Frequency Of Injuries Research Articles

CLINICAL EFFECTIVENESS AND FEATURES OF THE POSTOPERATIVE PERIOD IN PATIENTS AFTER OSTEOSYNTHESIS OF THE MANDIBLE USING CELL TECHNOLOGIES

Due to a signifi cant increase in the frequency and complexity of maxillofacial injuries, one of the priorities in the development of modern surgical dentistry is the search for new eff ective methods of treating facial bone fractures. In recent decades, the attention of clinicians has been focused on biological treatment methods aimed at restoring bone defects using cell technologies and biological transplants.The aim of the study was to determine the eff ect of using osteoplastic materials based on multipotent adipose- derived mesenchymal stromal cells in dental patients in the surgical treatment of mandibular fractures.Materials and methods. The clinical material included 56 patients, 13 of whom underwent mandibular osteosynthesis with hydroxyapatite bone graft substitute (subgroup 1I), 25 of whom underwent surgery with a combination of multipotent adipose tissue mesenchymal stromal cells, hydroxyapatite bone graft substitute and platelet-rich plasma (subgroup 1B), and 18 of whom underwent spontaneous healing of the fracture line (subgroup 1C). Patients were clinically evaluated on a daily basis. Clinical parameters were assessed on days 1, 3, 5, 7, 10, 14 and 28 after surgery. The postoperative pain syndrome was assessed using the Numerical Rating Scale (NRS), considering the subjective signs of pain in the operated patients.The statistical processing of the study results was performed using the statistical analysis software for biomedical research ‘Microsoft Excel 21’ and ‘Statistica’ (licence number STA862D175437Q). In the statistical processing of the results, we used the variational analysis of series – calculation of the arithmetic mean and its standard error (Mim) – and assessed the signifi cance of diff erences in the results obtained in the comparison groups using the Student’s t-test method. p<0.05 was considered a signifi cant diff erence. [17]. The study was conducted in accordance with the basic provisions of the «Rules of Ethical Principles for Scientifi c Medical Research Involving Human Subjects» approved by the Declaration of Helsinki (1964-2013), ICH GCP (1996), EEC Directive 609 (24.11.1986), Orders of the Ministry of Health of Ukraine ¹ 690 of 23.09.2009, ¹ 944 of 14.12.2009, ¹ 616 of 03.08.2012. The Commission on Biomedical Ethics of the Bukovinian State Medical University found no violations of ethical and moral standards in the conduct of the research (ProtocolNo. 6, 16.03.2023). Patients signed informed consent to participate in this study and all measures were taken to ensure their anonymity.The results. The comparative analysis of the clinical eff ectiveness of the use of various osteoplastic materials in the performance of osteosynthesis surgery of the lower law confi rmed the advantages of the use of bone tissue substitute based on hydroxyapatite and its combination with multipotent adipose tissue mesenchymal stromal cells before spontaneous augmentation. It is confi rmed by the data of subjective and objective symptoms of patients during the postoperative period.Conclusions. Our data show that osteoplastic material based on multipotent mesenchymal stromal cells of adipose tissue, bone substitute based on hydroxyapatite and platelet-rich blood plasma is a promising biological material. Its application improves the regenerative and reparative properties of bone tissue, facilitates the postoperative period and shortens the duration of hospitalization, promotes the development of innovative ways of reconstructive osteogenesis in modern maxillofacial surgery.

