History Of Recent Injury Research Articles

Study on psychological well-being and its determinants among elderly people attending geriatric clinic at Medical College, Kolkata

Background: Significant growth in the proportion of older people in India will lead to changes in the country’s society. If common psychological problems such as depression and anxiety are not addressed, they can have lasting effects on individuals, particularly older individuals. It has the potential to impair the management of ongoing chronic illnesses and result in both physical and mental limitations. Aims and Objectives: The objective was to assess the psychological well-being (PWB) of the study participants attending the geriatric outpatient department and its contributing factor(s). Materials and Methods: A descriptive, cross-sectional, hospital-based study was conducted in the Geriatric Clinic of Medical College, Kolkata, among 301 geriatric people during a 1-year time period. The assessment of PWB was done using Ryff’s PWB scales, 42-item version. The analysis of the data was done using SPSS version 16. Results: The mean age of the participants was 66.68 (±6.48) years. The mean PWB score was 156.2 ± 18.6 according to Ryff’s PWB scales. The minimum score was 94, and the maximum score was 226. Poor PWB was seen among 50.8% of the elderly. Conclusion: Poor PWB among seniors and several factors such as current living arrangements, socioeconomic status, employment history, history of recent injury, and patients’ spiritual history play an important role. To handle the issue, new and modified geriatric health policies are very much needed.

Exceptionnel Complication after Intramedullary Nailing of the Tibia

Management of tibia fractures by intramedullary nails, has become the gold standard for diaphyseal fractures. High rate of union, acceptable alignment in all planes, and a low complication rate have been reported. A 52 - year - old women with a surgical antecedent fracture of the right leg operated 20 years ago, presented to the traumatology clinic for the removal of osteosynthesis materials from the leg. There was no history of recent injury and no information was available about the patient’s subsequent progress, Examination revealed a frail old lady whose mobility was restricted by quasi complete expulsion of nail from right leg showing that blocked extension; signs of a moderately severe cellulitis over the lower part of leg. The fracture was well consolidated and showed no sign of complication radiographs showed a complete expulsion of nail proximally; we performed an ablation under spinal anesthesia with bone biopsy, who was normal at immediately after surgery, the patient was able to walk without difficulty with a walker without pain. the patient was lost sight of after. To the best of our knowledge, this is the first report of complete expulsion of nail in a patient after centromedullary nailing of the tibia.

Immediate effects of static stretching and post isometric relaxation on hamstring flexibility among sedentary young adults: a pilot study

Background: ‘Hamstrings’ is a group of muscles in the posterior compartment of the thigh crossing both hip and knee joints. Hamstring muscles are frequently subjected to reduced flexibility, especially among young adults 18-25 years old. Hamstring tightness is found to cause several conditions affecting the human body. Stretching has immediate effects on muscle stiffness, such that, positive effects can be obtained within few seconds or minutes after a stretching session.Methods: A total of 32 Undergraduates who satisfied the inclusion criteria were recruited for the pilot study. The subjects needed to have hamstring tightness measured by active knee extension (AKE) to be included to the study. The subjects with a history of recent injury or surgery to the spine or lower limbs, those who involved in sports activity at competitive level and obese subjects were excluded. The subjects were allocated randomly by 1:1 ratio to the Static Stretching (SS) and Post Isometric Relaxation (PIR) groups.Results: The data of both the groups was normally distributed. The baseline values of AKE for both the groups (SS=46.68±5.31; PIR=49.03±6.53) were matched and there was no significant difference before stretching. Independent sample T-Test was used to compare the means of the two groups post stretching. There was a significant difference in the mean of the AKE values of the two groups. The improvement was higher in the PIR group (SS= 42.62±4.78; PIR=36.28±6.51), such that the range of flexion was lesser in the PIR group indicating a greater degree of knee extension.Conclusions: Immediate effects from single bout with few repetitions of Post Isometric Relaxation stretching were more effective in reducing hamstring tightness among sedentary young adults compared to static stretching.

Explaining Sudden Unexpected Infant Deaths, 2011-2017.

