External Violence Research Articles

Testing the Limits: Christa Reinig's Radical Vision

It was during my research women's studies that I found Christa Reinig, in Munich, in the summer of 1980? We met in the feminist bookstore Lillemor's. In a sideroom for women decorated with women's art and feminist posters, surrounded by women's books, feminist journals and the sound of women's music, we sat, drank tea and talked. We talked about women and utopia. Utopian (i.e., anticipatory, change-oriented) thinking was necessary, women in general and the women's movement in particular, on this point we were in complete and immediate agreement. However, insisted Reinig, although unarguably necessary, Utopian thinking alone was clearly not enough. If we as women want to create an alternative future, she said, indeed if we as human beings hope to have any liveable future at all, we will have to deal with the question of violence. When we set out in search of our utopia, we must leave our fears behind, she explained; and what women must leave behind is their fear of violence. Not only, she went on, their fear of the external violence all around them with which they are forced to live as a constant threat and daily reality, but also (and perhaps most importantly) their fear of their own, internalized violence ? the violence within. For it is this potential violence within us, she insisted, that can empower us to fight off those who see us as weak and ready victims. Violence, she concluded, is a useful weapon; we must merely learn to wield it effect ively. I was immediately convinced by the logic of her argument. Yes, I agreed, certainly the solution proposed by people like Marcuse, that we base our hopes the future on the feminine potential gentle ness, passivity and nurturance has not exactly been borne out by history.

The use of indwelling ureteral stents in managing ureteral injuries due to external violence.

Eighteen consecutive cases of ureteral injury due to external violence occurring over a 6-year period were reviewed. The diagnosis of ureteral injury was made either preoperatively on an intravenous urogram, or intraoperatively using indigo carmine. No patient had an isolated ureteral injury. Four patients with ureteral contusions were managed expectantly and needed no further therapy. Eleven patients with ureteral lacerations underwent spatulated, interrupted anastomoses of absorbable suture and placement of Silastic double-J ureteral catheters and had prompt resolution of urinary drainage and normal urograms post stent removal. Two initially nonstented patients with lacerations required delayed ureteral stent placement for massive retroperitoneal urine leakage while one patient did well with simple ureteroureterostomy without stenting. The only important complication from the use of ureteral stents was limited to a single patient, who failed to return for followup and developed a staghorn calculus on the stent. The use of Silastic double-J ureteral catheters resulted in little morbidity and allowed: relatively maintenance-free care; an extra measure of safety in multiply injured patients; and early hospital discharge.

Deaths among child and adolescent psychiatric patients

Of 1,206 patients treated during the period 1970-1980 in a department of child psychiatry in a large city in Sweden 24 (2%) (14 boys and 10 girls) had died by the end of 1981. Twenty-one of these (88%) died of "injuries following external violence and poisoning", of whom 15 (63%) were suicides. Twenty subjects (83%) had grown up in surroundings characterised by one or more psychosocial stress factors. The study indicates a possible link between psychosocial background factors and deaths from "injuries following external violence and poisoning".

Indikationen zum Notarzteinsatz bei schweren Unfällen im Kindesalter

50 % of deaths in children result from external violence. Immediate treatment by the emergency doctor at the site of accident, to clear the airways and prevent shock, enables the patient to be moved (to hospital). Seriously injured children thus survive to reach hospital, and be successfully treated.Until now, the emergency team stationed at our hospital has treated a total of 464 children injured in accidents. 7 % were in immediate danger of their lives, whereby 2 cases could successfully be reanimated at the scene of the accident. We have not experienced any deaths during transport.

Sudden death, coronary heart disease, atherosclerosis and myocardial lesions in young men.