RADIOLOGICAL ASSESSMENT OF SPONDYLOLISTHESIS OF LUMBOSACRAL SPINE

Introduction: One major injury or frequent minor injuries cause the vertebral body, pedicle and superior articular surfaces to slide forward. This disorder is known as spondylolisthesis and is usually accompanied by symptoms, often proportional to the degree of forward movement. Patients may complain of pain in the lower back that spreads to the thighs, and limited range of motion is possible Objectives: The aim of this study is to determine the frequency of spondylolisthesis by age and gender in the patients studied at SKB Mostar. Research methodology: The method of content analysis was used to retrospectively examine X-ray, CT and MRI examinations of patients with the clinical features of lumbar pain syndrome in the period from 1 January 2019 to 1 January 2020 in patients who underwent radiological examination of the LS spine at the Clinical Institute of Radiology of the University Clinical Hospital Mostar. Data were collected from IMPAX at the SKB Mostar Department of Radiology. The input parameters that were observed were: pain syndrome, diagnosis. The output parameters were the radiological findings from the X-ray, CT, and MRI scans. Results: During the study period, 297 spinal scans were performed, and spondylolisthesis was found in 32 patients, or 11%. The youngest respondent was 8 years old, and the oldest was 85 years old. The average age of the respondents was 64.37 years. The largest number of respondents was in the age group of over 75 years old. Of the tests performed, the most common were CT scans, followed by MRI, and the rarest were X-ray scans. The highest prevalence of spondylolisthesis was found in vertebrae L4-L5 and L5-S1 at 41%. Spondylolisthesis was found bilaterally in 9% of cases at the L3-L4 and L5 vertebrae. Conclusion: Most often, spondylolisthesis is found in L4-L5 and L5-S1 vertebrae. There was no difference according to gender, and most often subjects older than 75 years had spondylolisthesis.

CLINICAL CASE OF CONSERVATIVE MANAGEMENT OF INFEROMEDIAL ORBITAL WALL FRACTURE

Justification. Orbital fractures are one of the most common injuries of the middle zone of the face, second only to damage to the bones of the nose in adults and the lower jaw in children. An increase in the frequency of facial skeletal injuries, the complexity of diagnosis, multidisciplinary interaction, ambiguity and the lack of uniform algorithms for the treatment and rehabilitation of such patients increase interest in studying the topic of orbital fractures, require improved approaches in diagnosis and treatment.Objective: Demonstration of a clinical case of conservative management of an inferomedial orbital fracture.Methods. While getting off the bus, the patient tripped and hit the left side of her face on the curb. She sought medical help. A diagnosis was made: Inferomedial orbital fracture, surgical treatment was proposed. The patient refused surgery. Conservative treatment was carried out.Results. After 3 months from the moment of diagnosis, almost complete restoration of functions and absence of aesthetic deformation was achieved. Conclusions. The optimal treatment plan is often variable and depends on the clinical situation, extent of injury, and patient comfort level.

Location and accumulation of primary head injuries, and prevalence of secondary injuries among neuropathologically examined medico-legal autopsy cases – A comparative study of falls and assaults

Even though traumatic brain injury (TBI) is a major cause of death globally, detailed data on the location and accumulation of primary head injuries, and prevalence of secondary injuries in distinct injury circumstances such as falls and assaults is limited. This study aimed to highlight the differences in injury patterns between falls and assaults among neuropathologically examined medico-legal autopsy cases. Data were collected on a total of 128 cases from the Forensic Medicine Unit, Finnish Institute for Health and Welfare, between the years 2016 and 2022. All cases had suspected or confirmed acute head injuries and underwent a full neuropathological examination. Background and circumstantial variables, as well as the presence of head and brain injuries, were extracted from the medico-legal autopsy case files. Comparative analyses were conducted between assured falls (n = 26) and assaults (n = 23). Any primary head injury was observed in 57.0 % of the full sample; the most common primary injuries were scalp haemorrhage (47.7 %), subarachnoid haemorrhage (SAH) (24.2 %), and diffuse traumatic axonal injury (13.3 %). Assault cases showed a significantly higher prevalence of scalp haemorrhage (82.6 % vs. 46.2 %, p = 0.016) and SAH (52.2 % vs. 11.5 %, p = 0.004) compared to fall cases. In assault cases, the left hemisphere was clearly more frequently affected than the right one (91.3 % vs. 65.2 %). Of secondary injuries, brain oedema was more common in assaults than falls (47.8 % vs. 7.7 %, p = 0.003). In conclusion, this study highlights differences in head and brain injury patterns between falls and assaults. Scalp haemorrhage and SAH are more common in assaults than falls. Assaults appear to lead to a higher frequency and diversity of injuries, particularly in the left hemisphere.

