Traumatic Contact Research Articles

ВЕРОЯТНОСТЬ ИНФЕКЦИОННОГО ПРОЦЕССА RABIES У ЛЮДЕЙ В РЕГИОНЕ СО СЛОЖНОЙ ЭПИЗООТИЧЕСКОЙ ОБСТАНОВКОЙ ПО БЕШЕНСТВУ

The aim of the study was to establish the relationship between cases of animal rabies and cases of people seeking medical help after bites of synanthropic and wild animals in various geographical areas of the Saratov Region. An analysis of the number of people who sought medical help for animal bites in the right-bank Districts of the Saratov Region in 2022 showed that the largest number of people sought medical help after traumatic contacts with animals in Balashovsky (272 people), Volsky (213 people), Rtishchevsky Districts (126 people), and in the left-bank Districts of the Region, the largest number of people sought medical help after traumatic contacts with animals in Balakovsky, Pugachevsky and Krasnokutsky Districts of the Region, which amounted to 580, 167 and 82 people, respectively. The lea-ding positions in the number of people injured by animal bites during the period under review are occupied by the city of Saratov – 2,342 people, as well as the city of Engels and the Engels District of the Region – 1,037 people. Having analyzed the number of people injured by animals with established rabies in the Saratov Region in 2022, it was found that the largest number of people were injured in Saratov (11 people). In Dergachevsky – 9 people, in Rtishchevsky and Sovetsky Districts – 8 people, respectively. An analysis of the number of cases of rabies in animals of different species in the region in 2022 showed that the lea-ding positions among the recorded cases of rabies were occupied by dogs (16 cases), cats (14 cases), and wild animals (9 cases). The probability of infection of the population with the rabies virus during traumatic contact with an animal is 0.066. In conditions of stationary trouble in the Region over a long period of time, the contagiousness index is 2.1, which indicates an extremely high danger and probability of rabies among the population of the Region.

Preventive medicine for anorexia of female adolescent

IntroductionAnorexia of females adolescents has a high mortality rate and heavy health, psychological, family consequences even in case of survival.ObjectivesTo reduce the mortality rate and the consequences of anorexia by providing a theory that allows us to have early or even predictive diagnosisMethods25 years ago I found blood type (O, A, B, AB) difference between an anorexic patient and her mother. Pregnancy had been with placental detachment and birth was traumatic, presumed causes of a mother/daughter blood contact. From that day on, I checked, in the case of Anorexia of the Female Adolescent, the blood types of the anorexic girl and her mother.ResultsIn my collection of data (more than 100 cases in 25 years): only the girls who have a different blood type (O, A, B, AB) from the mother are anorexic and from the patient’s history, we could think of a mother/daughter blood contact during the pregnancy. There are no exceptions in my data. My new theory is that Anorexia of the Female Adolescent, in addition to the girl’s psychological causes, needs a “conditio sine qua non” (a necessary but not sufficient condition): Different mother/daughter blood types (O,A,B,AB) and traumatic contact between the two blood types during pregnancy and/or birth”.ConclusionsMy theory facilitates early diagnosis (Preventive Medicine) by limiting observation, for Anorexia risk, to only daughters with a different blood type than that of the mother. Recognizing this “conditio sine qua non” for Anorexia of the Female Adolescent allows us an early diagnosis and a predictive hypothesis.DisclosureNo significant relationships.

Juvenile Offenders: Suspension of Trial and “Probationary Period”. A Study on Re-Educational Role of Social Service in Italy

The aim of this study is to investigate the institution of the “probationary period” for juvenile offenders in Italy, after the suspension of criminal proceedings. The aim of this alternative measure to detention is to re-educate and resocialise minors who have entered the criminal circuit, avoiding traumatic contact with prison and the reiteration of criminal conduct. The data collection was carried out through the cooperation of the Italian Juvenile Service Offices and the Ministry of Justice. The statistical method used Mathlab R2020b made it possible to process data from 2010 to 2020 to quantify criminal conduct, types and specificity of offences committed by Italian and foreign minors (both male and female), as well as to verify the effectiveness of probation. The positive results exceed 80% and demonstrate the effectiveness of the “probationary period” instrument in the process of re-education and re-socia- lisation of juvenile offenders.