A standardized method for examining hearts and coronary arteries was applied in a study of sudden deaths in 227 autopsies of New Orleans men aged 25-49 years. Of these autopsies, 102 deaths were due to external violence, 125 were from natural causes and 45 occurred suddenly. Of the sudden natural deaths, 14 (31%) were due to coronary heart disease (CHD), seven (16%) were possibly due to CHD and 24 (53%) were due to other causes without evidence of CHD. Large recent myocardial lesions (greater than or equal to 1 cm) were present in 19 (95%) of 20 CHD deaths and in 16 (18%) of 91 non-CHD deaths. The myocardial lesions in sudden CHD deaths were subendocardial involving preferentially the posterior septum and the apex of the heart. The lesions in non-sudden CHD deaths were transmural involving preferentially the anterior, lateral and posterior left ventricle and the base of the heart. Men who died of CHD had extensive coronary atherosclerosis, while those who died of other causes had minimal coronary atherosclerosis. The large proportion of CHD deaths which occurred suddenly (70%) reaffirms the need for primary prevention and the need for improved predictive factors for early detection of CHD.

The clinical course of subdural haematoma. A retrospective study of aetiological, chronological and pathological features in 212 patients and a proposed classification.

A retrospective study of 212 cases of subdural haematoma has been carried out in an attempt to find a basis for classification and to propose a useful terminology. It is argued that a subdural haematoma should be considered as traumatic when preceded by a trauma in the sense of a 'morbid condition of body produced by wound or external violence'. The present series contained 154 cases with and 50 cases without preceding trauma. The 154 traumatic cases were categorized according to the duration of their asymptomatic and symptomatic phases, that is the chronological criterion. It was found that the material represented a full spectrum of manifestations without natural boundaries. Combining the chronological criterion with the criteria 'outcome' and 'associated brain injury' did not improve perspectives for a useful classification. The 50 non-traumatic cases, on the other hand, could be subdivided into acute (8) and non-acute or chronic (42), the acute cases presenting with severe symptoms within six hours after sudden onset, and carrying a poor prognosis. Cases presenting from one day to six months after the onset of symptoms may be referred to as non-acute or chronic and have a relatively good prognosis. Comparison of outcome of traumatic and non-traumatic cases with symptomatic phases exceeding twenty-four hours suggests that these groups, despite their clinical and pathological similarities, have different aetiological backgrounds.

Three Cases of Renal Trauma Caused Presumably by Relatively Low External Violence

Three Cases of Renal Trauma Caused Presumably by Relatively Low External Violence

Childhood urethral trauma

Urethral trauma in childhood due to external violence other than vehicular accident is discussed. The need for careful, planned management is highlighted by a satisfactory outcome in each of 4 cases, with no incontinence and no persistent urethral stricture. Temporary suprapubic cystostomy in 2 of these children caused no difficulty in the ultimate repair and permitted a more deliberate approach to these diminutive strictures in the pediatric age group.

Gunshot injuries to ureter

A brief discussion of ureteral injuries with emphasis on injuries secondary to penetrating external violence is presented. Four cases with gunshot injuries to the ureter are documented. The symptoms, diagnosis, and treatment of injuries due to penetrating missiles are presented. The need for routine preoperative intravenous urography and the necessity of having urinary diversion proximal to the anastomosis are stressed.

A Relationship Between Collective Racial Violence and War

Racism is a necessary condition for the outbreak of interracial violence. Racism has been with us from the beginning of our experience with slavery and is present today, but collective racial violence fluctuates so as to indicate time-related patterns of high and low intensity and frequency during the twentieth century. Racism has been a constant for over 300 years and cannot of itself explain the fluctuations of racial violence. Collective black-white violence has erupted during the 1960s for the third time this century. In both world wars and in the Vietnam War corresponding outbreaks of racial violence have occurred. The significance of an association between the external violence of war and the collective racial violence is that war may be a factor which precipitates racial violence. It is the purpose of this paper to demonstrate that the high frequency of collective racial violence during both world wars and the Vietnam War and the low frequency of

RUPTURE OF MITRAL CHORDAE TENDINEAE

MOST of the attention given to rupture of the chordae tendineae of the mitral valve has been accorded those instances which occur during the course of acute or subacute bacterial endocarditis, or which result from severe external violence to the chest. Frew 1 described a case in which rupture of the mitral chordae tendineae took place during a prolonged attack of acute rheumatic fever; and Frothingham and Hass 2 have reported an instance of spontaneous rupture of mitral chordae which were apparently not the site of previous disease. In the last 2,400 autopsies at the Peter Bent Brigham Hospital, there were eleven instances of rupture of the mitral chordae tendineae. Four were associated with bacterial endocarditis involving this valve. The other seven patients presented no evidence of bacterial endocarditis and no history of severe trauma to the chest, but the mitral valves and their chordae tendineae showed scarring, calcification, or

Hypertension associated with traumatic perinephritis ∗

A case of hypertension secondary to the unilateral renal disease is presented. The disease in this instance was perinephritis secondary to trauma from external violence. The secondary capsular contraction reduced the natural distensibility of the kidney and resulted in the formation of an angiotensin-producing hypertension. The juxtaglomerular cell count in the nephrectomized kidney was increased. This is thought to be the source of increased production of renin and therefore the precursor of angiotensin hypertension.