Safety of vertical osteotomies in segmental Le Fort I procedures: a one-year radiological follow-up study

The aim of this study was to evaluate the frequency of dental and periodontal injuries, as well as radiological bone healing, at the vertical osteotomies in patients treated with segmental Le Fort I (LFI) osteotomy, as observed on cone beam computed tomography (CBCT) scans. This retrospective study analysed 105 patients who underwent segmental LFI osteotomy, in whom vertical osteotomies between the lateral incisor and canine were performed using a bur and extended in depth with an osteotome. CBCT scans were obtained preoperatively and at the 1-week and 1-year follow-ups. Measurements at the 1-week follow-up included interdental distances, root injuries, and periodontal detachment, while assessment at the 1-year follow-up included endodontic treatment and healing of the vertical osteotomies. The results showed no damage to the 420 roots at risk adjacent to the osteotomies; however, the osteotomy extended into the periodontal ligament in 38 roots. The mean preoperative minimum distance between roots differed significantly between osteotomy sites with intact periodontal ligament and those with periodontal ligament detachment (P < 0.001). One tooth was endodontically treated at the 1-year follow-up. Incomplete healing of the vertical osteotomy occurred more frequently in female patients than in male patients (P = 0.012). The study findings suggest that segmental LFI osteotomy is safe when performed with a bur and osteotome, provided a minimum distance of 2.5 mm between roots is maintained.

Frequency and mechanism of injury for unintentional paediatric femoral fractures associated with consumer products over a 10-year period in the USA.

Femoral shaft fractures tend to be rare among children; however, these injuries are the most common major paediatric injuries treated by orthopaedic surgeons. The purpose of this study is to characterise the demographics and mechanisms of femoral injury associated with consumer products in the age group treated with spica casting, children 6 months to 6 years, to identify areas for injury prevention. Data from 2012 to 2021 were obtained from the National Electronic Injury Surveillance System maintained by the Consumer Products Safety Commission, documenting emergency department visits for unintentional injuries associated with consumer products. Narrative descriptions were analysed to identify common factors in the injury events such as location, products and mechanisms of action. From 2012 to 2021, the estimated incidence of femur fractures was 23.5 cases per 100 000 children with no significant difference in yearly frequency. The most common mechanism of injury was a fall with the most frequent fracture sources being bed/bunk beds (16.1%), floor (slips/falls, 9.7%) and trampolines (9.7%). Most fractures occurred at the patient's home (58.4%). The incidence of injury outside of the home and frequency of fractures involving play structures/trampolines increased with age. The incidence and demographic characteristics of paediatric femur fractures associated with consumer products have remained consistent over the past 10 years. As home was the most common location of fracture, prevention of femur fractures should focus on caregiver education around high-risk sources of fracture (bed, stairs and trampolines) and manufacturers should consider design alternatives that discourage potential misuse.

Relationship between Cognitive Demands and Biomechanical Indicators Associated with Anterior Cruciate Ligament Injury: A Systematic Review.

Anterior cruciate ligament (ACL) injury during contact sports has a high incidence that has not been reduced despite the immense resources devoted to understanding its aetiology. A neurocognitive approach could increase knowledge of the mechanisms contributing to ACL injury enabling practitioners to address and minimise future risk. To systematically review the influence of manipulating cognitive demands during motor tasks (i.e. degree of uncertainty) on biomechanical variables associated with ACL injury risk. A systematic review was performed according to the Cochrane Handbook for Systematic Reviews of Interventions by searching the major sporting electronic databases. The search strategy included four groups of terms and was conducted by two authors independently. All studies were screened using unique inclusion criteria, with the included studies assessed for risk of bias. Twenty-five studies were identified from 2031 records and included into the review process. During the experimental conditions where cognitive demands were higher, most biomechanical indicators associated with a greater risk of ACL injury during landing and cutting tasks were significantly enhanced compared with conditions with low or no cognitive demands. An increase in task complexity through cognitive load significantly leads to changes in mechanisms associated with ACL injury during single-leg landings and cutting movements. Consequently, coaches and exercise professionals should consider inclusion of dual-task paradigms or uncertainty during injury risk assessment scenarios and injury prevention programs to help identify athletes at risk of ACL injury and reduce ACL injury frequency. This protocol was registered in the PROSPERO database ( https://www.crd.york.ac.uk/PROSPERO ) in May 2022, with the registration number CRD42022315795.