Sudden unexpected infant death (SUID) represents a broad group of explained and unexplained infant deaths (<1 year old). Explaining why SUID occurs is critical to understanding etiology and prevention. Death certificate data cannot differentiate explained from unexplained SUID cases nor describe the surrounding circumstances. We report SUID rates by explained and unexplained categories and describe demographics and history of recent injury or illness using the Centers for Disease Control and Prevention SUID Case Registry. The registry is a population-based surveillance system built on Child Death Review programs. Data are derived from multiple sources, including death certificates, scene investigations, and autopsy reports. Cases included SUIDs reported by states or jurisdictions participating in the registry during 2011-2017. Cases were classified into explained and unexplained categories by using the registry's classification system. Frequencies, percentages, and mortality rates per 100 000 live births were calculated. Of the 4929 SUID cases, 82% were categorized as unexplained. Among all cases, 73% had complete case information. Most SUIDs (72%) occurred in an unsafe sleep environment. The SUID mortality rate was 97.3 per 100 000 live births. Among explained and possible suffocation deaths, ∼75% resulted from airway obstruction attributed to soft bedding. Unsafe sleep factors were common in explained and unexplained SUID cases, but deaths could only be classified as explained suffocation for ∼20% of cases. Further analysis of unexplained deaths, including continued improvements to death scene investigation and documentation, may generate hypotheses for physiologic and genetic research, advance our understanding of gaps in SUID investigation, and enhance our understanding of infants at highest risk.

Saksenaeae Subcutaneous Abscess in an Immunocompetent Child

Molds, in the order Mucorales, are found worldwide in soil and decaying vegetation. They lead typically to disseminated infection in immunocompromised patients. In contrast, members of the family Saksenaeaceae can cause skin and soft-tissue infections in healthy individuals.1 We report a rare case of a subcutaneous abscess because of Saksenaea vasiformis in a previously healthy 4-year-old boy without a history of recent injury. He presented initially with calf cellulitis, which despite intravenous flucloxacillin, evolved into a subcutaneous abscess requiring multiple incision and drainage procedures (see Fig., Supplemental Digital Content 1, http://links.lww.com/INF/C291). He remained systemically well with a normal full blood count, C-reactive protein was 11 mg/L and erythrocyte sedimentation rate of 11 mm/h. Operative findings revealed caseous material and histology showed necrotic fat, suppurative inflammation and numerous pauciseptate hyphae with right-angled branching and angioinvasion (see Figs., Supplemental Digital Content 2 and 3, http://links.lww.com/INF/C292 and http://links.lww.com/INF/C293).

Quiz: A middle-aged lady with intermittent turbid urine

A 51-year-old lady complained of on and off turbid urine for two months. Her symptom was aggregated after meals and disappeared upon fasting. She enjoyed good past health. She had no fever, dysuria, abdominal pain nor history of recent injury. Urine test strip showed presence of red blood cells and protein. Patient's urine specimens were collected (Figure 1). Urine investigations including white cell count, cast, cytology, bacterial and acid-fast bacillus cultures were all negative. Her complete blood picture, liver and renal function blood tests were normal. Her fasting lipid profile was abnormal with total cholesterol of Figure 1. Turbid and clear urine specimen collected from the patient. 7.09 mmol /L and low-density lipoprotein of 4.38 mmol/L. Computed tomography urogram showed no specific finding.

Intramedullary fat globules related to bone trauma: a new MR imaging finding.

The purpose of this study is to describe intraosseous fat globules related to bone trauma that are detectable with magnetic resonance imaging (MRI), to define the relationship of this finding to fracture and bone contusion, to establish the frequency and associated findings. A proposed pathogenesis is presented. We retrospectively reviewed 419 knee MRI examinations in patients with a history of recent injury and MRI findings of fracture or bone contusion. As a control population, 268 knee MRI examinations in patients without MRI findings of recent bone injury were also reviewed. Eight of 419 (1.9%) patients with acute or subacute knee injury with positive findings of osseous trauma on MRI demonstrated intraosseous fat globules. The mean age of patients with fat globules was greater than that of those without fat globules, and the finding was more commonly seen in women. Fat globules were hyperintense to the normal fatty marrow present elsewhere in the bone on TI-weighted imaging and had a surrounding halo of high signal intensity on fluid-sensitive imaging. Intramedullary fat globules related to bone injury visible on MRI are thought to be due to coalesced fat released by the necrosis of fatty marrow cells. The pathogenesis is supported by histologic studies of fat globules related to osteomyelitis, bone contusions and fractures. As the medullary cavity of long bones in older patients contains more fat than hematopoetic bone marrow, it is likely that this finding is more common with advancing age.

