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https://www.readbyqxmd.com/read/29022788/developing-a-simplified-clinical-prediction-score-for-mortality-in-patients-with-cerebral-gunshot-wounds-the-maritzburg-score
#1
V Y Kong, J Odendaal, B Sartorius, D L Clarke, J L Bruce, G L Laing, T Esterhuizen
Introduction Cerebral gunshot wounds are highly lethal and literature on the clinical scores for mortality prediction is limited. Materials and methods A retrospective study was undertaken over a 5-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa. A simplified clinical prediction score was developed based on clinical and/or physiological variables readily available in the resuscitation room. Results A total of 102 patients were included; 92% (94/102) were male and the mean age was 29 years; 22% (22/102) died during the admission...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28988190/the-outcome-of-patients-in-traumatic-cardiac-arrest-presenting-to-deployed-military-medical-treatment-facilities-data-from-the-uk-joint-theatre-trauma-registry
#2
Ed B G Barnard, P A F Hunt, P E H Lewis, J E Smith
BACKGROUND: The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns. METHODS: A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken...
October 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28956148/rna-dna-co-analysis-from-bloodstains-on-aged-polyvinyl-alcohol-gloves-prepared-for-securing-evidence-from-the-hands-of-victims-of-fatal-gunshot-injuries
#3
Melanie Grabmüller, Cornelius Courts, Burkhard Madea, Tim Eichhorst, Christian Schyma
In contrast to cumulative techniques (e.g., tape-lift) for qualitative gunshot residues (GSR) analysis, topographic methods are commonly applied to preserve the integrity of evidence from a shooter's or victim's hand in cases of gun-related crimes. Topographic sampling techniques employing adhesive foils, latex, or the polyvinyl alcohol (PVAL) method enable unambiguous sampling of biological and non-biological trace material while preserving its spatial distribution and relation to each other. The PVAL method in particular allows for a topographically veridic and quantitative conservation of traces of GSR and biological stains that are embedded in the PVAL glove, because it completely removes these traces from the hand...
September 27, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28948121/novel-use-of-an-image-guided-stereotactic-approach-in-trauma-for-localization-of-transcranial-bullet
#4
Dat T Vo, George F Cravens, Robert E Germann
Penetrating brain injuries from gunshot wounds can carry a poor prognosis and require an aggressive, multifaceted approach to obtain a good prognosis and outcome. An initial evaluation requires appropriate imaging studies followed by management and prophylaxis against increased intracranial pressure, infection, and seizures. Surgical management is then followed to ensure the watertight closure of any wounds, removal of any areas of hematoma, and removal of any potential areas of infection. In this paper, we report the case of a patient who presented with a self-inflicted gunshot wound to the head and then received aggressive medical and surgical management...
July 21, 2017: Curēus
https://www.readbyqxmd.com/read/28900668/validation-of-the-baragwanath-mortality-prediction-score-for-cerebral-gunshot-wounds-the-pietermaritzburg-experience
#5
V Y Kong, G V Oosthuizen, B Sartorious, J L Bruce, G L Laing, R Weale, D L Clarke
INTRODUCTION: Cerebral gunshot wounds (GSW) are highly lethal injuries. To date, only one clinical scoring system to predict mortality in a developing world setting has been described. This is the Baragwanath mortality prediction score ("ABC": admission blood pressure, brain matter spillage and consciousness level). MATERIALS AND METHODS: We performed a retrospective review of prospectively entered data for a cohort of patients with isolated cerebral GSWs over a 5-year period (January 2010-December 2014) in our institution...
September 12, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28834611/a-molecular-method-to-detect-wound-cells-in-bloodstains-resultant-of-sharp-force-injuries-for-crime-scene-reconstruction
#6
Donald J Johnson, David E Raymond, Cynthia Chen, Matthew Quon, Julian Lis, Mo Re Choi, Christopher Lopez, Aileen Han, Ray D de Leon, Cynthia Bir
Previous research by the authors on an animal model showed that bloodstains can contain additional information about their somatic origin in the form of wound cells. Bloodstains produced by a gunshot wound to the head were distinguished from bloodstains produced by a gunshot wound to the chest by testing the stains for a brain microRNA marker. In this study, the effectiveness of the technique was examined on blood drops shed externally from a stab wound to the liver of rat carcasses. Specifically, investigations were conducted on the liver microRNA marker, rno-mir-122-3p, with the QIAGEN miScript System, and PCR analysis...