Frequency, Causes and Medico-Legal Aspects of Grievous Injury to the Eye after Physical Assault

Aims: A medicolegal report is prepared by the medicolegal officer in conjunction with an ophthalmologist in cases of physical assault claiming vision loss. The objective was to report the frequency and cause of grievous injury to the eye after a physical assault. Methods: This was a descriptive cross-sectional study, conducted in the Department of Ophthalmology of a tertiary care hospital in Pakistan from October 2019 to August 2022. A total of 378 medicolegal cases were reported in the ophthalmology outpatient. Among them, 285 patients of physical assault were included with consecutive sampling technique. Results: The mean age of the patients was 33.93±12.96 years. The mean reporting time to an ophthalmologist was 4.1±8.2 days. Simple and grievous injuries were found in 278 (97.5%) and 7 (2.4%) cases, respectively. Among the grievous injuries, 4 (57.2%) were close globe injuries and 3 (42.8%) were open globe injuries. Thirteen (4.5%) were malingers. Domestic violence was observed in 82 (28.8%) study subjects. Conclusion: The frequency of grievous injury to the eye is very low (2.4%) in patients with physical assault. The patients of assault-related grievous injury were mostly males, young age, low level of education, and doing manual jobs. Vitrolage with corneal melting, and firearm injury caused the grievous injury in open globe patterns. Vitreous hemorrhage, retinal detachment, macular hole, and secondary glaucoma were seen among close globe patterns. J Bangladesh Coll Phys Surg 2024; 42: 336-341

Frequency of periprocedural myocardial injury and infarction stratified by cardiac troponin I and T

Abstract Background There are different definitions of periprocedural myocardial infarction (PPMI) both in terms of thresholds for cardiac biomarkers and the ancillary criteria for myocardial ischemia. Cardiac Troponin I (cTnI) and cardiac Troponin T (cTnT) are used interchangeably to diagnose PPMI. Objectives This study evaluated the frequency of periprocedural myocardial injury and infarction as defined by the Society of Cardiovascular Angiography &amp; Interventions (SCAI), the Academic Research Consortium-2 (ARC-2), and the 4th Universal definition of MI (4UDMI) stratified using cTnT versus cTnI, among patients with chronic coronary syndrome (CCS) and unstable angina. Results Among 830 patients, PPMI rates according to the SCAI, ARC2 and 4UDMI criteria were 4.34%, 2.05%, and 4.94% respectively, with higher rates seen for all definitions when using cTnI versus cTnT (SCAI: 9.84% vs. 1.91%, p&amp;lt;0.001; ARC 2: 3.15% vs. 1.56%, p=0.136; and 4UDMI 5.91% vs. 4.51%, p=0.391). Minor and major periprocedural myocardial injury was respectively observed in 58.31% and 27.10% of patients, with rates of both significantly higher when using cTnI versus cTnT (Minor: 69.29% vs. 53.47%, p&amp;lt;0.001, Major: 49.21% vs. 17.36%, p&amp;lt;0.001). Conclusions Among patients with CCS and unstable angina, PPMIs defined by SCAI occurred more frequently when using cTnI as opposed to cTnT, whereas the type of troponin had no impact on the incidence of PPMIs according to the ARC-2 and 4UDMI

Splenic injury associated with colonoscopy in hospitalized patients: incidence, risk factors, management and outcome

Objectives: The frequency of splenic injuries due to coloscopy is largely unknown. Therefore, the aim of this study was to give an estimate on the risk for hospitalized patients. Methods: Using an administrative data base of a health insurance company with more than 10 million insured subjects, patients undergoing in-patient colonoscopy associated with a splenic injury within 2 weeks were retrieved from the administrative records based upon OPS (comparable to ICPM) and ICD-10 codes. In each case identified (n=141), the individual course of the hospital stay was reconstructed and analyzed by 2 experienced physicians. Patients with overt other causes of splenic injuries (e. g. abominal surgery, trauma etc.) were not further evaluated. Results: Among 190,927 total colonoscopies over a 5-year period, 27 splenic lesions were most likely solely due to colonoscopy. This accounts for 14.1 splenic injuries per 100,000 colonoscopies or 1 lesion in 7,071 patients. Afflicted patient were older and more likely to be female than male (risk in females: 1 in 5,324 colonoscopies). Surgical interventions were carried out in 17 cases, predominantly splenectomy (n=15) whereas 10 events were managed conservately. Transfusions and requirement of intensive care unit treatment were strong predictors for the need of surgery. Most lesions (74%) were diagnosed within 48 hours after colonoscopy. Death occurred in 2 patients, but less likely directly due to the splenic injury. Conclusion: Adminstrative data analysis suggests that splenic injuries due to colonoscopy are more frequent than previously estimated. Endoscopists should be aware of this rare life-threatening adverse event.