Injuries of the Ureter Due to External Violence

Injuries of the Ureter Due to External Violence

The Administration of the Privy Purse

IT is generally conceded by historians that internal factors had a good deal more to do than external violence of barbarians in bringing about disintegration of Roman Empire and ignominious collapse of its western half in fifth century. The possible role of corruption of bureaucracy in bringing about collapse of its administrative machinery merits detailed attention.' One must proceed with caution, however, in evaluating extent to which this factor may or may not have been operative. Corruption on a considerable scale, both of public and officials, one supplementary to other, there undoubtedly was, as codes and literary sources abundantly indicate. But, on other hand, there seems little room to doubt that an efficient bureaucracy one of main factors in perennial strength of fragment of Empire that survived in East after collapse of West and continued to be a major power in Levant until Fourth Crusade. Jones speaks of the usual abuses of an overripe bureaucracy2 flourishing in Late Empire, further qualifying Byzantine bureaucracy as cumbersome and corrupt:' on other hand, he concludes that bureaucracy a source of strength as well as weakness, especially in eastern half of Empire, which survived, among other reasons, due to more effective administrative control exercised by East, which enabled it to mobilize for defence of Empire a larger proportion of wealth and manpower available. And principal reason for this, he continues, was that in West great offices of state were perquisite of wealthy landowning class who used their powers to protect their own interests, but in East powers of State were, from fifth century at any rate, wielded by bureaucrats, men like Marinus Syrian and John Cappadocian, who, it is true, lined their own pockets liberally, but did also fill treasury.4

Minor surgical aspects of closed wounds

Basic surgica1 principIes are appIicabIe in any situation but there is much to be considered in the attempt to restore the injured tissue, member, organ or individua1 to its pre-trauma function. Christopher2 defines a wound as an injury or forcible soIution of continuity of any tissue of the body caused by external violence. A cIosed wound is a wound without a break in the skin or mucous membrane. AIthough the term viotence generaIIy indicates physica force, thermal or chemica1 disturbances are incIuded. (TabIe I.) A contusion or bruise is a traumatic soIution of continuity of tissue without compIete anatomic separation. It is accompanied by an effusion of bIood or Iymph by sweIIing and occasionaIIy by the formation of blebs. When the skin is unbroken, the fluid collection can be considered steriIe and severa methods may be applied to hasten reabsorption of the effusion. In general, the time-honored treatment of bruises or contusions has been a preIiminary attempt to IocaIize and prevent edema by the immediate appIication of coId, be it a coId tabIe knife, ice packs or ethy1 chIoride spray. KessIer and Van Emburgh treated 198 cases of trauma with antihistamines on the theory that the edema was on the basis of JocaJIy liberated histamine. They were greatIy impressed with their resuIts and found that pain and IocaI edema were markedly decreased. After gathering their materia1, Kessler and Van Emburgh were somewhat dismayed by Mayer’s6 report which indicated that the inffammatory reaction in tissue produces a high hyaIuronidase concentration. As it is known that the antihistamines have the capacity to destroy or Jimit the action of hyaluronidase, it was their amended conclusion that the action of the antihistamines was that of destroying the hyaIuronidase-spreading factor. When the initial phase of edema and vasospasm has been controIIed by coJd applications or the use of antihistamines, some methods of removing IocaI Auid accumuIations is indicated. Needle aspiration wiJ1 frequentIy be sufficient, but contaminated or infected hematomas may require incision and drainage. Hyaluronidase can be used in aseptic conditions in an attempt to disseminate ffuid accumuIations under tension. The usuaJ dose, $00 viscosity units aIidase@* mixed in a small amount of normal saline, is injected into the localized Auid. Mixing the hyaluronidase in I per cent procaine soIution wiI1 aIso produce IocaI vasodilatation, relief of IocaI pain and more rapid absorption of the fluid mass. This method can aIso be applied to traumatized bursae or synovia1 spaces which do not respond to repeated aspirations. The treatment of sprains and strains can be considered as a single entity. They both consist of incompIete tears or overstretching of the invoIved structure, producing spasm and Iimited function. The initia1 concept of treatment of a torn muscIe or Iigament was that of immobiIization and rest unti1 the injured tissue healed. It is surprising that this misconception has persisted with the use of adhesive tape strapping, pIaster casts and compIete disuse being the most wideIy accepted method of treatment for a sprained joint or strained back, shouIder or hip. Leriche and ArnuIf6 described

