Knife Stab Research Articles

Possible XOR fallacy – Case report of combined foramen sternale with an osseous sternal knife stab injury

Abstract This case report details a sternal finding that first was reported as penetrating knife stab wound. It was one in a series of 24 otherwise relatively superficial skin stab wounds allegedly performed by a single assailant within the scope of a single attack. The effort required to penetrate the sternum with a knife appears to be considerably higher than to inflict relatively superficial skin and soft tissue penetration. This initially raised suspicion of another person contributing to the attack, or, a different weapon being used. After reviewing the clinical CT scans, we identified the combination of a preexisting sternal foramen with a marginal fracture and concluded that the sternal “penetration” was in keeping with the depth of the other 23 stab wounds. None of the injuries were lethal, the victim survived the attack. Assuming that a knife penetration fracture of a sternum and a foramen sternale are mutually exclusive constitutes an exclusive-OR fallacy (XOR fallacy).

Vitamin D deficiency in critically ill patients with traumatic injuries.

BackgroundVitamin D depletion has been associated with increased rate of infections, lengthened hospital stay, and worsened mortality for critically ill patients. The purpose of this study was to evaluate the prevalence and variables associated with vitamin D deficiency in critically ill patients with severe traumatic injuries.MethodsCritically ill adult patients admitted to the trauma intensive care unit (ICU) between June 2013 and June 2014, referred to the nutrition support service for enteral or parenteral nutrition, and had a serum 25-hydroxyvitamin D (25-OH vitamin D) concentration determination were retrospectively evaluated. Patients were stratified as vitamin D sufficient, insufficient, deficient, or severely deficient based on a 25-OH vitamin D concentration of 30–80, 20–29.9, 13.1–19.9, and ≤13 ng/mL, respectively.ResultsOne hundred and twenty-one patients out of 158 (76 %) patients were vitamin D deficient or severely deficient. Thirty-one patients (20 %) were insufficient and 6 (4 %) had a normal 25-OH vitamin D concentration. 25-OH vitamin D was determined 7.5 ± 5.1 days after ICU admission. African-Americans had a greater proportion of patients with deficiency or severe deficiency compared to other races (91 versus 64 %, P = 0.02). Penetrating gunshot or knife stab injury, African-American race, and obesity (elevated body mass index) were significantly associated with vitamin D deficiency or severe deficiency: OR 9.23 (1.13, 75.40), 4.0 (1.4, 11.58), and 1.12 (1.03, 1.23), P < 0.05, respectively.ConclusionsThe majority of critically ill patients with traumatic injuries exhibit vitamin D deficiency or severe deficiency. Penetrating injuries, African-American race, and obesity are significant risk factors for deficiency. Severity of injury, extent of inflammation (elevated C-reactive protein concentration), or hospital admission during the winter season did not significantly influence the prevalence of vitamin D deficiency.

Successful Management of a Stab Wound to the Left Ventricle

A 24 year old male presented to the emergency room with a 2 hour history of knife stab wound. He was haemodynamically stable with good bilateral air entry. However on X-ray an enlarged cardiac silhouette was seen. The patient suddenly became hypotensive and on suspicion of cardiac tamponade a catheter was introduced in pericardial space, but the measure was unsuccessful and he was rushed to the Operating Room. During the surgery a 2 cm long laceration was identified in the mid-left ventricular (LV) wall less than 1mm away from the Left Anterior Descending (LAD) Artery. The Left Anterior Descending Vein was damaged which was then repaired along with the ventricular wall by the interrupted pledgeted 3-0 prolene suture, whilst a cardiopulmonary bypass was kept on the stand by. The patient was checked for a ventricular septal defect via an intraoperative echocardiography. Subsequently, he had an uneventful recovery and was discharged.Cardiovasc. j. 2016; 9(1): 60-63

A Challenging Penetrating Trauma Case

We present the prehospital management of a 23-year-old Australian Aboriginal man with an isolated knife stab wound to the posterior right chest. The lead author attended to the prehospital management of this young man during tenure as a registrar in retrieval medicine for CareFlight Medical Services (CMS) in North Queensland, Australia. The case is noteworthy because it involved a combination of a life-threatening injury with a superimposed iatrogenic injury. The case will be of interest to physicians and clinicians in prehospital medicine as well as those in low-volume emergency departments or facilities in which major trauma may present infrequently.

