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Gouda, Hebe N., Riley H. Hazard, Seri Maraga, Abraham D. Flaxman, Andrea Stewart, Jonathan C. Joseph, Patricia Rarau, et al. "The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies." International Journal of Epidemiology 48, no. 3 (March 26, 2019): 966–77. http://dx.doi.org/10.1093/ije/dyz018.
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Abstract Background Recent economic growth in Papua New Guinea (PNG) would suggest that the country may be experiencing an epidemiological transition, characterized by a reduction in infectious diseases and a growing burden from non-communicable diseases (NCDs). However, data on cause-specific mortality in PNG are very sparse, and the extent of the transition within the country is poorly understood. Methods Mortality surveillance was established in four small populations across PNG: West Hiri in Central Province, Asaro Valley in Eastern Highlands Province, Hides in Hela Province and Karkar Island in Madang Province. Verbal autopsies (VAs) were conducted on all deaths identified, and causes of death were assigned by SmartVA and classified into five broad disease categories: endemic NCDs; emerging NCDs; endemic infections; emerging infections; and injuries. Results from previous PNG VA studies, using different VA methods and spanning the years 1970 to 2001, are also presented here. Results A total of 868 deaths among adolescents and adults were identified and assigned a cause of death. NCDs made up the majority of all deaths (40.4%), with the endemic NCD of chronic respiratory disease responsible for the largest proportion of deaths (10.5%), followed by the emerging NCD of diabetes (6.2%). Emerging infectious diseases outnumbered endemic infectious diseases (11.9% versus 9.5%). The distribution of causes of death differed across the four sites, with emerging NCDs and emerging infections highest at the site that is most socioeconomically developed, West Hiri. Comparing the 1970–2001 VA series with the present study suggests a large decrease in endemic infections. Conclusions Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems, to more usefully serve the needs of health priority setting.
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Ramdass, MJ, and P. Harnarayan. "A decade of major vascular trauma: Lessons learned from gang and civilian warfare." Annals of The Royal College of Surgeons of England 99, no. 1 (January 2017): 70–75. http://dx.doi.org/10.1308/rcsann.2016.0296.
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INTRODUCTION Trinidad and Tobago is a trans-shipment point for the illegal trade of drugs, arms and ammunition and, as such, has a high incidence of gang-related warfare and drug-related crimes. This has led to a high incidence of gunshot and stab wounds, with associated major vascular injuries. We describe our management strategies learned from a decade of vascular trauma experience. METHODS A retrospective analysis of age, gender, type of trauma, vessel injured, procedure and outcome for all cases of vascular trauma between 2006 and 2015 at two surgical units in Trinidad and Tobago. RESULTS There were 198 vascular trauma cases (232 procedures), involving 159 (80%) males at a mean age of 33 years. Gunshots accounted for 103 (52%) cases, followed by stabs/chops (n=50; 25%) and lacerations (n=15; 8%). The most commonly injured vessels were the radial/ulnar arteries (n=39; 20%) and the superficial femoral artery (n=37; 19%). There were seven pseudoaneurysms and three traumatic arteriovenous fistulae. Repair techniques included primary (n=82; 35%), reversed vein (n=63; 27%), polytetrafluoroethylene (n=58; 25%), oversew (n=24; 10%) and endovascular (n=5; 2%) techniques. There were eight (4%) secondary amputations and eight (4%) deaths. CONCLUSIONS Major vascular trauma causes significant morbidity and mortality in Trinidad and Tobago, with the majority of cases due to gunshot injuries secondary to gang-related warfare and civilian violence. We compare our experience with that in the literature on the epidemiology and management of vascular trauma.
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Jaiswal, K. Ashish, Himanshu Aggarwal, Pooja Solanki, P. S. Lubana, R. K. Mathur, and Sudarshan Odiya. "Epidemiological and socio-cultural study of burn patients in m. y. hospital, indore, india." Indian Journal of Plastic Surgery 40, no. 02 (July 2007): 158–63. http://dx.doi.org/10.1055/s-0039-1699195.
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ABSTRACT Background: developing countries have a high incidence of burn injuries, creating a formidable public health problem. the exact number of cases is difficult to determine: however in a country like india, with a population of over 1 billion, we would estimate 700,000 to 800,000 burn admissions annually. objective: the study was done to investigate the epidemiology of various causations and their outcomes in terms of morbidity and mortality. also, the effect of social stigma and cultural issues associated with burns on the victim and his family was assessed.Materials and methods: All burn cases (n=412) admitted to the burns unit of m. y. hospital, indore over a period of one year (2005-2006) were investigated. the data regarding sex, age predisposition, geographical origin, mode and nature of injury were obtained by questionnaire-interview with the patient themselves. clinical assessment was done in the form of depth and extent of injury and complications. in case of mortality, again various factors like age, sex and cause of death were analyzed. the data was analyzed by spss 11.0 version. the interrelationship between various factors was studied using multivariate logistic regression analysis.Results: Burns were found more commonly in middle-aged groups. the incidence was more in females as an absolute number (70.3%) as well as when stratified by age. most burns were domestic, with cooking being the most prevalent activity. flame (80.3%) was the most common agent. most of the cases of burn were accidental (67.7%). moreover, the patients had third degree burn that leads to more mortality in our circumstances. death occurred in more than one-half (62.3%) of cases with septicaemia and disseminated intravascular coagulation (35.4%) as the leading causes. when using logistic regression analysis, the outcome of the burn injury was significantly associated with degree, depth, extent and mode of injury.Conclusion: This series provides an overview of the most important aspects of burn injuries for hospital and non-hospital healthcare workers. the majority of deep burns are accidental, seen in middle-aged housewives as a result of flame burns, and lead to death. so measures should be taken to provide proper education to prevent these accidents and ensure safety.
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Macpherson, Alison K., and Michael J. Schull. "Penetrating trauma in Ontario emergency departments: a population-based study." CJEM 9, no. 01 (January 2007): 16–20. http://dx.doi.org/10.1017/s1481803500014688.
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ABSTRACT Background: There is a paucity of population-based research on health service utilization related to penetrating trauma in Canada, even though such trauma can result in serious injury or death, and gunshot wounds have been labelled the “the new public health issue.” Complete epidemiologic data, including emergency department (ED) visits and hospitalizations, for penetrating trauma is not available. The objective of this paper is to describe the epidemiology of ED visits for firearm-related and knife-related penetrating trauma in one Canadian province. Methods: All EDs in the province of Ontario (pop. approx. 12 400 000 at the time of the study) submit data on ED visits to the National Ambulatory Care Reporting System. This database includes patients' demographic information (i.e., age, sex and geographic area of residence), the reason for the visit, disposition (i.e., admitted to hospital or sent home), and other diagnostic information. For visits related to injuries, the cause of injury is also reported (e-codes according to the Canadian Enhancement to the International Statistical Classification of Diseases and Related Health Problems, 10th rev [ICD-10-CA]). All patients seen in Ontario EDs for an injury related to a firearm, knife, or sharp object, were included in our study. Results: Of the 1.2 million ED visits in 2002-03 for trauma in Ontario, 40 240 (3.4%) patients were treated for injuries relating to penetrating trauma. Most patients were male, and most were 15–24 years of age. Penetrating trauma was frequently a result of knives or sharp objects (39 654 visits or 98.5%); only 1.5% (n = 586) of these injuries were caused by firearms. Of those hospitalized, 151 were related to firearms and 1455 were related to knives/ sharp objects. Conclusions: Analyzing administrative data provides an estimate of the impact of penetrating trauma on a population, thereby providing prevention programs with data upon which to design their strategies. Evidence-based prevention strategies are needed to reduce the burden of penetrating trauma. Monitoring ED and hospitalization data over time will help to assess trends and provide evidence for the effectiveness of such strategies.
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Saeid, Feyzizadeh, Javadi Aniseh, Badalzadeh Reza, and Vafaee S. Manouchehr. "Signaling mediators modulated by cardioprotective interventions in healthy and diabetic myocardium with ischaemia–reperfusion injury." European Journal of Preventive Cardiology 25, no. 14 (February 14, 2018): 1463–81. http://dx.doi.org/10.1177/2047487318756420.
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Ischaemic heart diseases are one of the major causes of death in the world. In most patients, ischaemic heart disease is coincident with other risk factors such as diabetes. Patients with diabetes are more prone to cardiac ischaemic dysfunctions including ischaemia–reperfusion injury. Ischaemic preconditioning, postconditioning and remote conditionings are reliable interventions to protect the myocardium against ischaemia–reperfusion injuries through activating various signaling pathways and intracellular mediators. Diabetes can disrupt the intracellular signaling cascades involved in these myocardial protections, and studies have revealed that cardioprotective effects of the conditioning interventions are diminished in the diabetic condition. The complex pathophysiology and poor prognosis of ischaemic heart disease among people with diabetes necessitate the investigation of the interaction of diabetes with ischaemia–reperfusion injury and cardioprotective mechanisms. Reducing the outcomes of ischaemia–reperfusion injury using targeted strategies would be particularly helpful in this population. In this study, we review the protective interventional signaling pathways and mediators which are activated by ischaemic conditioning strategies in healthy and diabetic myocardium with ischaemia–reperfusion injury.
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Deng, Hansen, John K. Yue, Ethan A. Winkler, Sanjay S. Dhall, Geoffrey T. Manley, and Phiroz E. Tarapore. "Pediatric firearm-related traumatic brain injury in United States trauma centers." Journal of Neurosurgery: Pediatrics 24, no. 5 (November 2019): 498–508. http://dx.doi.org/10.3171/2019.5.peds19119.
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OBJECTIVEPediatric firearm injury is a leading cause of death and disability in the youth of the United States. The epidemiology of and outcomes following gunshot wounds to the head (GSWHs) are in need of systematic characterization. Here, the authors analyzed pediatric GSWHs from a population-based sample to identify predictors of prolonged hospitalization, morbidity, and death.METHODSAll patients younger than 18 years of age and diagnosed with a GSWH in the National Sample Program (NSP) of the National Trauma Data Bank (NTDB) in 2003–2012 were eligible for inclusion in this study. Variables of interest included injury intent, firearm type, site of incident, age, sex, race, health insurance, geographic region, trauma center level, isolated traumatic brain injury (TBI), hypotension in the emergency department, Glasgow Coma Scale (GCS) score, and Injury Severity Score (ISS). Risk predictors for a prolonged hospital stay, morbidity, and mortality were identified. Odds ratios, mean increases or decreases (B), and 95% confidence intervals were reported. Statistical significance was assessed at α < 0.001 accounting for multiple comparisons.RESULTSIn a weighted sample of 2847 pediatric patients with GSWHs, the mean age was 14.8 ± 3.3 years, 79.2% were male, and 59.0% had severe TBI (GCS score 3–8). The mechanism of assault (63.0%), the handgun as firearm (45.6%), and an injury incurred in a residential area (40.6%) were most common. The mean hospital length of stay was 11.6 ± 14.4 days for the survivors, for whom suicide injuries involved longer hospitalizations (B = 5.9-day increase, 95% CI 3.3–8.6, p < 0.001) relative to those for accidental injuries. Mortality was 45.1% overall but was greater with injury due to suicidal intent (mortality 71.5%, p < 0.001) or caused by a shotgun (mortality 56.5%, p < 0.001). Lower GCS scores, higher ISSs, and emergency room hypotension predicted poorer outcomes. Patients with private insurance had lower mortality odds than those with Medicare/Medicaid (OR 2.4, 95% CI 1.7–3.4, p < 0.001) or government insurance (OR 3.6, 95% CI 2.2–5.8, p < 0.001). Management at level II centers, compared to level I, was associated with lower odds of returning home (OR 0.3, 95% CI 0.2–0.5, p < 0.001).CONCLUSIONSFrom 2003 to 2012, with regard to pediatric TBI hospitalizations due to GSWHs, their proportion remained stable, those caused by accidental injuries decreased, and those attributable to suicide increased. Overall mortality was 45%. Hypotension, cranial and overall injury severity, and suicidal intent were associated with poor prognoses. Patients treated at level II trauma centers had lower odds of being discharged home. Given the spectrum of risk factors that predispose children to GSWHs, emphasis on screening, parental education, and standardization of critical care management is needed to improve outcomes.
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Pradhan, Subrat Kumar, Himansu Prasad Acharya, Rudra Prasanna Mishra, Jay Kumar Panda, Durga Madhab Satapathy, and Sanjeeb Kumar Mishra. "Epidemiology of Fatal Injuries reported in the mortuary of a tertiary care hospital." International Journal Of Community Medicine And Public Health 6, no. 2 (January 24, 2019): 633. http://dx.doi.org/10.18203/2394-6040.ijcmph20190182.
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Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or “accidental” causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases.Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages.Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%).Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.
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Mohanty, Sachidananda, Manoj Kumar Mohanty, Manoj Kumar Panigrahi, and Sreemanta Kumar. "Fatal Head Injury in Homicidal Victims." Medicine, Science and the Law 45, no. 3 (July 2005): 244–48. http://dx.doi.org/10.1258/rsmmsl.45.3.244.
