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https://www.readbyqxmd.com/read/28431721/intra-aortic-missile-after-gunshot-wound-to-chest-an-interesting-case-of-traumatic-cardiac-injury
#1
Charles D Fraser, Lee Goeddel, Nishant D Patel, Said C Azoury, Joshua C Grimm, Rosanne B Sheinberg, Christopher M Sciortino
Missile embolus to the heart, although uncommon, is one of the most challenging scenarios in trauma. We describe a 36-year-old man who presented with a gunshot wound to the left chest and a chest x-ray revealing a foreign body in the mediastinum. A median sternotomy was performed and an injury to the left ventricle was identified. After intraoperative echocardiography and fluoroscopy confirmed a foreign body in the aortic root, cardiopulmonary bypass was implemented. A bullet was retrieved from the noncoronary sinus of the aortic valve...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28424127/analysis-of-mortality-in-traumatically-injured-patients-based-on-body-mass-index-and-mechanism-reveals-highest-mortality-among-the-underweight-in-comparison-with-the-ideal-weight-patients
#2
Kevin Treto, Karen Safcsak, David Chesire, Indermeet S Bhullar
The purpose of this study was to evaluate the effect of body mass index (BMI) on mortality after traumatic injury. The records of patients from 2012 to 2015 were retrospectively reviewed. The patients were stratified into the following groups based on admission BMI (kg/m2): underweight (UW) (BMI <19), ideal weight (IW) (BMI = 19-24.9), overweight (OW) (BMI = 25-29.9), obese (OB) (BMI = 30-39.9), and morbid obese (MO) (BMI >40). The groups were well matched with no significant differences in demographics and Injury Severity Score...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422918/reassessing-the-cardiac-box-a-comprehensive-evaluation-of-the-relationship-between-thoracic-gunshot-wounds-and-cardiac-injury
#3
Rashi Jhunjhunwala, Michael J Mina, Elizabeth I Roger, Christopher J Dente, Michael Heninger, Jacquelyn S Carr, Stacy D Dougherty, Rondi B Gelbard, Jeffrey M Nicholas, Amy D Wyrzykowski, David V Feliciano, Bryan C Morse
BACKGROUND: High energy missiles can cause cardiac injury regardless of entrance site. This study assesses the adequacy of the anatomic borders of the current "cardiac box" to predict cardiac injury. METHODS: Retrospective autopsy review was performed to identify patients with penetrating torso gunshot wounds 2011-2013. Using a circumferential grid system around the thorax, logistic regression analysis was performed to detect differences in rates of cardiac injury from entrance/exit wounds in the "cardiac box" vs...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28417686/trauma-epidemiology-in-puerto-rico-in-hospital-morbidity-and-mortality-from-2002-to-2011
#4
Annette Pascual-Marrero, Ediel O Ramos-Meléndez, Omar García-Rodríguez, José E Morales-Quiñones, Pablo Rodríguez-Ortiz
This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002-2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.19 (95%CI: 1.07-1.33) times as likely as road-traffic victims to have an ISS ≥25. Pedestrians were 1.76 (95%CI: 1...
April 18, 2017: International Journal of Injury Control and Safety Promotion
https://www.readbyqxmd.com/read/28393320/prevalence-and-ethnic-racial-disparities-in-the-distribution-of-pediatric-injuries-in-south-florida-implications-for-the-development-of-community-prevention-programs
#5
Carmen Ramos Irizarry, Patrick C Hardigan, Mark G Mc Kenney, Gretchen Holmes, Rudy Flores, Brenda Benson, Ascension M Torres
BACKGROUND: The state of Florida continues to report significant gender, ethnic and racial disparities in trauma incidence, access to care and outcomes in the adult population. Our objective was to assess pediatric injury profiles and ethnic/racial disparities of specific injuries in a Regional Trauma Center (TC) in South Florida. METHODS: Retrospective data from November 2011 to December 2015 were obtained from the Level 2 TC registry for children ≤21 years old...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28392030/an-unusual-exit-wound-as-a-result-of-a-shotgun-suicide-to-the-head
#6
S N Kunz
The location of a gunshot entrance wound as well as the wound path trajectory are the main findings that help to determine the position from which a weapon was fired and thus distinguish firearm suicides from homicides and accidents. We present a case of a 28-year old man, who was found dead in his car. Because of an unusual position of the firearm, which was clamped into the steering wheel, and an unclear entrance/exit wound, an autopsy was performed. The deceased showed typical signs of a contact shotgun wound to the head with an entrance wound in the right temporal region and an exit wound in the midface...