URSZULA SOSNA, „GDY W 1945 R. WYBUCHŁA U NAS WOJNA…”

The text contains a transcription and commentary on the account of Urszula Sosna recorded within the framework of the 9th “Oral History Grant”. The narrator talks about the Silesian Uprisings, the plebiscite, the incorporation of Tarnowskie Gory into Poland and the creation of the Polish–German border. In terms of her personal memories, she talks about school, work on the family farm in the inter-war period. She presents 1945 as the start of the war in Silesia which is associated with traumatic contact with the Soviets and recalls the deportation of the male population to the USSR, the necessity to hide in cellars, the repression of local civilians by soldiers and her own time in a labour camp in Kedzierzyn.

Lymphocutaneous Sporotrichosis in a Patient with Underlying Systemic Lupus Erythematosus

Sporotrichosis is a globally prevalent subcutaneous mycosis commonly acquired through traumatic inoculation. A 66-year-old woman with underlying systemic lupus erythematosus (SLE) presented initially with a painful non-healing nodule on her right thumb. There was no history of traumatic contact with soil, plants or animals. She was started on an antibiotic but developed multiple nodules on her right forearm which appeared to spread proximally. Culture of her skin biopsy specimen yielded Sporothrix schenckii. The lesions were successfully treated with oral itraconazole. In conclusion, a history of traumatic inoculation need not always be present in SLE patients with sporotrichosis and obtaining a laboratory diagnosis is crucial for those presenting with nodular skin lesions that spread proximally
 J MEDICINE JAN 2020; 21 (1) : 59-61

Hip Injuries in Ice Hockey Goaltenders

Hip and groin injuries are among the most common locations for sports-related injuries in ice hockey players due to the specialized movements and physical nature of the sport. Goaltenders are at particular risk for hip injuries due to the unique demands of their position, particularly with the widespread use of the “butterfly style” technique, placement of the hip in extremes of motion during play, and the emphasis on repetition of skills. Hip injuries in ice hockey goalies are mainly attributed to overuse, traumatic contact injuries, or a developmental process. These injuries can be acute or chronic and involve the intra-articular joint and/or extra-articular structures including core muscles, adductors, or hip flexors. They can be treated either conservatively or operatively, depending on the player's goals and level of play. A more complicated picture arises when intra- and extra-articular hip pathologies coexist, presenting challenges in diagnosis and treatment. Fundamental understanding of goaltenders’ hip kinematics, diagnostic physical exam maneuvers, and operative indications is crucial to accurately diagnosing, treating, and preventing hip-related injuries in goalies.

Stages of Transmutation: Science Fiction, Biology, and Environmental Posthumanism by Tom Idema