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Homicide represents one of the leading causes of death, and the head is the target in the majority of cases. The objective of the present study was to analyze the pattern of head injury among homicidal death victims. Information was obtained by interviewing the accompanying persons, post-mortem examination and perusal of hospital records. Most of the victims were predominantly male and belonged in the age group 21-30 years. Blunt weapons caused the majority of the injuries. Defence wounds were present in 48% of the victims. The street was the place of crime in the majority of cases (46.7%) and in most of the cases there was more than one offender. Multiple assaults were seen on the body in 70% of cases. The skull was fractured in more than 80% of victims and intracranial haemorrhages were seen in 47 victims. Out of 77 cases, 55 victims showed intracranial lesions along with injuries to the skull and scalp. Associated fatal injuries were most commonly present on the neck and chest. The majority of the victims died instantly or within 24 hours. Blunt force is commonly used when the head is the target. Defence wounds, when present, are indicative of the homicidal nature of the attack, and multiple strokes present over the body indicate determination on the part of the accused to end the life of the victim.
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Golovko, K. P., V. Yu Markevich, T. Yu Suprun, A. B. Vertiy, S. E. Komyagin, N. A. Zhirnova, and I. M. Samokhvalov. "Prospects for improving pre-hospital care for wounded with gunshot penetrating wounds to the chest." Bulletin of the Russian Military Medical Academy 22, no. 3 (December 15, 2020): 140–47. http://dx.doi.org/10.17816/brmma50550.
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Abstract. The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set UD-02v for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the UD-02v set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of UD-02v exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.
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Hocking, DP, FG Marx, WMG Parker, JP Rule, SGC Cleuren, AD Mitchell, M. Hunter, JD Bell, EMG Fitzgerald, and AR Evans. "Inferring diet, feeding behaviour and causes of mortality from prey-induced injuries in a New Zealand fur seal." Diseases of Aquatic Organisms 139 (April 30, 2020): 81–86. http://dx.doi.org/10.3354/dao03473.
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New Zealand fur seals Arctocephalus forsteri are the most abundant of the 4 otariid (eared seal) species distributed across Australasia. Analyses of stomach contents, scats and regurgitates suggest a diet dominated by bony fish and squid, with cartilaginous species (e.g. sharks and rays) either absent or underrepresented because of a lack of preservable hard parts. Here we report on a subadult specimen from south-eastern Australia, which was found ashore emaciated and with numerous puncture wounds across its lips, cheeks, throat and the inside of its oral cavity. Fish spines embedded in the carcass revealed that these injuries were inflicted by chimaeras and myliobatiform rays (stingrays and relatives), which matches reports on the diet of A. forsteri from New Zealand, but not South Australia. Shaking and tearing of prey at the surface may help to avoid ingestion of the venomous spines, perhaps contributing to their absence from scats and regurgitates. Nevertheless, the number and severity of the facial stab wounds, some of which led to local necrosis, likely affected the animal’s ability to feed, and may account for its death. Despite their detrimental effects, fish spine-related injuries are difficult to spot, and may be a common, albeit cryptic, type of trauma. We therefore recommend that stranded seals be systematically examined for this potentially life-threatening pathology.
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Hamid, Saira, Savvas Nicolaou, Faisal Khosa, Gordon Andrews, Nicolas Murray, Waleed Abdellatif, and Sadia Raheez Qamar. "Dual-Energy CT: A Paradigm Shift in Acute Traumatic Abdomen." Canadian Association of Radiologists Journal 71, no. 3 (March 11, 2020): 371–87. http://dx.doi.org/10.1177/0846537120905301.
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Abdominal trauma, one of the leading causes of death under the age of 45, can be broadly classified into blunt and penetrating trauma, based on the mechanism of injury. Blunt abdominal trauma usually results from motor vehicle collisions, fall from heights, assaults, and sports and is more common than penetrating abdominal trauma, which is usually seen in firearm injuries and stab wounds. In both blunt and penetrating abdominal trauma, an optimized imaging approach is mandatory to exclude life-threatening injuries. Easy availability of the portable ultrasound in the emergency department and trauma bay makes it one of the most commonly used screening imaging modalities in the abdominal trauma, especially to exclude hemoperitoneum. Evaluation of the visceral and vascular injuries in a hemodynamically stable patient, however, warrants intravenous contrast-enhanced multidetector computed tomography scan. Dual-energy computed tomography with its postprocessing applications such as iodine selective imaging and virtual monoenergetic imaging can reliably depict the conspicuity of traumatic solid and hollow visceral and vascular injuries.
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Piatt, Joseph, and Nicholas Imperato. "Epidemiology of spinal injury in childhood and adolescence in the United States: 1997–2012." Journal of Neurosurgery: Pediatrics 21, no. 5 (May 2018): 441–48. http://dx.doi.org/10.3171/2017.10.peds17530.
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OBJECTIVEThere has been no successful study of trends in population-based incidences of pediatric spinal injury in the United States. The goal of the current study was to develop robust data to correct this deficiency in contemporary trauma epidemiology.METHODSDischarges coded for spinal injury were extracted from the Kids’ Inpatient Database for 1997, 2000, 2003, 2006, 2009, and 2012 for patients younger than 18 years. Childhood was defined as ages 0 through 14 years and adolescence as ages 15, 16, and 17 years. Denominator population data were taken from the website of the US Census. Annual incidences were estimated for hospitalization for spinal injury, spinal cord injury (SCI), and hospital death with spinal injury. Mechanistic and anatomical patterns of injury were studied.RESULTSThe annual population-based incidences of hospitalization for spinal injury, SCI, and death with spinal injury trended downward from 1997 to 2012 for children and adolescents in the United States. Rates of SCI and death fell faster than overall hospitalization rates, suggesting lower thresholds for admission or greater diagnostic sensitivity to minor injuries over time. The incidence of hospitalization for spinal injury was roughly 8 times greater for adolescents than for children, and the incidence of SCI was roughly 6 times greater. Motor vehicle crash predominated among mechanisms for both children and adolescents, but penetrating injuries and sport injuries were more commonly associated with SCI. Lumbosacral injuries predominated in both children and adolescents, but injuries of the cervical spine were more commonly associated with SCI.CONCLUSIONSFurther research is needed to identify the cause or causes of the observed decline in injury rates. Epidemiological data can inform and support prevention efforts.
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Meel, B. L. "Gender-Related Traumatic Deaths in Transkei: Incidence and causes." Medicine, Science and the Law 43, no. 3 (July 2003): 215–20. http://dx.doi.org/10.1258/rsmmsl.43.3.215.
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This study is unique in that it strives to unfold, perhaps for the first time, the problem of female mortality due to trauma in the Transkei region of the Eastern Cape Province of South Africa. This study was carried out in the Umtata and Ngqeleni magisterial districts which have a combined population of about 400,000. Most of the people have very few resources and have historically relied on money repatriated by migrant workers. The objective was to establish the incidence and the causes of deaths due to gender-related trauma and to formulate recommendations which could probably help prevent or reduce these deaths. The study reviewed cases of female traumatic death during the period January 1993 to December 1999 that were brought to the mortuary in Umtata General Hospital (UGH). There were 1,054 (23%) traumatic deaths recorded in females between 1993 and 1999. Of these 486 (28%) were related to motor vehicle collisions, 219 (18%) due to gunshot injuries, 152 (19%) due to stab wounds and 139 (21%) as a result of blunt trauma. The male to female ratio was 3.3:1 in traumatic deaths. In homicides the male: female ratio was 4.4:1, gunshot 4.5:1, stab 4.2:1 and blunt injuries 3.7:1. In motor vehicle collisions (MVC's) the ratio was 2.5:1. There is an increasing incidence of traumatic deaths in women. Gun shot injuries are the commonest among traumatic deaths in females. This article recommends stricter measures to protect women in the form of legislation. Social uplifting and economic support should be carried out as part of the process of social change. In this case educating the entire community is necessary to safeguard women and their future survival.
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Mahat, Arun Kumar, Gopal Gurung, Merina Shrestha, and Bishwanath Chaudhary. "Epidemiology of Maxillofacial Fracture – A Hospital Based Study." Journal of Nepalgunj Medical College 17, no. 2 (May 3, 2020): 23–27. http://dx.doi.org/10.3126/jngmc.v17i2.28756.
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Introduction: Maxillofacial trauma is the most common problem seen by maxillofacial surgeons in Nepal. The causes of facial fractures are road traffic accidents (RTA), assaults, falls, gunshot wounds, domestic violence, sports and work injuries. Maxillofacial injury varies from soft tissue injury to facial bone fractures. This study was conducted to assess the burden of maxillofacial trauma in mid-western and far-western regions of Nepal.
Material and Method: Patients with maxillofacial fractures admitted in dental ward of NGMCTH, Kohalpur, from April 2017 to April 2019 were included in the study. Patients having soft tissue injury without facial bone fractures and OPD cases were excluded from the study. Patient demographics, mechanism of injury, associated soft tissue injury, accompanying injuries to other parts of body and facial bone fractures were recorded. Patient were treated by open reduction internal fixation or lateral compression splint with circum-mandibular wiring or managed conservatively as necessary.
Result: A total of 87 patients were included in the study. The age of patient ranged from 2 years to 67 years with a mean of 26.87 years. Most of the injuries occurred between the age group of 20-29 years with male: female ratio 5.2:1. The most frequent cause of facial bone fracture was RTA (51.7%) and the most frequently fractured facial bone was mandible. Contusion 54(49.5%) was the most common associated soft tissue injury. Head injury 20(52.6%) was the most common accompanying injury to other parts of body. The mean duration of hospital stay was 6.29.
Conclusion: Male patient in their third decade mostly had mandible fracture due to road traffic accident. Head injury was the most common accompanying injury. Contusion was the most common type of associated soft tissue injury.
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Esterov, Dmitry, Erica Bellamkonda, Jay Mandrekar, Jeanine E. Ransom, and Allen W. Brown. "Cause of Death after Traumatic Brain Injury: A Population-Based Health Record Review Analysis Referenced for Nonhead Trauma." Neuroepidemiology 55, no. 3 (2021): 180–87. http://dx.doi.org/10.1159/000514807.
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<b><i>Introduction:</i></b> Traumatic brain injury (TBI) is a leading cause of disability and is associated with decreased survival. Although it is generally accepted that TBI increases risk of death in acute and postacute periods after injury, causes of premature death after TBI in the long term are less clear. <b><i>Methods:</i></b> A cohort sample of Olmsted County, Minnesota, residents with confirmed TBI from January 1987 through December 1999 was identified. Each case was assigned an age- and sex-matched non-TBI referent case, called <i>regular referent</i>. Confirmed TBI cases with simultaneous nonhead injuries were identified, labeled <i>special cases</i>. These were assigned 2 age- and sex-matched <i>special referents</i> with nonhead injuries of similar severity. Underlying causes of death in each case were categorized using death certificates, <i>International Classification of Diseases</i>, <i>Ninth Revision</i>, <i>International Statistical Classification of Diseases</i>, <i>Tenth Revision</i>, and manual health record review. Comparisons were made over the study period and among 6-month survivors. <b><i>Results:</i></b> Case-regular referent pairs (<i>n</i> = 1,257) were identified over the study period, and 221 were special cases. In total, 237 deaths occurred among these pairs. A statistically significant difference was observed between total number of deaths among all cases (<i>n</i> = 139, 11%) and regular referents (<i>n</i> = 98, 8%) (<i>p</i> = 0.006) over the entire period. This outcome was not true for special cases (32/221, 14%) and special referents (61/441, 14%) (<i>p</i> = 0.81). A greater proportion of deaths by external cause than all other causes was observed in all cases (52/139, 37%) versus regular referents (3/98, 3%) and in special cases (13/32, 41%) versus special referents (5/61, 8%) (<i>p</i> < 0.001 for both). Among all case-referent pairs surviving 6 months, no difference was found between total number of deaths (<i>p</i> = 0.82). The underlying cause of death between these 2 groups was significantly different for external causes only (<i>p</i> < 0.01). For special cases surviving 6 months versus special referents, no difference was observed in total number of deaths (<i>p</i> = 0.24) or underlying causes of death (<i>p</i> = 1.00) between groups. <b><i>Discussion/Conclusion:</i></b> This population-based case-matched referent study showed that increased risk of death after TBI existed only during the first 6 months after injury, and the difference was due to external causes.
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Hadžismajlović, Ademir, and Alen Pilav. "Pleural Drainage and its Role in Management of the Isolated Penetrating Chest Injuries During the War Time in Sarajevo, 1992.-1995." Bosnian Journal of Basic Medical Sciences 7, no. 2 (May 20, 2007): 152–56. http://dx.doi.org/10.17305/bjbms.2007.3071.
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Penetrating chest injuries are the most frequent causes of serious demage and death in wounded indivisuals. In reports from the last wars where wounds caused by high velocity projectiles predominated, thoracotomies were perfomed in about 15% of the wounded individuals, mostly encompassing injuries of the heart and great vessels, accomanied by massive bleeding that could not be resolved by chest tube insertion. This retrospective analysis was performed on the medical records of 477 patients tretaed for isolated penetrating chest injuries in Department of Thoracic Surgery Clinical Center of the University in Sarajevo between april 1992 - june 1995. We analised the ways of their menagement with special view on pleural drainage, indication for this method and results of treatment. 398 (83,4%) wounded individuals have been treated with pleural tube inserting as definitive mesaure and for the urgent thoracotomy there were 79 (16,6%) patients left. Average hospital treatment in wounded drained patients was 7,68 days. With shrapnels there were 357 (74,84%) wounded individuals, and with bullet 120 (25,16%) wounded individuals. The complications of plaural tube inserting were - empyema in 34 (7,13%) patients and there were no other complications. Chest tube inserting as definitive mesaure was used in 398 (83,44%) patients. Chest tube inserting as preoperative measure (urgent thoracotomy) was used in 79 (16,56%) patients. There were 460 (96,44%) healed patients. Death occurred in 17 (3,56%) patients.