March 30, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28390919/symptomatic-deep-femoral-artery-pseudoaneurysm-endovascular-exclusion-case-report-and-literature-review
#7
Felice Pecoraro, Ettore Dinoto, Umberto M Bracale, Giovanni Badalamenti, Arduino Farina, Guido Bajardi
Deep femoral artery pseusoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.9 cm). The patient was managed urgently, under local anaesthesia, by placement in the distal DFA of a Viabahn 8 x 100mm stent-graft (W L Gore & Associates, Inc). The post-operative course was uneventful and the 24-months CT showed regular stent-graft patency and 20 mm DFPA shrinkage...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28383472/battlefield-pain-management-a-view-of-17-years-in-israel-defense-forces
#8
Avi Benov, Margaux M Salas, Helit Nakar, Ben Antebi, Bader Tarif, Avraham Yitzhak, Elon Glassberg
INTRODUCTION: Pain control in trauma is an integral part of treatment in combat casualty care (CCC). More soldiers injured on the battlefield will need analgesics for pain than those who will need life-saving interventions (LSI). It has been shown that early treatment of pain improves outcomes after traumatic injury, while inadequate treatment leads to higher rates of PTSD. The purpose of this article is to report the Israel Defense Forces Medical Corps (IDF-MC) experience with point of injury (POI) use of analgesia...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28382215/central-cord-syndrome-from-blast-injury-after-gunshot-wound-to-the-spine-a-case-report-and-a-review-of-the-literature
#9
Juan Galloza, Juan Valentin, Edwardo Ramos
INTRODUCTION: Central Cord Syndrome (CCS) is the most common of the spinal cord injury syndromes. Few cases have been presented with gunshot wound (GSW) as a cause of a central cord syndrome, and none, to our knowledge, has been presented without any evidence of central canal bullet/bone fragments. CASE PRESENTATION: A 27-year-old male suffered two close-range gunshot wounds, one to the left neck and one to the left shoulder. CT scan showed C5 spinous process fracture and paraspinal muscle hemorrhage without evidence of central canal stenosis or bullet/bone fragments...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28378323/trends-in-officer-involved-firearm-deaths-in-oklahoma-from-2000-to-2015
#10
Kyla M Jorgenson, Andrea L Wiens, Eric A Pfeifer, Joshua Lanter
The purpose of this study was to collect data and disseminate trends in officer-involved firearm deaths in Oklahoma from 2000 to 2015. The Oklahoma Office of the Chief Medical Examiner (OCME) database was searched for civilian decedents with gunshot wounds inflicted by law enforcement officers and officer decedents with gunshot wounds inflicted by civilians. Five decedents were law enforcement officers, while 274 decedents were civilians. The number of civilian decedents throughout the study followed a quadratic trend...