633 BOOKS IN REVIEW Life Lessons. Tom Idema. Stages of Transmutation: Science Fiction, Biology, and Environmental Posthumanism. New York: Routledge, 2019. 186 pp. $120 hc, $54.95 ebk. Tom Idema’s Stages of Transformation offers readings of four works of posthuman sf, together with a broader argument that speculation on the posthuman, whether in sf writing or more generally, needs to get away from technologically-based fantasies of the Singularity and of jacking into the network, and instead pay greater attention to biological and environmental themes. The book is well-written, and accessible without sacrificing complexity. Its readings are good and interesting, but I think it is the overall thesis that makes this book an important one. In successive chapters, the author considers Kim Stanley Robinson’s MARS trilogy, Greg Bear’s Darwin’s Radio, Jeff VanderMeer’s SOUTHERN REACH trilogy, and Octavia Butler’s XENOGENESIS/LILITH’S BROOD trilogy. All of these works have been widely discussed by previous critics, but Idema provides some new insights about all of them. The sequencing of the book is also interesting, as Idema moves from Robinson’s political epic of terraforming, to Bear’s biological mysticism, to VanderMeer’s fabulation of ecological catastrophe, and finally to Butler’s wrenching vision of traumatic contact. This makes the works seem highly diverse, but Idema convincingly finds a common thread running through all of them. He achieves this largely by shifting his focus away from what might seem the most obvious features of these works. Idema’s reading of the MARS trilogy soft-pedals the political discords and contentions that feature so prominently in these books, as they do in most of Robinson’s other novels. Instead, Idema is most interested in how the scientific and engineering program of terraforming the planet itself becomes transformed as the human actors, whatever their politics, are increasingly forced to take account of Mars itself not just as an object-background to be altered or preserved, but rather as an active participant in the project of development and change. What starts out as a narrative about the potentials and the politics of human-directed technology becomes, instead, a “more-than-human drama that occurs mostly outside of human vision and control” (63). This necessarily means shifting the focus away from the utopian dynamics that are arguably Robinson’s own most central concern. In his account of Darwin’s Radio, Idema is most concerned to defend the novel against charges of being either reductively genetic-determinist on the one hand, or overly spiritualistic on the other. The novel imagines a worldwide phenomenon in which pregnant women find their fetuses altered in strange and surprising ways. Bear focuses the novel on renegade scientists who reject the general consensus that the genetic alterations constitute a plague or epidemic that desperately needs to be suppressed. Instead, they regard it as a new step in directed evolution; potentialities long buried in the human genome have been activated as a result of environmental stress. Idema shows how the novel traces out the complex politics behind large-budget scientific and medical research; in this way, Idema contends that Bear is covering much of the same ground as STS 634 SCIENCE FICTION STUDIES, VOLUME 46 (2019) (science and technology studies), in seeing science as a social process rather than as the simple uncovering of facts. The chapter on the SOUTHERN REACH trilogy is, to my mind, the strongest section of the book. Idema is well attuned to the way that VanderMeer’s uncanny writing disables the pretensions of the traditional humanist subject extending rational mastery over a world of objects. The discussion focuses on the figure of the biologist, who is the narrator of the first volume of the series, and whose metamorphoses are tracked in the subsequent volumes. She is a scientist, but in the course of the narrative she finds herself unable to keep separate from the organisms and environment that are supposed to be the objects of her study. Rather, she is more or less absorbed into, or interpenetrated by, the ambiance, as she allows herself to be changed by it. Idema shows how VanderMeer’s writing, by being evocatively precise without being objective...

샤일록의 재번역

This paper is to discuss the re-translation of Shylock in Julia Pascal’s The Shylock Play. Pascal who declares The Merchant of Venice as a play that she wishes it had never been written reveals master dicourse in terms of historical trauma, which has been accumulated by the stage performances for over 400 years. She invites marginalized and enigmatic Shylock to the center of the stage by creating a framing device Sarah who has been traumatized by the direct experience of Holocaust. Pascal projects historical trauma of Jewish community to Sarah and deconstitutes master narratives and society’s necessity with the dramatic device of play within play. Pascal shows traumatic contact between historical Jewish trauma for over 400 years and Holocaust trauma by foreground the communication among Sarah and characters in The Merchant of Venice and digs social and racial prejudice which has been permeated on stages over hundreds of years. Pascal blurs the boundaries of time and space and enforces meta theatrical politics by inducing play within play and defamiliarization. By providing heterogeneous field to Shylock shifted from unified personification and enlightening Pascal tries to warn audience cultural dementia and critical fallacy of the author including Shakespeare and join to create 21SUPst/SUP century Shylock asking the problem of diversity, tolerance and acceptance.

Descriptive Epidemiology of Soccer Injury During Elite International Competition in Africa

Epidemiological research on soccer injuries during African soccer competition is sparse. This study was conducted among 12 teams in the Council of East and Central Africa Football Association (CECAFA) challenge cup tournament. Fifty-seven injuries were reported (2.7 injuries per match), or 82.25 injuries per 1,000 match hours. The ankle was most often injured (23%). The majority (81%) of injuries occurred as a result of traumatic contact, with the most injuries occurring in the last 30 min of the match. A majority (84%) of athletes who sustained injuries continued to play. African medical personnel should be trained to handle the unique constraints and variety of injuries sustained during soccer competition.

