Kind Of Injury Research Articles

The modern concept of car injury

The modern concept of car injury

The role of computed tomography as a prognostic tool in traumatic brain trauma

Traumatic brain injury (TBI) is a critical public health problem. It represents one of the most important medicalsurgical pathology worldwide. The occurrence indicate that this kind of injury cause a large number of deaths and impairments leading to permanent disabilities, that is why is necessary to triage the patient and identify the injury extension. Imaging has become a significant tool not only in the diagnosis of patients with TBI, but also as a patient outcome predictor. This review of literature provides evidence of the current state of TBI imaging as to what is considered to be the indications, benefits and limitations of computed tomography (CT).

Fall-related injury among people with arthritis, a concern among different age groups!

Background and objectives: The association between arthritis and falls has been study mainly in older adults, and information about fall-related injuries and arthritis in younger population is scarce. In addition, there is a gap of knowledge about the activities and types of injury associated with falls among people with arthritis in different age groups. The aims of the study were: 1) to explore the association between arthritis and fall-related injury among different age groups, and 2) to compare the main activity associated with fall-related injury and the type of injury resulted from falls between age groups in people with arthritis.Methods: This study used aggregated data from the Canadian Community Health Survey for the years 2001, 2003, 2005, 2009/2010 and 2013/2014.Results: People with arthritis were significantly more likely to report fall-related injuries than people without arthritis across all age groups. Younger people (12-19 years) were over six times more likely to fall when practicing sports, whereas all adults were more likely to slip/trip/stumble while walking. As a result of the falls, older adults (65 and over) were more likely to have broken bones and other kind of injuries (i.e., bruises, cuts, etc.), while all younger age groups reported more strains/sprains.Conclusion: Fall-related injury is a concern across all age groups in people with arthritis, and not only among older adults. In addition, the activities performed when the fall occurred and the type of injuries resulted from the falls were different between age groups. These findings contribute to reduce the gap of knowledge about fall-related injuries among people with arthritis in different age groups.

Controversies in the Management of the First Time Shoulder Dislocation.

Background:Traditionally, initial management of first anterior shoulder dislocations consists of reduction of the glenohumeral joint followed by a period of immobilization and subsequent physical therapy to recover shoulder range of motion and strength. This traditional approach in management is now controversial due to the high rate of recurrence. The aim of this paper is to review and discuss the literature about the global management of patients presenting with first-time traumatic anterior glenohumeral dislocation, analyzing the factors that affect shoulder instability after the first episode of dislocation.Methods:Scientific publications about the management of first-time shoulder dislocations are reviewed. Pubmed is used for that and no limit in the year of publication are stablished. These papers and their conclusions are discussed.Results:Younger patients, patient´s activities and the kind of injury are the most important factors related to the shoulder instability after a first time traumatic dislocation. Authors that recommend surgical treatment after the first episode of dislocation argue that the possibilities of recurrence are high and therefore surgery should be performed before its occurrence. Other authors, however, argue that surgical treatment is demanding, and keep in mind that complications, such as recurrence, stiffness and pain after surgery, are still present.Conclusion:Currently, there is still no consensus in the literature with regard to the management of first episode of shoulder dislocation. It is necessary to analyze carefully every individual case to manage them more or less aggressive to obtain the best result in our practice.

Volar Dislocation of Second, Third and Fourth Carpometacarpal Joints in Association with a Bennet's Fracture of the Thumb Carpo-Metacarpal Dislocation: A Case Report.

Injuries of the carpometacarpal joints of the long fingers are infrequent and go often unnoticed if a thorough clinical exploration and complete radiological assessment is not carried out. The overall frequency of carpometacarpal joints injuries is of 1-2% among trauma of the wrist and the carpus. These are normally secondary to high energy trauma (such as a car or a motorbike accidents). Among these kinds of injuries, the volar dislocation of the metacarpals is much less frequent than the dorsal dislocation, being even rarer the cases in which the three middle metacarpals are involved.In this case report, we present a case of volar dislocation of the middle three carpometacarpal joints in association with a Bennet’s fracture of the thumb in a 30-year-old male. He was treated in the operating room with reduction and stabilization using Kirschner wires, which allowed a satisfactory recovery of the mobility of the fingers eight weeks after the intervention. It is important to produce an admission diagnosis of this kind of injuries to be able to treat them immediately. Treatment must be performed quickly to reduce and stabilize the dislocation, since this will avoid the vasculo-nervous compression or the edema which increases cutaneous suffering and the risk of complications.

