J Trauma
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We describe four cases of ocular trauma incurred while playing women's lacrosse without eye protection. Women's lacrosse is potentially hazardous because, unlike men's lacrosse, helmets and face masks are not required. These ocular injuries could have been prevented with the use of protective eyewear.
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A patient with a stab wound to the back with suspected major vascular injury was evaluated by computed tomography instead of arteriography. The computed tomographic (CT) scan demonstrated no injury to the aorta, inferior vena cava, or esophagus, which were adjacent to the blade, and excluded a hematoma. The information from the CT scan made possible a less extensive surgical procedure than might have otherwise been necessary.
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A new concept of cerebral hemodynamic and metabolic physiology, cerebral hemodynamic reserve (CHR), was evaluated in 20 comatose adults with acute traumatic brain swelling who were undergoing continuous monitoring of the arteriojugular difference in oxyhemoglobin saturation, along with cerebral perfusion pressure and expired PCO2. The CHR was measured as the ratio of relative (percent) changes in cerebral oxygen extraction to relative changes in cerebral perfusion pressure during spontaneous increases in intracranial pressure. ⋯ It is concluded that cerebral hemodynamic reserve abnormalities very closely associate with signs of increased intracranial "tightness" on computed tomographic scans of the head. Cerebral hemodynamic reserve could therefore become an important guide in the functional evaluation and management of acute brain swelling (focusing on cerebral oxygenation and perfusion pressure) in a variety of predominantly diffuse acute intracranial disorders.
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The Abbreviated Injury Scale (AIS) score and the Injury Severity Score (ISS) were calculated for all passengers and crew of the M1 Kegworth aircraft crash. Regional injury scores were significantly higher in nonsurvivors than survivors of the impact. ⋯ The use of injury scoring has highlighted variations in the severity of injuries sustained by occupants involved in an impact crash of an airliner. This information has demonstrated that other factors in addition to the force of the impact were involved in the causation of injury, such as structural integrity, attempts by occupants to protect adjoining passengers, and rear-facing seats.