Main Mechanism Of Injury Research Articles

Surgical management of camel-related craniofacial injuries.

There are no studies focused on the types and management of camel-related craniofacial injuries. We aimed to analyze the pattern of injuries that required surgical management and their specific operative treatment. We prospectively collected data of all patients who were admitted to Al Ain Hospital with camel-related craniofacial injuries that were treated operatively during the period of January 2015 to January 2020. Eleven patients were studied; all were males having a median (range) age of 29 (19-66) years. Falling from a camel was the most common mechanism of injury (45.5 %) followed by camel bite (36.4 %). The most common injured region was the middle third of the face, which accounted for 56.5% of the bony fractures. Zygomatico-maxillary complex fractures were present in 60% of patients who fell while riding a camel. The most common surgical procedure performed in our patients was an open reduction with internal fixation (54.5%). There was no mortality. camel-related craniofacial injuries are complex. The main mechanism of injury is falling from a camel on the face causing fractures of the zygomatico-maxillary complex. These fractures usually need open reduction with internal fixation. Taking safety precautions may help in injury prevention.

Research Progress on the effect of calcium overload on myocardial ischemia-reperfusion injury

In the case of acute myocardial infarction, after coronary angioplasty, thrombolytic therapy and cardiac arrest and rebound surgery, the ischemic myocardium of patients may suffer from blood reperfusion injury. However, this is an inevitable complication of treatment, mainly manifested in arrhythmia, myocardial stunning, heart failure and so on, and even death in severe cases. The main mechanisms of myocardial ischemia-reperfusion injury include inflammatory response, autophagy, apoptosis, oxidative stress response, calcium overload, mitochondrial dysfunction and so on. What makes me curious is the calcium overload mechanism, which is the main inducement of reperfusion injury, and can act with other inducing mechanisms to further aggravate reperfusion injury. It is an important cause of myocardial injury and provides a new idea for myocardial protection. This paper comprehensively discusses calcium overload from the perspective of the mechanism of ischemia-reperfusion injury.

The Impact of Invasive Brain Oxygen Pressure Guided Therapy on the Outcome of Patients with Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Traumatic brain injury (TBI) is a major public health burden, causing death and disability worldwide. Intracranial hypertension and brain hypoxia are the main mechanisms of secondary brain injury. As such, management strategies guided by intracranial pressure (ICP) and brain oxygen (PbtO2) monitoring could improve the prognosis of these patients. Our objective was to summarize the current evidence regarding the impact of PbtO2-guided therapy on the outcome of patients with TBI. We performed a systematic search of PubMed, Scopus, and the Cochrane library databases, following the protocol registered in PROSPERO. Only studies comparing PbtO2/ICP-guided therapy with ICP-guided therapy were selected. Primary outcome was neurological outcome at 3 and 6months assessed by using the Glasgow Outcome Scale; secondary outcomes included hospital and long-term mortality, burden of intracranial hypertension, and brain tissue hypoxia. Out of 6254 retrieved studies, 15 studies (n = 37,245 patients, of who 2184 received PbtO2-guided therapy) were included in the final analysis. When compared with ICP-guided therapy, the use of combined PbO2/ICP-guided therapy was associated with a higher probability of favorable neurological outcome (odds ratio 2.21 [95% confidence interval 1.72-2.84]) and of hospital survival (odds ratio 1.15 [95% confidence interval 1.04-1.28]). The heterogeneity (I2) of the studies in each analysis was below 40%. However, the quality of evidence was overall low to moderate. In this meta-analysis, PbtO2-guided therapy was associated with reduced mortality and more favorable neurological outcome in patients with TBI. The low-quality evidence underlines the need for the results from ongoing phase III randomized trials.

Traumatic Brain Injury in Honduras: The Use of a Paper-based Surveillance System to Characterize Injuries Patterns.