Antitrust and Innovation: Where We Are and Where We Should Be Going

For large parts of their history intellectual property law and antitrust law have worked so as to undermine innovation competition by protecting too much. Antitrust policy often reflected exaggerated fears of competitive harm, and responded by developing overly protective rules that shielded inefficient businesses from competition at the expense of consumers. By the same token, the IP laws have often undermined rather than promoted innovation by granting IP holders rights far beyond what is necessary to create appropriate incentives to innovate. Perhaps the biggest intellectual change in recent decades is that we have come to see patents less as a species of monopoly and more as a kind of property. While a good development overall, this makeover in conception has contributed to some less desirable expansions in the patent system. The “propertization” of patent law has not been attended by requirements that apply to other types of property. One principle of property law is that claimants have the obligation to articulate clear boundaries of ownership. Another is that property owners must communicate timely and effective notice of their claims, because the cost of giving notice is typically much lower than the cost of searching. Although one should not push the point too far, antitrust law, which is judge made, claims relatively more freedom from interest group capture than does statutory IP law. And if antitrust tribunals go too far, Congress can be trusted to respond to the voices of IP holders, who have consistently shown themselves to be a more effective interest group than IP users or consumers. For its part, IP law can take some important lessons from the road that antitrust has taken toward reform and redemption. Roughly 40 years ago antitrust pursued a course of protecting small competitors at consumers’ expense and even condemning such practices precisely because they reduced costs. Then in the late 1970s the Supreme Court dramatically shifted the ground, requiring not only that injury be clearly proven, but also that it be the right kind of injury – that is, injury to competition and not merely injury to the plaintiff. This transformation was accomplished entirely by the Supreme Court, largely in the face of Congressional indifference and in apparent conflict with a private injury statute that guarantees liberal recovery for every kind of injury. Intellectual property law would profit by continuously examining its root motivations as antitrust law does.

Fingerluxationen im PIP-Gelenk – Therapie einer sehr häufigen (Ball)Sportverletzung

Background Fractures or fracture dislocations of the proximal interphalangeal joint often occur during sports or accidents. Dislocations of the PIP-joint are the most common ligamentary injuries of the hand. As this kind of injury is so frequent, hand surgeons and other physicians should be aware of the correct treatment. Objectives This paper summarises the most common injury patterns and the correct treatment of PIP-joint dislocations. Materials and Methods This paper reviews the current literature and describes the standardised treatment of PIP-joint dislocations. Results What is most important is that reposition is anatomically correct, and this should be controlled by X-ray examination. Depending on the instability and possible combination with other injuries (e. g. injury to the palmar plate), early functional physiotherapy of the joint or a short immobilisation period is indicated. Conclusions Early functional treatment of the injured PIP-joint, initially using buddy taping, is important to restore PIP-joint movement and function. Depending on the injury, joint immobilisation using a K-wire may be indicated. Detailed informed consent is necessary to explain to the patient the severity of the injury and possible complications, such as chronic functional disorders or development of arthrosis.

A clinical profile of patients with distal tibia fractures attending tertiary care hospital

Introduction: History of fractures and its knowledge dates back to Egyptian ummies of 2700 BC. For thousands of years the only option for the management of fracture was some form of external splintage. 5000 years ago, Egyptians used palm bark and Lenin bandages for management of fractures. Methodology: Appropriate and valid written consent was taken. The patient was taken for surgery after routine investigation and after obtaining fitness towards surgery. The investigations done were Hemoglobin percentage, fasting blood sugar, blood urea, serum creatinine, HIV, HbsAg and ECG. A dose of tetanus toxoid and antibiotic was given pre-operatively. Results: Our study revealed the average age of patients with such injuries to be 40 years (21-60). In our study, the male predominance for such kind of injuries was high. Conclusion: Closed fractures were more when compared to open fractures.