Leveraging Telemedicine for Disaster Response: Longitudinal Study on Return-to-Work Programs During the COVID-19 Crisis.

Since COVID-19, Indonesia has legalized telemedicine in medical services, including Return to Work (RTW). RTW programs help occupational injury-disabled workers return to work. This research examines how telemedicine supports RTW for employees with occupational injuries. The study used Interrupted Time Series Analysis (ITSA) to find patterns and trends in RTW program telemedicine case numbers and claim settlements over time. A total of 1 314 data were obtained from the Indonesian National Social Security Agency on Employment (BPJS Ketenagakerjaan) from July 1, 2015, to December 2022. Telemedicine reduces the frequency of recurrent occupational injuries in persons with impairments (Relative Risk [RR] = 0.59). In addition, the integration of telemedicine into health care practices exhibits promising prospects in terms of mitigating the financial burden on social security programs. This is supported by a robust RR (0.6). Telemedicine reduced the number of repeat cases and optimized medical claims cost in the RTW program during the COVID-19 pandemic. The results will contribute to policy and assist health care professionals and employers in improving RTW outcomes for disabled people.

Cerebral damage after malignant hypertensive crisis: cerebral MRI follow-up data

Abstract Background Malignant hypertension (MHT) crisis is characterized by acute and diffuse microvascular damages, and the brain is a primary target organ. While a recent MRI study has revealed extensive and frequent cerebral injuries during the acute phase of MHT crisis (1), there is a scarcity of follow-up data. Purpose This study aims to investigate the evolution of MRI markers of cerebral injury following the management of the acute phase of MHT. Methods In this retrospective analysis, we examined brain MRI data from patients admitted for acute MHT between 2008 and 2022 at our center. Eligible patients had at least one follow-up brain MRI available. A skilled operator conducted a comprehensive analysis of each brain MRI, searching for posterior reversible encephalopathy syndrome (PRES), acute stroke or cerebral hemorrhage and microangiopathy markers, blinded for clinical and demographical data. Results Among 149 patients enrolled, 104 had a brain MRI at inclusion, 47 individuals had at least one follow-up brain MRI and were included in the analysis. 72,3% were male, mean age was 48,2 ± 10.8 years and 45,7% presented blood pressure control at the time of the follow-up brain MRI. Median interval between initial and follow-up brain MRI was 228 (84 – 726) days. Five (10,6%) new recent strokes, 2 (4,3 %) cerebral hemorrhage and 0 PRES were recorded during follow-up. On the follow-up brain MRI, more patients presented chronic lacunar infarct and/or microbleeds, in higher numbers. On the contrary, overall Fazekas score was stable in 31 patients (66,0%), improved in 15 patients (31,9 %) and worsened in 1 patients (2,1%). Comparison of subgroups dichotomized according to blood pressure control or follow up duration showed no difference in brain MRI markers. Conclusion This study offers valuable insights into the risk of new cerebrovascular events and the evolution of brain MRI markers after managing the acute phase of MHT. Our findings emphasize the dynamic nature of cerebral microvascular burden and the potential for regression of white matter hyperintensities. A better understanding of these phenomena might contribute to improved diagnosis, tailored treatment, and proactive patient care in the context of MHT.

Microdosing of alteplase leads to thrombolysis in an in vitro flow model of cardiac microvascular obstruction

