Automobile Accident Victims Research Articles

(Why?) Evidence-Based Treatments for War-Related Posttraumatic Stress Disorder

Any war increases at least twice the prevalence of post-traumatic stress disorder (PTSD) in its victims. Post-traumatic stress disorder (PTSD) affects about 10% of car accident victims, half of the people who have experienced rape or war, and victims of violence. PTSD negatively affects the quality of life. It is associated with direct and indirect health costs. Any effort to treat and prevent PTSD with evidence-based methods is our obligation toward trauma victims and to professionals at an increased risk of job-related traumatization. In the paper, we will focus on three aspects. First – a rationale of decision making – the role of evidence in elaborating the intervention guidelines will be described. Second, an overview of evidence-based guidelines for the psychological help and for the diagnosis and treatment of PTSD will be presented, according to current NICE (National Institute of Care Excellence) and APA (American Psychological Association) and meta-analyses focusing on war-related trauma. The third part of the paper will be devoted to the prevention of PTSD in people who are exposed to professional, duty-related trauma – the data on the efficacy of preventive interventions together with a short description of the programs (on the example of “Effective performance under stress” program designed to prevent PTSD in firefighters and other professions).

Comparative Analysis of Traumatic Brain Injury Severity in Motorcycle and Car Accident Victims Treated at Korle-Bu Teaching Hospital

Abstract Background: Traumatic brain injury (TBI) is one of the common causes of long-term disabilities, with about 10 million deaths annually. Objectives: Our aim is to compare the severity and outcomes of TBI between motorcycle and car accident victims. Materials and Methods: A prospective cohort study focusing on TBI patients. Data were collected from patients on admission at Korle-Bu Teaching Hospital (KBTH). Road traffic accident patients attending KBTH were recruited consecutively. Data collected included demographics, injury severity score (ISS), Glasgow coma scale (GCS), Marshall’s computed tomography (CT) grading, and Glasgow outcome scale-extended. We employed descriptive summaries for all variables. Mann–Whitney U and Kruskal–Wallis tests were used in comparing severity. Results: A total of 164 individuals were enrolled, with males comprising (73.8%) and a study average age of 33.2 years. Accidents involved cars and motorcycles almost equally. The GCS revealed 43.9% of injuries to be mild, and ISS indicated severe injuries in 49.4% of cases. CT showed grade 2 injuries per Marshall’s classification and no significant differences in injury patterns. Nonsurgical treatment predominated, and a higher proportion of motorcycle cases required surgery. There were no significant differences in mortality or disability. The average hospital stay was 11.26 days, with 57.9% of deaths occurring within 72 h. Car accident survivors and pedestrians experienced longer days to mortality. Conclusion: Across groups, the severity of TBIs showed a substantial proportion of participants with severe injuries, although no significant differences were observed between groups. The findings highlight the need for preventive measures and trauma care strategies to mitigate the impact of TBIs, particularly among high-risk demographics and road user categories.

The role of dentistry in forensic medicine: the process of human remains identification.

The use of dentistry in forensic medicine has gradually become an indispensable tool in the process of identifying human remains. In recent years, there has been a significant increase in the importance of this field in the identification of victims in mass disasters, criminal investigations, ethnic research, and the identification of decomposed and distorted bodies, such as drowning, fire and car accident victims. Dental examinations allow for precise determination of individual identities based on unique dental features. Various methods applied in forensic medicine in the realm of dentistry include dental impressions, radiographs, photographic examinations, rugoscopy, cheiloscopy, and molecular methods. Advanced dental analysis techniques make it possible to restore identities even in the most challenging cases. Equally important is the integration of knowledge and methods of forensic dentistry with other forensic disciplines such as molecular genetics and anthropology. Further research and development in this branch of science are crucial for improving investigative processes and ensuring the dignity of mass disaster victims. The aim of this work is to present methods using teeth for the identification of human remains along with the latest advancements in forensic DNA technology, which utilizes dental evidence to aid in the identification of human remains.

The Imperative of Regulation: The Co-creation of a Medical and Non-medical US Opioid Crisis.