Arteriovenous Fistula between Renal Artery and Inferior Vena Cava following Penetrating Abdominal Trauma; A Case Report

An arteriovenous fistula (AVF) from the renal artery following a penetrating abdominal trauma is not common. We report the case of a 19-year-old male who presented with a knife stab wound in the right upper quadrant. Due to unstable vital signs and to the protrusion of the mesentery through the stab...

It's the football stupid: a knife stab through the mandible – a case report

It's the football stupid: a knife stab through the mandible – a case report

EPA-0609 – This time was serious

The potential suicide is a person with intense suffering and is always a serious patient, for whom by their despair, future expectations do not exceed a painful present. Expose more carefully try this idea by describing a case of a patient with highly lethal suicide attempts, severe, recurrent (repeated blows with a hammer to the skull, incised wound in the abdomen after a knife stab, multiple cuts with a knife upper and lower limbs …). Besides these aspects, point out the risk factors found in this patient and further foster suicide problem. Borderline personality disorder and depressive disorder, in which we highlight a high difficulty in solving problems and hopelessness, the harmful use of cocaine and alcohol, and demographic factors such as age, gender and part of socially minority group. The profile of temperament and personality point out a tendency to novelty seeking and harm avoidance, coupled with aggressive and impulsive behavior, without a clear definition of objectives and targets, and low capacity for cooperation which is observed by manipulative attitude posing in repeated hospital admissions. Therefore, we emphasize that suicide is a complex entity and their pricing strategies, risk detection and prevention, are hampered by the lack of a definition and classification operative. That said, and considering that you have to work in a comprehensive manner, we considered what we should prioritize in the treatment of this patient to prevent another attempted suicide, is the psychiatric disorder, substance use, social status risk that found, or suicidal symptoms itself?

Comparison of stab wound probing versus radiological stab wound channel depiction with contrast medium

BackgroundInstillation of contrast medium into stab wounds has shown promising results regarding visibility and assessment of general stab direction with computed tomography. However, the accuracy of this method – and, incidentally also probing of stab wounds – has to our knowledge not previously been examined. Also the effect of bluntness of different stabbing objects on the examination of stab wounds was not considered before this study. MethodsUsing a pocket-knife, a steak-knife, and a Phillips screwdriver, nine stab wounds each were inflicted to three pork haunches. The depths of the stab wounds were determined by probing and multislice computed tomography (MSCT) after instillation of a contrast medium (CM) and then compared to those observed by dissection, our internal “gold standard”. ResultsIn stab wounds inflicted by knives, MSCT-CM and probing provided results which differed by roughly 10–11% from the dissection results. In screwdriver stabs MSCT-CM showed a deviation of almost 30%, probing over 33%. DiscussionMSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate. ConclusionMSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate.

Traumatic spinal perimedullary arteriovenous fistula due to knife stabbing and subsequent kyphosis

Perimedullary arteriovenous fistula (AVF) is a relatively rare spinal vascular malformation. Although it has traditionally been considered to be a congenital lesion, some cases identified in adults have suggested that the lesion may be acquired. The etiology and exact mechanism of these lesions are unknown. The authors present a case of a perimedullary AVF caused by a direct stabbing injury of the spinal cord and induced by subsequent kyphosis, and they discuss the pathogenesis and treatment strategy.

Study of the knife stab and puncture-resistant performance for shear thickening fluid enhanced fabric

This work developed a shear thickening fluid enhanced fabrics and the influence of the shear thickening fluid types on the knife stab and puncture resistance performance were investigated. The rheological properties of the shear thickening fluids were tunable by varying both the dispersing particles (silica, polymethylmethacrylate and polystyrene-ethylacrylate) and the mediums (ethylene glycol, polyethylene glycol 200 and polyethylene glycol 600). The mechanical properties of the shear thickening fluid reinforced fabrics were evaluated by the knife and spike drop tower testing, respectively. The hardness of the particles was the dominant factor for the knife stab resistance, while the inter-yarn friction played as the critical role for improving the puncture resistance. In comparison to neat fabric, the knife stab and puncture resistance of the shear thickening fluid-fabrics exhibited significant enhancement, which can be proven by the results of yarn pull-out testing and optical microscope images investigation. The enhancing effect was systematically discussed and the improving mechanism was analyzed. Because the influencing factors for the knife stab resistance and puncture resistance were different, the enhancing effect of the dispersing particles and the mediums for the shear thickening fluid-fabrics should be also different.