Polyphenol-Related Epigenetic Modifications in Osteoarthritis: Current Therapeutic Perspectives.

The hyaline cartilage is an avascular, aneural and alymphatic tissue with a limited ability to repair itself. When the cartilage is exposed to some kind of injury, it usually triggers osteoarthritis (OA), a prevalent and degenerative joint disease closely related to aging. OA is both complex and multifactorial, and is the most common form of arthritis, being positioned as a major cause of pain and dysfunction in the world. In addition, high OA prevalence can greatly affect work capacity, making this disease a significant social problem, therefore, its prevention and treatment becomes a priority. At this time, there are numerous therapeutic strategies available to improve hyaline cartilage repair by using chondrocytes or mesenchymal cells, but neither is effective enough to generate functional and durable tissue reparation over time. In OA, chondrocytes have an aberrant gene expression and phenotype, resulting in a loss of balance between anabolic and catabolic processes. Environmental influences such as radiation, infection, smoking, nutrients, toxins and stress can affect gene expression patterns, which may constitute risk factors for various chronic and degenerative diseases, such as OA. In addition, considerable evidence shows that epigenetic mechanisms play an important role in OA chondrogenesis and pathogenesis. Natural plant-derived products such as polyphenols, which are secondary metabolites considered to have potential activity to block inflammation in several degenerative diseases, can stimulate epigenetic modifications, and may provide new therapeutic targets and cost-effective treatments. This review aims to present various polyphenolbased therapies currently used for the treatment of several progressive diseases, including OA.

Assessment of Non-Lethal Projectile Head Impacts

Anti-personnel NLW (Non-Lethal Weapons) are used to impart sufficient effect onto a person in order to deter uncivil, suspect or hazardous behaviour with a low probability of permanent or fatal injury. In many situations of conflict, where the army and law-enforcement units are involved, the use of such weapons can ensure a minimal risk of collateral damage. The most used NLW are Kinetic Energy Non-Lethal Weapons (KENLW) that involve the shooting of a deformable or breakable projectile. Since their first use, real cases indicate that the injuries inflicted by such projectiles may be irreversible and sometimes lead to death, especially for the head impacts. Therefore, there is a necessity to assess the head impacts in order to allow a safer use of such projectiles. This article concludes a 4-year study where three methods, independently developed, are considered to be applicable for the head risk assessment. The first method links force measurements on rigid wall structure with cadaveric and animal impact test results. Lesional thresholds, in terms of the maximum impact force and intracranial pressure, are proposed for unconsciousness, meningeal damages and bone damages, respectively. The second one is based on direct impact force measurements on a specific mechanical surrogate. The third method makes use of numerical simulations using a validated finite element head model. The numerical model allows the prediction of different kind of injuries. Firstly, the necessity of the assessment of the non-lethal head impacts is highlighted through some examples taken from literature. Secondly, the three different methods are detailed and illustrated for different projectiles. Outstanding results are given and a comparison between the different methods is proposed including some correlations between different criteria. Finally, some discussions and remarks conclude the present article.

Leg length inequality and its relationship with injuries incidence of young basketball players: an observational study

Background: The leg length inequality (LLI) creates postural changes collaborating with the emergence of functional limitations and musculoskeletal disorders. In a sport like basketball inequality of the lower limbs may be added to the demands of the sport and generate an increase in the incidence of injuries. The aim of this study was to identify young basketball players from with structural or functional LLI and its influence in injury incidence in a period of 6 months. Methods: 18 players were followed with an average age of 14.50 ± 1.86 of a basketball team from the city of Sorocaba for a period of 6 months. At the beginning and end of that period were applied tests from the Morbidity Survey Report modified for basketball to obtain data such as physical characteristics, training time, incidence of injuries, quantitative and qualitative measurement of the length of the lower limbs. Results: 72.2% of players had LLI and 50% had some kind of injury during this period, among the most common, sprains and muscle strains. Conclusions: There was a high rate of players with LLI and a positive relationship between this inequality with the incidence of injury.