The ravaging COVID-19 pandemic has almost pushed into oblivion the fact that the United States is still struggling with an immense addiction crisis. Drug overdose deaths rose from 16,849 in 1999 to nearly 110000-of which an estimated 75,000 involved opioids-in 2022. On a yearly basis, the opioid casualty rate is higher than the combined number of victims of firearm violence and car accidents. The Covid-19 epidemic might have helped to worsen the addiction crisis by stimulating drug use among adolescents and diverting national attention to yet another public health crisis. In the past decade the sharpest increase in deaths occurred among those related to fentanyl and fentanyl analogs (illicitly manufactured, synthetic opioids of greater potency). In the first opioid crisis wave (1998-2010), opioid-related deaths were mainly associated with prescription opioids such as Oxycontin (oxycodone hydrochloride). The mass prescription of these narcotic drugs did anything but control the pervasive phenomenon of 'addiction on prescription' that played such an important role in the emergence and robustness of the US opioid crisis. Using a long-term drug lifecycle analytic approach in this article I will show how opioid producing pharmaceutical companies created a medical market for opioid painkillers. They thus fueled a consumer demand for potent opioid drugs that was eagerly capitalized on by criminal entrepreneurs and their international logistic networks. I will also point out the failure of US authorities to effectively respond to this crisis due to the gap between narcotic product regulation, regulation of marketing practices and the rise of a corporate dominated health care system. Ironically, this turned the most powerful geopolitical force in the war against drugs into its greatest victim. Due to formulary availability and regulatory barriers to accessibility European countries have been relatively protected against following suit the US opioid crisis.

Pattern of Injuries among Victims of Motor Car Accidents admitted to Tanta University Emergency Hospital

Pattern of Injuries among Victims of Motor Car Accidents admitted to Tanta University Emergency Hospital

Surgical Treatment of Blow-out Fracture: A New Perspective.

The present work aims to report 2 clinical cases of the use of current technologies for the treatment of orbital fractures. The cases are of patients who were victims of car accidents and who developed a blow-out orbital fracture. Clinically, they presented periorbital ecchymosis, blepharoedema, enophthalmos, and ophthalmoplegia and, therefore, underwent surgical reconstructive treatment. For both cases, preoperative computed tomography and biomodel impression of the orbits were performed. The modeling of the titanium mesh covering the defect in the biomodel that would be used in the surgery was performed. In the intraoperative period of reduction and fixation of the fracture with the titanium mesh, optics were used to better visualize the posterior defect, as well as computed tomography to ensure that the entire affected area was reconstructed. Both patients were followed up in the postoperative period and evolved without clinical and functional complaints.

FRATURAS DA COLUNA VERTEBRAL E LESÕES TORACOABDOMINAIS EM PACIENTES POLITRAUMATIZADOS: AVALIAÇÃO EPIDEMIOLÓGICA

ABSTRACT Objective: Establish the frequency of incidences, management, and description of the relationship between thoracic and abdominal trauma and spinal injury. Methods: Observational, retrospective study of quantitative analysis carried out through the analysis of medical records of patients who presented spinal fractures and associated thoracoabdominal injuries. The participants were treated at a reference hospital in trauma care in Curitiba-PR from 2019 to 2021. The data were from patients with spine fractures referring to gender, age, trauma mechanism, fracture classification, associated injuries, Frankel neurological scale, and proposed treatment. Results: There was a predominance of male patients (84.5%) and young, with a mean age of 37.3 years, victims of car accidents. The main vertebrae affected were the lumbar spine (36.8%) and thoracic spine (36.2%). The most prevalent associated injuries were extra vertebral and cervical spine fractures. The most observed thoracic injuries were hemothorax, chest contusion, and fracture of multiple costal arches, while the most observed abdominal injuries were kidney injury, hemoperitoneum/abdominal hematoma, and liver injury. Of the total patients analyzed, 68% had fractures with associated thoracoabdominal injuries. Conclusion: Abdominal and thoracic injuries are frequently associated with spine fractures, with an association of 14.6% and 53.4%, respectively. The production of knowledge on the subject contributes to creating action plans to optimize the management and reduce the morbidity and mortality of these cases. Levels of evidence III; Systematic Review.

Evaluation of an assistance system supporting older pedestrians' road crossing in virtual reality and in a real-world field test.