Foreign bodies in the kidney; a review of the literature and reports of four additional cases.

Foreign bodies in the kidney and renal pelvis are reported so rarely that we should be reminded of their clinical symptoms and roentgen signs. This subject is not discussed in standard textbooks and few physicians are well acquainted with the entity. A study of the Quarterly Cumulative Index Medicus reveals only 34 cases reported in detail. In several of these it was the radiographic examination that disclosed the cause of obscure septicemia or urinary symptoms. Twenty-six of the reports were available for review and 4 new cases will be reported. Foreign bodies may reach the kidney by one of three routes: through the urethra, bladder, and ureter; from the gastrointestinal tract; by means of external violence. It is well known that foreign bodies are frequently introduced into the urinary bladder. If the object is small enough, it is entirely possible for it to enter the ureteral orifice and ascend to the renal pelvis by means of antiperistaltic action of the ureter. A foreign body may be started on this path by an erotogenic act, by a mentally disturbed patient, or even during an operative procedure. A more frequent and more bizarre route is taken by the foreign body that is swallowed and eventually perforates the intestinal wall at the second portion of the duodenum or after entering the colon. The majority of foreign objects reach the kidney directly as a result of external violence. Postoperative drains should be included in this group, as well as bullets, shell fragments, needles, and explosion debris. Sex and Age Incidence: The 26 previously reported cases of foreign bodies in the kidney are summarized in Table I. Nineteen of the patients were males and 7 females, the preponderance of males being due to the inclusion of numerous war casualties reported in the foreign literature. The ages ranged from two to sixty-one years. The right kidney was involved in 15 instances and the left in 10. Etiology: As may be seen from the table, most of the foreign bodies reached the kidney directly by means of external violence. Of these, 10 were bullets or shell fragments, 2 were needles, 1 debris from an explosion, and 1 a fragment of a drain overlooked at the time of a pyelotomy. Eight patients swallowed objects which later reached the kidney. These included 3 bobby pins, 2 needles, 1 hairpin, 1 toothpick, and 1 wire clip. All of these entered the right renal pelvis. Six were shown to have perforated the second portion of the duodenum. It was presumed that the other 2 perforated the ascending colon to reach the right renal area. In one unusual case (No.5) a seed-bearing grass straw was found to be the cause of unexplained hematuria. It was considered that this had been introduced through the urethra, had passed through the bladder and then ascended the ureter to reach the left renal pelvis. In a similar case (No. 11) a single seed-bearing grass straw had been in the right renal pelvis for fourteen months.

Crushing Foot Injuries Due to External Violence from below

Crushing Foot Injuries Due to External Violence from below

Traumatic brain-stem thrombosis: report of a case and analysis of the mechanism of injury.

Excerpt Infarction of the medulla oblongata as a sequel to external violence is an uncommon form of vascular accident. Particularly rare are reports of such lesions secondary to manipulation of the...

Rupture of the pregnant uterus by external violence: Ellis, Mary: The Lancet p. 253, Aug. 12, 1950

Rupture of the pregnant uterus by external violence: Ellis, Mary: The Lancet p. 253, Aug. 12, 1950

The question of traumatic heart disease.

Excerpt In a socially enlightened age of compensation and disability insurance, the relation of trauma to disease requires careful analysis. Only too often the prospect of reimbursement induces the...