Traumatic brain injuries (TBI) are a leading cause of death and disability worldwide. Violence is the leading cause of mortality in Honduras. However, the incidence and impact of TBI in this low-middle income country (LMIC) is unknown. The aim of this study is to describe the epidemiology of TBI in Honduras, as captured by an injury surveillance tool in the country's major referral center. A cross sectional review of all TBI-related emergency department visits at the main referral hospital in Honduras from January to December 2013 was conducted. The calculation of descriptive statistics from Injury Surveillance System (InSS) data was performed. Of 17,971 total injuries seen in 2013, 20% were traumatic brain injuries (n=3,588). The main mechanisms of injury were falls (41.11%), road traffic accidents (23.91%), blunt trauma (20.82%), penetrating knife injuries (5.85%), and firearm injuries (2.26%). Most TBI were classified as mild; 99.69% (Glasgow Coma Scale=15). Emergency room mortality was low (1.11%). The modified Kampala Trauma Score median was 8 (interquartile range 7-8). Mild TBI accounts for a significant percentage of all injuries presenting to a high-volume referral center in Honduras in 2013. Despite the high incidence of violence in this country, most TBI were accidental, secondary to road traffic accidents and falls. Further research is required with more recent data as well as with prospective data collection methods.

Gender Discrepancy in Patients with Traumatic Brain Injury: A Retrospective Study from a Level 1 Trauma Center

Objectives The objective of this study is to explore the gender discrepancy in patients with traumatic brain injury (TBI). Methods A retrospective analysis of Qatar Trauma Registry (QTR) was conducted among patients (age ≥14y) who were hospitalized with TBI. Data were collected and analyzed based on the gender and age. Results Over 5 years (2014-2019), 9, 309 trauma patients (90% males and 10% females) were admitted to the trauma center. Of these, 1, 620 (17.4%) patients were hospitalized with TBI (94% males and 6% females). Motor vehicle crash was the main mechanism of injury (MOI) in females, and fall from height was predominant among males. Subdural hematoma (SDH) was the more frequent type of TBI in both genders, but it was more prevalent in male patients ≥55 years. Injury severity score, Glasgow coma scale, and head abbreviated injury score were comparable between males and females. The length of stay in the ICU and hospital and mortality were similar in both genders. However, mortality was higher among males ≥55 years when compared to 14-54 years within the same gender (21% vs. 12%, p = 0.002). The crude and adjusted odds ratio did not show that gender is a significant predictor of mortality among TBI patients. Conclusions Although the incidence and MOI of TBI show significant differences between male and female patients, the severity and outcomes are comparable.

Lesões desportivas em atletas recreacionais amadores de taekwondo

ABSTRACT Combat sports are very common in sport mega-events. Taekwondo is a combat sport that prioritizes direct contact between participants, specially by kicks and punches, and provides ambiguity in the health-sport relationship, as its practice could be harmful. This study aimed to quantify the prevalence of injuries in amateur Taekwondo athletes, from training or competitions, and assess their association with intrinsic and extrinsic factors. This is a descriptive, observational, and retrospective study that assessed injuries by a reported morbidity inquiry. Information on sports injuries considered the last six months of 2018. Participants were athletes aged from 12 to 25 years old, of both sexes, practicing Taekwondo in the city of Pelotas, Rio Grande do Sul, Brazil. The prevalence of sports injuries in amateur Taekwondo athletes in Pelotas was 26.2% (n=1), without significant differences between sexes. The main reason for the practice was physical conditioning (35.7%). The main mechanism of injury was kick when attacking (45.4%), followed by impact when defending (27.3%). The most frequent type of injury was sprain (27.3%). followed by contusion (18.2%), and the most injured body parts were knees (36.4%) and ankles (36.4%). The prevalence of sports injuries in amateur Taekwondo athletes in Pelotas was lower than the one found in the literature, and it may be due to the nature of the practice, as they are recreational amateur athletes aiming to improve physical conditioning.

Ventilator-induced lung injury results in oxidative stress response and mitochondrial swelling in a mouse model