Older pedestrians are at a high risk of becoming victims of car accidents because they tend not to pay sufficient attention to upcoming traffic. Within our research project, an assistance system for older pedestrians has been developed. It detects the street and communicates with the users through a vibrotactile interface. Two evaluation studies have been carried out in order to understand the potential benefits and drawbacks of the developed assistance system. One study was conducted in a virtual environment (VR) with 23 participants, aged 65+. The other experiment was a field test in a real street environment with 26 participants, aged 65+. Objective dependent variables in both experiments were checking for traffic (operationalized via head tracking) and stopping in front of the street (VR study), i.e., approaching time (field test). Workload and acceptance served as subjective dependent variables. Analysis of the VR experiment showed significantly more head rotation with the assistance system than without it, as well as significantly more with cars than without cars. The same was true for the frequency of stopping. No significant difference was found concerning workload. With regard to acceptance, the majority of participants indicated that the system was supportive and able to reduce risks in traffic. In the field test, results for head rotation confirmed the findings of the VR study. Analysis showed a marginally significant higher head rotation frequency with the alarm system than without, and significantly different patterns of checking for traffic at marked and unmarked crossings. However, unlike in the VR study, no differences were found in approaching time with and without the assistance system. Approaching time was slower at marked crossings. No difference was found with regard to workload, meaning the use of the assistance system did not increase the subjectively perceived workload of participants. Analysis of the acceptance questionnaire showed a positive attachment to the assistance system. However, most reported that they did not experience any advantage from the use of the system, and expressed no intention to buy such a system for themselves.

Government Control and Supervision of Motor Vehicle Insurance Companies in Cameroon: An Appraisal of the Cima Code

The increasing number of victims of automobile accidents has created in every country an urgent social problem. The government’s interest is aroused here since insurance touches the economy much. That is the more reason why government regulates the activities of insurers in order to guarantee a sound economic environment and to protect the interest of policyholders. This control is exhibited by way of preventive, concurrent and final controls extended to the place of business and subsidiaries. The objective of this paper is therefore to examine the extent of government control and supervision of motor vehicle insurance company in Cameroon, its compliance with the CIMA Code and challenges faced. To achieve this objective, the paper adopts a methodology which is doctrinal consisting of primary and secondary data. The findings reveal that though measures have been put in place in compliance with the provisions of the CIMA Code to regulate the activities of motor vehicle insurance companies, the intentions of the legislator have not been reached as it is fraught with challenges. Considering that insurance contracts are contracts of adhesion par excellence, it is recommended that the government should step up measures to better protect the parties involved in the contract as well as ensure that parties perform their obligations

Опыт применения телемедицинских технологий в работе Воронежского областного клинического центра медицины катастроф

The purpose of the study is to determine the role of telecommunication technologies in increasing the efficiency of Voronezh Regional Clinical Center for Disaster Medicine. Materials and methods of research. The data contained in analytical reports and other documentation of the Center for 2018-2020 in terms of identifying patterns of their change with the introduction of telecommunications technologies were analyzed. Results of the study and their analysis. Introduction of telemedicine technologies in the work of the Center resulted in increase of volume of rendering of medical care by its specialists. The neurosurgeons were the most demanded specialists, who performed telemedical consultations, which is mostly related to the necessity of performing consultations for the doctors of trauma centers of the II and III levels, engaged in treatment of victims of car accidents. Voronezh Regional Clinical Center for Disaster Medicine plans to further expand the use of telecommunication technologies not only in treating victims of road accidents, but also victims of other man-made and natural emergencies.

Sensitive nerve function measurement in facial trauma: An observational study.

BackgroundFacial trauma is responsible for various types of health damage and may be functional or aesthetic. Depending on the degree of energy released in this type of trauma, sometimes an irreversibility degree is obtained. This study aimed to perform an objective evaluation of traumatic peripheral nerve injuries resulting from mandibular fractures and midface, using silicon monofilaments. Material and MethodsThis was an observational, cross-sectional study. All patients with maxillofacial fractures, who were hospitalized by the department of Oral and Maxillofacial Surgery of Instituto Dr. José Frota Hospital, were randomly recruited and screened for inclusion in the present study. Sixty patients, victims of automobile accidents or firearms, were evaluated using Semmes Weinstein monofilaments in the regions corresponding to the mental and infraorbital nerves, right and left. ResultsThe highest frequencies mandibular nerve changes were those that there was a loss protective sensation, but in which, the patient can feel deep pressure and pain; In which the worst sensory alterations occurred in patients’ victims of firearm. In the middle third of the face, the worst alterations were those that there was a loss of the protective and discriminating sensation for hot and cold. ConclusionsThe use of monofilaments is a support tool in oral and maxillofacial traumatology for the diagnosis and monitoring of peripheral sensory alterations. Key words:Peripheral nerve injuries, facial trauma, wounds and injuries, accidents, traffic, violence.