Two cases of acute hepatitis after a serial knife stabbing

Three persons became victims of a serial knife stabbing in a fight. Three months later, one of the victims presented with acute hepatitis. On the fifth day of his admission to the hospital, another victim of this serial stabbing presented to our clinic with acute hepatitis B infection. The patients told that the first victim stabbed in this fight was their relative and he was a carrier of hepatitis B virus for a long time. They said that the carier of hepatitis B was stabbed first and then, with the same knife, the first and second patients were stabbed, respectively. After 8 months, the index case (first victim) was admitted to our clinic with elevation of liver enzymes. HBsAg and HBeAg were positive. HBV DNA was 2 × 10 9 copy/mL. Histopathologic examination of liver biopsy showed chronic hepatitis with histologic activity index of 6/18 and grade I fibrosis.

Giant pseudoaneurysm of the left axillary artery following a stab wound : case report - online article

Axillary artery pseudoaneurysms are rare. We report on a 30-year-old patient with a 6.5-cm post-traumatic pseudoaneurysm of the left axillary artery two months after a knife stab wound of the shoulder. The patient showed axillary fullness and signs of severe brachial plexus compression. A surgical repair was undertaken. The aneurysm was excluded and a saphenous vein interposition was performed. The early and late postoperative periods were uneventful. This is probably not only the largest axillary artery pseudoaneurysm ever reported, but also the first secondary to a stab wound.

Macroscopic and Microscopic Analysis of Knife Stab Wounds on Fleshed and Clothed Ribs

Stab wounds upon bone are analyzed to interpret the weapon used and the physical context in which the attack occurred. The literature demonstrates that most research conducted pertaining to wound patterns has been carried out on defleshed and unclothed bone samples, not adequately replicating actual circumstances. For this research, six half pig torsos (Sus scrofa), fleshed (including muscle, fat, epidermis, and dermis layers) and clothed, were stabbed using three knife types, applying both straight and downward thrusts. Analysis conducted macroscopically and through a scanning electron microscope with an environmental secondary electron detector revealed a general lack of consistency in wound pattern and associated secondary effects. Consequently, it was not possible to establish wound pattern per knife type as suggested in previous research or relate it to stab motion. Advantage of microscopic analysis was evident in recognizing wound traits and observation of trace evidence not visible macroscopically.

The experience of emergency cardiac rupture

Objective To summarize the experience of emergency cardiac rupture.Methods 17 cases of cardiac rupture and the average age of 27.5 years old injuries,all caused by a knife stab,all emergency line of exploratory thoracotomy the heart of cleft repair surgery at the same time dealing with concomitant injuries.Results There was 1 died.Some patients had postoperative myocardial infarction performance was confirmed by the observation of treatment for cardiac rupture after repair of the clinical manifestations,may not need special treatment.Postoperative recovery is ideal.Conclusion Emergency exploratory thoracotomy to lift pericardial tamponade,cardiac repair cracks,control bleeding and to continue to correct postoperative shock and restore blood clotting function and a series of treatment is the key to improve the success rate of resuscitation cardiac laceration. Key words: Heart laceration; Pericardium tamponade; Emergency

Penetrating knife injury to the frontal lobe – a case report

Penetrating injuries of the craniofacial region are increasing and have the potential to cause severe vascular and neurological deficit. We present our management of a case with a knife stab injury to the infra-orbital region, traversing the orbit and penetrating into the anterior cranial fossa, the tip lying in close proximity to the anterior cerebral circulation.