Accidental falls in urgent and emergency care: results of the 2014 VIVA Survey.

This cross-sectional study aimed to analyze the cases of falls in urgent and emergency care services of 24 Brazilian capitals and the Federal District participating in the 2014 VIVA Survey. We sought to describe the epidemiological profile of victims, characterizing the event and the severity of injuries it caused and to perform an association study. We calculated the simple and relative frequencies of variables and performed multivariate logistic regression analysis for complex sample data in order to verify associations between falls and selected variables. Fall victims profile results show a predominance of males, age groups 0-9years and 20-39 years and brown skin. Outcomes show that 56% fell from own height, public road was the most frequent place of falls and 92.7% of people receiving care for falls suffered some kind of injury, of which most common were bruises, sprain and strains, followed by cut/laceration. In the final model, we were able to associate fall with gender, age, education, disability and place of the event. The likelihood of falls at school is 14% higher than at home, but falls in recreation areas, public roads and other places are less likely than at home.

Tip-apex distance and calcar-referenced tip-apex distance used as a predictor of screws cutout from the femoral head

Intertrochanteric fracture, a common kind of injury in orthopaedic surgery, often requires surgical intervention, especially the unstable ones. Since far back in 1995, Baumgaertner et al. recommended using the distance between the screw tip and femoral head apex(tip-apex distance, TAD)as a predictor of the risk of lag screw cutout, the importance of TAD has been recognized by orthopaedic surgeons. This concept has been widely accepted in practice, and even used as a standard in determining the helical blade position. It is not clear, however, whether the helical blade system is equal to lag screws in terms of TAD. After the limitations of TAD had been reported, Kuzyk et al. proposed a tip-apex distance referenced from the calcar(Cal-TAD)as a predictor of lag screw cutout to improve the concept further. In this article, these concepts and the latest clinical applications of TAD and Cal-TAD are reviewed based on the publications available. Key words: Hip fractures; Fracture fixation, internal; Bone nails; tip-apex distance; Calcar referenced tip-apex distance

Academic Dysfunction Following Concussion

Studies of the academic effect of concussion are limited by lack of a comparison group experiencing health effects from other kinds of injuries. In the

Sox10 Expression in Goldfish Retina and Optic Nerve Head in Controls and after the Application of Two Different Lesion Paradigms.

The mammalian central nervous system (CNS) is unable to regenerate. In contrast, the CNS of fish, including the visual system, is able to regenerate after damage. Moreover, the fish visual system grows continuously throughout the life of the animal, and it is therefore an excellent model to analyze processes of myelination and re-myelination after an injury. Here we analyze Sox10+ oligodendrocytes in the goldfish retina and optic nerve in controls and after two kinds of injuries: cryolesion of the peripheral growing zone and crushing of the optic nerve. We also analyze changes in a major component of myelin, myelin basic protein (MBP), as a marker for myelinated axons. Our results show that Sox10+ oligodendrocytes are located in the retinal nerve fiber layer and along the whole length of the optic nerve. MBP was found to occupy a similar location, although its loose appearance in the retina differed from the highly organized MBP+ axon bundles in the optic nerve. After optic nerve crushing, the number of Sox10+ cells decreased in the crushed area and in the optic nerve head. Consistent with this, myelination was highly reduced in both areas. In contrast, after cryolesion we did not find changes in the Sox10+ population, although we did detect some MBP- degenerating areas. We show that these modifications in Sox10+ oligodendrocytes are consistent with their role in oligodendrocyte identity, maintenance and survival, and we propose the optic nerve head as an excellent area for research aimed at better understanding of de- and remyelination processes.