Motor Vehicle Injury and Kidney Damage: Trauma, Rhabdomyolysis, Acute Kidney Injury and Beyond.

Clinical Background: Automobile accidents constitute one of the main causes of morbidity and mortality worldwide. Kidney injury related to automobile accidents occurs through several mechanisms. Among the mechanisms are direct traumatic injury, rhabdomyolysis, acute renal failure, hypovolemic shock, and others. Kidney injuries after traffic accidents can have different forms of clinical presentation, which can include morphological and functional changes of the organ. Epidemiology: Annually, approximately 1.35 million individuals are fatal victims of motor vehicle accidents. Challenges: It is of the utmost importance to recognize and adequately manage kidney injuries secondary to automobile events, since their timely identification can prevent permanent damage to the organ and, at times, save lives. Prevention and Treatment: An approach with a focus on traffic safety is ideal for all users. The cornerstones of this approach are safe roads and road shoulders, adequate speeds, safe vehicles, and trained drivers. Kidney injury and death due to this condition can be prevented by effective and integrated traffic legislation. After the occurrence of traffic accidents, effective emergency care is vital. Thus, a series of urgent actions are essential to provide assistance to the injured individual. In patients who are victims of car accidents and develop acute kidney injury and rhabdomyolysis, a timely diagnosis is extremely important to be able to offer assistance to the patient still in the early stages.

Evaluation of the Severity of Maxillo-Facial Injuries by Motorcycle Road Accident in the Teaching Hospital of Conakry: A Case-Control Study

Introduction: Maxillofacial injuries caused by motorcycle road accidents are serious and represent a real public health issue. They mainly affect young adult males. The objectives of this study were to determine the frequency of motorcycle road accidents, describe the socio-demographic characteristics of the injured, determine the degree of severity of motorcycle injuries compared to car injuries, and describe the therapeutic modalities. Materials and Method: This study was a prospective case-control study carried out in the Department of Odontostomatology, Maxillofacial Surgery and Surgical Emergencies at the National Hospital of Donka. The data was collected over a period of six months from January 1st to June 30th, 2017. All victims of road accidents by motorcycle (cases) or car (controls) that received care and post-surgical follow up were included. Results: A total of 505 patients with maxillofacial injuries were reviewed during the period of the study. From the review, 205 (40.6%) motorcycle accidents were recorded as “cases” and 109 (21.58%) car accidents were classified as “controls” group. Men were the most affected in both groups, n = 254 (177 males in the case group and 77 in the control) (p = 0.01). There was a proportionate relationship between helmet use and death (p = 0.015). A motorcycle accident victim is more likely to develop a mandibular fracture (p = 0.029) and limb injury (p = 0.034) when compared to a car accident victim. However, there was no significant difference between cases and controls for head trauma (p = 0.4878), Facial Injury Severity Scale (FISS) (p = 0.130), and Glasgow score (p = 0.709). Conclusion: Maxillofacial injuries caused by motorcycle accidents are increasing in Guinea. Young adult males have the highest incidence of motorcycle accidents. The death rate related to motorcycle road accidents is high, and mandatory use of a helmet for all drivers and passengers is recommended. These preventative actions could reduce the mortality and morbidity of motorcycle road accidents in Guinea.