BackgroundMechanical ventilation is a life-saving therapy for critically ill patients, providing rest to the respiratory muscles and facilitating gas exchange in the lungs. Ventilator-induced lung injury (VILI) is an unfortunate side effect of mechanical ventilation that may lead to serious consequences for the patient and increase mortality. The four main injury mechanisms associated with VILI are: baro/volutrauma caused by overstretching the lung tissues; atelectrauma, caused by repeated opening and closing of the alveoli resulting in shear stress; oxygen toxicity due to use of high ratio of oxygen in inspired air, causing formation of free radicals; and biotrauma, the resulting biological response to tissue injury, that leads to a cascade of events due to excessive inflammatory reactions and may cause multi-organ failure. An often-overlooked part of the inflammatory reaction is oxidative stress. In this research, a mouse model of VILI was set up with three tidal volume settings (10, 20 and 30 mL/kg) at atmospheric oxygen level. Airway pressures and heart rate were monitored and bronchoalveolar lavage fluid (BALF) and lung tissue samples were taken.ResultsWe show a correlation between increased inflammation and barrier failure, and higher tidal volumes, evidenced by increased IL-6 expression, high concentration of proteins in BALF along with changes in expression of adhesion molecules. Furthermore, swelling of mitochondria in alveolar type II cells was seen indicating their dysfunction and senescence-like state. RNA sequencing data present clear increases in inflammation, mitochondrial biogenesis and oxidative stress as tidal volume is increased, supported by degradation of Keap1, a redox-regulated substrate adaptor protein.ConclusionsOxidative stress seems to be a more prominent mechanism of VILI than previously considered, indicating that possible treatment methods against VILI might be identified by impeding oxidative pathways.

Karakteristik Klinis Pasien Laserasi Kelopak Mata Akibat Trauma di Pusat Mata Nasional Rumah Sakit Mata Cicendo

Introduction : Trauma of eyelids due to sharp object, blunt object, road traffic accidents etc. are the major causes resulting in injuries to eyelids. A good identification and prompt treatment can improve the outcome of palpebral laceration. Purpose : To describe clinical characteristics of eyelids laceration due to trauma without involvement of lacrimal system and other orbital Methods : A retrospective descriptive cross sectional study was conducted. Data is taken from medical records of patients diagnosed as eyelid laceration from January 2016 to November 2020. Age, gender, laterality, first reference, place, onset, cause, site of trauma, depth, outcome, complication and System for Peri-Ocular Trauma (SPOT) classification was reviewed. Results : This study comprised of total 157 patients. Most of them were males 119 (75.80%) with median of age 24. The main mechanism of injury was direct trauma 88 (56.05%). The location where the injury occured was road side accidents 81 (51.59%). Superior eyelid was the most affected 96 (61.15%). Subcutaneus tissue as wound base 68 (43.31%) and affected to margin of eyelid 36 (22.92%). Hypertropic scar was the most complication found in 40 (25.47%). The most common SPOT type injury were Type IA. Conclusion : Eyelids laceration due to trauma is common in male productive age, mainly affecting superior palpebra, mostly because of road side accidents. Hypertropic scar was most complication beside traumatic ptosis, lagophthalmos and lid margin notching. The SPOT classification can simplify a recording of palpebral injuries.

Pulsed field ablation as the first choice regarding oesophageal safety for atrial fibrillation ablation?

Abstract Funding Acknowledgements Type of funding sources: None. Background The occurrence of endoscopy-detected oesophageal lesions has been reported in patients with atrial fibrillation (AF) after thermal-based pulmonary vein isolation (PVI) with even higher risk in patients undergoing ablation of the left atrial posterior wall (LAPW) (1). The main mechanism of oesophageal injury is thermal, resulting in oesophageal dysmotility, ulceration, perforation, or left atrio-oesophageal fistula formation, which are rare but life-threatening sequelae. Pulsed-field ablation (PFA) is a non-thermal ablation technology that uses high amplitude pulsed electrical fields to ablate tissues through cell membrane disruption (2). Precommercial experience with PFA reported no injury to the oesophagus for both PVI and LAPW ablation (3). Purpose To assess oesophageal safety in AF patients treated with three different PFA platforms. Methods In this single-centre experience we retrospectively analysed a total of 72 upper gastrointestinal (GI) endoscopies performed by a certified gastroenterologist one day after left atrial PFA. GI analysis focused on detection of oesophageal lesions nearest the left atrium and evidence of gastric hypomotility. PVI was performed using focal or single shot PFA catheters. Focal PFA catheters achieved PVI using the wide antral circumferential ablation (WACA) technique. LAPW ablation was performed exclusively by using single shot PFA devices. Results The patient characteristics were summarized in Table 1. Focal PFA catheters were used in 78% of patients. Post-procedure endoscopies revealed no mucosal lesions in any patient. Gastroparesis and perioesophageal vagal nerve injury were not found (Table 2). Conclusion PFA, whether applied by single shot devices or focal catheters, seems to be a safe ablation option with respect to oesophageal injury resulting from PVI and LAPW ablation in paroxysmal and persistent AF patients. Irrespective of catheter design, PFA configuration (monopolar versus bipolar, maximum output), or LA lesion set, we found absolute GI safety of PFA as class effect.

