Purpose To describe ocular characteristics, surgical interventions, and anatomic and visual outcomes of traumatized eyes with no light perception (NLP) following open-globe injury and to investigate ...prognostic predictors for NLP cases after open-globe injury. Design Interventional case series study. Methods Thirty-three traumatized eyes with NLP were selected from the Eye Injury Vitrectomy Study database, a hospital-based multicenter prospective cohort study. Inclusion criteria were NLP cases following open-globe injury with outcomes of anatomic restoration, phthisis bulbi, or enucleation. Exclusion criteria were cases with missing records, undergoing vitrectomy after injury at nonparticipating hospitals, direct optic head injury, endophthalmitis, and hypotonous or silicone oil–sustained eyes. All cases underwent vitreoretinal surgery or enucleation after exploratory surgery and were followed up for at least 6 months. Two outcomes were assessed: favorable outcome (anatomically restored eye globes with light perception LP or better vision) and unfavorable outcome (NLP, phthisis bulbi, or enucleation). Results The following 7 risk factors were significant between the 2 groups: rupture ( P = .021); open globe III ( P = .046); scleral wound ≥10 mm ( P = .001); ciliary body damage ( P < .001); severe intraocular hemorrhage ( P = .005); closed funnel retinal detachment or retinal prolapse ( P = .005); and choroidal damage ( P = .001). Conclusions These 7 risk factors are possible predictors of poor prognosis. Traumatized eyes with NLP can be anatomically restored with LP or better vision if vitreoretinal surgery is attempted, and a favorable anatomic and visual outcome is increased by having a decreased number of these risk factors.
(1) Background: The use of force by public and private security forces is currently an issue of great relevance because of the potential injuries caused by any excessive use of force by either active ...or passive subjects or a deficit in the real mastery of appropriate physical intervention techniques (PITs). For this reason, certain traditionally used physical intervention techniques have been questioned by scientific research studies and punished by justice. On the other hand, certain media have dealt with this matter in a biased and unfair manner by broadcasting videos where the use of force by police officer is displayed out of context. As a consequence, this problem has been brought under the spotlight, causing general uneasiness of the communities and rapidly spreading over social networks while favoring all sorts of parallel judgments. (2) Research method: A suit was equipped with 19 inertial measurement units (IMUs) and a Biomechanics of Bodies software application for Marras analysis of the data collected on trajectory, trunk twisting velocity, sagittal angle, load, and nature and severity of the injuries associated with the different intervention techniques examined. (3) Results: According to the data registered, the implementation of operational tactical procedures (OTPs) reduces the probability of injuries and leads to a more satisfactory outcome. (4) Conclusions: The implementation of operational tactical procedures, together with an awareness of the risks associated with the excessive use of force by public and private security forces and bodies, could reduce the risk of injuries suffered by both officers and citizens.
The study was inspired after the authors encountered a patient with a penetrating globe injury due to drywall, who had retained intraocular drywall foreign body. Computed tomography (CT) was read as ...normal in this patient. Open globe injury with drywall has never been reported previously in the literature and there are no previous studies describing its radiographic features.
The case report is described in detail elsewhere. This was an experimental study. An ex vivo model of 15 porcine eyes with 1 mm to 5 mm fragments of implanted drywall, 2 vitreous only samples with drywall and 3 control eyes were used. Eyes and vitreous samples were CT scanned on Days 0, 1, and 3 postimplantation. Computed ocular images were analyzed by masked observers. Size and radiodensity of intraocular drywall were measured using Hounsfield units (HUs) over time.
Intraocular drywall was hyperdense on CT. All sizes studied were detectable on Day 0 of scanning. Mean intraocular drywall foreign body density was 171 ± 52 Hounsfield units (70-237) depending on fragment size. Intraocular drywall foreign body decreased in size whereas Hounsfield unit intensity increased over time.
Drywall dissolves in the eye and becomes denser over time as air in the drywall is replaced by fluid. This study identified Hounsfield Units specific to intraocular drywall foreign body over time.
