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https://www.readbyqxmd.com/read/28631272/a-unique-fatal-moose-attack-mimicking-homicide
#1
Petur Gudmannsson, Johan Berge, Henrik Druid, Göran Ericsson, Anders Eriksson
Fatalities caused by animal attacks are rare, but have the potential to mimic homicide. We present a case in which a moose attacked and killed a woman who was walking her dog in a forest. Autopsy showed widespread blunt trauma with a large laceration on one leg in which blades of grass were embedded. Flail chest was the cause of death. The case was initially conceived as homicide by means of a riding lawn mower. A review of the case by moose experts and analyses of biological trace material that proved to originate from moose, established the true source of injury...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28627763/suspected-methadone-toxicity-from-hospital-to-autopsy-bed
#2
Jaber Gharehdaghi, Asieh Takalloo-Bakhtiari, Hossein Hassanian-Moghaddam, Nasim Zamani, Mohammad-Javad Hedayatshode
High mortality rates have been reported for methadone in both adults and children. We aimed to determine the pattern of toxicity, possible underlying diseases and treatment challenges in patients referred to our center with early diagnosis of methadone toxicity and who later died. Medical files of all methadone-poisoned patients who had been admitted to a referral center of toxicology between March 2011 and March 2016, died during the hospital stay and sent for autopsy to Legal Medicine Organization were retrospectively evaluated...
June 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28624042/wound-management-and-outcome-of-595-electrical-burns-in-a-major-burn-center
#3
Haisheng Li, Jianglin Tan, Junyi Zhou, Zhiqiang Yuan, Jiaping Zhang, Yizhi Peng, Jun Wu, Gaoxing Luo
BACKGROUND: Electrical burns are important causes of trauma worldwide. This study aims to analyze the clinical characteristics, wound management, and outcome of electric burns. METHODS: This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University during 2013-2015. Data including the demographics, injury patterns, wound treatment, and outcomes were collected and analyzed. RESULTS: A total of 595 electrical burn patients (93...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28616810/accuracy-of-non-contrast-pmct-for-determining-cause-of-death
#4
Garyfalia Ampanozi, Yannick A Thali, Wolf Schweitzer, Gary M Hatch, Lars C Ebert, Michael J Thali, Thomas D Ruder
The aim of this study was (1) to compare levels of accuracy regarding the categorization of causes of death between non-contrast post-mortem computed tomography (PMCT) and the final forensic report as well as between autopsy and the final forensic report, and (2) to assess levels of confidence regarding the categorization of causes of death after non-contrast PMCT and after autopsy. This prospective study was conducted over a 5 month period during which 221 cases were admitted to our institute for forensic investigations...
June 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28610777/a-meta-analysis-of-the-efficacy-of-whole-body-computed-tomography-imaging-in-the-management-of-trauma-and-injury
#5
Swathikan Chidambaram, En Lin Goh, Mansoor A Khan
BACKGROUND: Traumatic injury is the third leading cause of death overall. To optimize the outcomes in these patients, hospitals employ whole-body computed tomography (WBCT) imaging due to the high diagnostic yield and potential to identify missed injuries. However, this delays time-critical interventions. Currently, there is an absence of any high-level evidence to support or refute either view. We present a meta-analysis of the available literature to elucidate the efficacy of WBCT in improving the outcomes of trauma, specifically the mortality rate...
June 9, 2017: Injury
https://www.readbyqxmd.com/read/28610457/suicidal-self-stabbing-a-report-of-12-cases-from-crete-greece
#6
Elena F Kranioti, Anastasia E Kastanaki, Despoina Nathena, Antonis Papadomanolakis
Sharp-force trauma is a popular cause of homicide and suicide in many countries. Characterisation of the injuries between the two is crucial for a differential diagnosis. The current paper reviews 12 self-inflicted sharp-force trauma deaths from the island of Crete in Greece. Forensic reports between 1999 and 2015 were collated, and we studied the number and location of injuries, the demographic characteristics of the deceased, the sharp object and the medical history of the deceased. One third of the cases where the forensic reports were available (3/10) involved multiple injuries, and one case involved a combination of stabbing and hanging...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28609309/spontaneous-regression-of-malignant-melanoma-is-it-based-on-the-interplay-between-host-immune-system-and-melanoma-antigens
#7
Monika Cervinkova, Petra Kucerova, Jana Cizkova
Malignant melanoma (MM) is the most aggressive and uneasily treatable form of skin cancer. Up to 90% of deaths because of skin tumours are estimated to be caused by this malignancy. Spontaneous regression is described as a partial or complete disappearance of cancer. It can be defined if the clinical and histological diagnosis of malignancy is verified and any therapeutic intervention potentially inducing mechanisms leading to regression has not been applied. Regression occurs more frequently in melanoma than in other types of tumours; it is reported to be six times higher than in other malignancies...