Abstract Background Cardiac microvascular obstruction (MVO) is a frequent injury of the myocardial microcirculation after successful recanalisation of the occluded coronary artery in myocardial infarction. At least in part, MVO is caused by embolised microthrombi of less than 200 µm diameter [1]. MVO leads to hypoperfusion of the myocardium and negatively affects patient outcomes. However, there is no effective treatment for MVO [2, 3]. Thrombolytic drugs are a promising approach, but they are difficult to deliver to the MVO area, and an increased risk of bleeding limits their use. In a previous study using an in vitro fluidic multi-scale model for MVO [4, 5], it was shown that controlled flow infusion (CFI) with a novel drug-delivering catheter could be used to effectively deliver highly concentrated intracoronary microdoses of a thrombolytic drug to the MVO area [6]. We now aim to investigate how such locally administered drug microdoses can induce thrombolysis as a possible therapeutic approach for MVO treatment. Methods A microfluidic chip (Fig.1) was used to study thrombolysis under flow using different microdoses of the thrombolytic drug alteplase. The chip consists of a tapered straight channel, which traps injected porcine microthrombi without causing complete channel occlusion (Fig. 1A). To mimic intracoronary CFI (consisting of temporary balloon occlusion of a coronary vessel for 90 seconds while drug is injected distally through a catheter) in vitro, microthrombi were incubated (without flow) directly in the chip for 90 seconds with various microdoses of alteplase (Fig. 2A, C). The chip was subsequently perfused with porcine plasma for 25 min (matched for physiological shear stress of 30 dyn/cm²). Conventional intravenous (IV) drug infusion (10 mg dose) resulting in a low systemic alteplase concentration, was mimicked by perfusing microthrombi with porcine plasma containing 2 µg/ml alteplase (Fig. 2B, C). Results Thrombolysis after CFI was concentration dependent, with the lowest microdose (0.3 mg) achieving 24% lysis of the thrombus area and the highest microdose (1.5 mg) achieving 60% lysis. In contrast, conventional IV drug infusion (corresponding to 10 mg alteplase IV dose) only achieved 10% lysis and was not significantly higher than the control perfused with pure porcine plasma. Conclusion Our findings suggest that intracoronary CFI is more efficient at achieving porcine microthrombus lysis than the current standard of IV bolus infusion (2 µg/ml alteplase in the circulating blood). Intracoronary CFI microdosing of fibrinolytic drugs using a drug-delivering catheter is a promising therapeutic approach for treating embolising MVO with a reduced systemic drug burden. Importantly, our intracoronary CFI approach achieves locally 6–40 times higher drug concentrations than a conventional IV drug infusion while reducing the total drug dose 60–300 times (Fig. 2C).

Accounts of Spine and Paraspinal Disease while Playing Golf

The twisting motion associated with the golf swing puts the intervertebral discs and the paraspinal musculature under stress. The objective of this study was to characterize the spinal and paraspinal pathologies associated with golf and their outcomes. The National Electronic Injury Surveillance System (NEISS) was queried for emergency department visits between 2003-2023 for golf-related injuries with body part codes "neck", "upper trunk", and "lower trunk", which includes the cervical, thoracic, and lumbar spine, respectively. Narratives were screened for relevance and reports related to spinal and paraspinal injuries were included. Weighted survey analysis was utilized to construct national estimates. Injury and diagnosis trends were analyzed using binomial logistic regression, and time trends were analyzed with a linear model. P-value of < 0.05 was considered significant. A total of 1441 relevant samples led to a national estimate of 69,153 emergency department visits for golf-related spinal-/paraspinal injuries between 2003-2023. The weighted mean age of those injured was 52.8 years, and the majority were male (85%, 95% CI 83-87). Strain was the most diagnosed injury (57.5%, 95% CI 54-61). Those aged > 55 years constituted more injuries than any other age group (50.1%, 95% CI 47-53). Injuries in the lumbar region accounted for most cases (76.9%, 95% CI 74-80). Injury frequency did not change over the years (p= 0.54), although the age of injury did increase over time (p < 0.001). Golf-associated paraspinal injuries are more common than neurological injuries, necessitating study into their mechanisms and onset.

Evidence of renal tubular injury in canine patients after elective desexing.