Intraocular foreign body injuries (IOFB) can lead to a number of intraocular pathologies; the visual results depend on the mechanism of the injury, the type of foreign body and the subsequent ...complications. The presence of intraocular cilia (eye lashes) following penetrating injury or surgical intervention is uncommon. In the present paper, we present a case of a 58-year-old woman with a history of eye trauma and a perforated corneal wound in the left eye that occurred 50 years ago. On the ophthalmological exam we noticed in the anterior chamber a straight linear extension, resembling cilia, extending behind the iris. The patient reports that it appeared during COVID-19 infection, after repeated episodes of coughing. After a follow-up period, we decided to remove the eyelash; 24 h after surgery, the patient complained of severe eye pain. Intraocular pressure (IOP) in LE was 54 mmHg. The slit-lamp examination showed perikeratic congestion, corneal edema and mydriasis. Eye hypotensive treatment was started immediately and the patient's general condition slightly improved. Intraocular cilia can be tolerated for many years without causing any ocular reaction. The decision for surgical intervention must be taken according to the individual needs of the patient and his ocular characteristics with careful pre- and post-operative follow up.
One of the most relevant public health issues among pediatric injuries concerns foreign body (FB) aspiration. The risk perception of choking hazards (CH) and risk perception, in general, are complex ...multifactorial problems that play a significant role in defining protective behavior. Risk prevention policies should take this aspect into account. A lack of scientific knowledge of FB injury risk perception may be evidenced in Brazil and other newly developed countries. This study aims to characterize the differences and peculiarities in risk perception of CH between Italian and Brazilian populations. The risk perception among adults in Italy and Brazil between September and October 2017 was investigated in a survey. A Multiple Correspondence Analysis was carried out to identify the latent components characterizing the risk perception in Italian and Brazilian population samples. The most relevant dimension characterizing risk perception is the “Professional–educational status and the related perception of Risk” (13% of factorial inertia). The Italians identify batteries and magnets as the most dangerous choking risks (20% of responses). On the other hand, Brazilian people, mainly manual laborers (22%) with secondary or primary education (94%), perceive coins as the most dangerous items (30% of responses, p < 0.001). Socio-economic issues characterize the subjective risk perception of Italian and Brazilian survey respondents. In this framework, data-driven prevention strategies could be helpful to tailor intervention strategies to the cultural context to which they are addressed.
Choking injuries in children represent a severe public health burden. Although most choking injuries are due to food, parents have often been found to be unaware of the choking hazards presented by ...food. In this context, healthcare professionals may play an important role in choking prevention by educating families. We investigate the perception of choking injury risk among healthcare profession students by comparing their awareness and knowledge of choking hazards with those of people without a specific health education. A survey was conducted among a sample of final year healthcare profession students from two universities in northern Italy and a sample of adults from the general population without any health education. Respondents were asked to look at ten pictures and identify the items that pose the greatest choking hazard to children of different age groups. Seventy-one students and 742 adults without any health education responded to the survey. A higher percentage of the adults without a health education identified a food item as posing the greatest choking hazard in comparison to the percentage of healthcare profession students. The results of this study suggest that there is a need to include specific educational modules on choking prevention in healthcare-related degree programs.
Thoracic transverse process fractures (TTPFs) are injuries that go unnoticed during traditional autopsies, as demonstrated by a lack of medicolegal publications regarding TTPFs. However, postmortem ...computed tomography (PMCT) has made detection of this type of injury easy. Thus, the goal of our study was to analyze the significance of TTPFs in the context of medicolegal opinions. Forensic autopsy reports and PMCT scans of 116 people who had died from high-energy trauma were analyzed. TTPFs were found in 34.48% (
n
= 40) of the total test group. The highest proportions of TTPFs were found in drivers (50%,
n
= 8) and in victims of falls from heights (41%,
n
= 14). Among seven car passengers, only one victim had suffered TTPFs. In comparison with persons without TTPFs, persons with TTPFs demonstrated more severe general injuries, especially to the chest and abdomen, and more often (in 90% of cases) died at the scene of injury (all these differences were statistically significant;
p
< 0.0001). Pedestrian TTPFs were present only in victims struck from their front or back. TTPFs in victims of falls were found only in those cases in which the height of the fall was at least 9 m. The presence of TTPFs indicates that the application of a very strong force leads to injuries that, in most cases, result in death at the scene of the event. Detecting TTPFs provides additional information about the mechanism of trauma, especially in pedestrians, drivers, passengers, and victims of falls from heights.