June 12, 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/28608636/aetiology-and-outcome-of-massive-transfusion-in-two-large-london-teaching-hospitals-over-a-3-year-period-2012-2014
#8
L Green, J Tan, C Grist, M Kaur, P MacCallum
OBJECTIVES: The objectives of this study were to determine: (i) the incidence of massive transfusion (MT) (defined as transfusion of ≥5 red-blood-cell (RBC) units within 4 h, and/or ≥10 RBC units within 24 h of bleeding) over a 3-year period; (ii) the cause, and mortality rate of patients who received MT (from any cause); and (iii) the risk factors for death. BACKGROUND: MT can occur in different clinical settings, yet little is known about its epidemiology/clinical outcomes...
June 13, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28606040/recent-advances-in-pathophysiology-of-traumatic-brain-injury
#9
Parmeet Kaur, Saurabh Sharma
Traumatic brain injury (TBI) constitutes the primary reason for mortality and morbidity in persons worldwide below 45 years of age. 1.7 million Traumatic events occur yearly in the United States alone, considering for 50,000 deaths. In severe traumatic brain injury sufferers, a considerable achievement attained in treating short-term consequences; but till date, huge failures are occurring in researcher's capability to render severe traumatic brain injury sufferers to an elevated degree of performing. Initial damage force results in Primary brain injury, causing tissue destruction and distortion in the early post-injury period...
June 12, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28605024/a-unique-type-of-birth-trauma-mistaken-for-abuse
#10
Carolyn V Isaac, Jered B Cornelison, Rudolph J Castellani, Joyce L deJong
Pediatric abusive head trauma is a challenging subject across many disciplines. Of particular importance is the identification of mimics of abuse, so cause and manner of death can be properly assigned. We present the case of suspected child abuse involving an infant who presented unresponsive to the hospital with hypoglycemia, hypothermia, and bilateral parietal fractures. An autopsy revealed fractures associated with organizing scalp hemorrhage and gross leptomeningeal congestion and hemorrhage. The fractures were circular with external displacement, rounded margins, and subperiosteal new bone formation indicative of healing...
June 12, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28601205/remote-damage-control-resuscitation-in-austere-environments
#11
REVIEW
Ronald Chang, Brian J Eastridge, John B Holcomb
Hemorrhage is the leading cause of preventable military and civilian trauma death. Damage control resuscitation with concomitant mechanical hemorrhage control has become the preferred in-hospital treatment of hemorrhagic shock. In particular, plasma-based resuscitation with decreased volumes of crystalloids and artificial colloids as part of damage control resuscitation has improved outcomes in the military and civilian sectors. However, translation of these principles and techniques to the prehospital, remote, and austere environments, known as remote damage control resuscitation, is challenging given the resource limitations in these settings...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28598906/mortality-following-emergent-trauma-laparotomy-a-multicenter-retrospective-study-mortality-after-emergent-trauma-laparotomy
#12
John A Harvin, Tom Maxim, Kenji Inaba, Myriam A Martinez-Aguilar, David R King, Asad J Choudhry, Martin D Zielinski, Sam Akinyeye, S Rob Todd, Russell L Griffin, Jeffrey D Kerby, Joanelle A Bailey, David H Livingston, Kyle Cunningham, Deborah M Stein, Lindsay Cattin, Eileen M Bulger, A Wilson, Vicente J Undurraga Perl, Martin A Schreiber, Jill R Cherry-Bukowiec, Hasan B Alam, John B Holcomb
BACKGROUND: Two decades ago, hypotensive trauma patients requiring emergent laparotomy had a 40% mortality. In the interim, multiple interventions to decrease hemorrhage-related mortality have been implemented but few have any documented evidence of change in outcomes for patients requiring emergent laparotomy. The purpose of this study was to determine current mortality rates for patients undergoing emergent trauma laparotomy. METHODS: A retrospective cohort of all adult, emergent trauma laparotomies performed in 2012-2013 at 12 Level I trauma centers was reviewed...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28593012/potential-benefit-of-physician-staffed-helicopter-emergency-medical-service-for-regional-trauma-care-system-activation-an-observational-study-in-rural-japan
#13
Tomohiro Abe, Takehiko Nagano, Hidenobu Ochiai
Objective: Involvement of all regional medical facilities in a trauma system is challenging in rural regions. We hypothesized that the physician-staffed helicopter emergency medical service potentially encouraged local facilities to participate in trauma systems by providing the transport of patients with trauma to those facilities in a rural setting. Materials and Methods: We performed two retrospective observational studies. First, yearly changes in the numbers of patients with trauma and destination facilities were surveyed using records from the Miyazaki physician-staffed helicopter emergency medical service from April 2012 to March 2014...