To investigate the frequency of perioperative acute kidney injury (AKI) in American Society of Anesthesiologists (SA) Grade I canine patients undergoing elective desexing using urine microscopy techniques and assess if pre- and intraoperative factors affect risk of developing AKI. Prospective observational clinical study conducted between September 2020 and October 2020. University teaching hospital. Thirty-two female and four male dogs between 5 months and 5 years of age classified as ASA I undergoing elective desexing surgery. Urinalysis was performed preoperatively and 20-24 h postoperatively to identify markers of renal tubular injury (RTI), particularly the presence of granular and renal tubular epithelial cell (RTEC) casts on sediment analysis. Dogs underwent a full physical examination and a preoperative assessment including measurement of urine specific gravity (USG), packed cell volume (PCV), total plasma protein and serum creatinine (sCr) was conducted as a part of the desexing programme. Anaesthetic records were examined for any evidence of intraoperative hypotension, defined as a mean arterial pressure (MAP) of <60 mmHg for any duration of time. MAP was measured using an indirect oscillometric technique. For analysis, animals were subdivided into affected and nonaffected groups, with affected animals those that hadpostoperative increases in granular and RTEC casts. Categorical and comparative analyses were then performed between groups to identify associations of increased casts with pre-, intra- and postoperative variables. A frequency of RTI of 5.6% was identified. This was accompanied by a significant association between increases in casts with total duration (p = 0.027) and number (p = 0.016) of hypotensive episodes. RTI is an anaesthetic consideration in ASA I veterinary patients undergoing elective desexing surgery. The identification of an association between the total duration and number of hypotensive episodes and the frequency of RTI highlights the importance of early detection of hypotension along with prompt and effective intervention in veterinary patients.

Transient Apical Breakdown: Incidence, Pathogenesis, and Healing.

Transient apical breakdown (TAB) is a phenomenon that indicates temporary apical periodontal destruction and root resorption after tooth luxation injuries, followed by the healing process of the dental pulp. Andreasen in 1986, reported that TAB was seen in approximately 4.2% of all luxation injuries. However, there have been no reports thereafter on the types and frequency of the luxation traumatic injuries in which TAB occurs. Therefore, this retrospective study was aimed to assess the incidence and pathogenesis of dental trauma-induced TAB and to suggest a possible mechanism of subsequent healing based on a series of cases. Data analysis included mature teeth (n = 56) of 49 patients aged 9-30 years who presented in a private dental office over a period of 10 years (2012-2022) to investigate the incidence and healing sequala of TAB. TAB was observed in 43.8% of subluxation, 62.5% of extrusive luxation, and 75% of lateral luxation injuries. The average age of patients who developed TAB was 14.5 years, ranging from 9 to 28 years old. TAB can be expected in many cases of luxation injuries with minimal dislocation. Therefore, mild injuries (subluxation, extrusion, and lateral luxation), may exhibit spontaneous healing, recovery of dark discoloration of the crown, disappearance of a periapical radiolucent lesion and return to normal response to EPT as long as 12 months after the traumatic injury. Thus, a decision to perform endodontic treatment in these cases might be postponed until clear evidence for an infection exists.

Biomechanic Differences Between Anticipated and Unanticipated Volleyball Block Jump: Implications for Lower Limb Injury Risk

Volleyball is a high-intensity sport characterized by repetitive jumping, sudden directional changes, and overhead movements, all of which significantly increase the risk of injuries, particularly to the shoulders, knees, and ankles. Despite the frequency of injuries caused by actions like blocking and spiking, there has been limited research focused on the specific biomechanical risk factors unique to volleyball. This study aimed to investigate the lower limb biomechanics during block jumps in both the dominant and non-dominant directions, under both anticipated and unanticipated conditions, in fifteen elite male volleyball players. Kinematic and kinetic data from the ankle, knee, and hip joints were recorded. Our results revealed statistically significant differences between the dominant and non-dominant directions at the ankle, knee, and hip joints. The non-dominant direction exhibited a greater ankle dorsiflexion angle and velocity, as well as higher knee flexion angle, velocity, moment, power, and abduction moment, along with increased hip flexion angle and power. Additionally, unanticipated movements led to increases in vertical ground reaction force (vGRF), hip extension moment, and flexion power, while ankle dorsiflexion plantarflexion velocity and knee flexion power decreased. It appears that movements in the dominant direction were stiffer and less cushioned, potentially increasing the risk of injury. While the non-dominant direction provided better shock absorption, it also elevated the knee valgus moment, which could increase the load on the knee. Furthermore, in unanticipated situations, athletes with short reaction times, unable to quickly adjust their automated movement patterns, faced a higher risk of limb overuse, thereby increasing the likelihood of injury. In practice, coaches should consider differences in limb coordination and movement direction, incorporating unilateral preventive exercises to reduce the risk of injury.