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Bair, Sarah D. "Making Good on a Promise: The Education of Civil War Orphans in Pennsylvania, 1863–1893." History of Education Quarterly 51, no. 4 (November 2011): 460–85. http://dx.doi.org/10.1111/j.1748-5959.2011.00354.x.
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During and after the American Civil War, individual state governments, faced with numerous economic demands, struggled to meet the needs of soldiers and their families. Among other pressing questions, they had to decide what to do with the massive number of dependent children orphaned by the war. Pennsylvania, a state that contributed the second most soldiers to the Union cause (only New York contributed more) suffered heavy losses. More than 15,000 Pennsylvania soldiers died in battle or of mortally inflicted battlefield wounds during the conflict. When one factored in death from disease and other causes, the number of Pennsylvania casualties exceeded 33,000. In addition to those who died, many others had their lives shortened by wartime injuries and diseases. Thousands more Pennsylvania soldiers survived the battle and its aftermath, but suffered severe injuries and were left too disabled to work. As a result, an unprecedented number of children became either full orphans or half orphans (those with mothers still living) or lived in families without adequate income to support them.
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Sahraravand, Ahmad, Anna-Kaisa Haavisto, Päivi Puska, and Tiina Leivo. "Work tool-related eye injuries: Helsinki Ocular Trauma Study." International Ophthalmology 40, no. 3 (December 6, 2019): 753–61. http://dx.doi.org/10.1007/s10792-019-01237-y.
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Abstract Purpose To quantify and characterize the epidemiology, treatments, long-term outcome, and use of resources for work tool-related eye injuries and their severity. Methods We included all new patients with a work tool-related eye injury treated at the Helsinki University Eye Hospital in 1 year. The data were from hospital records, examinations, and patient questionnaires. The follow-ups were at 3 months and 6 years. Results Work tools caused 3% (37/1151) of all eye injuries. The mean age was 37 and 84% were men. Most injuries (84%) occurred at work (17) or at home (15). There were 14 minor injuries, 12 contusions, 9 open globe injuries (OGI), and 2 eyelid wounds. The annual incidence of work tool-related eye injuries was 2.4/100,000 and hospitalization 0.6/100,000. At 6-year follow-up, we re-examined 18 patients and 17 were interviewed by phone. Four patients were blinded. We recorded 690 sick leave days and 43 major operations. No traumatic glaucoma was diagnosed. Fifteen patients needed lifelong follow-up. Permanent impairment occurred in 30% (11) of work tool-related eye injuries, from whom, nine were caused by manual tools. Work tools comprised 10% of the permanently impaired, but 2.5% of the non-permanently impaired cases among all eye injuries (1151). Conclusion The proportional difference between the permanently impaired and the non-permanently impaired was higher in work tool-related eye injuries than other causes reported in previous Helsinki Ocular Trauma Studies. High-risk injuries were mainly caused by manual tools and nails and resulted in OGI.
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Hodges, Nichole L., Sarah A. Denny, and Gary A. Smith. "Rare-Earth Magnet Ingestion–Related Injuries in the Pediatric Population: A Review." American Journal of Lifestyle Medicine 11, no. 3 (July 22, 2015): 259–63. http://dx.doi.org/10.1177/1559827615594336.
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Foreign-body ingestions are common among children and usually resolve with limited, if any, treatment. The ingestion of rare-earth magnets, however, commonly results in serious injury or death. These dangerous high-powered magnets can be found in the United States in a variety of consumer products, including magnetic toy sets designed for children and adults. The ingestion of one of such magnet is unlikely to cause significant harm. However, if multiple magnets are ingested, or if a magnet is ingested along with a metal object, the magnets are powerful enough to attract each other through the walls of the intestine, potentially resulting in significant internal damage. Rare-earth magnet ingestion cases are difficult to diagnose and the symptoms are not easy to differentiate from other causes of gastrointestinal illness or pain. However, delays in medical treatment can lead to serious injury or death. This review article describes the epidemiology of rare-earth magnet ingestion-related injuries and provides recommendations for diagnosis and treatment. Federal regulatory efforts related to rare-earth magnets and other prevention strategies are also discussed.
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Farzaneh, Esmaeil, Ghasem Fattahzadeh-Ardalani, Vahid Abbasi, Fariba Kahnamouei-aghdam, Behnam Molaei, Elham Iziy, and Habib Ojaghi. "The Epidemiology of Hospital-Referred Head Injury in Ardabil City." Emergency Medicine International 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/1439486.
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Background and Purpose. Trauma is the leading cause of death for youth in developing countries. Given the prevalence of head trauma (HT) in society and its complication and burden, the epidemiologic study of head trauma is necessary and is the main aim of this study.Materials and Methods. This retrospective population-based survey describes the epidemiology of head injury in a defined population in Ardabil city. It includes all 204 patients with head injury referred to the University Hospital of Ardabil, Iran, during 2013-2014. Data were collected by a checklist and analyzed by statistical methods in SPSS.19. Significance levelp<0.05was considered.Results. Of all registered cases, 146 (71.6%) were male and the rest of them were female. Most of HT patients lived in Ardabil city (60.8%). The mean age of patients was 22.6 ± 25.9 and most of victims were young. 24.5% of traumatic patients have injuries in severe to critical level (grade 3-4). The most cause of trauma was accidents (41.7%). Most of injuries occurred in night (55.9%) and in summer season (42.2%). Causes were traffic accident in 41.7%.Conclusion. Results showed that the leading cause of head trauma especially in the warm seasons is accidents and so, designing programs to reduce road accidents can dramatically reduce the rate of trauma in the future in Ardabil province.
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Strong, Kathleen L., Jon Pedersen, Emily White Johansson, Bochen Cao, Theresa Diaz, Regina Guthold, Danzhen You, Jennifer Requejo, and Li Liu. "Patterns and trends in causes of child and adolescent mortality 2000–2016: setting the scene for child health redesign." BMJ Global Health 6, no. 3 (March 2021): e004760. http://dx.doi.org/10.1136/bmjgh-2020-004760.
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The under-5 mortality rate has declined from 93 deaths per 1000 live births in 1990 to 39 per 1000 live births in 2018. This improvement in child survival warrants an examination of age-specific trends and causes of death over time and across regions and an extension of the survival focus to older children and adolescents. We examine patterns and trends in mortality for neonates, postneonatal infants, young children, older children, young adolescents and older adolescents from 2000 to 2016. Levels and trends in causes of death for children and adolescents under 20 years of age are based on United Nations Inter-agency Group for Child Mortality Estimation for all-cause mortality, the Maternal and Child Epidemiology Estimation group for cause of death among children under-5 and WHO Global Health Estimates for 5–19 year-olds. From 2000 to 2016, the proportion of deaths in young children aged 1–4 years declined in most regions while neonatal deaths became over 25% of all deaths under 20 years in all regions and over 50% of all under-5 deaths in all regions except for sub-Saharan Africa which remains the region with the highest under-5 mortality in the world. Although these estimates have great variability at the country level, the overall regional patterns show that mortality in children under the age of 5 is increasingly concentrated in the neonatal period and in some regions, in older adolescents. The leading causes of disease for children under-5 remain preterm birth and infectious diseases, pneumonia, diarrhoea and malaria. For older children and adolescents, injuries become important causes of death as do interpersonal violence and self-harm. Causes of death vary by region.
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Berbiglia, Lindsay, Peter P. Lopez, Leah Bair, Adelaide Ammon, Gwyneth Navas, Melissa Keller, and Lawrence N. Diebel. "Patterns of Early Mortality after Trauma in a Neighborhood Urban Trauma Center: Can We Improve Outcomes?" American Surgeon 79, no. 8 (August 2013): 764–67. http://dx.doi.org/10.1177/000313481307900815.
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Even with specialized trauma systems, a significant number of deaths occur within the early postinjury period. Our goal was to examine deaths within this period for cause and determine if care could improve outcomes. A retrospective chart review was performed on all patients who were dead on arrival or died within 4 hours of arrival between January 1, 2005, and December 31, 2011. Survival probabilities and Injury Severity Score (ISS) were calculated. Chart review and trauma review processes were used to determine cases with opportunities for care improvement. Two hundred eighty-nine patients were dead on arrival (DOA), and 176 patients died within 4 hours of arrival. The most common mechanism of injury was gunshot wounds (68.4%). The most common causes of death were uncontrolled hemorrhage (68.2%) and neurologic trauma (23.4%). Average ISS was 32. Twenty-nine patients had survival probability percentages over 50. Ten of 176 (5.7%) deaths were found to have opportunities for care improvement. In three cases (1.7%), errors contributed to death. The majority of trauma patients DOA or dying within 4 hours of hospital arrival have nonsurvivable injuries. Regular trauma review processes are invaluable in determining opportunities for care improvement. Autopsy information increases the reliability of the review process.
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Kenney, Anne, Wendy Shields, Alexandra Hinton, Francene Larzelere, Novalene Goklish, Kyle Gardner, Shannon Frattaroli, and Allison Barlow. "Unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation, 2006–2012." Injury Prevention 25, no. 6 (March 30, 2019): 574–76. http://dx.doi.org/10.1136/injuryprev-2018-043082.
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This study aims to describe the epidemiology of unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation between 2006 and 2012. Unintentional injury death data were obtained from the Arizona Department of Health Services and death rates were calculated per 100 000 people per year and age adjusted using data obtained from Indian Health Service and the age distribution of the 2010 US Census. Rate ratios were calculated using the comparison data obtained through CDC’s Web-based Injury Statistics Query and Reporting System. The overall unintentional injury mortality rate among American Indians residing on the Fort Apache Indian Reservation between 2006 and 2012 was 107.0 per 100 000. When stratified by age, White Mountain Apache Tribe (WMAT) mortality rates for all unintentional injuries exceed the US all races rate except for ages 10–14 for which there were no deaths due to unintentional injury during this period. The leading causes of unintentional injury deaths were MVCs and poisonings. Unintentional injuries are a significant public health problem in the American Indian and Alaska Native communities. Tribal-specific analyses are critical to inform targeted prevention and priority setting.
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Báez, Amado Alejandro, Matthew D. Sztajnkrycer, Richard Zane, and Ediza Giráldez. "Twenty-Five Years of Violence: The Epidemiology of Terrorism in South America." Prehospital and Disaster Medicine 23, no. 2 (April 2008): 128–32. http://dx.doi.org/10.1017/s1049023x00005732.
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AbstractIntroduction:Terrorism is a global public health burden. South Americans have been victims of terrorism for many decades.While the causes vary, the results are the same: death, disability, and suffering.The objective of this study was to perform a comprehensive, epidemiological, descriptive study of terrorist incidents in South America.Methods:This is a cross-sectional, descriptive study. Data from January 1971 to July 2006 was selected using the RAND Terrorism Chronology 1968–1997 and RAND®-Memorial Institute for Prevention of Terrorism (MIPT) Terrorism Incident database (1998–Present). Statistical significance was set at 0.05.Results:The database reported a total of 2,997 incidents in South American countries that resulted in 3,435 victims with injuries (1.15 per incident) and 1,973 fatalities (0.66 per incident). The overall case fatality ratio (CFR) was 35.8%. Colombia had the majority of incidents with 57.9% (1,734 of 2,997), followed by Peru with 363 (12.1%), and Argentina with 267 (8.9%). The highest individual CFR occurred in Paraguay (83.3%), and the lowest in Chile with 4.8%. Of the total injuries and deaths, Colombia had 66.1% (2,269 of 2,997) of all injuries and 75.2% (1,443 out of 1,920) of all deaths. Living in the country of Colombia was associated with a 16 times greater likelihood of becoming a victim of terrorist violence [odds ratio (OR) 16.15; 95% CI 13.45 to 19.40; p <0.0001].The predominant method of choice for terrorist incidents was the use of conventional explosives with 2,543 of 2,883 incidents (88.2%).Conclusions:Terrorist incidents in South America have accounted for nearly 2,000 deaths, with conventional explosive devices as the predominant method of choice. Understanding the nature of terrorist attacks and the medical consequences assist emergency preparedness and disaster management officials in allocating resources and preparing for potential future events.
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Klimov, Aleksei G., Yaroslav A. Stepanov, Leonid P. Erdniyev, Igor V. Mokshanov, Alexandr Yu Mikshta, Igor P. Ivashev, Nadezhda V. Stepanova, and Viktor A. Andreev. "Safety of anesthesia in acute blood loss moderate hypovolemia." Reviews on Clinical Pharmacology and Drug Therapy 19, no. 1 (May 21, 2021): 79–86. http://dx.doi.org/10.17816/rcf19179-86.
