J Trauma
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Handguns are a ubiquitous consumer product in the United States, which annually cause significant morbidity and mortality. Handgun safety devices are often proposed as potential solutions to this problem. Their effectiveness at reducing handgun injuries and deaths is intensely debated. However, to effectively analyze the potential utility of handgun safety devices, physicians need to be aware of the safety devices available in the consumer market and how they operate. ⋯ Physicians have the potential to reduce the risk of firearm injuries with their patients and communities. Providing accurate information on firearm safety devices and their limitations is important, just as it is for other aspects of health care advice. Armed with accurate information, physicians can hopefully be effective in firearm injury prevention.
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Outcome after severe head injury has been shown in some studies to be more favorable in children than in adults. Mortality rates reported range between 20% and 40% for children. Only contradicting data are available regarding the impact of trauma modalities on long-term outcome, or the relative influence of head fractures, intracranial hemorrhages, and brain edema on survival or neurologic sequelae in children. ⋯ The overall death rate in this study of children with severe head injury was low (22%) compared with other studies. However, the incidence of severe neurologic impairment at discharge remained high. The major risks for death or neurologic impairment were primary areflexia and the development of secondary brain swelling/edema, indicated by a low GCS score.
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The purpose of this study was to determine the statistical model that best predicted mortality from blunt trauma using a contemporary population-based database. ⋯ The ICISS has promise as an alternative to TRISS, but many more comparative studies need to be undertaken using updated TRISS coefficients. Models should also be developed for mechanisms of injury, not just for blunt and penetrating injuries.
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This study focuses on the analysis of snowboarding versus skiing injuries, especially fracture, dislocation, or both, of the elbow, based on 7 years of medical records and roentgenograms of patients injured at a ski-snowboard area, Mt. Zao National Park, and demonstrates the precise characteristics of snowboard injury in the elbow region. ⋯ Posterior dislocation; fractures of coronoid process, radial neck, and radial head; and extension-type fracture of the distal humerus characterize the particular and frequent injury mechanism responsible for snowboarding trauma in the elbow region. Thus, snowboarding injury of the elbow is recognized as a severe injury and is characterized by a frequent risk of posterior dislocation, fracture, or both. The severity of elbow injuries in snowboarding mainly seems to be due to direct mechanical force on the elbow, receiving the full impact of falling down, combined with an outstretched hand and elbow extension, or with an outstretched hand and longitudinal thrust force, to the proximal radius and ulna and distal humerus.
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Comparative Study
Comparative use of magnetic resonance imaging and electrophysiologic investigation for the prognosis of head injury.
To compare magnetic resonance imaging (MRI) and electrophysiologic investigation as prognostic methods in acute head injury. ⋯ MRI scans performed early after head injury provide several indicators for unfavorable outcome. Electrophysiologic investigations add to this prognostic evidence. Both methods have comparably high specificity. However, because of the higher density of prognostic information obtained, MRI seems superior to electrophysiologic testing.