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James R Yon, Charles Fredericks, Frederic Starr, Faran Bokhari, Laura J Moore
No abstract text is available yet for this article.
November 2016: Journal of Trauma and Acute Care Surgery
Kate E Smith, Martin M Shafer, Debora Weiss, Henry A Anderson, Patrick R Gorski
Exposure to the neurotoxic element lead (Pb) continues to be a major human health concern, particularly for children in US urban settings, and the need for robust tools for assessment of exposure sources has never been greater. The latest generation of multicollector inductively coupled plasma mass spectrometry (MC-ICPMS) instrumentation offers the capability of using Pb isotopic signatures as a tool for environmental source tracking in public health. We present a case where MC-ICPMS was applied to isotopically resolve Pb sources in human clinical samples...
October 19, 2016: Biological Trace Element Research
Roger Christopher Gill, K M Inam Pal, Fatima Mannan, Amber Bawa, Saulat H Fatimi
INTRODUCTION: Penetrating oesophageal injuries are extremely rare. Their timely recognition can be difficult and optimal treatment remains controversial. Early recognition of injury is possible with the help of a high index of suspicion and early radiological and endoscopic examinations. Prompt surgical intervention with primary repair of injury, should be the goal. PRESENTATION OF CASES: We describe two cases of penetrating oesophageal trauma where T-Tube placement through the oesophageal defect, was successfully employed...
January 4, 2016: International Journal of Surgery Case Reports
N R Zembower, A Zhu, M Malczynski, C Qi
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the prevalence of brain and spinal cord injury (BSCI) patients among all patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) and to evaluate clinical characteristics and duration of colonization. SETTING: Tertiary care academic medical center. METHODS: Electronic medical records of BSCI patients with KPC-KP from February 2009 to December 2014 were reviewed to determine clinical characteristics...
October 18, 2016: Spinal Cord
V Sterzik, B P Kneubuehl, M Bohnert, F Riva, M Glardon
In medico-legal literature, only a small number of publications deal with lethal injuries caused by shots with modified guns. This might lead to the conclusion that such cases are extremely rare. However, there are cases again and yet again. During the investigation process, the modified gun is of particular importance since it can show an unusual ballistic behaviour. The present paper reports on a suicide of a 60-year-old man, committed with a modified revolver and a lead bullet. The man had a single gunshot wound with entrance at the right temporal bone...
October 15, 2016: International Journal of Legal Medicine
Steven A Sumner, Matthew J Maenner, Christina M Socias, James A Mercy, Paul Silverman, Sandra P Medinilla, Steven S Martin, Likang Xu, Susan D Hillis
INTRODUCTION: Accurately identifying youth at highest risk of firearm violence involvement could permit delivery of focused, comprehensive prevention services. This study explored whether readily available city and state administrative data covering life events before youth firearm violence could elucidate patterns preceding such violence. METHODS: Four hundred twenty-one individuals arrested for homicide, attempted homicide, aggravated assault, or robbery with a firearm committed in Wilmington, Delaware, from January 1, 2009 to May 21, 2014, were matched 1:3 to 1,259 Wilmington resident controls on birth year and sex...
September 8, 2016: American Journal of Preventive Medicine
S Saar, M Sokirjanski, L K Junkin, J Laos, A L Laar, I Merioja, U Lepner, L Kukk, A Remmelgas, T Asser, K Innos, J Starkopf, P Talving
PURPOSE: Trauma mechanisms and patterns of severe injuries during the Estonian independence have not been evaluated. The aim of the study was to compare the incidence and outcomes of severe injuries between time periods of early independence from the Soviet Union and the present time. METHODS: After the ethics review board approval, all adult trauma admissions to major trauma facilities in 1993-1994 and 2013-2014 with Injury Severity Score >15 were identified...
October 13, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Chad Turner, Shane Hiatt, Brian Mullis
Commonly accepted dogma is that patients with a long bone fracture due to a penetrating injury (gunshot wound) are less likely to follow up than blunt trauma patients. An institutional trauma database from a Level 1 academic trauma center was utilized to include all patients with long bone fractures from penetrating trauma from 2006-2009 (N = 132). Demographically matched blunt trauma patients with long bone fractures were included as a comparison group (N = 104). The medical records of these 236 patients were reviewed to observe their follow-up at 3, 6, 9, and 12 months...