Sixty-Four Cases of Major Vessel Injury Associated with Laparoscopic Surgery

Abstract Objective: This report is a sequel to an earlier study that described 31 major vascular injuries associated with laparoscopic procedures. The current study details the factors that are etiologically linked to this catastrophic complication and focuses on which patients are at the greatest risk for sustaining this kind of injury. Given that avoidance of major hemorrhage with its attendant secondary complications was a major reason for the compiling and organizing these data, the aforesaid comprises a significant portion of this article. Study Design: This retrospective cohort study described 68 lacerations sustained during laparoscopic entry and surgical dissection in 64 women. Materials and Methods: Records for women undergoing laparoscopic operations were obtained between 1995 and 2015 (20 years). Two time periods during which data was obtained were 1995–2003 and 2003–2015. Calculations were made based on: body mass index; specific vessel(s) injured; management; and collateral damage. Although o...

Baseline Values of the SCAT in Mexican Football Association Players

Recently, there has been increasing cases of sports-related concussion. Individuals with this kind of injury may develop acute or chronic symptoms that may affect their health and athletic performance.

Effect of picroside II on erythrocyte deformability and lipid peroxidation in rats subjected to hind limb ischemia reperfusion injury.

BackgroundIschemia reperfusion injury (I/R) in hind limb is a frequent and important clinical phenomenon. Many structural and functional damages are observed in cells and tissues in these kinds of injuries. In this study, we aimed to evaluate the effect of picroside II on lipid peroxidation and erythrocyte deformability during I/R in rats.MethodsRats were randomly divided into four groups – each containing six animals (sham, I/R, sham + picroside II, and I/R + picroside II). The infrarenal section of the abdominal aorta was occluded with an atraumatic microvascular clamp in I/R groups. The clamp was removed after 120 minutes and reperfusion was provided for a further 120 minutes. Picroside II (10 mg·kg−1) was administered intraperitoneally to the animals in the appropriate groups (sham + picroside II, I/R + picroside II groups). All rats were euthanized by intraperitoneal administration of ketamine (100 mg·kg−1) and taking blood from the abdominal aorta. Erythrocytes were extracted from heparinized complete blood samples. Buffer (PT) and then erythrocytes (PE) were passed through the filtration system and the changes in pressure were measured to investigate the role of serum malondialdehyde and nitric oxide (NO) in lipid peroxidation and erythrocyte deformability index.ResultsDeformability index was significantly increased in the I/R group compared to groups sham, sham + picroside-II, and I/R + picroside-II (P<0.0001, P<0.0001, and P=0.007). Malondialdehyde (MDA) and NO levels were evaluated. MDA level and NO activity were also higher in the I/R group than in the other groups. Picroside II treatment before hind limb I/R prevented these changes.ConclusionThese results support that deformability of erythrocytes is decreased in I/R injury and picroside II plays a critical role to prevent these alterations. Further experimental and clinical studies are needed to evaluate and clarify the molecular mechanisms of action and clinical importance of these findings.

Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Bird collisions at an offshore platform in the North Sea

Capsule Collisions with offshore structures in the North Sea could account for the mortality of hundreds of thousands of nocturnally migrating birds.Aims To assess, for the first time, the circumstances of mass fatalities at an offshore structure, including the species involved, their numbers, ages, body conditions and injuries.Methods At an unmanned tall offshore research platform in the southeastern North Sea, bird corpses were collected on 160 visiting days from October 2003 to December 2007. Corpses were identified to species and kinds of injury, ages, and fat and muscle scores were determined. Nocturnal bird calls were recorded, identified to species and quantified. Local and large-scale weather parameters were also considered.Results A total of 767 birds of 34 species, mainly thrushes, European Starlings and other passerines, were found at 45 visits. Most carcasses were in good body condition and young birds were not more affected than adults. Three quarters of 563 examined individuals had collision induced injuries. Birds in poor body condition were less likely to be collision victims than those in good condition. Mass collision events at the illuminated offshore structure coincided with increasingly adverse weather conditions and an increasing call intensity of nocturnal birds.Conclusions Assuming an average of 150 dead birds per year at this single offshore structure and additionally assuming that a considerable proportion of the corpses were not found, we estimate that mortality at the 1000 + human structures in the North Sea could reach hundreds of thousands of birds. Since offshore industrialization will progress and collision numbers at offshore turbines will consequently increase considerably, we recommend reinforced measures to reduce bird strikes at offshore structures, especially in the light of substantial declines in some migrant species.