Trunk-Rotation Flexibility in Collegiate Softball Players With or Without a History of Shoulder or Elbow Injury

Throwing is a whole-body motion that requires the transfer of momentum from the lower extremity to the upper extremity via the trunk. No research to date examines the association between a history of shoulder or elbow injury and trunk flexibility in overhead athletes. To determine if injury history and trunk-rotation flexibility are associated and to compare trunk-rotation flexibility measured using 3 clinical tests: half-kneeling rotation test with the bar in the back, half-kneeling rotation test with the bar in the front, and seated rotation test in softball position players with or without a history of shoulder or elbow injury. Cross-sectional design. University softball facilities. Sixty-five female National Collegiate Athletic Association Division I softball position players. Trunk-rotation flexibility was measured with 3 clinical tests. Recent injury history was obtained using a questionnaire and verified by the certified athletic trainer. Binomial regression models were used to determine if injury history was associated with flexibility categories (high, normal, or limited tertiles) for each of the 6 (3 tests × 2 directions) trunk-rotation flexibility measures. Trunk-rotation flexibility measures from 3 clinical tests were compared between participants with and without a history of shoulder or elbow injury using analysis-of-variance models. When measured using the half-kneeling rotation test with the bar in the back and the seated rotation test, injury history and forward trunk-rotation flexibility were associated. However, no mean group differences were seen in trunk-rotation flexibility between participants with and without a history of shoulder or elbow injury. Limited forward trunk-rotation flexibility may be a risk factor for shoulder or elbow injuries. However, further study is needed to confirm the study finding.

Peer youth physical violence among secondary schools students in south west Nigeria

BackgroundYouth violence has been associated with adverse health behaviours and health outcomes in developed countries. However, there is limited information on the prevalence and factors associated with violence among adolescents...

Spontaneous spinal extradural haematoma presenting with chest pain: a case report and literature review

An 85 year old lady was admitted to hospital after experiencing an abrupt onset of right sided chest and mid thoracic back pain. This pain was exacerbated by movement and coughing but not by inspiration. There was no history of recent injury. Her past medical history included atrial fibrillation (AF), aortic stenosis, hypertension and chronic obstructive pulmonary disease. Medication on admission included bendrof lumethiazide 2.5mg od, digoxin 125 mcg od, doxazosin 4mg od, enalapril 20mg od, warfarin and salbutamol and seretide inhalers. Prior to the onset of the pain she had been independently mobile with a stick.