September 2016: American Journal of Orthopedics
Arzu Ozcan Akcal, Kerim Ünal, Tahsin Gorgulu, Mehmet Akif Akcal, Zekiye Bigat
In this report we present two cases of gunshot injury related midfoot defects, reconstructed with a chimeric partial scapula and latissimus dorsi muscle flap and short perforator-based skin flap. The first case, a 14 years old male, had 10 × 8 cm medial plantar and 6 × 4 cm dorsal foot defects and the second case, a 55 years old female, had only 8 × 6 cm dorsal foot defect. In both cases the defects were associated with fractures, one with lateral cuneiform and cuboid with 90% bone loss and the other with navicular bone, respectively...
October 2016: Microsurgery
Myles R McKenzie, Ernest W Parrish, Ethan A Miles, James C Spradling, Lanny F Littlejohn, Mark D Quinlan, George A Barbee, David R King
During an assault on an extremely remote target, a US Special Operations Soldier sustained multiple gunshot and fragmentation wounds to the thorax, resulting in a traumatic arrest and subsequent survival. His care, including care under fire, tactical field care, tactical evacuation care, and Role III, IV, and V care, is presented. The case is used to illustrate the complex dynamics of Special Operations care on the modern battlefield and the exceptional outcomes possible when evidence-based medicine is taken to the warfighter with effective, farforward, expeditionary medical-force projection...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Joel M Fahling, L Kendall McKenzie
BACKGROUND: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature. CASE REPORT: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound...
October 8, 2016: Journal of Emergency Medicine
R T Spence, E Zargaran, M Hameed, D Fong, E Shangguan, R Martinez, P Navsaria, A Nicol
BACKGROUND: The cost of Abbreviated Injury Scale (AIS) coding has limited its utility in areas of the world with the highest incidence of trauma. We hypothesised that emerging mobile health (m-health) technology could offer a cost-effective alternative to the current gold-standard AIS mechanism in a high-volume trauma centre in South Africa. METHODS: A prospectively collected sample of consecutive patients admitted following a traumatic injury that required an operation during a 1-month period was selected for the study...
September 8, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
(no author information available yet)
It has been known for some time that common principles should be applied to the management of civilian and military trauma, even though the differences in presentation can be significant. Civilian trauma predominantly presents as blunt trauma, for example from road collisions, whereas military trauma generally comprises blast and gunshot wounds.
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
S M Balaji
Ballistic injuries of oral and maxillofacial region are usually fatal due to close propinquity with the vital structures. The severity of injury depends on the caliber of the weapon used and distance from which the patient is shot. The preliminary care of facial ballistic wounds strictly adheres to the basics of trauma resuscitation. Early and appropriate surgical management has proved to be influential on the final outcome and esthetic result. Treatment of facial gunshot wounds should be planned and carried out carefully to avoid esthetic complications...
July 2016: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Emma Nally, James Jelinek, Robert D Bunning
Lead toxicity in adults is characterized by nonspecific symptoms of abdominal pain, vomiting, constipation, fatigue, and weight loss. We present a case of severe lead toxicity that developed subacutely, causing quadriparesis 9 years after a gunshot wound with retained bullet fragments. The onset of symptoms may have been related to the development of a pseudocyst. The long interval between the gunshot wound and the onset of symptoms contributed to a delay in suspecting that the retained bullet was a source of lead toxicity...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Harriet Kiwanuka, Mario A Aycart, David F Gitlin, Elaine Devine, Bridget J Perry, Thet-Su Win, Ericka M Bueno, Muayyad Alhefzi, Nicco Krezdorn, Bohdan Pomahac
BACKGROUND: Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructible defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) sustained SIGSWs. In this study, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional, and psychosocial examination of outcomes...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Merete Nordentoft, Trine Madsen, Annette Erlangsen
No abstract text is available yet for this article.
October 3, 2016: American Journal of Psychiatry
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: J Spine Surg
Koffi Benjamin Manou, Ndoula Espérance Kounkou, Romaric Toe, Awo Dorcas Akadje, Cisse Ali, Amonso Daniel Alloh, Manse Béatrice Nandjui
OBJECTIVE: The quality of the residual limb of the amputations in the consequences of a ballistic trauma often was compromised and limits the success of a good equipment for a satisfactory locomotive function. The objective of the study is to describe the various anomalies of the residual limb and their difficulty of equipment of the traumatic amputations by bal PATIENTS AND METHODS: A descriptive retrospective study concerned patients amputated of lower limbs in the consequences of a ballistic trauma during the military crisis in Ivory Coast from 2010 to 2012 and dealt in the center of equipment "Vivre Debout" in the Teacher Hospital of Yopougon...
September 2016: Annals of Physical and Rehabilitation Medicine
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
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