August 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28828175/combination-of-dura-turning-over-and-decompressive-craniectomy-a-new-pattern-of-surgery-for-cerebral-infarction-caused-by-craniocerebral-gunshot-injury
#7
Qi-Yong Mei, Yao Li, Chao He, Hong-Wei Shan, Yun-Kun Wang, Yan Dong, Ming-Kun Yu, Li-Jun Hou
BACKGROUND: Craniocerebral gunshot injury refers to a wound caused by a bullet passing through or lodged in brain tissue, resulting in the loss of function of a certain area or other fatal damage to the human brain. Craniocerebral gunshot injury is usually life-threatening and is very common in modern warfare, accounting for the majority of battle casualties. Most of the patients suffer from acute cerebral infarction caused by vascular injury. Lack of early and solid battlefield emergency medical interference adds to the risk of death among the wounded...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28758543/inconsistencies-with-screening-for-traumatic-brain-injury-in-spinal-cord-injury-across-the-continuum-of-care
#8
Seema Sikka, Angela Vrooman, Librada Callender, David Salisbury, Monica Bennett, Rita Hamilton, Simon Driver
OBJECTIVE: Explore how traumatic brain injury (TBI) is screened among spinal cord injury (SCI) patients across the continuum of care. DESIGN: Retrospective chart review Setting: Emergency department, trauma, inpatient rehabilitation Participants: 325 patients with SCI from inpatient rehabilitation facility (IRF) between March 1, 2011 and December 31, 2014 were screened. 49 eligible subjects had traumatic SCI and received care in adjoining acute care (AC) hospital...
July 31, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28585791/-pediatric-traumatic-brain-injury-due-to-civil-gunshot-wounds-at-a-general-hospital-in-cali-colombia
#9
L Parrado Sánchez, C Gómez, J A Valderrama Chaparro, L D Beltrán Osorio, M Sierra Ruiz, A Enríquez Marulanda, J Lobato Polo
OBJECTIVES: Traumatic brain injury (TBI) due to gunshot-wounds (GSW) is a critical situation in the pediatric population. The aim of this study is to characterize TBI in this population since there are few reports that describe it especially in Colombia where its incidence is high, also to determine which were the main mortality predictor within our population. MATERIAL AND METHODS: We conducted a retrospective cross-sectional study in which we reviewed pediatric medical records of patients that had consulted at the Fundacion Valle del Lili pediatric Emergency Room between January of 2011 and December of 2015 because of TBI due to GSW...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28532914/penetrating-bihemispheric-traumatic-brain-injury-a-collective-review-of-gunshot-wounds-to-the-head
#10
REVIEW
Lauren Turco, David L Cornell, Bradley Phillips
BACKGROUND: Head injuries that cross midline structures of the brain are bihemispheric. Other terms have been used to describe such injuries, but bihemispheric is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with greater mortality and morbidity than other penetrating traumatic brain injuries (TBIs). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head nonoperatively, despite reports of improved outcome in military patients treated aggressively...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28392030/an-unusual-exit-wound-as-a-result-of-a-shotgun-suicide-to-the-head
#11
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/28314903/diatoms-in-drowning-cases-in-forensic-veterinary-context-a-preliminary-study
#12
Nadia Fucci, Carlo P Campobasso, L Mastrogiuseppe, C Puccinelli, S Marcheggiani, L Mancini, L Marino, V L Pascali
In this preliminary study, a digestive method used in forensic context to extract diatoms has been applied in organs taken from ten wildlife animals belonging three species of mammals (a deer, a roe and five otters) and one species of birds (two magpies). Only four carcasses were recovered from aquatic environments (bath trough for animals, bathtub irrigation, river) and only in three cases out of ten that the cause of death was ruled out as drowning. In seven cases, the death was due to other causes: gunshot injuries for one otter, blunt trauma for a magpie, and traumatic injuries followed by motor vehicle collision in other four otters and a roe...
March 17, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28249550/amelioration-of-penetrating-ballistic-like-brain-injury-induced-cognitive-deficits-after-neuronal-differentiation-of-transplanted-human-neural-stem-cells
#13
Markus S Spurlock, Aminul I Ahmed, Karla N Rivera, Shoji Yokobori, Stephanie W Lee, Pingdewinde N Sam, Deborah A Shear, Michael P Hefferan, Thomas G Hazel, Karl K Johe, Shyam Gajavelli, Frank C Tortella, Ross M Bullock
Penetrating traumatic brain injury (PTBI) is one of the major cause of death and disability worldwide. Previous studies with penetrating ballistic-like brain injury (PBBI), a PTBI rat model revealed widespread perilesional neurodegeneration, similar to that seen in humans following gunshot wound to the head, which is unmitigated by any available therapies to date. Therefore, we evaluated human neural stem cell (hNSC) engraftment to putatively exploit the potential of cell therapy that has been seen in other central nervous system injury models...
