Although injury is a leading cause of death worldwide, the association between ambient temperature and injury has received little research attention compared to the association of temperature with ...mortality and morbidity from non-external causes. With current climate change and increases in weather extremes, assessing the association between temperature and injury is important for determining public health priorities. Therefore, the present study examined the association between ambient temperature and injury risk with a focus on the intentions and mechanisms of injury. Using the national emergency database, we identified a total of 703,503 injured patients who had visited emergency departments in Seoul, South Korea from 2008 to 2016. We conducted a time-stratified case-crossover study using a conditional Poisson regression model, and applied a distributed lag nonlinear model to explore possible nonlinear and delayed effects of daily mean temperature on injury risk. Injury risk was significantly associated with ambient temperature, and temperature-injury association curves markedly differed with respect to intentions and mechanisms of injury. Although unintentional injuries increased significantly at both high and low temperatures, intentional injuries – including self-harm and assault – significantly increased only at high temperatures. The mechanism-specific analyses showed that injuries caused by traffic accidents and burns significantly increased at both high and low temperatures. However, injuries caused by all other mechanisms (i.e., fall, blunt object, machinery, penetration, and poisoning) significantly increased only at high temperatures, while injury due to slipping increased at low temperatures. Our study provides evidence that ambient temperature is associated with risk of injury, and this association differs depending on the intentions and mechanisms of injury. Overall, our findings help foster a more comprehensive understanding of the association between temperature and injury that can be used to establish appropriate public health policies and targeted interventions.
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•We assessed temperature-injury associations by intentions and mechanisms of injury.•Unintentional injury significantly increased at both high and low temperatures.•Self-harm and assault injury only significantly increased at high temperatures.•Injury by traffic accident and burn increased at both high and low temperatures.•Injury by fall, blunt object, and penetration only increased at high temperatures.
•Recognizing physical elder abuse injuries among purportedly unintentional injuries is a critical role for trauma providers, and understanding injury patterns may be helpful.•Victims of physical ...elder abuse with injuries are more commonly assaulted with an abuser's body part than with an object.•When an object is used, it is more commonly a household object than a weapon.•Mechanisms, weapons, characteristics of the older adults, and surrounding circumstances each impact the injury patterns found.
Elder abuse is common, but many characteristics have not been well-described, including injury mechanisms and weapons in physical abuse. Better understanding of these may improve identification of elder abuse among purportedly unintentional injuries. Our goal was to describe mechanisms of injury and weapons used and their relation to injury patterns.
We partnered with District Attorney's offices in 3 counties and systematically examined medical, police, and legal records from 164 successfully prosecuted physical abuse cases of victims aged ≥60 from 2001 to 2014.
Victims sustained 680 injuries (mean 4.1, median 2.0, range 1–35). Most common mechanisms were: blunt assault with hand/fist (44.5%), push/shove, fall during altercation (27.4%), and blunt assault with object (15.2%). Perpetrators more commonly used body parts as weapons (72.6%) than objects (23.8%). Most commonly used body parts were: open hands (55.5% of victims sustaining injuries from body parts), closed fists (53.8%), and feet (16.0%). Most commonly used objects were: knives (35.9% of victims sustaining injuries from objects) and telephones (10.3%). The most frequent mechanism/injury location pair was maxillofacial/dental/neck injury by blunt assault with hand/fist (20.0% of all injuries). The most frequent mechanism/injury type pair was bruising by blunt assault with hand/fist (15.1% of all injuries). Blunt assault with hand/fist injury was positively associated with victim female sex (OR: 2.27, CI: 1.08 – 4.95; p = 0.031), while blunt assault with object mechanisms was inversely associated with victim female sex (OR: 0.32, CI: 0.12 - 0.81; p = 0.017).
Physical elder abuse victims are more commonly assaulted with an abuser's body part than an object, and the mechanisms and weapons used impact patterns of injury.