Pulled elbow: Diagnosis and management, the Paraguay experience

Objectives: The objectives of the study were to show the Paraguay experience in the diagnosis and handling of pulled elbows in recent years. Methods: A retrospective study of patients who presented to the emergency service was carried out from July 2019 to December 2021. Patients under 6 years with typical symptoms and signs of pulled elbow were included in the study. The data collected were demographics, affected side, mechanism of injury, and number of times pulled elbow occurred. The maneuver performed for the treatment and its success was also recorded. Results: There were 30 pulled elbow cases in 26 patients. Age ranged from 1 to 5 years, with a median of 3 years. The left side was more frequently affected (53%). There were more females affected (77%). The main mechanism of injury was upper limb traction, which occurred in 26 elbows (86.6%), followed by falling from a standing height in four cases. We found that imaging studies are requested when the reason for consultation is referred to as a possible fall from one’s own height. The hyperpronation method of reduction was effective in all cases. The treating physician felt the “click” in 93.3% of the times. Conclusion: The pulled elbow is a frequent injury in pediatric emergencies. It requires a high index of suspicion to make the diagnosis and a training to perform the hyperpronation reduction maneuver. Physicians subjected to the diagnosis and reduction maneuver training, can treat these injuries successfully without consultation of pediatric orthopedics.

Pediatric major burns: a monocentric retrospective review of etiology and outcomes (2008–2020)

BackgroundBurns are one of the most common causes of mortality and morbidity among children. This study aims to assess the epidemiology of pediatric major burns in a third level hospital in Spain to evaluate demographics, etiology, and outcomes.MethodsA retrospective study was held by the Plastic, Reconstructive and Burn Surgery department of the hospital. We included 147 patients under 18 admitted to hospital between January 2008 and December 2020 who meet the inclusion criteria: partial thickness burns > 10% total body surface area (TBSA) in patients < 18 years old. Clinical data extracted included age, gender, date of admission, %TBSA, burn types, severity and sites of burn, length of stay, length of ventilator support, intensive care admission, blood transfusion, surgical interventions, and complications.ResultsThree groups of age were analyzed. The average %TBSA was 18.7 (SE 0.9). Scalds were the main mechanism of injury (70.1%) and upper extremity was the most frequent location affected (68%). The 28.6% of patients suffered some complication, but the mortality rate was low (0.7%). In our series, the group aged 13–18 showed significantly higher %TBSA, more number of surgeries and blood transfusions.ConclusionsScald burns are the most frequent mechanism of injury in pediatric burns. However, teenagers suffer more severe burns and complications, usually caused by flame. Despite the low mortality rates, more measures of prevention should be taken to increase children security.Level of evidence: Level IV, Risk/Prognostic.

Possible pathophysiological mechanisms of cardiac troponin level elevations in blood serum and urine in arterial hypertension

The review aimed to discuss and detail the main mechanisms of myocardial cell injury and increased concentrations of cardiac specific troponin isoforms (cTnI and cTnT) in blood serum and urine in hypertension. The search and analysis of foreign and domestic literature were carried out using the MedLine, EMBASE, Scopus and eLibrary databases to achieve this goal. According to recent experimental and clinical researches using high and ultra-sensitive methods for determining cTnI and cTnT, cardiomyocytes are extremely sensitive to many damaging factors in a number of physiological and pathological conditions. The serum concentrations of cTnI and cTnT can increase at the earliest stages of cardiovascular diseases (for example, in prehypertension, latent forms of coronary heart disease, arterial hypertension) and are important for predicting subsequent complications in the form of acute and life-threatening cardiovascular diseases (myocardial infarction, stroke, heart failure, and others). Moreover, troponin molecules can be detected not only in blood serum but also in non-invasively obtained biological fluids, including urine and oral fluid, which in the future can be used as new methods for the non-invasive diagnosis of many cardiovascular diseases. Although elevated levels of cTnI and cTnT in blood serum and urine in hypertension have a fairly high diagnostic and prognostic value, the pathophysiological mechanisms of cardiac troponins level elevations in human biological fluids in this pathological condition remain unclear.