Clinicopathologic characterization of oral pyogenic granuloma in 8 cats.

This case series characterizes the clinicopathologic features and treatment of oral pyogenic granuloma in 8 cats. The cats reported here were patients originating from collaborative efforts at an academic clinical teaching hospital and a specialty dentistry/oral surgery referral practice. Although the initial biopsy results were variable, in all cases the diagnosis reflected an inflammatory process. A second clinicopathologic evaluation of these cases determined that all lesions were consistent with oral pyogenic granuloma. The location of the lesion was consistent among all cats within the present study Lesions developed at the vestibular mucogingival tissues of the mandibular first molar teeth. We propose that malocclusion and secondary traumatic contact of the ipsilateral maxillary fourth premolar tooth with the mandibular soft tissues is a possible contributing factor in the etiopathogenic mechanism.

A metrópole como lugar do exílio: Dispersão e trauma na experiência urbana

The novels Um taxi para Viena d´Austria (Antonio torres) e As cinco estacoes do amor (Joao Almino) stage the urban experience as exile. This exile can be due to geographical distance (as it happens to the migrational processes typical of the greater urban centers), to economic circumstances (linked to social exclusion) or to psychological crackdown. All those urban experiences reflect the suspension of speech and of life jouissance, both provoked by a traumatic contact with reality.

Paediatric epidemiology of Pasteurella multocida meningitis in France and review of the literature

We report on six cases of Pasteurella multocida (P. multocida) meningitis occurring between 2001 and 2011 by a French nationwide active surveillance network of paediatric bacterial meningitis (ACTIV/GPIP). The cases accounted for 0.15 % of the paediatric meningitis cases reported between 2001 and 2011 in France, all in infants <4 months old. A review of the literature allowed us to gather information on 42 other cases of P. multocida meningitis in infants <1 year old reported since 1963. Among all 48 cases, 44 % were newborns. An animal source of the infection, including 39 household dogs and cats, was suspected or identified in 42 of 48 cases. A traumatic contact between the child and a pet occurred in 8 % of cases, and a vertical transmission from mother to child during birth in 10.4 %. Most of the time, the infection resulted from non-traumatic contact between the child and the pet, through licking or sniffing. The absence of host risk factors suggests that an immature immune system is responsible, given the young age of the children. Although complications, especially neurological lesions, were not rare (37.5 %), the long-term outcome was usually good. Four infants died of meningitis. This rare disease could be prevented by reducing contact between infants and household pets, and by performing simple hygiene measures before handling babies.

Bartonellaentry mechanisms into mammalian host cells

The Gram-negative genus Bartonella comprises arthropod-borne pathogens that typically infect mammals in a host-specific manner. Bartonella bacilliformis and Bartonella quintana are human-specific pathogens, while several zoonotic bartonellae specific for diverse animal hosts infect humans as an incidental host. Clinical manifestations of Bartonella infections range from mild symptoms to life-threatening disease. Following transmission by blood-sucking arthropods or traumatic contact with infected animals, bartonellae display sequential tropisms towards endothelial and possibly other nucleated cells and erythrocytes, the latter in a host-specific manner. Attachment to the extracellular matrix (ECM) and to nucleated cells is mediated by surface-exposed bacterial adhesins, in particular trimeric autotransporter adhesins (TAAs). The subsequent engulfment of the pathogen into a vacuolar structure follows a unique series of events whereby the pathogen avoids the endolysosomal compartments. For Bartonella henselae and assumingly most other species, the infection process is aided at different steps by Bartonella effector proteins (Beps). They are injected into host cells through the type IV secretion system (T4SS) VirB/D4 and subvert host cellular functions to favour pathogen uptake. Bacterial binding to erythrocytes is mediated by Trw, another T4SS, in a strictly host-specific manner, followed by pathogen-forced uptake involving the IalB invasin and subsequent replication and persistence within a membrane-bound intra-erythrocytic compartment.