To date, it is well known that a significant number of diseases of cardiovascular genesis (coronary heart disease, myocardial infarction, cardiomyopathy, Takotsubo syndrome, heart failure, etc.) and ...extra-cardiac genesis (renal failure, chronic obstructive pulmonary disease, sepsis, diabetes mellitus, etc.) cause injury to contractile cells of the heart muscle (myocardial cells). The most sensitive and specific criteria for proving myocardial cell injury are cardiospecific troponins (CSTns) - CSTnI and CSTnT. According to the current clinical recommendations of the European, American, and Russian Cardiological Communities, CSTnI and CSTnT are the main biomarkers for early diagnosis of myocardial infarction. Hypertension is one of the most dangerous and common risk factors for the development of cardiovascular pathologies and is associated with a high risk of dangerous cardiovascular complications. Therefore, there is an urgent need to search for new biomarkers for the timely assessment of the prognosis of patients with hypertension. This mini-review aims to substantiate the possibilities of using the cardiomarkers (CSTnI and CSTnT) to assess the prognosis of patients suffering from hypertension and to discuss potential mechanisms that cause injury to myocardial cells and increase serum levels of CSTnI and CSTnT. This is a narrative mini-review, which was prepared using the following databases: Pubmed/Medline, PubMed Central, Embase, Scopus, and Web of Science. The following keywords were used in the literature search: "myocardial cells", "injury", "damage", and "hypertension" in combination with the terms "mechanisms of injury" "predictive significance", "cardiac troponins", or "cardiospecific troponins".
The location and severity of tibiofemoral bone contusions in magnetic resonance imaging scans in patients with acute non-contact anterior cruciate ligament injuries can reflect the primary mechanisms ...of anterior cruciate ligament injuries. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the femoral condyle.
A retrospective review of 93 consecutive magnetic resonance imaging examinations of patients with acute non-contact anterior cruciate ligament injuries was conducted to identify bone contusions of the knee. The locations and the severity of the bone contusions were determined using magnetic resonance imaging scans for each anatomic site, including the lateral femoral condyle, the lateral tibial plateau, the medial femoral condyle, and the medial tibial plateau. The bone contusions in the lateral-medial and anterior-posterior directions of four anatomical sites were subdivided into six compartments. The severity of the bone contusions was graded on a scale of 1-4. The location and the severity of bone contusions were accessed in the sagittal and coronal planes on the femoral and tibial sides of the knee using the radiology information system.
The prevalence of bone contusions on the magnetic resonance imaging scans was as follows: 78.49% on the lateral femoral condyle, 88.17% on the lateral tibial plateau, 49.46% on the medial femoral condyle, and 69.89% on the medial tibial plateau. The most common and severe compartments of the lateral femoral condyle, the lateral tibial plateau, the medial femoral condyle, and the medial tibial plateau were the central-lateral (CL), the posterior-medial (PM), the CL, and the posterior-lateral (PL) compartments, respectively.
The location patterns and severity of bone contusions in patients indicated that internal tibial rotation, valgus, and the anterior and lateral translation of the tibia were the primary mechanisms of non-contact anterior cruciate ligament injury.
Background: Low back pain (LBP) is a condition prevalent among rowers due to the repetitive and physically demanding nature of rowing. Information concerning LBP among university-level rowers is, ...however, outdated and not widely available.
Objective: To determine the prevalence, severity and disabilities of LBP among university-level rowers in South Africa.
Methods: An online questionnaire, including the Athlete Disability Index (ADI) Questionnaire, was distributed to nine South African university rowing clubs. One-hundred participants aged between 18 to 30 years completed the online questionnaires.
Results: Eighty-seven rowers admitted to sustaining LBP either at the time of the study or previously in their university rowing career. These rowers (n=87) completed the Athlete Disability Index (ADI) Questionnaire which provided a moderate LBP disability score (ADI score: 8.1±6.0; ADI %: 24.7%±18.1). Rowers who had been rowing for a longer duration reported a higher severity of LBP (p=0.001). There was no statistically significant difference for LBP prevalence (p=0.584), or severity (p=0.445) between the sexes. A small significant correlation between age and the ADI score (r=0.25, p= 0.021) was reported. The high prevalence and moderate severity highlight the significance of LBP among university rowers.
Conclusion: This study illustrates the prevalence of LBP with moderate severity among university rowers. Future research on LBP risk factors and aetiology is recommended to decrease the negative impact of this condition.
Endoscopic finding of immune checkpoint inhibitor‐related gastritis is characterized as shallow network‐like erosion, which is termed spiderwebs‐like appearance.
The cervical spine functions to position the head while maintaining stability and protecting the spinal cord. The anatomy of the cervical spine dictates the amount of physiologic motion at each ...level. Knowledge of the normal biomechanical anatomy of the cervical spine is imperative to the understanding of the biomechanics of injury to the cervical spine. There are a variety of reproducible injury patterns based on the direction and magnitude of force applied to the cervical spine. Knowledge of these forces can allow an understanding of the mechanical and neurologic stability of the cervical spine and can also help guide treatment options. It is also important to understand the mechanism of injury and injured cervical structures based on radiographic findings, as often patients will present with neurologic examinations that also reflect noncervical spine-related injuries. The goal of this chapter is to present a review of the normal biomechanics of the cervical spine, in addition to presenting different injury patterns of the cervical spine from the minor to life-threatening, with the goal of maximizing postinjury function by ensuring proper treatment protocols are followed.