April 4, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28374715/-clinical-experience-with-various-techniques-integrated-treat-the-wounded-with-gunshot-fractures-of-limbs
#11
V K Kozlov, B G Akhmedov, A M Chililov
AIM: To increase an efficiency of complex treatment of patients with diaphyseal gunshot fractures of long bones by introduction of modern minimally invasive surgical techniques of internal osteosynthesis into clinical practice of civil health care and to improve the outcomes in victims. MATERIAL AND METHODS: Prospective comparative clinical trial included 104 victims from the Republic of Yemen with gunshot wounds of limbs of various severity for the period 2009-2011...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28369306/surgical-management-of-penetrating-thoracic-injuries-during-the-paris-attacks-on-13-november-2015
#12
Guillaume Boddaert, Pierre Mordant, Françoise Le Pimpec-Barthes, Emmanuel Martinod, Sonia Aguir, Pascal Leprince, Mathieu Raux, Jean-Paul Couëtil, Antonio Fiore, Thomas Lescot, Brice Malgras, François Pons, Yves Castier
OBJECTIVES: The Paris terrorist attacks on 13 November 2015 caused 482 casualties, including 130 deaths and 352 wounded. Facing these multisite terrorist attacks, Parisian public and military hospitals simultaneously managed numerous patients with penetrating thoracic injuries. The aim of this study was to analyse this cohort, the injury patterns, and assess the results of this mobilization. METHODS: The clinical records of all patients admitted to Parisian public and military hospitals with a penetrating thoracic injury related to the Paris 13 November terrorist attacks were reviewed...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28338614/unintentional-injuries-and-violence-among-adults-in-northern-jordan-a-hospital-based-retrospective-study
#13
Manal M Alzghoul, Mohammed K Shakhatreh, Nihaya Al-Sheyab
Injuries (unintentional and intentional) are the main cause of death and disability worldwide, including Jordan. The main purpose of this hospital-based retrospective study was to identify characteristics, causes, and risk factors of unintentional injuries and violence among all adult patients who approached the Accidents and Emergency department because of injury in Northern Jordan. Data were collected retrospectively from four major hospitals from January 2008 to January 2013. A total of 2425 Jordanian individuals who accessed and were treated by the four hospitals were included in this study...
March 24, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-13-november-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#14
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326453/violent-trauma-recidivism-does-all-violence-escalate
#15
R M Nygaard, A P Marek, S R Daly, J M Van Camp
PURPOSE: Rates of trauma patients presenting with history of prior trauma range from 25 to 44%. Outcomes involving recidivists in the setting of intentional trauma, especially penetrating trauma, are conflicting. We hypothesized that if violence does escalate with successive incidence, then injuries due to successive violence should escalate or become increasingly severe with successive admissions. METHODS: The trauma registry from an urban level I adult and pediatric trauma center was queried for injuries due to blunt assault, stabbing, and firearm injury...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#16
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28317616/review-of-166-gunshot-injury-cases-in-dogs
#17
Hrvoje Capak, Nika Brkljaca Bottegaro, Ana Manojlovic, Ozren Smolec, Drazen Vnuk
The study is aimed to establish predilection signalment and history data, and to investigate clinical findings and risk factors associated with a poor outcome in dogs with projectile injuries. A retrospective study was undertaken of 166 canine cases in which a projectile was found on radiograph in a university׳s diagnostic imaging center more than a 4-year period. The study included dogs with both apparent (obvious recent traumatic event) and incidental (traumatic event unknown to the owner) projectile injury...
December 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28299274/bullet-removal-from-the-infratemporal-fossa
#18
Ahmed Maki Merza
War injuries are the cornerstone of maxillofacial surgery, and it led to the initiation and development of this specialty, and each case represents a challenge to the surgeon who deals with it. In this article, we present a 30-year-old male patient who was referred to our emergency department complaining of gunshot wound, severe pain, and limitation in mouth opening. Preoperative imaging showed a bullet with a very long path lodged in the infratemporal fossa. Three different approaches with the aid of C-arm imaging system were used for the removal of this bullet; the last approach was the successful one...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28292518/the-management-of-penetrating-rectal-and-anal-trauma-a-systematic-review
#19
Daniel P Ahern, Michael E Kelly, Danielle Courtney, Emanuele Rausa, Des C Winter
INTRODUCTION: Traumatic injuries to the lower gastrointestinal tract (rectum and anus) have been largely reported in the military setting with sparse publications from the civilian setting. Additionally, there remains a lack of international consensus regarding definitive treatment pathways. This systematic review aimed to assess the current literature and propose a standardised treatment algorithm to aid management in the civilian setting. METHODS: A systematic review of available literature from 1999 to 2016 that was performed...
March 7, 2017: Injury
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#20
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
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