Fear of crime: Research of students' attitudes

In this paper we have researched the students' perception of fear of crime. To begin with, our attention was at emotional, cognitive and behavioral dimension of this manifestation. Since this subject is rarely researched in our country, it was our ambition to establish the extent of fear of crime and potential differences in regard to gender, and what we are conditionally referring to as cohesiveness variables. The subjects were 59 second year sociology students. The findings pointed out that emotional and cognitive dimension of fear of crime is present only in regard to certain crimes: sexual assault, knife stabbing, home burglary regardless if home is empty, and homicide. It is indicative that dimension of emotional fear is higher with female subjects as opposed to their male counterparts, particularly in the case of sexual assault. Also, it has been noted that female subjects adopt certain behavioral patterns (avoiding particular part of town, at specific hours) generated by the possible casualty assessment. On our sample fear of crime can be explained by some micro model variables, like personal or victim experience of someone dear. That is to say that such experience goes hand in hand with lower fear of crime. On the other hand, perception of crime threat is connected to models of social disorder and social care variables, such as: feeling of cohesiveness in the area of living and trusting the police force. Finally, it should be pointed out that some of the findings of this research, primarily those relating between fear(lessness) and: gender, experience as victim and community cohesiveness, do not differ from the results of foreign studies.

Serial knife stabbings with HIV exposure – Implications for post-exposure prophylaxis

Thirty-three persons became victims of a serial knife stabbing incident. One of the first victims one day later disclosed that he was HIV-infected. Thereafter thirty-one victims initiated HIV post-exposure prophylaxis (PEP), one exposed patient declined. None of the victims evaluated had seroconverted six months later. In most such incidents HIV exposure will be difficult to rule out as reliable information on the HIV serostatus of all serial victims will be lacking. It appears prudent, however, to inform serial stab victims about the potential risk of HIV transmission and to at least consider PEP in such scenarios.

Transcatheter closure of a large abdominal aortic pseudoaneurysm with a septal occluder device

A 15-year-old boy with a pulsating abdominal mass was admitted to our department. Six months ago, he had suffered a knife stab injury in the right upper abdomen and had undergone an emergency laparotomy (involving the stomach, retroperitoneum, and superior mesenteric vein repair) in a local hospital. On clinical examination, the patient was emaciated …

Measuring knife stab penetration into skin simulant using a novel biaxial tension device

This paper describes the development and use of a biaxial measurement device to analyse the mechanics of knife stabbings. In medicolegal situations it is typical to describe the consequences of a stabbing incident in relative terms that are qualitative and descriptive without being numerically quantitative. Here, the mechanical variables involved in the possible range of knife–tissue penetration events are considered so as to determine the necessary parameters that would need to be controlled in a measurement device. These include knife geometry, in-plane mechanical stress state of skin, angle and speed of knife penetration, and underlying fascia such as muscle or cartilage. Four commonly available household knives with different geometries were used: the blade tips in all cases were single-edged, double-sided and without serrations. Appropriate synthetic materials were used to simulate the response of skin, fat and cartilage, namely polyurethane, compliant foam and ballistic soap, respectively. The force and energy applied by the blade of the knife and the out of plane displacement of the skin were all used successfully to identify the occurrence of skin penetration. The skin tension is shown to have a direct effect on both the force and energy for knife penetration and the depth of out of plane displacement of the skin simulant prior to penetration: larger levels of in-plane tension in the skin are associated with lower penetration forces, energies and displacements. Less force and energy are also required to puncture the skin when the plane of the blade is parallel to a direction of greater skin tension than when perpendicular. This is consistent with the observed behaviour when cutting biological skin: less force is required to cut parallel to the Langer lines than perpendicularly and less force is required to cut when the skin is under a greater level of tension. Finally, and perhaps somewhat surprisingly, evidence is shown to suggest that the quality control processes used to manufacture knives fail to produce consistently uniform blade points in knives that are nominally identical. The consequences of this are that the penetration forces associated with nominally identical knives can vary by as much as 100%.

Transcatheter closure of a ventricular septal defect resulting from knife stabbing using the Amplatzer muscular VSD occluder

We report for the first time the transcatheter closure of a traumatic ventricular septal defect (VSD) with the Amplatzer muscular VSD occluder in a 34-year-old man who had been stabbed through the heart. After his initial life-saving surgery to relieve tamponade, control bleeding, and repair the lacerated right ventricle, the risks and difficulties of subsequent open heart surgery were felt to favor transcatheter closure. We review other reports of transcatheter closure of traumatic VSD.