June 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28091809/a-review-of-penetrating-brain-trauma-epidemiology-pathophysiology-imaging-assessment-complications-and-treatment
#14
REVIEW
Mona T Vakil, Ajay K Singh
Gunshot injuries are the most common cause of penetrating brain injury (PBI) and carry a high morbidity and mortality. The incidence of PBI has increased over the last decade with an estimated 35,000 civilian deaths annually. Patients that survive to reach the hospital require rapid triage and imaging evaluation. CT findings in conjunction with the Glasgow Coma Scale are typically used to determine which patients are surgical candidates. Radiologists should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators, notably brainstem, bilateral hemispheric, multilobar, or transventricular injuries...
June 2017: Emergency Radiology
https://www.readbyqxmd.com/read/27903839/the-effect-of-brain-tomography-findings-on-mortality-in-sniper-shot-head-injuries
#15
Çağdaş Can, M Bolatkale, A Sarıhan, Y Savran, A Ç Acara, M Bulut
OBJECTIVES: Penetrating gunshot head injuries have a poor prognosis and require prompt care. Brain CT is a routine component of the standard evaluation of head wounds and suspected brain injury. We aimed to investigate the effect of brain CT findings on mortality in gunshot head injury patients who were admitted to our emergency department (ED) from the Syrian Civil War. METHODS: The study group comprised patients who were admitted to the ED with gunshot brain injury...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27871133/civilian-cerebral-gunshot-wounds-a-south-african-experience
#16
Victor Kong, Jocinta Odendaal, Benn Sartorius, Damian Clarke, Petra Brysiewicz, Ellen Jerome, John Bruce, Grant Laing
BACKGROUND: Cerebral gunshot wounds represent one of the most lethal forms of traumatic brain injury, but there is a paucity of literature on the topic, especially from the developing world. We reviewed our experience and describe the spectrum and outcome of civilian cerebral gunshot wounds in a major metropolitan trauma centre in South Africa. METHODS: This was a retrospective study of all patients with isolated cerebral gunshot wounds managed by the Pietermaritzburg Metropolitan Trauma Service over a 5-year period from 2010 to 2014...
March 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27843239/unique-neuro-ophthalmic-presentation-of-gun-pellet-injury
#17
Reena Sharma, Sanjay Sharma, Swati Phuljhele, Rohit Saxena
We describe a unique case of orbital gunshot injury with isolated intraorbital pellets lodged symmetrically in the two apices, causing identical clinical presentation, and absence of any associated globe or cerebral injury. He developed bilateral complete third nerve palsy with bilateral traumatic optic neuropathy. The optic nerve strut prevented the pellets from going into the brain on both the sides.
September 2016: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/27752059/klebsiella-pneumoniae-carbapenemase-producing-k-pneumoniae-kpc-kp-in-brain-and-spinal-cord-injury-patients-potential-for-prolonged-colonization
#18
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...
April 2017: Spinal Cord
https://www.readbyqxmd.com/read/27546337/surgical-resection-for-epilepsy-following-cerebral-gunshot-wounds
#19
Yoshua Esquenazi, Giridhar P Kalamangalam, Omotola A Hope, Sonia N Krish, Jeremy Slater, Nitin Tandon
OBJECTIVE: The surgical management of epilepsy after penetrating gunshot wounds (GSWs) to the head has not been described in the modern era. Given the extensive damage to the cranium and cortex from such injuries, the safety and efficacy of surgical intervention are unclear. We report surgical strategy and outcomes after resection for medically refractory epilepsy following GSWs in 4 patients. METHODS: A prospectively compiled database of 325 patients with epilepsy was used to identify patients undergoing surgery for medically refractory epilepsy after a GSW to the brain...
November 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27488491/effect-of-time-to-operation-on-mortality-for-hypotensive-patients-with-gunshot-wounds-to-the-torso-the-golden-10-minutes
#20
Jonathan P Meizoso, Juliet J Ray, Charles A Karcutskie, Casey J Allen, Tanya L Zakrison, Gerd D Pust, Tulay Koru-Sengul, Enrique Ginzburg, Louis R Pizano, Carl I Schulman, Alan S Livingstone, Kenneth G Proctor, Nicholas Namias
INTRODUCTION: Timely hemorrhage control is paramount in trauma; however, a critical time interval from emergency department arrival to operation for hypotensive gunshot wound (GSW) victims is not established. We hypothesize that delaying surgery for more than 10 minutes from arrival increases all-cause mortality in hypotensive patients with GSW. METHODS: Data of adults (n = 309) with hypotension and GSW to the torso requiring immediate operation from January 2004 to September 2013 were retrospectively reviewed...
October 2016: Journal of Trauma and Acute Care Surgery
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