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Acute blood loss is the most common cause of death in armed conflicts. During the great Patriotic war, 37.2% of the wounded died on the battlefield from acute blood loss and its consequences. According to statistics of military surgeons in local wars, the percentage of deaths from bleeding on the battlefield has remained quite high in recent decades: in Afghanistan, 43% due to untimely first aid for gunshot and mine-explosive wounds, of which 27% died from acute blood loss. During counter-terrorism operations in the North Caucasus, acute blood loss was the cause of death in 26.6% of cases. Analysis of recent armed conflicts shows that the main causes of death on the battlefield are the consequences of penetrating wounds, in particular blood loss with combined traumatic brain injuries of various origins. The issue of analgesia for a lack of circulating blood volume, as well as for continuing bleeding, is complex due to the need to prevent the development of shock conditions against the background of possible side effects of anesthesia. The paper presents pharmacometric and toxicometric characteristics of a model agonist of opioid receptors in acute blood loss of moderate hypovolemia in an experiment. It was shown that the sensitivity of white rats and rabbits to intravenous anesthesia according to the criteria of deep anesthesia increased by 7.3 and 7.5 times, respectively; there were no changes in the mortality criterion for acute blood loss of moderate hypovolemia. A decrease in the speed of action and an increase in the duration of the effect of deep anesthesia in hypovolemia after intravenous administration of a model opioid receptor agonist at doses of 1 ED50 was revealed. An assessment of the breadth of therapeutic action of the model agonist of opioid receptors was made, according to the results of which an increase in this indicator was revealed. It is shown that it is necessary to clarify the anaesthetic manual for more severe variations of polytrauma with blood loss.
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Rosin, Nicole R., Robyn S. Tabibi, John D. Trimbath, and Mary Kristina Henzel. "A Primary Care Provider’s Guide to Prevention and Management of Pressure Injury and Skin Breakdown in People With Spinal Cord Injury." Topics in Spinal Cord Injury Rehabilitation 26, no. 3 (October 2020): 177–85. http://dx.doi.org/10.46292/sci2603-177.
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Skin breakdown, including burns and pressure injuries (PrIs), is a devastating complication of spinal cord injury (SCI). Chronic wounds place the person with SCI at high risk of infections, sepsis, and death. Skin health and breakdown is individual and multifactorial, thus prevention requires individualized education focused on patient preferences and goals. Assessment requires an accurate description of wound type/PrI stage, location, size, wound bed, wound margin, epithelialization, exudate, and peri-wound condition. PrIs should be staged using the National Pressure Injury Advisory Panel (NPIAP) staging system. Successful treatment requires optimal wound bed preparation, pressure off-loading, and access to surgical specialists if needed. Mattress and seating systems, pressure relief, skin microclimate, nutrition, and home supports should be optimized. To promote wound healing and aid prevention, identifiable causes need to be removed, risk factors improved, and wound care provided. Infection should be treated with input from infectious disease specialists. Consideration for specialized surgical management including flaps and primary closures should be coordinated with the interdisciplinary team to optimize outcomes. If comorbid conditions promote wound chronicity, a palliative rather than curative treatment plan may be needed.
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Finès, P., E. Bougie, N. Oliver, and DE Kohen. "Hospitalizations for unintentional injuries among Canadian adults in areas with a high percentage of Aboriginal-identity residents." Chronic Diseases and Injuries in Canada 33, no. 4 (September 2013): 204–17. http://dx.doi.org/10.24095/hpcdp.33.4.02.
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Introduction Injuries are a leading cause of death and morbidity. While individual Aboriginal identifiers are not routinely available on national administrative databases, this study examines unintentional injury hospitalization, by cause, in areas with a high percentage of Aboriginal-identity residents. Methods Age-standardized hospitalization rates (ASHRs) and rate ratios were calculated based on 2004/2005-2009/2010 data from the Discharge Abstract Database. Results Responses from parents living in provinces with legislation (n = 640) and without legislation (n = 362) were as follows: concern for injury (63% vs. 68%, nonsignificant [NS]); believe helmets are effective (98% vs. 98%, NS); child always wears a helmet (74% vs. 69%, NS); support legislation for children (95% vs. 83%, p $lt; .001); support legislation for all ages (85% vs. 75%, p $lt; .001); support police enforcement (83% vs. 76%, p = .003); believe legislation decreases the amount of time their child bicycles (5% vs. 8%, NS). Conclusion Residents of high-percentage Aboriginal-identity areas also live in areas of lower socio-economic conditions, suggesting that the causes for rate differences among areas require further investigation.
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Askgaard, Gro, David A. Leon, Thomas Deleuran, and Janne S. Tolstrup. "Hospital admissions and mortality in the 15 years after a first-time hospital contact with an alcohol problem: a prospective cohort study using the entire Danish population." International Journal of Epidemiology 49, no. 1 (July 23, 2019): 94–102. http://dx.doi.org/10.1093/ije/dyz159.
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Abstract Background Potential benefits of preventing continued alcohol intake in individuals presenting at the hospital with an alcohol problem can be highlighted by studying their excess risk of subsequent morbidity and mortality. Methods All Danish residents with a first-time hospital contact with alcohol problems (intoxication, harmful use or dependence) in 1998–2002 were followed through 2012 using healthcare registries. We compared their cause-specific rates of hospital admission and mortality to the expected rates derived from the general population by calculating standardized incidence rate ratios. Results The 26 716 men and 12 169 women who were hospitalized with alcohol problems (median age 44 years) had more than 10 times the rate of subsequent admission to psychiatric departments and three times the rate of subsequent admission to somatic departments compared with the general population. In particular, the hospital admission rates for gastroenterological disease and injuries were high. The cumulative all-cause 10-year mortality risk was 29% [95% confidence interval (CI), 28–30] in men and 26% (95% CI, 24–27) in women with alcohol problems. The ratios of observed to expected death rate for all-cause mortality were 4.0 (95% CI, 3.8–4.1) in men and 4.3 (95% CI, 4.0–4.7) in women and, for causes of death fully attributable to alcohol, 16 (95% CI, 15–17) in men and 33 (95% CI, 29–38) in women. Conclusions Individuals hospitalized with alcohol problems have much higher rates of subsequent alcohol-related hospital admission and mortality than the general population. Increased focus on preventing continued alcohol consumption in these individuals may reduce their subsequent morbidity and mortality.
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Mokdad, Ali H., George A. Mensah, Varsha Krish, Scott D. Glenn, Molly K. Miller-Petrie, Alan D. Lopez, and Christopher J. L. Murray. "Global, Regional, National, and Subnational Big Data to Inform Health Equity Research: Perspectives from the Global Burden of Disease Study 2017." Ethnicity & Disease 29, Suppl 1 (February 21, 2019): 159–72. http://dx.doi.org/10.18865//ed.29.s1.159.
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Objectives: Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.Design: GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortality. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to premature mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility.Results: There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alcohol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course.Conclusions: Policymakers need a comprehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop programs to improve health and health equity.Ethn Dis. 2019;29(Suppl 1): 159-172; doi:10.18865/ed.29.S1.159.
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Mokdad, Ali H., George A. Mensah, Varsha Krish, Scott D. Glenn, Molly K. Miller-Petrie, Alan D. Lopez, and Christopher J. L. Murray. "Global, Regional, National, and Subnational Big Data to Inform Health Equity Research: Perspectives from the Global Burden of Disease Study 2017." Ethnicity & Disease 29, Suppl 1 (February 21, 2019): 159–72. http://dx.doi.org/10.18865/ed.29.s1.159.
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Objectives: Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.Design: GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortality. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to premature mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility.Results: There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alcohol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course.Conclusions: Policymakers need a comprehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop programs to improve health and health equity.Ethn Dis. 2019;29(Suppl 1): 159-172; doi:10.18865/ed.29.S1.159.
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Khodadadizadeh, Ali, Katayoun Jahangiri, Davoud Khorasani-Zavareh, and Reza Vazirinejad. "Epidemiology of Vehicle Fire Fatalities of Road Traffic Injuries in Kerman Province, Iran: A Cross-Sectional Study." Open Access Macedonian Journal of Medical Sciences 7, no. 12 (July 8, 2019): 2036–43. http://dx.doi.org/10.3889/oamjms.2019.483.
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BACKGROUND: Vehicle fires are one of the most important causes of fatalities in road traffic injuries (RTIs), but there are no accurate statistics about vehicle fire fatalities (VFFs) due to RTIs in Iran. AIM: This study aimed to investigate the Epidemiology of vehicle fire fatalities (VFFs) due to road traffic injuries (RTIs) in Iran.METHODS: In this cross-sectional study, a researcher-made checklist was used to collect the required data from the files of RTI fatalities in the Kerman Legal Medicine Organization (KLMO), or coroner’s office. All reported victims of vehicle fires in the ten years from 2007 to 2017 were included in the study. The data were analysed using SPSS ver. 18, with p = 0.05 considered as the level of significance. RESULTS: The authors found 124 cases of vehicle fire fatalities in Kerman, with a mean age of 30.45 ± 12.41, of which 50% were in the 25-49 years age group. Most frequently, the victims were Iranian (91.9%), married (66.1%), self-employed (51.6%), and urban dwellers (79.8%), and had died because of burns (91.9%). In 46.8% of cases, the victims were the driver, and in the remaining 53.2%, they were the passenger of the crashed vehicle. Most frequently, vehicle fires occurred on extra-urban roads (90.3%), during spring (35.5 %) or summer (32.3%), due to a vehicle-to-vehicle collision (66.9%), between sedans (69.9%), and at night (63.7%). Most victims died at the scene of the incident (87.9%) and had been transferred to hospital by an ambulance (71%).CONCLUSION: This study indicated that car fires caused the death of young and middle-aged people. The authors suggest the implementation of preventative measures promoting car safety; establishing speed management; establishing laws governing driving, manufacturing and importation of vehicles; construction of safe roads; identifying accident-prone points; installing road warning signs; establishing more roadside stations; ensuring stricter police monitoring; and improving vehicle safety standards and public awareness about the risks of speeding.
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Canher, Balkan, Jefri Heyman, Maria Savina, Ajay Devendran, Thomas Eekhout, Ilse Vercauteren, Els Prinsen, et al. "Rocks in the auxin stream: Wound-induced auxin accumulation andERF115expression synergistically drive stem cell regeneration." Proceedings of the National Academy of Sciences 117, no. 28 (June 29, 2020): 16667–77. http://dx.doi.org/10.1073/pnas.2006620117.
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Plants are known for their outstanding capacity to recover from various wounds and injuries. However, it remains largely unknown how plants sense diverse forms of injury and canalize existing developmental processes into the execution of a correct regenerative response. Auxin, a cardinal plant hormone with morphogen-like properties, has been previously implicated in the recovery from diverse types of wounding and organ loss. Here, through a combination of cellular imaging and in silico modeling, we demonstrate that vascular stem cell death obstructs the polar auxin flux, much alike rocks in a stream, and causes it to accumulate in the endodermis. This in turn grants the endodermal cells the capacity to undergo periclinal cell division to repopulate the vascular stem cell pool. Replenishment of the vasculature by the endodermis depends on the transcription factor ERF115, a wound-inducible regulator of stem cell division. Although not the primary inducer, auxin is required to maintainERF115expression. Conversely, ERF115 sensitizes cells to auxin by activating ARF5/MONOPTEROS, an auxin-responsive transcription factor involved in the global auxin response, tissue patterning, and organ formation. Together, the wound-induced auxin accumulation andERF115expression grant the endodermal cells stem cell activity. Our work provides a mechanistic model for wound-induced stem cell regeneration in which ERF115 acts as a wound-inducible stem cell organizer that interprets wound-induced auxin maxima.
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Goldberg, Marcel, Alexis Descatha, Annette Leclerc, Yves Roquelaure, Jack Siemiatycki, and Marie Zins. "O3D.7 Constances: a population-based cohort for occupational epidemiology." Occupational and Environmental Medicine 76, Suppl 1 (April 2019): A29.2—A29. http://dx.doi.org/10.1136/oem-2019-epi.78.
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The CONSTANCES general-purpose population-based cohort is intended to serve as an epidemiological research infrastructure accessible to the epidemiologic research community. CONSTANCES also provides useful public health information to the public health authorities. CONSTANCES was designed as a randomly selected sample of French adults aged 18–69 years at inception; 2 00 000 subjects will be included over a six-year period. At inclusion, the selected subjects are invited to complete questionnaires, including a lifetime job history, and to attend a Health Screening Centre (HSC) for a comprehensive health examination. A biobank is being set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and health data are collected from the French national administrative databases. Data collected for participants include social and demographic characteristics, socioeconomic status, life events, and behaviours. Regarding occupational factors, a full job history and a wealth of data on employment and organizational, chemical, biological, biomechanical and psychosocial lifelong exposure are collected at inception and during the follow-up. The health data cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death. To consider non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants was set up and will be followed through the same national databases as participants.Inclusion began in 2012 and more than 1 80 000 participants were enrolled by July 2018. Several projects on occupational risks are already in progress, and an Occupational Health Users Club was established. This platform and its potential contributions will be described, as well as the means for international investigators to access it.
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Indiaminov, Sayit I., and Antonina A. Kim. "Epidemiological aspects and a current approach to the problem of carbon monoxide poisoning." Russian Journal of Forensic Medicine 6, no. 4 (December 15, 2020): 4–9. http://dx.doi.org/10.19048/fm344.
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Background: Carbon monoxide (CO) poisoning is the leading cause of death from poisoning (accidental and intentional). The number of cases of CO poisoning is increasing day by day.