Mild Traumatic Brain Injury: A Silent Epidemic in Our Practices

In recent years, traumatic brain injury (mTBI), also known as concussion, has emerged as a major public health concern. Of the 1.5 million Americans whose TBIs are documented by medical staff each year, estimates suggest that 85 percent are considered mild (Bazarian et al., 2005). Although these kinds of injuries were once considered a virtual rite of passage--particularly in sports--we now know that they have potentially lifelong cognitive, physical, emotional, and social consequences. Despite this slowly increasing awareness, countless mTBIs go undiagnosed every year as a result of a confluence of underawareness, underreporting, underdiagnosis, and misdiagnosis. The endemic prevalence of undiagnosed mTBI presents a significant and worrisome public health challenge, especially given the clear links between injury and mental illness, substance abuse, and criminality (Helgeson, 2010). For social workers, this silent epidemic has practice implications that we cannot afford to ignore. There is mounting evidence that individuals in our practices may also be struggling with a history of TBI. One study found that approximately 70 percent of individuals with co-occurring substance abuse and mental health issues had a history--although not necessarily a diagnosis--of TBI (Corrigan & Deutschle, 2008). In another study, an astounding 87 percent of a county jail population reported a history of injury (Slaughter, Fann, & Ehde, 2003). Combined with findings that suicide rates are higher among TBI survivors (Silver, Kramer, Greenwald, & Weissman, 2001), and potentially highest among the injury group (Teasdale & Engberg, 2001), this evidence suggests the need for new standards in competent practice. BACKGROUND A TBI is sustained when the brain experiences an external trauma resulting in neurological or neuropsychological impairment. Most commonly, TBI is understood as the result of direct traumatic contact with an object that sometimes results in structural damage, penetration, or both. This includes hitting your head or being hit in the head, as we might expect in contact sports or domestic violence assaults. A less common understanding of TBI is the trauma that results from rapid acceleration/ deceleration in which the brain actually ricochets within the skull, as occurs in whiplash or shaken-baby syndrome. Even more misunderstood are the types of TBIs that occur as a result of blasts and explosions typical in combat situations. The sheer energy of the supersonic waves created from blasts can cause brain trauma, even without blunt force or acceleration/deceleration. A soldier who escapes a blast without any physical signs of trauma, such as wounds or broken bones, can sustain the same brain injury as someone whose hits the windshield in a motor vehicle accident. TBI is categorized as severe, moderate, or mild. A diagnosis of severe or moderate TBI is relatively straightforward given the availability of diagnostic technology, including computer tomography scans and magnetic resonance imaging. Mild injuries, however, are far more difficult to diagnosis. The first issue is that survivors are often unaware of their injury, either because symptoms are subtle enough not to cause alarm or because the presence of other more acute injuries takes priority. Even when individuals suspect an injury, diagnosis is complicated because the current technology is not able to reliably detect the neural damage that occurs in injuries (Borg et al., 2004). Diagnoses of mTBI are often based on self-report. Individuals who experience mTBI experience a range of symptoms, including dizziness and vertigo, nausea, decreased coordination or balance, cognitive impairment, impaired vision, ear ringing, headaches and fatigue. Although symptoms often resolve within a few weeks or months, frequently without treatment, some survivors experience symptoms for long periods of time, even resulting in permanent disability. …

Treatment of localized lesion of the tooth and surrounding tissue caused by dental disharmony: Case report

The loss of proper contact of the adjacent teeth, which usually occurs as a result of caries or tooth extraction, can lead to serious consequences on oral tissues health as well as on the function of complete oral system, unless timely repaired. It often happens that the irregular contact of the tooth due to inadequate filling remains unnoticed by the patient and dentist. Also, if the loss of contact caused by caries or after tooth extraction is not treated, it often leads to inclination of adjacent teeth and their traumatic contact in relation to the antagonists. If this situation remains for a long time, it can cause significant disorder for which rehabilitation, complex therapy and long period of time are required. The aim of this study was to point out the proper procedure for the treatment of complex lesions of teeth and adjacent tissues, caused by extraction of the second lower right premolar and impaired contact between the first molar and first premolar.