PERFIL DOS PACIENTES INTERNADOS POR ACIDENTES AUTOMOBILÍSTICOS NO HOSPITAL METROPOLITANO DE URGÊNCIA E EMERGÊNCIA DE ANANINDEUA NO PERÍODO DE 2006 À 2012

Methods: A retrospective observational descriptive obtained through secondary data, carried out at the statistics of the Metropolitan Hospital Emergency and Emergency. We recorded 10,476 admissions due to traffic accidents from March 2006 to September 2012. Objective: To evaluate the profile of patients hospitalized for traffic accidents at the Metropolitan Hospital for Urgency and Emergency in Belém from 2006 to 2012. Results: Of 10,476 patients, 7179 were men, 1839 are women, mean age 30 years, coming from interior of the state 8034 cases, and motorcycle accidents over the incidents with 3514 of admissions, followed roadkill with 2395 cases, car accidents with 2050 and bicycle accidents with 173 cases. The CID was prevalent S06 with 2238 cases. The incident was over Belém municipality with 2102 cases and the months were more incidents in August in 2007 (10.02%) and 2009 (9.68%), September in the years 2010 (10.28%) and 2012 (14.03%) and October 2006 (13.44%) and 2008 (10.20%). Conclusion: We observed that victims of car accidents in HMUE hospitalized between 2006 to 2012 are men aged 30 years from the interior, and the motorcycle accidents the leading cause of hospitalization highlighting the CID S06 as most incident. The municipality with the highest accident record was Belém and months were more incidents in August in 2007 and 2009, the years 2010 and September 2012 and October 2006 and 2008.

The legal status of automobile accident victims in auto liability insurance

본고에서는 자동차사고 피해자가 자동차책임보험에서 손해전보를 위하여 행사할 수 있는 대표적인 청구권인 직접청구권과 가불금청구권에 대한 법적지위를 살펴본다. 자동차사고가 발생하였으나 피해자(제3자)가 가해자(피보험자)로부터 손해를 배상받을 수 없게 되는 경우를 대비해서 우리 상법(제724조 제2항)과 자동차손해배상보장법(제10조 제1항)은 피해자가 직접 보험자에게 보상을 청구할 수 있도록 직접청구권을 규정하고 있으며, 사고가 발생하였으나 손해배상이 확정되지 않더라도 피해자가 가해자가 가입하고 있는 보험자에게 보상을 청구할 수 있도록 가불금청구권을 자동차손해배상보장법(제11조 제1항)에 규정하고 있다. 양 청구권 모두 법에서 피해자의 손해전보를 위해 부여한 권리이며 이들 청구권은 피해자의 보호를 위해 법이 특별히 규정한 것이라 할 수 있다. 이처럼 직접청구권과 가불금청구권이 피해자 보호를 위해 마련된 제도임에도 그 청구권행사에 있어 여러 문제점이 야기되고 있어 본고에서는 직접청구권의 법적성질, 청구권의 행사, 직접청구권과 타청구권과의 관계 및 소멸시효에 대하여 살펴보았고 가불금청구권에 있어서는 가불금청구권의 적용범위와 손해배상책임의 유무에 따른 가불금청구에 대한 지급의무에 대하여 살펴보고 이들 청구권과 관련한 문제점에 대한 개선방안을 제시하였다.

Proving whiplash injury cases in court.

Car accident victims commonly report cervical spine distortion as their injury. Problems with proving this kind of injury, including its effects, come to light in insurance claims adjustment, and if the tortfeasor driver or the insurer refuses to pay compensation or general damages, such problems should be resolved in court. This paper discusses legal issues involved in proving whiplash-associated disorders under the law as it stood before 7 November 2019 and after the rules of civil procedure were amended.

Prevalência de fraturas de platô tibial em pacientes de um hospital público do Piauí

OBJETIVO: Determinar prevalência de fraturas de platô tibial em pacientes internos em um Hospital Público do Piauí. MATERIAIS E MÉTODOS: Foram analisados 50 prontuários com Fraturas de Platô Tibial de Janeiro de 2017 a Janeiro de 2018. O instrumento de análise foi um questionário composto por informações relevantes, como: sexo, idade, raça, mecanismo de lesão, tipos de fratura e lado acometido, para a coleta dos dados. Para análise dos dados utilizou-se a estatística descritiva com cálculos de médias, desvio padrão e frequências absoluta e relativa. RESULTADOS: A maior incidência das fraturas foi no sexo masculino (72%). A média de idade dos pacientes foi de 38 ± 13,86 anos, vítimas principalmente de acidentes automobilísticos (66%), sendo o lado mais acometido o direito (70%) com a incidência maior de fratura oblíqua (48%). CONCLUSÃO: há maior prevalência de fraturas do platô tibial no sexo masculino, faixa etária de 19-29 anos, vítima de acidente automobilísticos, com fraturas oblíquas.