Aims: The aim of the study was to analyze the epidemiological situation of CO poisoning and identify the urgent aspects of this problem. In the article, the author provided a retrospective analysis of 117 cases of CO poisoning, registered in a number of regional branches of the Republican Scientific and Practical Center of the Forensic Medical Examination of Uzbekistan, after he studied and analyzed the world literature on the epidemiology of CO poisoning. It has been revealed that fatal poisoning ranks third after mechanical injuries and mechanical asphyxia and constitutes 6.3% (513 cases) in the range of deaths by violence (8078 cases). Therefore, CO poisoning is considered as one of the most prevailing (51%) causes of mortality.
Conclusion: This is a global problem, with young males at risk. Further studies on the current clinical and forensic aspects of CO poisoning are required, and the necessity for regular analysis of epidemiological data for taking comprehensive measures to prevent CO poisoning is emphasized.
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Marlow, Robin, Julie Mytton, Ian K. Maconochie, Hazel Taylor, and Mark D. Lyttle. "Trends in admission and death rates due to paediatric head injury in England, 2000–2011." Archives of Disease in Childhood 100, no. 12 (August 13, 2015): 1136–40. http://dx.doi.org/10.1136/archdischild-2015-308615.
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BackgroundThe number of children admitted to hospital is increasing year on year, with very short-stay admissions doubling in the last decade. Childhood head injury accounts for half a million emergency department attendances in the UK every year. The National Institute for Health and Care Excellence (NICE) has issued three iterations of evidence-based national guidance for head injury since 2003.ObjectivesTo assess if any changes in the rates of admission, death or causes of head injury could be temporally associated with the introduction of sequential national guidelines by longitudinal analysis of the epidemiology of paediatric head injury admissions in England from 2000 to 2011.MethodsRetrospective analysis of English Hospital Episode Statistics data of children under the age of 16 years old admitted to hospital with the discharge diagnosis of head injury.ResultsThe number of hospital admissions with paediatric head injury in England rose by 10% from 34 150 in 2000 to 37 430 in 2011, with the proportion admitted for less than 1 day rising from 38% to 57%. The main cause of head injury was falls (42–47%). Deaths due to head injury decreased by 52% from 76 in 2000 to 40 in 2011. Road traffic accidents were the main cause of death in the year 2000 (67%) but fell to 40% by 2011. In 2000, children who were admitted or died from head injuries were more than twice as likely to come from the most deprived homes compared with least deprived homes. By 2011, the disparity for risk of admission had narrowed, but no change was seen for risk of death.ConclusionsTemporal relationships exist between implementation of NICE head injury guidance and increased admissions, shorter hospital stay and reduced mortality. The underlying cause of this association is likely to be multifactorial.
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Preikšaitis, Aidanas, and Saulius Ročka. "Ligoninėje gydytos galvos smegenų traumos epidemiologija Vilniuje ir Vilniaus krašte." Lietuvos chirurgija 5, no. 1 (January 1, 2007): 0. http://dx.doi.org/10.15388/lietchirur.2007.1.2243.
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Aidanas Preikšaitis, Saulius RočkaVilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 VilniusVilniaus universiteto Neurologijos ir neurochirurgijos klinikos Neurochirurgijos skyrius,Šiltnamių g. 29, LT-04130 VilniusEl paštas: danas911@gmail.com; ross@aiva.lt Įvadas / tikslas Pasaulyje galvos trauma patiriama kas penkiolika sekundžių, kas dvylika minučių nuo jos miršta žmogus. Daugiausia asmenų iki 40 metų miršta dėl išorinių priežasčių, tarp jų ir įvairių traumų. Mirtys dėl galvos smegenų traumų sudaro apie 30% visų trauminių mirčių. Ši studija buvo suplanuota dėl to, kad epidemiologinė galvos smegenų traumos situacija mūsų krašte yra neaiški. Ligoniai ir metodai Retrospektyvusis tyrimas atliktas Vilniaus greitosios pagalbos universitetinėje ligoninėje. Buvo ištirta 622 dėl galvos smegenų traumos hospitalizuotų pacientų. Duomenys buvo renkami į asmeninį kompiuterį ir apdoroti naudojant "MS office Excel 2003" ir "SPSS 10" programas. Rezultatai Vyrai galvos smegenų traumą patiria vidutiniškai tris kartus dažniau negu moterys. 20–59 metų žmonės sudarė 72,5%. Dažniausios galvos smegenų traumos priežastys: kritimai (40,7%), eismo nelaimės (20,5%) ir smurtiniai sužalojimai (19%). Lengvų galvos smegenų traumų (pagal Glasgow komų skalę (GKS) 13–15 balų) pasitaikė 67,8% atvejų, vidutinio sunkumo (GKS 9–12 balų) buvo 15,2%, o sunkių galvos smegenų traumų (GKS < 8 balai) – 17%. Remiantis radiologiniais duomenimis dažniausiai buvo diagnozuojama subduralinė kraujosruva (29,1%), kiek rečiau – trauminė subarachnoidinė kraujosruva (19,5%). Net 86,4% baigtis buvo gera (pagal Glasgow baigčių skalę 4–5 balai), 6,4% pacientų, patyrusių galvos smegenų traumą, neišgyveno. Išvados Galvos smegenų traumą reikšmingai dažniau patiria 20–59 metų vyrai. Dažniausia traumos priežastis – kritimai. Vilniaus ligoninėse dažniausiai gydomi pacientai, patyrę lengvą galvos smegenų traumą (GKS 15–13 balų). Net trys ketvirtadaliai baigčių yra labai geros. Pusė žmonių, patyrusių sunkią galvos traumą (GKS 3 balai), neišgyvena. Pasitvirtino ankstyvieji galvos smegenų traumos prognoziniai veiksniai: atvykimo GKS, amžius, vyzdžių skersmuo ir jų reakcija į šviesą, pakitimai galvos kompiuterinėje tomogramoje. Vilniaus ligoninėje hospitalizuojama santykinai daugiau lengvą galvos smegenų traumą patyrusių pacientų negu kitose pasaulio klinikose. Pagrindiniai žodžiai: galvos trauma, galvos smegenų trauma, neurochirurgija, epidemiologija The epidemiology of in-hospital-treated brain traumas in Vilnius city and region AIDANAS PREIKŠAITIS, SAULIUS ROČKAVilnius University, Faculty of Medicine, M. K. Čiurlionio str. 21, LT-03101 Vilnius, LithuaniaVilnius University, Clinic of Neurology and Neurosurgery, Department of Neurosurgery,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: danas911@gmail.com; ross@aiva.lt Background / objective Every fifteen seconds a head injury happens in the world, and every twelve minutes it causes a death. Most individuals younger than 40 years die due to external causes including different traumas. Deaths caused by traumatic brain injury comprise about 30% of all traumatic deaths. This study has been planned because of the unclear epidemiology of traumatic brain injuries in our country. Patients and methods A retrospective study was carried out at Vilnius University Emergency Hospital. 622 hospitalized traumatic brain injury patients were enrolled in the study. The data were stored in a personal computer and analyzed using Microsoft Excel 2003 and SPSS 10 statistical package. Results The male gender was dominant among the brain-injured. 72.5% of these patients were 20–59 years of age. Most frequent causes of traumatic brain injuries were falls (40.7%), traffic accidents (20.5%) and assaults (19%). Mild traumatic brain injuries (Glasgow Coma Scale (GCS) 13–15) were proved in 67.8%, moderate (GCS 9–12) in 15.2% and severe (GCS < 8) – in 17.0% of cases. Radiological evaluation revealed subdural hemorrhage in 29.1% and traumatic subarachnoid hemorrhage in 19.5% of victims. Good outcomes (according to GOS 4–5) were reGBStered in 86.4% patients, 6.4% patients did not survive. Conclusions Traumatic brain injuries in males were three times more frequent than in females. The age group of 20–59 years was prevalent. The most frequent cause of trauma was fall. Mild traumatic brain injuries (GCS 15–13) prevailed in Vilnius among the in-hospital patients. Three quarters of the outcomes were very good. Half of the patients brought in with three-point coma did not survive. The following early prognostic factors of traumatic brain injury were approved: GCS score, age, pupils diameter and light reflex, CT features. It was established that hospitalization of mild traumatic brain injuries in Lithuania was more frequent than in neurosurgical departments of other countries. Keywords: head injury, traumatic brain injury, neurosurgery, epidemiology
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Kafle, Prakash, Babita Khanal, Dipak Kumar Yadav, Deepak Poudel, Tejendra Karki, and Iype Cherian. "Head Injury in Nepal: An Institutional Based Prospective Study on Clinical Profile, Management and Early Outcome of Traumatic Brain Injury in Eastern Part of Nepal." Birat Journal of Health Sciences 4, no. 2 (September 4, 2019): 750–54. http://dx.doi.org/10.3126/bjhs.v4i2.25459.
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Introduction: Traumatic brain injuries (TBI) are among the worst consequences and are the major causes of death and disability worldwide. It is considered as silent epidemics affecting individuals of all the ages and one of the major burden of neorological disease. Hence, TBIs are often overlooked and are sometimes called “the neglected disease of modern society”. Presenting GCS is the best predictor of outcome.
Objective: The present study aims to portray the epidemiology, clinical profile, its management, early outcome and to evaluate the outcome predictors in a tertiary care center in eastern part of Nepal.
Methodology: This is a prospective cross-sectional study conducted at the Department of Neurosurgery, Nobel Medical College Teaching Hospital, Biratnagar, Nepal over the period of 1 year (October, 2016 - December 2017). The primary objective of this study was to review the etiology, clinical profile and early outcome of patients with TBI.
Results: During the study period, 1056 patients with head injuries were studied. Of these 202 cases required surgical intervention and 32 were excluded. Mean age of the study population was 38.7 years with the male to female ratio of 3.49:1. Road traffic accident was the most common cause of TBI (76%). Overall mortality rate was 11.17%. Unfavorable GOS at discharge was 43.5% and 26.1% at three months follow-up.
Conclusion: TBI continues to be a significant burden of neurosurgical care in major neurosurgical centers in Nepal. This study contributes data on the etiology and clinical profile of patients with TBI from tertiary care center of Nepal.
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Oktora, Saptiadi, Eka Marwansyah Oli'i, and Endang Sjamsudin. "Penatalaksanaan kegawatdaruratan medis trauma maksilofasial pada anak disertai cedera kepalaEmergency management of maxillofacial trauma in children with a head injury." Jurnal Kedokteran Gigi Universitas Padjadjaran 32, no. 3 (February 28, 2021): 173. http://dx.doi.org/10.24198/jkg.v32i3.29510.
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Pendahuluan: Pasien dengan fraktur maksilofasial mempunyai risiko tinggi disertai cedera kepala karena dekatnya letak anatomi tulang wajah dan kranium. Trauma maksilofasial sering menyebabkan cedera pada jaringan lunak, gigi geligi dan komponen utama rangka wajah termasuk mandibula, maksila, zigoma, kompleks nasoorbital-ethmoid (NOE) dan struktur supraorbital. Kegawatdaruratan medis pada anak merupakan suatu kondisi yang mendesak yang membutuhkan penanganan segera pada anak untuk mengurangi resiko kematian dan kecacatan. Laporan kasus ini bertujuan agar memberikan gambaran dan mengevaluasi tindakan pasien trauma maksilofasial yang disertai cedera kepala pada anak. Laporan kasus: Seorang anak laki-laki usia 9 tahun datang dengan keluhan perdarahan dari mulut, 3 jam karena terjatuh saat mengendarai sepeda. Pasien mengalami cedera kepala dan fraktur dentoalveolar rahang atas dan rahang bawah. Diagnosis cedera kepala ringan, fraktur palatum inkomplit, fraktur dentoalveolar regio gigi 54-21, 85-32 dengan fraktur segmental dentoalveolar regio gigi 42-83 disertai avulsi gigi 11,12,53,54,21,32,31,41,84 dan mobility grade 3 gigi 42,83,85, luka laserasi pada regio frontal, labii inferior, palatum, mentale dan gingiva regio gigi 54-21 dan 85-32, serta luka punctum pada regio labiomental. Penatalaksanaan kasus ini adalah dilakukan pembersihan luka, ekstraksi gigi 83, 85, 42, alveolektomi regio gigi 54-21, 32-85 serta penjahitan pada luka laserasi dan punctum dengan melibatkan bagian bedah saraf, ilmu kesehatan anak dan anestesi. Simpulan: Penatalaksanaan kegawatdaruratan medis cedera kepala dan trauma maksilofasial pada kasus ini dilakukan penjahitan pada intra oral dan ekstra oral serta ekstraksi gigi 42,83,85 dengan anestesi umum yang melibatkan bagian bedah saraf, ilmu kesehatan anak, anestesi dapat mencegah kematian dan mengurangi resiko kecacatan yang lebih parah. Penilaian awal secara komprehensif sangat penting dalam menentukan rencana perawatan kegawat daruratan pada pasien trauma maksilofasial.Kata kunci: Cedera kepala, trauma maksilofasial, kegawatdaruratan medis anak ABSTRACTIntroduction: Patients with maxillofacial fractures are at a high risk of head injury due to the cranium and facial bones' anatomy. Maxillofacial trauma often causes injury to soft tissues, teeth, and significant facial skeleton components, including the mandible, maxilla, zygoma, nasoorbitoethmoid (NOE) complex and supraorbital structures. A paediatric medical emergency is an urgent condition that requires immediate treatment to reduce the risk of death and disability. This case report was aimed to provide an overview and evaluation of the treatment for child patient with maxillofacial trauma accompanied by head injuries. Case report: A 9-year-old male child presented with complaints of bleeding from the mouth, 3 hours after falling while riding a bicycle. The patient had head injuries and dentoalveolar fractures of the maxilla and mandible. Diagnosis of minor head injury, incomplete palatal fracture, dentoalveolar fracture of teeth number 54-21, 85-32 with segmental fracture of the dentoalveolar region of teeth number 42-83 accompanied by avulsion in teeth number 11, 12, 53, 54, 21, 32, 31, 41, 84, and mobility grade 3 of teeth number 42, 83, 85. Laceration wounds in the frontal region, inferior labii, palate, mentale, and gingiva regions of teeth number 54-21 and 85-32, and punctum wounds in the labiomental region. This case management included rinsing the wound; extracting teeth number 83, 85, 42; alveolectomy in the region of teeth number 54-21, 32-85; suturing the laceration and punctum wounds involving neurosurgery, paediatric medicine and anaesthesia. Conclusion: Management of medical emergency of head injury and maxillofacial trauma in this case is performed with intraoral and extraoral suturing and extraction of teeth number 42, 83, 85, with general anaesthesia involving the Neurosurgery and Paediatrics Division. Anaesthesia can prevent death and reduce the more severe risk of disability. A comprehensive initial assessment is essential in determining the emergency treatment plan for maxillofacial trauma patients.Keywords: Head injury, maxillofacial trauma, paediatric medical emergency.