Functional Decline After Nonhospitalized Injuries in Older Patients: Results From the Canadian Emergency Team Initiative Cohort in Elders

To estimate the cumulative incidence of functional decline over 6 months following emergency department (ED) assessments of nonhospitalized injuries and to identify its main determinants. We conducted a prospective multicenter cohort of older adults discharged home following assessment for injuries in 8 Canadian EDs. Participants were assessed at 3 time points: baseline in the ED, 3 months, and 6 months. The primary outcome, functional decline, was defined as a 2-points loss from baseline on the Older American Resources Scale (OARS). Other measures included demographics, comorbidities, injury characteristics, frailty, cognition, mobility status, etc. Cumulative incidences were estimated using proportions with 95% confidence intervals. Log-binomial regressions and the "least absolute shrinkage and selection operator" (LASSO) were used to identify significant functional decline determinants. Among 2,919 participants, 403 (13.8%) were lost to follow-up. Mean age was 76.2±7.6 years, 65.3% were women, 9% were frail, and 40.0% prefrail. Main injury mechanisms were falls (65.5%) and motor vehicle accidents (18.6%). The cumulative incidence of functional decline over 6 months was 17.0% (95% confidence interval 12.5% to 23.0%). Occasional use of walking devices, less than 5 outings/week, frailty, and older age were significant baseline determinants of functional decline. A significant 17% of older adults with "minor" injuries experience a persistent functional decline over 6 months following their ED visit. Four frailty-related determinants were identified: occasional use of a walking device, less than 5 outings/week, frailty, and older age. Further work is needed to assess if these can help ED clinicians screen seniors at risk and initiate interventions at discharge.

Epidemiological characteristics of injury in Georgia: A one-year retrospective study

IntroductionInjury is a major health problem worldwide and a leading cause of death and disability. Disability caused by traumatic injury is often severe and long-lasting. Injuries place a large burden on societies and individuals in the community, both in cost and lost quality of life. Progress in developing effective injury prevention programs in developing countries is hindered by the lack of basic epidemiological injury data regarding the prevalence of traumatic injuries. The aim of this research was to describe the epidemiological characteristics of injury in all hospitals in Georgia. MethodsThe database of the National Center for Disease Control and Public Health of Georgia for 2018, which includes all hospital admissions, was used to identify injury cases treated in hospitals. Cases were included based on the S and T diagnosis coded of ICD-10. ResultsA total of 25,103 adult patients were admitted for an injury, of whom 14,798 (59%) were males and 10,305 (41%) were females, between the ages of 18 and 108 years old. The highest prevalence was among the age group 25–44 years old (n = 8654; 34%), followed by 45–64 years old (n = 6852; 27%). The main mechanism of injury was falls (n = 13,932; 55%) and exposure to mechanical forces (n = 2701; 11%). Over 1,50% (n = 379) of injuries resulted in death after hospitalization. The median hospital length of stay (LOS) was 2 days. There was a significant association between age, mechanism of injury, type of injury, performed surgical interventions, and longer LOS. ConclusionInjuries are prevalent throughout the life course and cause substantial hospitalization time. This research can help focus prevention efforts can focus on the demographic and injury causes that are most prevalent.

P53 inhibition attenuates cisplatin-induced acute kidney injury through microRNA-142-5p regulating SIRT7/NF-κB

Renal tubular epithelial cell apoptosis is the main mechanism of cisplatin-induced acute kidney injury. The role of microRNAs (miRNAs) in the apoptosis of renal tubular epithelial cells has been suggested, but the underlying mechanism has not been fully elucidated. We used microarray analysis to identify miR-142-5p involved in cisplatin-induced acute kidney injury. miR-142-5p was down-regulated in human renal tubular epithelial (HK-2) cells with cisplatin treatment. Notably, the overexpression of miR-142-5p attenuated the cisplatin-induced HK-2 cell apoptosis and inhibition of miR-142-5p aggravated cisplatin-induced HK-2 cell apoptosis. During cisplatin treatment, p53 was activated. The inhibition of p53 by pifithrin-α attenuated the cisplatin-induced kidney injury and up-regulated miR-142-5p expression. We also identified the Sirtuin7 (SIRT7) as a target of miR-142-5p. Furthermore, we demonstrated that the inhibition of SIRT7 prevented cisplatin-induced HK-2 cell apoptosis and decreased the expression of nuclear factor kappa B (NF-κB). Our data revealed that p53 inhibition could attenuate cisplatin-induced acute kidney injury by up-regulating miR-142-5p to repress SIRT7/NF-κB. These findings may provide a novel therapeutic target of cisplatin-induced acute kidney injury.