Buckle Up: The Long, Winding Road to Improved Auto Insurance Premiums in Louisiana

Currently, the State of Louisiana has the second most expensive auto insurance in the nation. Louisiana ranks first in an even more devastating automobile insurance statistic, unaffordability. An already poor state simply cannot afford the repercussions of inaction. The higher auto insurance premiums rise, the more Louisiana citizens will forgo insurance coverage, resulting in loss of compensation for victims of automobile accidents and loss of protection for tortfeasors. Many peg the Louisiana tort system as a key factor in the automobile insurance crisis and call for tort reform. This Article closely examines the various legislative efforts of Louisiana tort reform, specifically, proposed amendments to Louisiana Revised Statutes Section 32:295.1 Subsection E, which currently prohibits the admission of evidence that the plaintiff was not wearing a seat belt for purposes of comparative fault and reduction of damages. Several legislators have argued reducing insurance payouts in Louisiana will in turn reduce cost shifting to Louisiana consumers. This Article reviews various Louisiana House and Senate Bills proposed over the last two decades, incorporates interviews with legislators who presented those bills, and distinguishes Louisiana law with the laws of states with the highest and lowest insurance cost, Michigan and Maine respectively. In addition, this Article examines the pros and cons of various proposed alternative tort reform solutions aimed at reducing automobile insurance costs. The author concludes that because the law has sat idle for nearly two decades, it is unknown whether seat-belt evidence admissibility will reduce automobile insurance costs. Tangible data simply does not exist. The author calls for further review of current and proposed Louisiana law and rapid action so that Louisiana citizens do not continue to endure such costly premiums.

Death in the Same Compartment as a Predictor for Injury Severity

Objective: To determine if death in same is useful as a predictor for injury severity and mortality. Methods: A retrospective cross-sectional study was conducted of 525 high-risk automobile accident victims. Data collected from Natividad Medical Center's trauma registry were used to analyze reports of adult patients from July 1 2014 to July 1 2017. 15 patients were victims of highrisk accidents with a death in the same compartment. These patients were compared with the other 510 patients. Results: Out of 15 patients who had death in same compartment, 2 (13%) were identified to have ISS>15 and 1 (6.7%) expired. Odds of severe injury (ISS>15) were not significantly different between groups [OR 0.73 95% CI 0.16-3.3]. Odds of death between the two groups were not significantly different [OR 2.0 95% CI 0.25-17]. Mean ISS between the two groups was not significant [9.1 ± 6.3 vs 8.3 ± 0.7 P=0.8]. Conclusion: Death in the same compartment has a similar prognostic value to other criteria outlined by the CDC.

Comparing Four Video Laryngoscopes and One Optical Laryngoscope with a Standard Macintosh Blade in a Simulated Trapped Car Accident Victim.

Background Tracheal intubation still represents the “gold standard” in securing the airway of unconscious patients in the prehospital setting. Especially in cases of restricted access to the patient, video laryngoscopy became more and more relevant. Objectives The aim of the study was to evaluate the performance and intubation success of four different video laryngoscopes, one optical laryngoscope, and a Macintosh blade while intubating from two different positions in a mannequin trial with difficult access to the patient. Methods A mannequin with a cervical collar was placed on the driver's seat. Intubation was performed with six different laryngoscopes either through the driver's window or from the backseat. Success, C/L score, time to best view (TTBV), time to intubation (TTI), and number of attempts were measured. All participants were asked to rate their favored device. Results Forty-two physicians participated. 100% of all intubations performed from the backseat were successful. Intubation success through the driver's window was less successful. Only with the Airtraq® optical laryngoscope, 100% success was achieved. Best visualization (window C/L 2a; backseat C/L 2a) and shortest TTBV (window 4.7 s; backseat 4.1 s) were obtained when using the D-Blade video laryngoscope, but this was not associated with a higher success through the driver's window. Fastest TTI was achieved through the window (14.2 s) when using the C-MAC video laryngoscope and from the backseat (7.3 s) when using a Macintosh blade. Conclusions Video laryngoscopy revealed better results in visualization but was not associated with a higher success. Success depended on the approach and familiarity with the device. We believe that video laryngoscopy is suitable for securing airways in trapped accident victims. The decision for an optimal device is complicated and should be based upon experience and regular training with the device.