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Tsatsanidis, Georgios V., Georgios I. Minopoulos, Nicolaos D. Liratzopoulos, Jannis V. Papathanasiou, and Konstantinos E. Simopoulos. "The Structure of Trauma Patients, its Management and Health Care in the University Hospital of Alexandroupolis." Folia Medica 56, no. 1 (January 1, 2014): 50–55. http://dx.doi.org/10.2478/folmed-2014-0008.
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ABSTRACT OBJECTIVE: The present study was designed to describe the patterns of trauma patients using a newly-introduced trauma registry, as well as retrospectively assess the management and outcome facts of these patients. MATERIALS AND METHODS: The study included 2346 patients (62.15% male) with a mean age of 34.06 ± 23.77 years. Of these patients, 355 were multiple trauma patients. Privately owned vehicles were used as a mode of transportation for most of the trauma patients (96.65%). Data regarding patient demographics, arrival at the Emergency Department, mechanism of injury, injury severity, anatomical location and type of injury were collected and analyzed. RESULTS: Falls were the most prevalent mechanism of injury, accounting for 62.19% of the total admitted cases, with other causes (that also included occupational accidents and machinery trauma) being the second most prevalent, and MVAs - the third with a rate of 11.46%. The most commonly injured body regions were the extremities (50.26%), the head (42.50%), and the torso (19.39%). Fractures represented 11.46% of the injuries, while open wounds were much more frequent (29.41%). The mean abbreviated injury severity (AIS) score was 1.78 ± 1.48 for all admitted patients and 3.56 ± 1.02 for multiple trauma patients. A multi-disciplinary approach was required for 23% of the multiple trauma patients. The clinic admission rate for the whole patient sample was 13.55% and 48.96% for multiple trauma patients. The mean duration of stay for all clinic admissions was 2.7 days and 2.9 days for multiple trauma patients. CONCLUSIONS: With the epidemiology of trauma in Greece being rather poorly investigated, the present study manages to identify the major epidemiological patterns of trauma cases presenting to a tertiary regional hospital and addresses the need for development and implementation of injury prevention activities and policies
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Lord, Sarah, Charles H. Tator, and Sandy Wells. "Examining Ontario Deaths Due to All-Terrain Vehicles, and Targets for Prevention." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 37, no. 3 (May 2010): 343–49. http://dx.doi.org/10.1017/s0317167100010234.
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Background:All-terrain vehicle (ATV) use is increasingly popular among people of all ages. Although ATV use is known to cause significant morbidity due to head and neck trauma, there is a lack of published data detailing ATV-related fatalities. We examined all ATV-related fatalities in Ontario from 1996 - 2005 to determine the epidemiology and risk factors as a guide for improved injury prevention strategies.Methods:All ATV-related fatalities from 1996 - 2005 in Ontario were examined through Coroner's reports in the Office of the Chief Coroner of Ontario. Epidemiologic information and risk factors relating to the driver, environment, and vehicle were recorded.Results:There were 74 ATV-related fatalities from 1996 - 2005. There was only one fatality per year in 1996 and 1997 and a peak of 16 per year in 2004 and 2005. Head and neck injuries were the commonest causes of death. Males comprised 90.5% of the cases. The highest risk was from age 15 - 29, and 21% of fatalities occurred in children under 16. Northeastern Ontario had the highest fatality rate.Conclusions:There was a major increase in the incidence of ATV-related fatalities in Ontario from 1996 - 2005 with the majority due to head trauma. Notable risk factors included alcohol use, riding at night, lack of helmet use, and excessive speed. We recommend the adoption of laws that focus on helmet requirements, a minimum driver age of 16, and certified training courses. Aggressive injury prevention efforts should be targeted toward males aged 15 - 29.
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Magnus, Dan, Santosh Bhatta, and Julie Mytton. "432 Establishing injury surveillance in emergency departments in Nepal: epidemiology and burden of paediatric injuries." Emergency Medicine Journal 37, no. 12 (November 23, 2020): 825.2–827. http://dx.doi.org/10.1136/emj-2020-rcemabstracts.7.
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Aims/Objectives/BackgroundGlobally, injuries cause more than 5 million deaths annually. Children and young people are a particularly vulnerable group and injuries are the leading cause of death in people aged 5–24 years globally and a leading cause of disability.In most low and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. There is a continuing need for better data on childhood injuries and for injury surveillance.The aim of our study was to introduce a hospital-based injury surveillance tool – the first of its kind in Nepal and explore its feasibility. We undertook prospective collection of data on all injuries/trauma presenting to 2 hospital emergency departments to describe the epidemiology of paediatric hospital injury presentations and associated risk factors.Methods/DesignA new injury surveillance system for use in emergency departments in Nepal was designed and used to collect data on patients presenting with injuries. Data were collected prospectively in two hospitals 24 h a day over 12 months (April 2019 - March 2020) by trained data collectors using tablet computers.Abstract 432 Table 1Socio-demographic profile and characteristics of injury among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020 (N=2696)CharacteristicsFrequencyGender Male 1778 Female 918 Age groups 0–4 years 653 5–9 years 866 10–14 years 680 15–17 years 497 Median year (IRQ) 8 (5 – 13) Ethnicity/caste Janajati 1384 Brahmin/Chhetri 892 Dalit 148 Madhesi 146 Muslim 74 Others 50 Unknown 2 Place where injury occurred Home/Compound 1576 Highway/road/street 636 School 233 Recreational area 138 Workplace 76 Other 37 Activities at the time injury occurred Leisure/Play 1889 Travelling (other than to/from school/work) 296 Work 202 Travelling (to/from school/work) 184 Education 42 Organised sports 11 Other 52 Unknown 20 Intent of injury Unintentional 2560 Intentional (self-harm) 61 Intentional (assault) 75 Unintentional (n=2560) Fall 912 Animal or insect related 728 Road traffic injury 356 Injured by a blunt force 201 Stabbed, cut or pierced 176 Fire, burn or scald 65 Poisoning 52 Suffocation/choking 36 Electrocution 12 Drowning and submersion 7 Other 13 Unknown 2 Self-harm (n=61) Poisoning 38 Hanging, strangulation, suffocation 12 Stabbed, cut or pierced 6 Injured by blunt object 4 Other 1 Assault (n=75) Bodily force (physical violence) 43 Injured by blunt object 18 Stabbed, cut or pierced 8 Pushing from a high place 2 Poisoning 2 Sexual assault 1 Other 1 Nature of injury (one most severe) Cuts, bites or open wound 1378 Bruise or superficial injury 383 Fracture 299 Sprain, strain or dislocation 243 Internal injury 124 Head Injury/Concussion 83 Burns 67 Other 115 Unknown 2 Not recorded 2 Severity of injury No apparent injury 125 Minor 1645 Moderate 813 Severe 111 Not recorded 2 Disposition Discharged 2317 Admitted to hospital 164 Transferred to another hospital 179 Died 21 Leave Against Medical Advice (LAMA) 11 Unknown 2 Not recorded 2 Note:Not recorded = missing cases95% CI calculated using one proportion test and normal approximation method in Minitab.Abstract 432 Table 2Distribution of injuries by age-group, sex and mechanism of injury among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Age groups & Sex0 - 4 years5 - 9 years10–14 years15–17 yearsMaleFemaleTotalIntent & mechanismsn (%)n (%)n (%)n (%)n (%)n (%)n (%)Unintentional Fall 239 (26.2) 328 (36.0) 249 (27.3) 96 (10.5) 636 (69.7) 276 (30.3) 912 (100) Animal or insect related 175 (24.0) 260 (35.7) 190 (26.1) 103 (14.1) 470 (64.6) 258 (35.4) 728 (100) Road traffic injury 49 (13.8) 108 (30.3) 86 (24.2) 113 (31.7) 223 (62.6) 133 (37.4) 356 (100) Injured by a blunt force 54 (26.9) 74 (36.8) 49 (24.4) 24 (11.9) 150 (74.6) 51 (25.4) 201 (100) Stabbed, cut or pierced 20 (11.4) 56 (31.8) 49 (27.8) 51 (29.0) 127 (72.2) 49 (27.8) 176 (100) Fire, burn or scald 42 (64.6) 10 (15.4) 9 (13.8) 4 (6.2) 27 (41.5) 38 (58.5) 65 (100) Poisoning 33 (63.5) 6 (11.5) 5 (9.6) 8 (15.4) 26 (50.0) 26 (50.0) 52 (100) Suffocation/choking 24 (66.7) 5 (13.9) 2 (5.6) 5 (13.9) 20 (55.6) 16 (44.4) 36 (100) Electrocution 2 (15.7) 0 (0.0) 3 (25.0) 7 (58.3) 10 (83.3) 2 (16.7) 12 (100) Drowning and submersion 1 (14.3) 1 (14.3) 3 (42.9) 2 (28.6) 3 (42.9) 4 (57.1) 7 (100) Other 6 (46.2) 4 (30.8) 3 (23.1) 0 (0.0) 10 (76.9) 3 (23.1) 13 (100) Unknown 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) 2 (100) Total 647 (25.3) 852 (33.3) 648 (25.3) 413 (16.1) 1702 (66.5) 858 (33.5) 2560 (100) Self-harm Poisoning 0 (0.0) 0 (0.0) 6 (15.8) 32 (84.2) 7 (18.4) 31 (81.6) 38 (100) Hanging 0 (0.0) 0 (0.0) 3 (25.0) 9 (75.0) 4 (33.3) 8 (66.7) 12 (100) Stabbed, cut or pierced 0 (0.0) 0 (0.0) 2 (33.3) 4 (66.7) 1 (16.7) 5 (83.3) 6 (100) Injured by blunt object 0 (0.0) 2 (50.0) 2 (50.0) 0 (0.0) 4 (100) 0 (0.0) 4 (100) Other 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) 1 (100) 0 (0.0) 1 (100) Total 0 (0.0) 2 (3.3) 13 (21.3) 46 (75.4) 17 (27.9) 44 (72.1) 61 (100) Assault Bodily force (physical violence) 3 (7.0) 1 (2.3) 11 (25.6) 28 (65.1) 37 (86.0) 6 (14.0) 43 (100) Injured by blunt object 2 (11.1) 8 (44.4) 4 (22.2) 4 (22.2) 13 (72.2) 5 (27.8) 18 (100) Stabbed, cut or pierced 1 (12.5) 0 (0.0) 2 (25.0) 5 (62.5) 7 (87.5) 1 (12.5) 8 (100) Pushing from a high place 0 (0.0) 1 (50.0) 1 (50.0) 0 (0.0) 1 (50.0) 1 (50.0) 2 (100) Poisoning 0 (0.0) 1 (50.0) 0 (0.0) 1 (50.0) 1 (50.0) 1 (50.0) 2 (100) Sexual assault 0 (0.0) 0 (0.0) 1 (100) 0 (0.0) 0 (0.0) 1 (100) 1 (100) Other 0 (0.0) 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) 1 (100) Total 6 (8.0) 12 (16.0) 19 (25.3) 38 (50.7) 59 (78.7) 16 (21.3) 75 (100) Abstract 432 Table 3Association of injury location, nature and severity with age among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Age groups0 – 4 years5 – 9 years10–14 years15–17 yearsTotalChi-SquareInjury characteristicsn (%)n (%)n (%)n (%)n (%)P valueLocation of injury sustained Home/Compound 537 (34.1) 504 (32.0) 319 (20.2) 216 (13.7) 1576 (100) <0.001 Highway/road/street 85 (13.4) 196 (30.8) 190 (29.9) 165 (25.9) 636 (100) School 15 (6.4) 107 (45.9) 85 (36.5) 26 (11.2) 233 (100) Recreational area 9 (6.5) 44 (31.9) 55 (39.9) 30 (21.7) 138 (100) Workplace 1 (1.3) 4 (5.3) 19 (25.0) 52 (68.4) 76 (100) Other 6 (16.2) 11 (29.7) 12 (32.4) 8 (21.6) 37 (100) Total 653 (24.2) 866 (32.1) 680 (25.2) 497 (18.4) 2696 (100) Nature of injury Cuts, bites or open wound 328 (23.8) 506 (36.7) 314 (22.8) 230 (16.7) 1378 (100) <0.001 Bruise or superficial injury 81 (21.1) 99 (25.8) 118 (30.8) 85 (22.2) 383 (100) Fracture 48 (16.1) 101 (33.8) 112 (37.5) 38 (12.7) 299 (100) Sprain, strain or dislocation 48 (19.8) 78 (32.1) 72 (29.6) 45 (18.5) 243 (100) Internal injury 44 (35.5) 8 (6.5) 18 (14.5) 54 (43.5) 124 (100) Head Injury/Concussion 18 (21.7) 26 (31.3) 18 (21.7) 21 (25.3) 83 (100) Burns 42 (62.7) 9 (13.4) 10 (14.9) 6 (9.0) 