To report the most recent developments in the diagnosis and management of cyclodialysis clefts.
Cyclodialysis clefts are rare. The most common reason for presentation is blunt-ocular trauma followed ...by various iatrogenic interventions. Diagnosis is particularly challenging and various new noninvasive techniques have been described to facilitate this process, such as ultrasound biomicroscopy (UBM) and the anterior segment OCT (AS-OCT). The management of cyclodialysis clefts should be conservative initially followed by a variety of nonsurgical and surgical modalities to achieve closure.
The management of cyclodialysis clefts requires a step-wise approach. Initially, it is of particular importance to identify the full extent and location of the cleft as in some cases more than one cleft may be present requiring a variety of nonsurgical and surgical interventions. Nonincisional interventions include the application of various lasers and cryotherapy in the vicinity of the cleft. The traditional approach of direct cyclopexy has more recently been complemented by recent reports of employing modified external plombage procedures, vitrectomy and gas assisted endotamponade. There are insufficient studies formally evaluating these techniques to be able to assess their safety and efficacy.
Intraocular foreign bodies (IOFBs) are an important cause of visual loss within the group of working age population. We aim to present the clinical features and the algorithm according to which we ...manage the foreign bodies that are located in the posterior segment of the eye. We define the outcomes and the prognostic factors that influenced the final visual acuity and globe survival in patients with IOFBs that we extracted by pars plana vitrectomy (PPV) over a 5-year period.
We reviewed the medical records of all the cases with IOFBs that we removed by PPV, over 5 years (2009-2013). We extracted the following parameters: age, gender, wound anatomy, IOFB characteristics, ocular lesions, initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.
During 5 years, we treated 21 IOFBs by PPV, representing 12.20 % of all the open globe injuries. All the patients were males with the median age of 36 years. The foreign body was located in the vitreous - 11 cases (52.38 %), retina--seven cases (33.33 %) and perforating--three cases (14.28 %). Retinal detachment (RD) at presentation was identified in eight cases (38.09 %) and endophthalmitis, in six cases (28.57 %). The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042). Endophthalmitis did not influence the visual outcome.
The worse prognostic factors were: RD at presentation and large foreign body.
IRCT2015040418966N3 / Apr. 9/2015.
Research in Health Risk Assessment is increasingly covering a preeminent role in health care studies. However, risk assessment faces the issue of properly measuring risk exposure.
The aim of the ...study has been to tackle some methodological issues regarding the risk assessment analysis in the health field, giving more emphasis to a philosophical and epistemological approach in order to show the difficulties in adopting suitable exposure assessment techniques.
Here, we present a methodological review and a critical discussion of foreign body injuries articles in child population as a case study. A Medline, Econlite and CIS bibliographic search was conducted considering the term "foreign bodies" only in "children" and "risk". Only English papers are considered. Further research on CDC, CPSC, DGSANCO databases has been performed. Different approaches in risk assessment are reviewed using four case-study papers with the purpose of pointing out their limitations.
Ten papers are retrieved though literature review reporting risk estimate of foreign bodies injuries in children.
Considering that different variables affecting the risk of choking injuries, like intrinsic characteristic of a product or the intensity levels at which children are exposed, and then it seems very difficult to correctly evaluate risk of injuries. For this reason, we have argued for an epistemological and holistic approach toward risk assessment.
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