Trend of Improvement in Visual Field Deficits after Transsphenoidal Endoscopic Surgery in Pituitary Tumour Patients: A Case Series

Abstract&#x0D; Introduction: Pituitary tumours account for approximately 15% of all brain tumours, and the growing tumours press against the optic chiasm, resulting in impairment of visual function manifested as visual field defects, decreased visual acuity, and decreased color vision . Compression of the optic chiasm by pituitary tumours generally results in selective loss of the temporal VFs, or bitemporal hemianopia, implying that the nasal retinal fibers are preferentially damaged. The reason for this preferential damage is not fully understood. Transsphenoidal surgery has been reported to safely reduce the pressure on the anterior visual pathway in most patients. Improvement in visual function may occur after transsphenoidal decompression of the chiasm. Because improvement in visual function may occur from a variety of proposed biologic processes.&#x0D; Case Series : The number of patients according to gender was 71% male (10 people) while 29% female (4 people). The age distribution was found mostly at the age of 40-50 years 36% (5 people). The most common clinical symptoms were field disturbances 85% (12 people). Patients complained of visual field disturbances for 1-2 years as many as 58% (7 people). Vision before surgery is /6 as much as 45% (4 people). Improvements in vision were found for 1 month postoperatively as much as 22% (2 people).&#x0D; Discussion : Compression of the optic chiasm by pituitary tumours generally results in selective loss of the temporal VFs, or bitemporal hemianopia, implying that the nasal retinal fibers are preferentially damaged. The minimally invasive transsphenoidal approach can be used effectively for 95% of pituitary tumours. Exceptions are those large tumours with significant temporal or anterior cranial fossa extension. In such circumstances, transcranial approaches are often more appropriate. Occasionally, combined transsphenoidal and transcranial approaches are used. Nevertheless, some surgeons extend the basic transsphenoidal exposure in order to remove some of these tumours and avoid a craniotomy . Potential mechanisms of axonal injury from a compressive lesion include direct disruption of conduction along the axon, impaired axoplasmic flow, demyelination with impaired signal conduction, and ischemia from compression or stretching of the blood supply of the chiasm by the tumour. An early fast phase of improvement is consistent with restoration of signal conduction along retinal ganglion cell axons after removal of a compressive lesion.In some individuals, we observed the rapid restoration of normal vision, which would be consistent with this hypothesis. In these individuals, a physiologic conduction block is presumably the main mechanism of injury.&#x0D; Conclusion: The pattern of improvement of visual function after decompression of the anterior visual pathways suggests three phases of improvement. Improvement in visual function may occur after transsphenoidal decompression of the chiasm. Because improvement in visual function may occur from a variety of proposed biologic processes, we sought to better define this potential for improvement.

Recovery Degree in Pediatric Patients with Antecedent Severe Traumatic Brain Injury in Mexico

Aims: To determine the recovery degree in pediatric patients with antecedent severe traumatic brain injury.&#x0D; Study Design: Prospective, analytical and relational.&#x0D; Place and Duration of Study: Pediatrics Intensive Care Area of ​​the “Hospital para el Niño Poblano” from March 2014 to February 2015.&#x0D; Methodology: Patients aged 2 to 192 months, both sexes, with antecedent severe traumatic brain injury. The degree of recovery was determined with the Glasgow Outcome Score (GOS) at hospital discharge and one year after. Descriptive and inferential statistics were used data analysis.&#x0D; Results: The study consisted of 23 patients, of which 69.56% were men. The mean age was 73.17±50.33 months. The predominant age group was middle childhood (34.78%). The main mechanism of injury was run over by a vehicle (39.13%). The group of toddler remained hospitalized for 17.50±8.58 days. Moreover, GOS at hospital discharge (p=0.391) and at one year (p=0.789) was not associated with sex. Additionally, an association of GOS at hospital discharge was found with GOS at one year of care (p=0.003), with greater improvement being observed, in those cases with less initial damage brain.&#x0D; Conclusion: The degree of recovery at one year after hospital discharge in pediatric patients with antecedent severe traumatic brain injury is associated with the degree of recovery at hospital discharge. Middle childhood, being the group at greatest risk. The complications can reduce the recovery of the patient. Rehabilitation therapy provided by the public health services and the family is of vital importance.