In an era of stalled reconciliation: the uncanny witness of Ray Lawrence’s Jindabyne

Ray Lawrence's Australian film Jindabyne is a powerful national allegory about the denial of historical responsibility and the politics of post-colonial apology across a 'traumatic contact zone' of historical injustice.1 Released in 2006, Jindabyne was produced during a period of stalled reconciliation in Australia. Like many nations in the past 20 years, Australia has been engaged in a painful and uneven process of coming to terms with historical injustice - a process that remains incomplete and unsettling. In 1991, the Council for Aboriginal Reconciliation, inaugurated under a federal Labor government, anticipated that reconciliation would be achieved by the centenary of Federation in 2001. In 1996, in what subsequently became a landmark event in the nation's attempt to respond to the divided legacies of settler-colonialism, a national inquiry was conducted into the forcible removal of Indigenous children from their families and communities.2 The final report, Bringing Them Home, found that the removal of children of mixed descent, with the aim of alienating them from their culture and assimilating them to white Australian culture, breached Australian common law and international human rights conventions.3 The national inquiry did not address issues of justice or responsibility. Instead, it documented Indigenous suffering and solicited an affective response from non-Indigenous Australians. By May 1997, when the national inquiry tabled its report calling for a national apology to the Stolen Generations, there had been a change of government. The then Liberal Prime Minister, John Howard, did not be heve the current generation of Australians should be made to feel responsible for the past and notoriously refused to offer a national apology. Instead, he expressed his 'personal regret' for the suffering and hurt caused by past policies of child removal. For the next 11 years, no apology was forthcoming, and by the new millennium, the reconciliation process had stalled. In a climate of widespread support for reconciliation generated by the national inquiry, Howard's refusal to apologise became a stain on the nation. In 2008, the first order of business for the new Labor government of Kevin Rudd, after opening Parliament on 13 February, was to offer a national apology to the Stolen Generations and their families and communities. Rudd's and Howard's responses to a national apology were symptomatic of opposing tendencies that marked the reception of Bringing Them Home: on the one hand, an affective response grounded in empathy and identification, and on the other, denial and forgetting. The former response was expressed through the signing of 'Sorry Books', Bridge Walks for Reconciliation in 2000 and support for a national apology. The latter resulted in criticisms of the report and of the 'black-armband view of history', outrage at the claim of genocide and an insistence that 'the past remain in the past'.4 These opposing responses are not, of course, surprising. As Dominick LaCapra reminds us, nations dealing with the unfinished business of the past must confront the problem of how to acknowledge and work through 'historical losses in ways that affect different groups differently'.5 What is striking, however, is how little explicit discussion there has been of what is involved in working through the divided legacies of colonial dispossession, violence and forced assimilation in Australia. Indeed, the long-awaited apology was viewed widely as a necessary and uncomplicated matter of acknowledging the suffering caused by past policies, which would move the nation towards reconciliation. At the same time, the government rejected the national inquiry's recommendation for reparations such as monetary compensation, and Stolen Generations cases repeatedly failed in court. These events raise a number of questions: what is the value of apology without justice or reparation? Is an apology without reparation simply a onesided acknowledgment and expression of regret for suffering caused by past policies? …

Erysipeloid

We report a case of erysipeloid in a 73-year-old woman. The disease was characterized clinically by erythematous and erosive lesions on three fingers of the left hand. Diagnosis was made based on the patient's occupation (housewife), history of previous traumatic contact with a scorpion fish, typical inflammatory lesions located on one hand, lack of severe systemic features, mild laboratory abnormalities and rapid remission after specific treatment.