Abstract Objectives To determine the most common mechanisms of traumatic nasal deformity referred to pediatric otolaryngology. To examine the efficacy of closed reduction of nasal fractures in ...children and adolescents based on the parents’ and surgeons’ ratings of post-reduction nasal symmetry. Methods Case series and chart review within an urban, tertiary pediatric otolaryngology practice. Results 100 cases of traumatic nasal deformity met inclusion criteria over a 3-year study period. The mean age at presentation was 13 years (4 weeks–18 years); 55% were male and 70% were over the age of 12 years. The most common mechanism of injury was sports-related trauma (28%), followed by accidental trauma (21%), interpersonal violence (10%), motor vehicle collision (6%) and alcohol-related (2%). Of these 100 cases, 22% underwent closed reduction within a 14-day period following injury. All patients achieved symmetry in the operating room immediately following reduction. 21 of 22 post-reduction patients were assessed for nasal symmetry at the postoperative visit (7–10 days following surgery). The operating surgeon was satisfied with nasal symmetry in 43% of cases and the parent(s) satisfied in 81% of cases. Both parent and surgeon were satisfied with post-reduction symmetry 33% of the time. Conclusion The most common sources of traumatic nasal deformity in children and adolescents vary by age. In cases meriting operative intervention, parents appear to be satisfied with early postoperative results following closed reduction in approximately 80% of cases, however a result in which both parent and surgeon agree with successful re-establishment of symmetry occurs in only one-third of cases.
Approximately 36 million Americans participate in running each year, with 10.5 million running at least 100 d x yr(-1). Although running injuries are well understood medically, their potential risk ...factors are not. Thus, we presently have limited ability to identify individuals at high risk for overuse injuries.
This study aimed to identify behavioral and physiological risk factors that influenced potential knee injury mechanisms, including knee joint forces and knee moments.
Participants included 20 adults ranging in age from 20 to 55 yr (n = 7 males and n = 13 females). During the first screening visit, quadriceps and hamstring flexibility was assessed, and Q-angle, height, and weight were measured. During the second screening visit, participants completed a series of questionnaires and a gait analysis to calculate knee joint loads. An isokinetic dynamometer was used to measure eccentric and concentric knee extension strength.
Body weight (r = 0.48, P = 0.03), weekly mileage (r = 0.62, P = 0.005), and concentric knee extension strength (r=0.68, P = 0.0001) were significantly correlated with tibiofemoral compressive force. Knee extension moment displayed a negative correlation with hamstring flexibility (r = -0.47, P = 0.04). Both weekly mileage (r = 0.50, P = 0.03) and concentric knee extension strength (r = 0.60, P = 0.01) had significant positive correlations with patellofemoral force.
The results of this study relate larger knee joint loads to poor hamstring flexibility, greater body weight, greater weekly mileage, and greater muscular strength. Most of these risk factors could potentially be modified to reduce joint loads to lower the risk of injury.
Abstract Background The aim of this study was to establish the profile and outcomes of paediatric major trauma care (PTMC) within an integrated inclusive regionalised trauma system. Methods ...Prospectively collected data from July 2001 to June 2009 from the Victorian State Trauma Registry of patients aged <18 years were reviewed. Results There were 1634 major trauma cases with a median (IQR) age of 13 (6–16) years and 69% were male. The median ISS (IQR) was 18 (16–26). There were 1361 patients treated at a major trauma centre of which 69% ( n = 943) were treated at the PMTC. Head injury (AIS > 2) was the most frequent injury ( n = 950, 58%). Surgery was required in 39% ( n = 637) of all cases; 437 patients in the 10–17 year old group and 200 patients in the 0–9 year old group; the mortality was 6.6%. There were 530 patients (32.4%) ventilated in ICU; these had a median ISS (IQR) of 25 (17–34) and mortality of 7.4%. Improvements in risk-adjusted mortality have occurred as the years have progressed adjusted OR 95% CI: 0.87 (0.76, 0.99) and being treated at a Level 1 trauma centre was associated with lower adjusted odds of mortality adjusted OR 95% CI: 0.27 (0.11, 0.68). Conclusion The establishment of this integrated inclusive regionalised trauma system has been associated with progressively improving risk-adjusted mortality. The relatively low volume of major trauma requiring surgery in the 0–9 year old age group is notable, creating a challenging environment for maintaining skills and institutional preparedness.
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