The emergence of lymphogranuloma venereum in Europe

A 42-year-old white homosexual man presented to our clinic in April, 2008, with a 12-day history of right knee and back pain, conjunctivitis, and proctitis. 10 days earlier, after a normal radiograph, an arthrocentesis of his right knee had been done; 40 mL of clear synovial fl uid was aspirated and corticosteroids were injected locally. There was no history of recent injury, febrile illness, or rheumatological conditions. He reported anonymous unprotected receptive anal sex 1 month earlier. Since 2000, he had had three episodes of uncomplicated urethritis, secondary syphilis, HIV, and an episode of primary syphilis (rapid plasma reagin [RPR] 1/32 in August, 2007). He had been taking antiretrovirals since October, 2007, with a CD4 count of 300 per μL (31%) and undetectable viral load in March, 2008. On examination, his right knee was cool, swollen, and painful, and he had a right non-purulent conjunctivitis. Proctoscopy showed a hyperaemic mucosa with superfi cial ulcers and a mucopurulent exudate (fi gure A); gram stain showed more than 40 leucocytes per high-power fi eld (magnifi cation ×1000) without diplococci. Making a presumptive diagnosis of lymphogranuloma venereum and sexually acquired reactive arthritis (SARA), we gave our patient 100 mg doxycycline twice daily for 21 days and non-steroidal anti-infl ammatory drugs (NSAIDs). He returned 4 days later because of diffi culty walking (he was using crutches), fever (38·5°C), and a painful and swollen right elbow and left knee (fi gure B). Arthrocentesis of his left knee was done and 45 mL of synovial fl uid was aspirated. Laboratory test results showed RPR 1/8 and TPHA 1/2560; rectal and conjunctival infection with Neisseria gonorrhoeae and conjunctival infection with chlamydia were ruled out. Rectal lymphogranuloma venereum was diagnosed using real-time PCR. On day 10 his general condition improved, he had no fever or conjunctivitis, and proctitis was improving, although he was still using crutches. Cultures from synovial fl uid were negative, haematological and other blood tests were normal, HLA-B27 was negative, although C-reactive protein was mildly raised at 13·79 mg/L. On day 12, he had another arthrocentesis of his right knee with aspiration of 112 mL of serous fl uid, and he was prescribed prednisone 5 mg three times daily. By day 39, on tapered prednisone, he felt “80%” better and proctoscopy showed no rectal infl ammation. PCR for the lymphogranuloma venereum-causing organism was negative on day 46. When last seen in August, 2008, the patient was well. SARA is a spondyloarthritis and an important cause of lower limb oligoarthritis, predominantly aff ecting young adults. It consists of sterile axial or peripheral articular infl ammation, enthesitis, and extra-articular manifestations. Reactive arthritis is precipitated by an infection localised in the genitourinary or gastrointestinal tract and susceptibility may be related with the HLA-B27 gene. The bacteria principally involved are chlamydia, salmonella, shigella, campylobacter, and yersinia species. Diagnosis is a two-stage process requiring demonstration of a temporal link with a recognised trigger infection. The standard therapy is NSAIDs and steroids. Lymphogranuloma venereum is a systemic sexually transmitted infection caused by the L serovars of Chlamydia trachomatis. Since 2003, outbreaks of rectal lymphogranuloma venereum have occurred in Europe aff ecting mostly core groups of HIV-positive homosexual men, although arthritis rarely accompanies infection. We have diagnosed 35 cases of lymphogranuloma venereum as of October, 2008. Lymphogranuloma venereum in Europe is unknown by many physicians not working in genitourinary medicine and is frequently diagnosed late in patients with proctitis. Therefore, because of increasing cases, physicians should be aware that lymphogranuloma venereum can also be a cause of SARA.

Long-term effects of polyacrylamide hydrogel on human breast tissue.

Polyacrylamide hydrogel is an atoxic, stable, nonresorbable sterile watery gel consisting of approximately 2.5% cross-linked polyacrylamide and nonpyrogenic water. Polyacrylamide hydrogel is widely used in ophthalmic operations, drug treatment, food packaging products, and water purification. In the former Soviet Union, polyacrylamide hydrogel has been used in plastic and aesthetic surgery for more than 10 years, and Kiev City Hospital treats approximately 300 women a year for breast augmentation using the polyacrylamide hydrogel Interfall (Contura SA, Montreux, Switzerland). Capsule shrinkage following these injections has never been observed. The authors examined breast tissue samples from a total of 27 women who had polyacrylamide hydrogel injected at Kiev City Hospital up to 8 years and 10 months earlier. Age at operation, duration of polyacrylamide hydrogel implantation, history of possible side effects to the gel injection, other intercurrent diseases, the reason for present open breast operation, and breast palpation findings before operation were in each case compared with the histological findings on samples taken from breast tissue bordering the gel. The gel presented itself as a dark violet, homogenous mass with a rounded or ragged outline in large or medium-size deposits and as elongated strands, which mimicked the extracellular matrix, in small deposits. Histological findings of the breast tissue bordering the gel showed three different patterns: large collections of gel gave rise to a thick, soft-looking cellular membrane of macrophages and foreign-body giant cells; medium-size deposits were surrounded by just a thin layer of macrophages; and small deposits were not associated with any reaction in the surrounding tissue. Projections of the cellular soft membrane, known as granulomas, were seen in six patients. The granulomas were composed of macrophages, foreign-body giant cells, lymphocytes, and blood cells. A thin layer of fibrous connective tissue was occasionally present around the foreign-body membrane, but the thick fibrous capsule, which has been described in connection with silicone implants, was completely absent. The gel changes could be correlated to neither time since gel injection nor a history of recent injury or inflammation. It is concluded that the polyacrylamide hydrogel Interfall, which has been used in the former Soviet Union, is stable over time, nondegradable, confined to the breast, and diffusion and migration resistant. When the hydrogel is injected in medium-size or large quantities a cellular foreign-body reaction occurs, but in small amounts it is capable of splitting up individual connective tissue fibers and fat cells, substituting for the extracellular connective tissue matrix without eliciting any foreign-body reaction. As far as these data are concerned, polyacrylamide hydrogel is well tolerated by the breast and does not give rise to severe fibrosis, pain, or capsule shrinkage. However, to determine safety with more certainty, a larger sample size would be necessary.