Physician-Led Thoracic Trauma Management in a Specialist Emergency Care Centre.

Introduction: Falls cause 75% of trauma in patients above 65 years of age, and thoracic trauma is the second commonest injury; rib fractures are the most common thoracic injury. These patients have up to 12% mortality, with 31% developing pneumonias. There is wide variation in care. Northumbria Healthcare has a team of respiratory consultants, physiotherapists, specialist nurses and anesthetists for thoracic-trauma management on a respiratory support unit. Methods: With Caldicott approval, basic demographics and clinical outcomes of patients admitted with thoracic trauma between 20 August–21 April were analyzed. A descriptive statistical methodology was applied. Results: A total of 119 patients were identified with a mean age of 71.1 years (range 23–97). Of the 119 patients, 53 were male, 66 females. The main mechanism of injury was falls from standing (65) and falls down stairs/bed or in the bath (18). Length of stay was 7.3 days (range 1–54). In total, 85 patients had more than one co-morbidity, 26 had a full trauma assessment and 75 had pan CTs. The mean number of rib fractures was 3.6 and 31 (26%) patients had a pneumothorax and/or haemothorax. A total of 18 chest drains were inserted (all small bore) and one needle aspiration was performed. No cardiothoracic input was required. Isolated chest trauma was present only in 45 patients. All patients had a pain team review, 22 erector spinae catheters were inserted with 2 paravertebral blocks. Overall, 82 patients did not require oxygen, 1 required CPAP and 1 HFNC. 7 needed intensive care transfer. Furthermore, 20 (17%) developed pneumonias and 16 (14%) deaths occurred within 30 days—all were in those with falls from standing. There was no correlation between number of fractured ribs, length of stay and mortality. Conclusions: High level care for thoracic trauma can be performed by a physician led team. Overall, 42% pneumothoraces/haemothoraces were observed. Further large scale randomised trials are warranted for definitive outcomes.

Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases

ObjectiveTo closely describe the injury inciting events of acute hamstring injuries in professional male football (soccer) using systematic video analysis.MethodsVideo footage from four seasons (2014–2019) of the two highest divisions...

Неосложненные переломы шейных позвонков у детей и подростков

Introduction Various aspects of uncomplicated fractures of the cervical vertebrae in children and adolescents remain topical. Purpose To study incidence, character and type of uncomplicated fractures of the vertebrae of the cervical spine in children and adolescents. Materials and methods Out of 1000 children who had uncomplicated vertebral fractures, 27 (2.7 %) people were diagnosed with fractures at the cervical level. There were more boys among the injured – 77.77 % of the injured. 29.63 % of the patients were under the age of 12, and 70.37 % of – aged 12–17. Traditional methods for emergency traumatology were used for clinical diagnostics. Results In 17 (62.96 %) of the patients only the cervical vertebrae were compressed, in 10 (37.04 %) patients – both the thoracic vertebrae and the cervical vertebrae. Among the cervical vertebrae, compression of C7 vertebral body was most often observed – in 30.64 % of cases, less often – the body of C3 – in 4.08 % of cases. The main mechanism of injury was falling on head from a height of 2 m and more – 25.98 % of cases. Analysis of the character of C2 fractures showed that four patients had fractures of the odontoid process (three patients – type I, one – type III), one patient – fractures of the arches of this vertebra corresponding to type I. Fractures of subaxial location mainly corresponded to group "A" (subgroup I (36 compressed vertebrae), subgroup II (6 injured vertebrae)). In 2 cases, vertebral fractures were referred to group "B" (subgroup I). In 25 (92.59 %) clinical cases conservative treatment was used, in 2 (7.41 %) – there were indications for surgical treatment. The average duration of in-patient treatment for fractures of the cervical vertebrae was 9.4 days. Evaluation of long-term treatment results showed "good" results in 83.33 % of cases, satisfactory – in 16.67 % of clinical observations. Discussion The results that we have received are mainly comparable with the literature data on the main aspects of cervical trauma in children. At the same time, it is necessary to mention some differences. For example, many authors report that younger children most often get fractures of the C2 vertebra. According to our data, the average age of patients with these fractures was 14.8 years.