May 2017: Journal of Rural Medicine: JRM
https://www.readbyqxmd.com/read/28592374/characteristics-and-outcomes-of-acute-pediatric-blunt-torso-trauma-based-on-injury-intent
#14
Rohit P Shenoi, Elizabeth A Camp, Daniel M Rubalcava, Andrea T Cruz
INTRODUCTION: Blunt trauma is a leading cause of pediatric morbidity. We compared injuries, interventions and outcomes of acute pediatric blunt torso trauma based on intent. METHODS: We analyzed de-identified data from a prospective, multi-center emergency department (ED)-based observational cohort of children under age eighteen. Injuries were classified based on intent (unintentional/inflicted). We compared demographic, physical and laboratory findings, ED disposition, hospitalization, need for surgery, 30-day mortality, and cause of death between groups using Chi-squared or Fisher's test for categorical variables, and Mann-Whitney test for non-normal continuous factors comparing median values and interquartile ranges (IQR)...
May 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28590355/pre-hospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#15
Shlaifer Amir, Siman-Tov Maya, Radomislensky Irina, Peleg Kobi, Shina Avi, Baruch N Erez, Glassberg Elon, Yitzhak Avraham
BACKGROUND: Hemorrhage, is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the pre-hospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28583456/outcomes-following-exploratory-burr-holes-for-traumatic-brain-injury-in-a-resource-poor-setting
#16
Jessica Eaton, Asma Bilal Hanif, Gift Mulima, Chifundo Kajombo, Anthony Charles
BACKGROUND: TBI is a leading cause of death and disability worldwide. The incidence of TBI in LMICs is disproportionately high, with an associated increased risk of mortality from TBI relative to high-income countries. While CT is the diagnostic method of choice, this is often unavailable in LMICs. Exploratory burr holes may provide a suitable choice for diagnosis and treatment of TBI. METHODS: We performed a retrospective review of prospectively collected data at KCH, a tertiary care center in Lilongwe, Malawi...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28573388/medical-management-of-the-severe-traumatic-brain-injury-patient
#17
Jonathan Marehbian, Susanne Muehlschlegel, Brian L Edlow, Holly E Hinson, David Y Hwang
Severe traumatic brain injury (sTBI) is a major contributor to long-term disability and a leading cause of death worldwide. Medical management of the sTBI patient, beginning with prehospital triage, is aimed at preventing secondary brain injury. This review discusses prehospital and emergency department management of sTBI, as well as aspects of TBI management in the intensive care unit where advances have been made in the past decade. Areas of emphasis include intracranial pressure management, neuromonitoring, management of paroxysmal sympathetic hyperactivity, neuroprotective strategies, prognostication, and communication with families about goals of care...
June 1, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28572638/mitochondrial-targeting-by-dichloroacetate-improves-outcome-following-hemorrhagic-shock
#18
Kumar Subramani, Sumin Lu, Marie Warren, Xiaogang Chu, Haroldo A Toque, R William Caldwell, Michael P Diamond, Raghavan Raju
Hemorrhagic shock is a leading cause of death in people under the age of 45 and accounts for almost half of trauma-related deaths. In order to develop a treatment strategy based on potentiating mitochondrial function, we investigated the effect of the orphan drug dichloroacetate (DCA) on survival in an animal model of hemorrhagic shock in the absence of fluid resuscitation. Hemorrhagic shock was induced in rats by withdrawing 60% of the blood volume and maintaining a hypotensive state. The studies demonstrated prolonged survival of rats subjected to hemorrhagic injury (HI) when treated with DCA...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28570538/uncontrolled-hemorrhagic-shock-modeled-via-liver-laceration-in-mice-with-real-time-hemodynamic-monitoring
#19
Mitchell Dyer, Shannon Haldeman, Andres Gutierrez, Lauryn Kohut, Anirban Sen Gupta, Matthew D Neal
Uncontrolled hemorrhage is an important cause of preventable deaths among trauma patients. We have developed a murine model of uncontrolled hemorrhage via a liver laceration that results in consistent blood loss, hemodynamic alterations, and survival. Mice undergo a standardized resection of the left-middle lobe of the liver. They are allowed to bleed without mechanical intervention. Hemostatic agents can be administered as pre-treatment or rescue therapy depending on the interest of the investigator. During the time of hemorrhage, real-time hemodynamic monitoring via a left femoral arterial line is performed...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28567968/sudden-death-by-spontaneous-epiglottic-hematoma-secondary-to-high-blood-levels-of-warfarin
#20
Séverine Gilard-Pioc, Pascal Guerard, François Paraf, Irène François-Purssell
A 67-year-old man was found dead, at his home. On external examination, we found a voluminous purplish black ecchymosis of the anterior neck area. On internal examination, we found a voluminous epiglottis hematoma completely obstructing the upper airway. It was associated with other sites of intra-abdominal hemorrhage. Toxicological studies revealed the presence of warfarin at a concentration of 8.4 mg/L in peripheral blood, which supposes an INR well above 4.5. To conclude, we supposed death was due to asphyxia secondary to a spontaneous epiglottic hematoma caused by a high blood concentration of warfarin...
June 1, 2017: Journal of Forensic Sciences
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