Who participates in the Get Fit to Ski program?

The Get Fit to Ski program, run by the Australian Physiotherapy Association, is a pre-season conditioning program designed for, and marketed to, alpine sports participants. This paper describes the characteristics of Get Fit to Ski program participants in Melbourne during 1997. All participants were surveyed prior to commencement of the program to determine their demographics, skiing experience, recent injury history, self-perceived fitness level and expectations of the program. Descriptive statistics and chi-square tests were used to analyse the data. Mostly, participants are experienced skiers from a professional background who attend the program to improve their fitness and recovery for subsequent days of skiing. Understanding the characteristics of program participants helps with marketing and program development which could potentially result in a greater number of satisfied participants.

Non-iatrogenic pneumomediastinum in infancy and childhood.

This report reviews forty-one cases of non-iatrogenic pneumomediastinum in children beyond the neonatal period. In about one-third of the children, the adventitious air was associated with asthma. Respiratory infection, unrelated to asthma, was found to be of significance in about one-fourth of the remaining patients. Another twenty-five percent of the patients had a history of recent injury, which in the majority of instances was minor accidental neck trauma. Reported for the first time is the association of leukemia and adventitious air in the mediastinum. Hamman's sign was heard in only 10 percent of the patients and invariably led to a misdiagnosis of pericarditis since it was usually interpreted as a pericardial friction rub. In our experience the course was benign. Surgical drainage was unnecessary and effective treatment of the associated illness resulted in rapid clinical improvement within days, and radiologic evidence of resorption of the air usually within a week.

Diffuse lymphocytic lymphoma with splenic rupture.

WHEN the splenic capsule is found to be lacerated or the spleen avulsed from its pedicle, it is almost always due to recent injury. Occasionally, a patient will present as an acute abdominal emergency with or without the signs of haemorrhage but no history of recent injury, and at laparotomy, rupture of the spleen will be found. If, in such circumstances, careful questioning has failed to reveal a history of trauma or unusual effort, and on examination of the spleen, both macroscopically and microscopically, no abnormality apart from the haemorrhage and laceration can be found, then such an example can be truly labelled spontaneous rupture of the normal spleen. Such an event is but rarely reported. Orloff & Peskin in 1958, after reviewing seventy-one reported cases in the literature, considered only twenty to be fully acceptable. Seven years later, Naiberg and his colleagues (Naiberg, Sidlofsky & Chris, 1965) reported a case conforming to the above criteria but were able to add only two further examples. Much commoner is sudden rupture of the diseased spleen and this event has been recorded in a wide range of splenic diseases. In this context, a controversial point which recurs in the literature concerns the interpretation of the meaning of the term 'spontaneous'. Whereas in 1964, Hynes, Silverstein & Fawcett found seventeen examples of spontaneous rupture of the spleen in leukaemia, Stiles & Ultman in 1966 in reviewing thirty-two cases of rupture of the leukaemic spleen accepted only eight as being truly spontaneous in origin. The following is a case report of rupture of the diseased spleen in the absence of any trauma.