National Trend of Surgical Stabilization of Rib Fractures: Indications, Approaches, and Disparities

IntroductionRib fractures are among the most frequent injuries in trauma. This study aims to assess the current nationwide trends in operative rib fixation and identify predictors of surgical stabilization of rib fractures (SSRFs). MethodsA 5-y (2017-2021) retrospective analysis of the Trauma Quality Improvement Program database was performed. Adult trauma patients who had at least one rib fracture were included. We analyzed data regarding type of SSRF including open and thoracoscopic approaches and its trends. ResultsA total of 780,275 patients were identified, of which 15,339 patients (1.9%) were managed with SSRF. Trends of both open and endoscopic approaches were increasing during the study period. Patients with ≤2 rib fractures had a decreasing rate of SSRF. Flail chest (odds ratio = 13.42, P < 0.001) was the strongest predictor of SSRF. ConclusionsSSRF is gaining popularity in the management of chest trauma. The presence of a flail segment and multiplicity of rib fractures is among the predictors of SSRF.

The Effect of Isometric Exercise Position on the Effectiveness of Isolated Work of the Thigh Flexor Muscles Based on the Results of the sEMG Study.

The main function of the hamstring muscles is to bend the knee joint and support the function of the hip extensors. Their frequent injuries are the result of overload related to, among others, dynamic running or jumping, and inadequate preparation for athletics activities. The asymmetry of the work of individual flexor muscle groups is clearly marked in the case of valgus or varus of the knee joint, i.e., in different positions of the lower limb. The aim of the study was to determine the position and form of a rehabilitation exercise in which an isolated group of muscles flexing the knee joint will show the greatest bioelectrical activity. The study involved 25 students of the Jagiellonian University Medical College. The students were aged 20-26. The average age was 22.9 (±1.4). The study participants included 17 women with an average age of 23.0 (±1.1) and 8 men with an average age of 22.6 (±1.9). Women constituted 68% and men 32% of all respondents. All participants agreed to participate in the study. Surface electromyography measurements in both lower limbs provided an initial number of 50 cases. The activity of the knee flexor muscles during isometric contraction with resistance was measured in correlation with three foot and lower leg settings: internal rotation, neutral position, and external rotation. The bioelectrical activity of the semitendinosus muscle is significantly higher (p < 0.01) in the internal rotation position than in the neutral position of the lower leg, while the bioelectrical activity of the biceps femoris muscle is inversely higher (p < 0.01) in the external rotation position than in the neutral position. The results are significant for both average and maximum values of muscle stimulation. During isometric contraction with resistance, the semitendinosus muscle shows the greatest bioelectrical activity in the internal rotation position of the lower leg and foot, and the biceps femoris muscle in the external rotation position of the lower leg and foot. The above information has important implicational applications when improving isolated groups of hamstrings. In the future, this may contribute to more effective rehabilitation of patients with injuries of the muscles described in the article.

Emergency Department Visits After Body Piercings.

There is a paucity of data describing the frequency and complications of body piercing injuries (BPI) in the United States. We conducted a cross-sectional study using the National Electronic Injury Surveillance System (NEISS) to identify emergency department (ED) visits for BPI from 2011-2020 and to estimate prevalence among US individuals ≤24 years of age. Additionally, estimates for infections, requirements for hospitalization/transfer, and exploring significant associations were investigated. A total of 10,912 ED visits extrapolates to a national estimate of 338,972 BPIs in the United States. A majority of BPI involved females (85%), adolescents or young adults (55%), and ears (71%). Foreign bodies comprised 72.6% of BPI. Thirteen percent of ED piercing visits were associated with infection. Of these ED visits for BPI-associated infection, 3% required hospitalization/transfer. In the context of all piercing-associated injuries, injuries to the pubic region were 16.8 times more likely to require hospitalization compared to body piercing injuries of the ear. In the context of all piercing-associated infections, navel (lower trunk), nipple (upper trunk), and oral (mouth) locations were associated with increased odds of infection when compared to BPI infections of the ear. BPI is a common problem in children, adolescents, and youth. Age and body piercing location significantly impact rates of BPI, infection, and hospitalization/transfer. Further study should identify the total number of annual body piercings in the United States. This could generate targeted counseling and risk reduction interventions aimed at specific groups, especially older children who appear to be at increased risk.