67 (100) Other 41 (35.7) 38 (33.0) 18 (15.7) 18 (15.7) 115 (100) Unknown 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Total 652 (24.2) 865 (32.1) 680 (25.2) 497 (18.4) 2694 (100) Severity of injury No apparent injury 39 (31.2) 45 (36.0) 26 (20.8) 15 (12.0) 125 (100) <0.001 Minor 419 (25.5) 535 (32.5) 406 (24.7) 285 (17.3) 1645 (100) Moderate 171 (21.0) 262 (32.2) 225 (27.7) 155 (19.1) 813 (100) Severe 23 (20.7) 23 (20.7) 23 (20.7) 42 (37.8) 111 (100) Total 652 (24.2) 865 (32.1) 680 (25.2) 497 (18.4) 2694 (100) Abstract 432 Table 4Association of injury location, nature and severity with sex among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020SexMaleFemaleTotalChi-SquareInjury characteristicsn (%)n (%)n (%)P valueLocation of injury sustained Home/Compound 979 (62.1) 597 (37.9) 1576 (100) <0.001 Highway/road/street 421 (66.2) 215 (33.8) 636 (100) School 176 (75.5) 57 (24.5) 233 (100) Recreational area 111 (80.4) 27 (19.6) 138 (100) Workplace 62 (81.6) 14 (18.4) 76 (100) Other 29 (78.4) 8 (21.6) 37 (100) Total 1778 (65.9) 918 (34.1) 2696 (100) Nature of injury Cuts, bites or open wound 959 (69.6) 419 (30.4) 1378 (100) <0.001 Bruise or superficial injury 246 (64.2) 137 (35.8) 383 (100) Fracture 200 (66.9) 99 (33.1) 299 (100) Sprain, strain or dislocation 154 (63.4) 89 (36.6) 243 (100) Internal injury 50 (40.3) 74 (59.7) 124 (100) Head Injury/Concussion 59 (71.1) 24 (28.9) 83 (100) Burns 27 (40.3) 40 (59.7) 67 (100) Other 79 (68.7) 36 (31.3) 115 (100) Unknown 2 (100) 0 (0.0) 2 (100) Total 1776 (65.9) 918 (34.1) 2694 (100) Severity of injury No apparent injury 81 (64.8) 44 (35.2) 125 (100) 0.048 Minor 1102 (67.0) 543 (33.0) 1645 (100) Moderate 533 (65.6) 280 (34.4) 813 (100) Severe 60 (54.1) 51 (45.9) 111 (100) Total 1776 (65.9) 918 (34.1) 2694 (100) Abstract 432 Table 5Distribution of injuries by outcome and mechanism of injury among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Outcome of injuryDischargedAdmittedTransferredDiedLAMAUnknownTotalIntent & mechanismsn (%)n (%)n (%)n (%)n (%)n (%)n (%)Unintentional Fall 787 (86.5) 65 (7.1) 53 (5.8) 0 (0.0) 4 (0.4) 1 (0.1) 910 (100) Animal/insect bite/sting 704 (96.7) 3 (0.4) 19 (2.6) 0 (0.0) 1 (0.1) 1 (0.1) 728 (100) Road traffic injury 260 (73.0) 47 (13.2) 44 (12.4) 5 (1.4) 0 (0.0) 0 (0.0) 356 (100) Injured by a blunt force 190 (94.5) 4 (2.0) 6 (3.0) 0 (0.0) 1 (0.5) 0 (0.0) 201 (100) Stabbed, cut or pierced 165 (93.8) 8 (4.5) 3 (1.7) 0 (0.0) 0 (0.0) 0 (0.0) 176 (100) Fire, burn or scald 52 (80.0) 12 (18.5) 1 (1.5) 0 (0.0) 0 (0.0) 0 (0.0) 65 (100) Poisoning 30 (57.7) 4 (7.7) 16 (30.8) 1 (1.9) 1 (1.9) 0 (0.0) 52 (100) Suffocation/choking/asphyxia 24 (66.7) 4 (11.1) 6 (16.7) 1 (2.8) 1 (2.8) 0 (0.0) 36 (100) Electrocution 7 (58.3) 2 (16.7) 2 (16.7) 1 (8.3) 0 (0.0) 0 (0.0) 12 (100) Drowning and submersion 4 (57.1) 0 (0.0) 0 (0.0) 3 (42.9) 0 (0.0) 0 (0.0) 7 (100) Other 12 (92.3) 1 (7.7) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 13 (100) Unknown 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Total 2237 (87.5) 150 (5.9) 150 (5.9) 11 (0.4) 8 (0.3) 2 (0.1) 2558 (100) Self-harm Poisoning 5 (13.2) 8 (21.1) 23 (60.5) 0 (0.0) 2 (5.3) 0 (0.0) 38 (100) Hanging 1 (8.3) 0 (0.0) 1 (8.3) 10 (83.3) 0 (0.0) 0 (0.0) 12 (100) Stabbed, cut or pierced 6 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 6 (100) Injured by blunt object 4 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 4 (100) Other 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) Total 17 (27.9) 8 (13.1) 24 (39.3) 10 (16.4) 2 (3.3) 0 (0.0) 61 (100) Assault Bodily force (physical violence) 34 (79.1) 5 (11.6) 3 (7.0) 0 (0.0) 1 (2.3) 0 (0.0) 43 (100) Injured by blunt object 18 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 18 (100) Stabbed, cut or pierced 6 (75.0) 1 (12.5) 1 (12.5) 0 (0.0) 0 (0.0) 0 (0.0) 8 (100) Pushing from a high place 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Poisoning 1 (50) 0 (0.0) 1 (50.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Sexual assault 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) Other 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) Total 63 (84.0) 6 (8.0) 5 (6.7) 0 (0.0) 1 (1.3) 0 (0.0) 75 (100) Abstract 432 Figure 1Seasonal variation of injuries identified by the injury surveillance system over a year among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Results/ConclusionsThe total number of ED patients with injury in the study was 10,154.2,696 were patients aged <18 years. Most injuries in children were unintentional and over half of children presenting with injuries were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with some (drowning, poisonings and burns) under-represented. Over half of injuries were cuts, bites and open wounds. The next most common injury types were superficial injuries (14.2%); fractures (11.1%); sprains/dislocations (9.0%). Child mortality was 1%.This is the biggest prospective injury surveillance study in a low or middle country in recent years and supports the use of injury surveillance in Nepal for reducing child morbidity and mortality through improved data.CHILD PAPER: RESULTS SECTIONTotal number of ED patients: 33046Total number of ED patient with injury: 10154 (adult=7458 & children=2696)8.2% (n=2696) patients with injury were children aged <18 yearsHetauda hospital: 2274 (84.3%)Chure hill hospital: 422 (15.7%)
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Carter, Mary W., Bo Kyum Yang, and Cyrus Y. Engineer. "MEDICAL COMPLICATIONS AND INJURY LEADING TO EMERGENCY DEPARTMENT USE AMONG OLDER ADULTS." Innovation in Aging 3, Supplement_1 (November 2019): S480. http://dx.doi.org/10.1093/geroni/igz038.1787.
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Abstract Medical injury consistently ranks among the most expensive hospital stay diagnoses and represents a frequent cause of hospital readmission. Although older adults are at greater risk of medical injury, in part, because of greater incidence of comorbidity and increased medical complexity, little is known about the burden of medical injury leading to ED use or the costs and outcomes associated with these events among older adults. In response, this study used nationally representative data from the 2014 Nationwide Emergency Department Survey to examine the epidemiology of older adult ED-visits for medical injury. Principal diagnosis codes were grouped using AHRQ’s Clinical Classification Software to identify medical injury-related visits. Results indicated that in 2014, 506,466 ED-visits for medical injuries occurred, comprising 2% of all older adult ED-visits. Leading causes of medical injury included malfunction of device, implant and grafts (24%); infection and inflammation of internal prosthetic device, implant, and graft (16%), and other complications of surgical and medical procedures (15%). Risk factors for medical injury included being male, Medicaid as primary payor, and number of chronic conditions. Multinominal logistic regression and multivariate regression results indicate that Medical injury-related ED visits were associated with higher hospitalization risk (RRR=2.08, p<0.000), 27% longer hospital stays, and 24% higher total charges relative to non-medical injury related visits. However, medical injury was not associated with risk of death after adjustment. Study findings suggest that ED-visits for medical injury occur frequently among older adults and are associated with significant burden and cost.
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Boden, Barry P., Ken M. Fine, Ilan Breit, Wendee Lentz, and Scott A. Anderson. "Nontraumatic Exertional Fatalities in Football Players, Part 1: Epidemiology and Effectiveness of National Collegiate Athletic Association Bylaws." Orthopaedic Journal of Sports Medicine 8, no. 8 (August 1, 2020): 232596712094249. http://dx.doi.org/10.1177/2325967120942490.
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Background: Football has the highest number of nontraumatic fatalities of any sport in the United States. Purpose: To compare the incidence of nontraumatic fatalities with that of traumatic fatalities, describe the epidemiology of nontraumatic fatalities in high school (HS) and college football players, and determine the effectiveness of National Collegiate Athletic Association (NCAA) policies to reduce exertional heat stroke (EHS) and exertional sickling (ES) with sickle cell trait (SCT) fatalities in athletes. Study Design: Descriptive epidemiology study. Methods: We retrospectively reviewed 20 academic years (1998-2018) of HS and college nontraumatic fatalities in football players using the National Registry of Catastrophic Sports Injuries (NRCSI). EHS and ES with SCT fatality rates were compared before and after the implementation of the NCAA football out-of-season model (bylaw 17.10.2.4 [2003]) and NCAA Division I SCT screening (bylaw 17.1.5.1 [2010]), respectively. Additionally, we compiled incidence trends for HS and college traumatic and nontraumatic fatalities in football players for the years 1960 through 2018 based on NRCSI data and previously published reports. Results: The risk (odds ratio) of traumatic fatalities in football players in the 2010s was 0.19 (95% CI, 0.13-0.26; P < .0001) lower in HS and 0.29 (95% CI, 0.29-0.72; P = .0078) lower in college compared with that in the 1960s. In contrast, the risk of nontraumatic fatalities in football players in the 2010s was 0.7 (95% CI, 0.50-0.98; P = .0353) in HS and 0.9 (95% CI, 0.46-1.72; P = .7413) in college compared with that in the 1960s. Since 2000, the risk of nontraumatic fatalities has been 1.89 (95% CI, 1.42-2.51; P < .001) and 4.22 (95% CI, 2.04-8.73; P < .001) higher than the risk of traumatic fatalities at the HS and college levels, respectively. During the 20 years studied, there were 187 nontraumatic fatalities (average, 9.4 per year). The causes of death were sudden cardiac arrest (57.7%), EHS (23.6%), ES with SCT (12.1%), asthma (4.9%), and hyponatremia (1.6%). The risk of a nontraumatic fatality was 4.1 (95% CI, 2.8-5.9; P < .0001) higher in NCAA compared with HS athletes. There was no difference in the risk of an EHS fatality in NCAA athletes (0.86 [95% CI, 0.17-4.25]; P = .85) after implementation in 2003 of the NCAA football out-of-season model. The risk of an ES with SCT fatality in Division I athletes was significantly lower after the 2010 NCAA SCT screening bylaw was implemented (0.12 [95% CI, 0.02-0.95]; P = .04). Conclusion: Since the 1960s, the risk of nontraumatic fatalities has declined minimally compared with the reduction in the risk of traumatic fatalities. Current HS and college nontraumatic fatality rates are significantly higher than rates of traumatic fatalities. The 2003 NCAA out-of-season model has failed to significantly reduce EHS fatalities. The 2010 NCAA SCT screening bylaw has effectively prevented ES with SCT fatalities in NCAA Division I football.
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Campos, Fernanda Aparecida, and Luciane Fernanda Rodrigues Martinho Fernandes. "Caracterizar o perfil clínico e sociodemográfico dos pacientes com trauma no punho e mão atendidos no ambulatório de mão e membro superior/Characterize the clinical and sociodemographic profile of patients with non-hand trauma and hand non-hand embedded a." Revista Interinstitucional Brasileira de Terapia Ocupacional - REVISBRATO 1, no. 4 (September 25, 2017): 499–508. http://dx.doi.org/10.47222/2526-3544.rbto12578.
