved the head and neck region (97%), with few injuries to the extremities (6%) and trunk (3%). Although the majority of injuries were minor, significant injuries occurred in 19 infants (29%). These injuries included skull fracture, concussion, intracranial hemorrhage, full-thickness burns, c-spine fracture, and death. After excluding the burned patients, all the serious injuries resulted from falls down stairs. The annual incidence of injuries occurring in infants <1 year of age, related to the use of walkers, and resulting in an emergency department visit was 8.9/1000, and for serious injuries was 1.7/1000. Conclusions. The incidence and significance of infant walker-related injuries in infants are unacceptably high.
46
Keller, Jennifer E., Jason W. Hindman, Joseph N. Kidd, Richard J. Jackson, Samuel D. Smith, and Charles W. Wagner. "Air-Gun Injuries: Initial Evaluation and Resultant Morbidity." American Surgeon 70, no. 6 (June 2004): 484–90. http://dx.doi.org/10.1177/000313480407000604.
Повний текст джерелаАнотація:
Severity of injuries from air-powered weapons can be underappreciated. Transformation of these weapons into toys makes them available to children. Our experience reveals the underestimated injury severity and emphasizes need for prompt trauma evaluation. Retrospective chart review of children sustaining air-gun injuries and evaluated at a single, pediatric hospital from 1991 to 2002 was performed. Medical record numbers were retrieved from a trauma data base. Data included age, weapon type, firing distance, injury site, radiographic studies, operative intervention, length of stay, and long-term disability. Ocular injuries were excluded secondary to known severity. All other injuries and treatments are described. Thirty-four children, average age 10 years ± 3.3 years, sustained 35 injuries from 1991 through 2002. Twenty-one children required admission, 19 children required surgery, and 5 children experienced long-term disability. Average time to definitive care was 3 hours 12 minutes. Sites of injury included head, neck, chest, abdomen, and extremities. Average hospital stay was 4.3 days. In the pediatric population, air-gun injuries can be underestimated. Lack of collateral tissue damage makes wounds appear innocuous to unsuspecting medical personnel resulting in delayed care. During initial evaluation, injuries from air guns deserve the same respect as those caused by conventional firearms.
47
Stassen, Nicole A., J. Jason Hoth, Melanie J. Scott, Carolyn S. Day, James K. Lukan, Jorge L. Rodriguez, and J. David Richardson. "Laryngotracheal Injuries: Does Injury Mechanism Matter?" American Surgeon 70, no. 6 (June 2004): 522–25. http://dx.doi.org/10.1177/000313480407000612.
Повний текст джерелаАнотація:
Laryngotracheal injuries are potentially lethal injuries whose diagnosis can be difficult. The purpose of this study was to delineate the effect of injury mechanism on the types of injury sustained and patient outcome. Patient records during a 7-year period were reviewed for injury mechanism, patient demographics, clinical presentation, patient evaluation, injury location, associated injuries, operative interventions, and outcome. Fifteen patients with laryngotracheal injuries were studied. Blunt injuries were more common (60%). Patient demographics, mortality, average length of stay, and Injury Severity Score were similar for both groups. Prevalent physical findings on examination included subcutaneous air (53%), hoarseness (47%), stridor (20%), and neck tenderness (27%). Diagnosis was confirmed by CT scan of the neck (66% blunt, 33% penetrating) or bronchoscopy (44% blunt, 66% penetrating). Injury location, patient disposition, and associated injures were the same for both groups. The most frequent operative intervention performed for both groups consisted of a primary airway repair via a collar incision within 8 hours of injury. Only patients with a laryngeal injury required concomitant tracheostomy regardless of mechanism. Blunt and penetrating neck injuries resulted in similar types of tracheal and laryngeal injuries. Anatomic location of the injury determined the need for tracheostomy. Regardless of mechanism, the overall outcome for patients with laryngotracheal injuries is good when injuries are recognized and treated expeditiously. A high level of suspicion must be maintained when evaluating all potential laryngotracheal injury patients irrespective of the mechanism of injury.
48
Villavicencio, Alan T., Sigita Burneikienë, Theresa D. Hernández, and Jeff Thramann. "Back and neck pain in triathletes." Neurosurgical Focus 21, no. 4 (October 2006): 1–7. http://dx.doi.org/10.3171/foc.2006.21.4.8.