Erysipeloid: a review

Erysipeloid is an occupational infection of the skin caused by traumatic penetration of Erysipelothrix rhusiopathiae. The disease is characterized clinically by an erythematous oedema, with well-defined and raised borders, usually localized to the back of one hand and/or fingers. Vesicular, bullous and erosive lesions may also be present. The lesion may be asymptomatic or accompanied by mild pruritus, pain and fever. In addition to cutaneous infection, E. rhusiopathiae can cause endocarditis, which may be acute or subacute. Endocarditis is rare and has a male predilection. It usually occurs in previously damaged valves, predominantly the aortic valve. Endocarditis does not occur in patients with valvular prostheses and is not associated with intravenous drug misuse. Diagnosis of localized erysipeloid is based on the patient's history (occupation, previous traumatic contact with infected animals or their meat) and clinical picture (typical skin lesions, lack of severe systemic features, slight laboratory abnormalities and rapid remission after treatment with penicillin or cephalosporin).

Lower-Extremity Zygomycosis in a Patient with Traumatic Injuries

Zygomycosis, also called mucormycosis, is an aggressive fungal infection found rarely in patients who have sustained traumatic injuries. Traumatic contact with an extremity may introduce the fungi through the mucocutaneous barrier, and progression of the infection can be fatal if vascular invasion, tissue infarction, and necrosis occur. Zygomycosis is usually found in immunocompromised individuals, but trauma may introduce and potentiate infection in patients without preexisting risk factors1-3. Although it is a rare complication of trauma, identification of the infection is important because the overall mortality rate from documented cutaneous zygomycosis inoculation has been reported to be as high as 31%4. Successful treatment depends primarily on early diagnosis and surgical debridement and secondarily on administration of appropriate antifungal medications. This case report describes an immunocompetent polytraumatized patient who died twenty-four days after an open femoral fracture that was complicated by a necrotizing lower-extremity zygomycosis infection. A fifteen-year-old, otherwise healthy girl was transferred from a community hospital after ejection from a motor vehicle traveling at a high speed in a rural setting. Major injuries included a ruptured spleen, liver laceration, bladder rupture, pneumothorax, pulmonary contusions, pelvic fractures, and bilateral femoral fractures (Fig. 1-A). A laparotomy and splenectomy were performed at the initial treatment facility prior to transfer to the regional trauma center, where the patient arrived in hypovolemic shock. After resuscitation, she underwent a repeat laparotomy and external fixation of both femora. Pelvic external fixation and preperitoneal pelvic packing were done as a part of our institutional protocol for the treatment of hemodynamically unstable pelvic fractures5. The patient was then transferred to the interventional radiology suite for distal hepatic artery embolization and investigation of absent distal lower-extremity pulses, which had been initially palpable in the emergency department. The left internal iliac artery was found …

Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren

The aim of this study was to provide detailed information concerning clinically relevant occlusal traits and the prevalence of occlusal anomalies in an orthodontically relevant period of dental development. Four hundred and ninety-four German schoolchildren (237 males and 257 females), median age 9 years, were orthodontically examined. Overjet and overbite were measured to the nearest 0.5 mm, and sagittal molar relationships were registered clinically to the nearest quarter unit. In addition, crossbites, scissor bites, and midline displacements were evaluated. Descriptive statistics was complemented by testing gender differences and differences between groups with Class I and Class II anomalies (Mann-Whitney U-test) as well as a statistical evaluation of differences between the three dental stages (Kruskal-Wallis test). Overjet exhibited an extreme range between -2 and 12 mm (median values 3-3.5 mm). An increased overjet was more prevalent than a reduced or reverse overjet, and a severely increased overjet greater than 6 mm was a common finding affecting around 5-10 per cent of the children. Similarly, overbite showed considerable variations of between -1 and 9 mm (medians 3-3.5 mm) and males exhibited a significantly larger overbite than females. In Class II malocclusion subjects, overbite was significantly enlarged (on average between 0.5 and 1 mm) when compared with those with a Class I malocclusion. Traumatic contact of the gingiva affected every 14th child. A Class II molar relationship of three-quarter units or more was a frequent finding affecting more than one child in five. In addition, at 9 years of age, 3 per cent of the children exhibited a Class III molar relationship of at least a half unit. The wide range of orthodontically relevant occlusal traits found in the present study underlines the need for orthodontic screening at 9 years of age (or earlier).