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A mão durante o seu uso acontece a interação com os objetos dispostos no contexto físico e se consegue o desempenho de ações cotidianas. A incidência de lesões traumáticas dos membros superiores em um hospital público além de ser elevada, possui uma grande variedade. Caracterizar o perfil clínico e sociodemográfico dos pacientes com trauma no punho e mão. Estudo epidemiológico observacional do tipo transversal da população atendida no Ambulatório de Mão e Membro Superior. Foram analisadas as fichas fisioterapêuticas dos pacientes atendidos no setor de fisioterapia do Ambulatório de mão e membro superior e os dados foram inseridos em uma base de dados. Foram analisadas as fichas de 430 pacientes (276 do sexo masculino e 154 do sexo feminino), com idade do primeiro atendimento entre 18 a 85 anos. A dominância foi direita em 397 (93,6%) e esquerda em 33 (6,4%) pacientes. O diagnóstico de maior incidência foi fratura. O local de maior lesão foi no punho com 213 (49,5%) casos. O tipo de tratamento mais usado é o cirúrgico em 289 (67,2%) casos. Os tipos de lesão ou trauma mais frequentes foram 191 (44,4%) por causas externas, seguido de 119 (27,7%) por quedas e 77 (17,9%) por acidente de trabalho. Conseguimos verificar o perfil clínico e sociodemográfico dos pacientes com trauma no punho e mão atendidos no ambulatório de mão e membro superior de um Hospital Público da Universidade Federal do Triângulo Mineiro. Abstract To characterize the clinical and sociodemographic profile of patients with trauma in the wrist and hand treated in an ambulatory of hand and upper limb of a Public Hospital. The records of 430 patients (276 males and 154 females) were analyzed, with the first service age between 18 and 85 years. The dominance was right in 397 (93.6%) and left in 33 (6.4%) patients. The diagnosis of higher incidence was fracture. The site of greatest lesion was in the wrist with 213 (49.5%) cases. The most used type of treatment is surgery in 289 (67.2%) cases. The most frequent types of injury or trauma were 191 (44.4%) from external causes, followed by 119 (27.7%) from falls and 77 (17.9%) from work-related accidents. Regarding the diagnosis, the highest incidence is of fractures. Where hand injuries are mostly isolated, arising from direct trauma or during the handling of tools in day-to-day tasks. Most of the population in general are right-handed and accidents usually occur when the individual uses the dominant hand in a situation of risk. We were able to verify the clinical and sociodemographic profile of patients with trauma in the wrist and hand treated in the outpatient clinic of hand and upper limb of a Public Hospital of the Federal University of Triângulo Mineiro.Keywords: epidemiology, wrist, hand, wounds and injuries. Resumen Fue caracterizar el perfil clínico y sociodemográfico de los pacientes con trauma en el puño y mano atendidos en un ambulatorio de mano y miembro superior de un Hospital Público. Se analizaron las fichas de 430 pacientes (276 del sexo masculino y 154 del sexo femenino), con edad de la primera atención entre 18 a 85 años. La dominación fue derecha en 397 (93,6%) e izquierda en 33 (6,4%) pacientes. El diagnóstico de mayor incidencia fue fractura. El lugar de mayor lesión fue en el puño con 213 (49,5%) casos. El tipo de tratamiento más utilizado es el quirúrgico en 289 (67,2%) casos. Los tipos de lesión o trauma más frecuentes fueron 191 (44,4%) por causas externas, seguido de 119 (27,7%) por caídas y 77 (17,9%) por accidente de trabajo. En relación al diagnóstico la mayor incidencia son de fracturas. Cuando los accidentes con las manos son en su gran mayoría aislados, derivados de traumas directos o durante el manejo de herramientas en tareas del día a día. La mayoría de la población en general son detras y los accidentes suelen ocurrir cuando el individuo usa la mano dominante en una situación de riesgo. Conseguimos verificar el perfil clínico y sociodemográfico de los pacientes con trauma en el puño y mano atendidos en el ambulatorio de mano y miembro superior de un Hospital Público de la Universidad Federal del Triángulo Minero. Palavras clave: epidemiologia, muñeca, mano, heridas y lesiones.
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Kalyan, S. R. "The epidemiology of traumatic brain injuries (TBI) – a literature review." South African Journal of Physiotherapy 63, no. 3 (February 18, 2007). http://dx.doi.org/10.4102/sajp.v63i3.141.
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A search of the literature showed limited reported research on the epidemiology of TBI in South Africa. This prompted a search of literature on the epidemiology of TBI in the rest of the world. Traumatic brain injury (TBI) is a leading cause of death and disability in most western countries. Motor vehicle accidents (MVA) are the main cause of TBI, followed by gunshot wounds (GSW) and falls. In South Africa, road accident fatalities are 27,3 per 100 000 of the population. The causes of death and disability vary with age, race and gender groups. Improved medical emergency care has resulted in a decrease in the mortality rate following TBI, but has increased the morbidity rate. The increase in the number of people living with neurological impairments is a significant economic burden when taking into account hospitalization, rehabilitation, medication and the loss of working hours. The emotional burden is unknown. The purpose of this paper is to place in perspective, the epidemiology of TBI, by looking at the published literature in the rest of the world. In the developing world it is projected that the burden of disease resulting from interpersonal violence will nearly double by 2020 unless preventive action is taken. Many more people survive acts of interpersonal violence than die from them.
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Cardi, Maurizio, Khushal Ibrahim, Shah Wali Alizai, Hamayoun Mohammad, Marco Garatti, Antonio Rainone, Francesco Di Marzo, et al. "Injury patterns and causes of death in 953 patients with penetrating abdominal war wounds in a civilian independent non-governmental organization hospital in Lashkargah, Afghanistan." World Journal of Emergency Surgery 14, no. 1 (November 21, 2019). http://dx.doi.org/10.1186/s13017-019-0272-z.
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Abstract Background Management of penetrating abdominal war injuries centers upon triage, echeloned care, and damage control. A civilian hospital based in a war zone can rarely rely upon these principles because it normally has limited resources and lacks rapid medical evacuation. We designed this study to describe organ injury patterns and factors related to mortality in patients with penetrating abdominal war injuries in a civilian hospital in an active war zone in Afghanistan, examine how these findings differ from those in a typical military setting, and evaluate how they might improve patients’ care. Methods We reviewed the records of all patients admitted at the Lashkargah “Emergency” hospital with penetrating abdominal injuries treated from January 2006 to December 2016. Demographic and clinical data were recorded; univariate and multivariate analyses were used to identify variables significantly associated with death. Results We treated 953 patients for penetrating abdominal injury. The population was mainly civilian (12.1% women and 21% under 14). Mean age was 23 years, and patients with blast injuries were younger than in the other groups. The mechanism of injury was bullet injury in 589 patients, shell injury in 246, stab wound in 97, and mine injury in 21. The most frequent abdominal lesion was small bowel injury (46.3%). Small and large bowel injuries were the most frequent in the blast groups, stomach injury in stab wounds. Overall mortality was 12.8%. Variables significantly associated with death were age > 34 years, mine and bullet injury, length of stay, time since injury > 5 h, injury severity score > 17, and associated injuries. Conclusions Epidemiology and patterns of injury in a civilian hospital differ from those reported in a typical military setting. Our population is mainly civilian with a significant number of women and patients under 14 years. BI are more frequent than blast injuries, and gastrointestinal injuries are more common than injuries to solid organs. In this austere setting, surgeons need to acquire a wide range of skills from multiple surgical specialties. These findings might guide trauma and general surgeons treating penetrating abdominal war wounds to achieve better care and outcome.
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McIntyre, Joshua. "Syrian Civil War: a systematic review of trauma casualty epidemiology." BMJ Military Health, February 27, 2020, jramc—2019–001304. http://dx.doi.org/10.1136/jramc-2019-001304.
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BackgroundThe Syrian Civil War has caused over 400 000 traumatic deaths. Understanding the nature of war casualties is crucial to deliver healthcare improvement. Historic regional conflicts and Syrian mortality data have been characterised by blast injuries. The aim of this novel review is to assess the trauma epidemiology of Syrian Civil War casualties from the perspective of healthcare facilities.MethodsThis review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Studies addressing Syria, trauma and war were investigated. Eligibility criteria included being conducted from a healthcare facility, published in English and peer reviewed. The outcomes were demography, mechanism of injury and anatomical injury site.Results38 papers satisfied the eligibility criteria. 13 842 casualties were reported across the entire data set. Casualties were 88.8% male (n=4035 of 4544). Children contributed to 16.1% of cases (n=398 of 2469). Mortality rate was 8.6% (n=412 of 4774). Gunshot wound was the most common mechanism of injury representing 66.3% (n=7825 of 11799). Head injury was the most common injured site at 26.6% (n=719 of 2701).ConclusionsThis conflict has a distinct trauma profile compared with regional modern wars. The prevalence of gunshot wounds represents a marked change in mechanism of injury. This may be related to higher mortality rate and proportion of head injuries identified. This review cannot correlate mechanism of injury, demographics or injuries sustained to outcomes. The quality of data from the included studies lacked standardisation; future research and consistent reporting tools are required to enable further analysis.
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Rajeswari, B., B. Shankari, and Angeline Selvaraj. "Epidemiology of Cracker (Fire Works) Injuries in a Tertiary Burn Care Centre." IRA-International Journal of Applied Sciences (ISSN 2455-4499) 4, no. 1 (July 25, 2016). http://dx.doi.org/10.21013/jas.v4.n1.p2.
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<div><p><em>Fireworks related burns are one of the causes of recurring incidences of burn injuries every year during festivals. Sporadic events are reported in family and communal celebrations / temple festivals and in funerals. These burns are different from other burns as the burn percentage is not the major burden, but the increasing number of patients with cracker burn injuries with loss of hand function, loss of vision and at times blast injury of the face with major tissue loss and multiple fractures (shattered tissues), which are challenging for the reconstructive surgeon, are major concern. The vulnerable groups are innocent children who sustain injuries due to ignorance, negligence and lack of supervision. These fire cracker burn wounds are to be classified separately as the wounds are more like traumatic wounds than burn wounds. They are also associated with more morbidity than mortality.<sup>(1,2,3)</sup></em></p><p><em> The management of these wound is multidisciplinary, with involvement of various specialists like paediatricians, ophthalmologists, psychiatrists, orthopaedic surgeons and specialists in rehabilitative medicine along with plastic and reconstructive surgeons.Reconstruction of blast hand and face needs multiple surgeries and prolonged period of physiotherapy and rehabilitation. The effective and appropriate decision made in the acute phase is important to reduce their morbidity.<sup>(4)</sup></em></p></div>
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Magnus, Dan, Santosh Bhatta, Julie Mytton, Elisha Joshi, Sumiksha Bhatta, Sunil Manandhar, and Sunil Joshi. "Epidemiology of paediatric injuries in Nepal: evidence from emergency department injury surveillance." Archives of Disease in Childhood, August 30, 2021, archdischild—2020–321198. http://dx.doi.org/10.1136/archdischild-2020-321198.
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BackgroundGlobally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5–24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited.MethodsA new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations.ResultsThe total number of children <18 years of age presenting with injury was 2696, representing 27% of all patients presenting with injuries enrolled. Most injuries in children presenting to the emergency departments in this study were unintentional and over half of children were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with poisonings, burns and drownings presenting proportionately less often. Over half of injuries were cuts, bites and open wounds. In-hospital child mortality from injury was 1%.ConclusionInjuries affecting children in Nepal represent a significant burden. The data on injuries observed from falls, road traffic injuries and injuries related to animals suggest potential areas for injury prevention. This is the biggest prospective injury surveillance study in Nepal in recent years and supports the case for using injury surveillance to monitor child morbidity and mortality through improved data.
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El_Tobgy, Khaled. "Ozone therapy in burns: our experience in Egypt [abstract]." Journal of Ozone Therapy 3, no. 4 (December 19, 2019). http://dx.doi.org/10.7203/jo3t.3.4.2019.15417.
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BACKGROUND: Burn injuries are one of the major health problems all over the world. The problem of infection in burn wounds is considered a major problem and the main cause of death in many burned patients. Ozone has been used with good results in the treatment of patients with diabetic foot, because of its germicidal properties and its influence on the processes of oxygen metabolism, and other effects.
PURPOSE: We report the effect of Ozone therapy on the healing process of recent burns in the Burn unit of the Alexandria Main University Hospital and Plastic Surgery Department Faculty of Medicine, Alexandria University.
Patients and methods: A review of two RCTs of 140 patients with recent burns done to investigate the effects of topical application of ozonized water, ozone gas (Sauna or Bagging), and ozonized olive oil in the treatment of recent burns.
RESULTS: All patients manifested clinical improvement by Topical Ozone therapy. The healing time of the ozone treated wounds was significantly lower than that of the control wounds. The full-thickness infected necrotic wounds that were treated with ozone showed earlier clearance of necrotic tissue and infection than the control wounds and became ready for skin grafting in a significantly lower time than the control wounds. Histopathological studies revealed marked increase in the expression of the fibronectin and transforming growth factor-B after treatment in comparison to the control wounds.
CONCLUSION: Topical application of ozone causes a highly significant reduction in the healing time of the recent burn injuries.