Повний текст джерелаАнотація:
Object As the sport of triathlon has continued to grow, increasing numbers of triathletes have presented in the neurosurgery clinics with various spinal disorders. This epidemiological study was undertaken to establish the lifetime incidence of neck and back pain, to gauge the prevalence of discogenic pain, and to identify risk factors among triathletes in the Boulder, Colorado, area. Methods A live online questionnaire was developed that was used to collect information about physical characteristics, training habits, athletic status, number of races completed, and back pain among triathletes. The incidence of cervical and/or lumbar discogenic back pain was defined according to the duration of symptoms for the most recent pain episode. The lifetime incidence of low-back pain was 67.8%, with 23.7% of cases possibly being discogenic in origin. The number of triathlons in which the respondents had participated and the presence of previous sports-related injuries were predictive of low-back pain (p = 0.02 and p < 0.00001, respectively). The lifetime incidence of neck pain was 48.3%, with 21.4% of cases being consistent with intervertebral disc involvement. The number of previous sports-related injuries was predictive of neck pain (p < 0.00001), and a strong tendency toward neck pain was observed for athletes with more total years of participation in sports (p = 0.06). Conclusions The two main risk factors for long-term spinal problems include sports-related injuries and overuse. The study results definitely support the influence of both mechanisms for low-back pain. Neck pain was associated with an injury event, and a strong (although not statistically significant) tendency toward neck pain was observed in respondents with overuse injuries.
49
Adler, Jakov, E. Golan, J. Golan, M. Yitzhaki, and N. Ben-Hur. "Terrorist Bombing Experiences During 1975-1979 in Jerusalem." Prehospital and Disaster Medicine 1, S1 (1985): 350–55. http://dx.doi.org/10.1017/s1049023x00045118.
Повний текст джерелаАнотація:
AbstractDuring 4½ years, 24 terrorist explosions occurred in Jerusalem. of 511 casualties, 340 were evacuated to the Emergency Department of our hospital. of a total of 272 admissions graded by the Injury Severity Score (ISS), 87% were light injuries, 2.9% medium and 10% severe. The high proportion of light injuries may be explained by the evacuation of all casualties to the nearest hospital by the public. The distribution of injuries to body areas is discussed. Head and neck injuries comprised 19.3% and extremity injuries 39%. The most common primary blast effect was acoustic trauma encountered in 16.3%. Solutions to the most commonly encountered problems in the Emergency Department are discussed.
50
Williams, Sean, Grant Trewartha, Simon Kemp, Matthew Cross, John Brooks, Colin Fuller, Aileen Taylor, and Keith Stokes. "Subsequent Injuries and Early Recurrent Diagnoses in elite Rugby Union Players." International Journal of Sports Medicine 38, no. 10 (July 31, 2017): 791–98. http://dx.doi.org/10.1055/s-0043-114862.
Повний текст джерелаАнотація:
AbstractAn eight-season (2005/06–2012/13) prospective cohort design was used to record time-loss injuries in 15 English Premiership teams. Data pertaining to a total of 1 556 players and 9 597 injuries (8 180 subsequent) were included in the analysis. Injuries subsequent to an index injury were classified as (1) New: different site; (2) Local: same site (and different type); or (3) Recurrent: same site and type. The severity of subsequent injuries (days missed) was compared with their related index injury. The proportions of early (<2 months), late (2–12 months) and delayed (>12 months) subsequent injuries were compared across injury classifications and diagnosis groupings. The majority of subsequent injuries (70%) were classified as new injuries, with 14% local and 16% recurrent. A large proportion of recurrent subsequent injuries (42%) occurred within two months of return-to-play. Subsequent injuries were not more severe than their corresponding index injury (effect sizes <0.20). Specific local and recurrent subsequent injury diagnoses with the highest risk of occurring within two months of return-to-play were: ‘neck muscle strain’, ‘ankle joint capsule sprain’, and ‘cervical nerve root’ injuries. These findings may be used to drive targeted secondary prevention efforts, such as reconsideration of return-to-play protocols for neck muscle strain injuries.