Iatrogenic right ventricular laceration: delayed presentation after abdominal surgery.
A 69-year-old man presented at our emergency department in marginal hemodynamic condition due to hemorrhagic shock and cardiac tamponade. Two months earlier, he had undergone total gastrectomy and left lobe hepatectomy for invasive gastric cancer. Delayed iatrogenic laceration of the right ventricle, consequent to the abdominal procedure, was the uncommon cause of the massive hemopericardium. To our knowledge, this is only the 2nd case in the literature of a cardiac laceration after abdominal surgery. (+info)
Laceration and ejection dangers of automotive glass, and the weak standards involved. The strain fracture test.
Glazing types are historically described, with the laceration injuries and ejection deaths associated with present glazing. Sixty tempered glass windows manufactured at nominally four temper levels were tested for uncracked fracture fragment size and weight and length by the American and European standards, which fracture the glass without strain, and our preliminary strain fracture test, which produces longer uncracked fragments and heavier clusters of fragments. Our study relates the results by the three methods to the temper measurements using birefringence, with a discussion of alternate safer glazing and the inadequacy of present standards for reducing laceration and ejection dangers. (+info)
Subcutaneous emphysema of upper limb.
A case is reported of subcutaneous emphysema involving upper limb resulting from a trivial laceration to the elbow. Gas in the soft tissues after the injury can be caused by infection with a gas forming organism or by a variety of non-infective causes. It is hypothesised that this minor skin wound has acted like a ball-valve mechanism leading to air being trapped in the soft tissue. (+info)
Regression models for unconstrained, partially or fully constrained continuation odds ratios.
Epidemiologists frequently encounter studies with ordered responses. Standard ordered response logit models, such as the continuation ratio model, constrain exposure to have a homogeneous effect across thresholds of the ordered response. We demonstrate a method for fitting regression models for unconstrained, partially or fully constrained continuation odds ratios using a 'person-threshold' data set. For each subject, we create a separate record for each response threshold the subject is 'at risk' of passing and then apply standard binary logistic regression to estimate the continuation-ratio model. An example demonstrates the unconstrained, partially and fully constrained continuation-ratio model, while a small simulation study examines some properties of the proposed 'person-threshold' approach. Finally, we present a brief discussion of statistical software to implement the method. (+info)
False-positive findings on (131)I whole-body scans because of posttraumatic superficial scabs.
Nonspecific (131)I uptake may affect both the specificity and the accuracy of whole-body scanning (WBS) performed after (131)I administration in the follow-up of thyroid carcinoma after thyroidectomy. We report a newly identified cause of false-positive WBS findings: posttraumatic superficial scabs. METHODS: Four patients who underwent thyroidectomy for differentiated thyroid carcinoma were studied after therapeutic administration of 3,700 MBq (131)I. RESULTS: WBS revealed an area of uptake in the lower limbs, in a site corresponding to a slight abrasion of the skin that had incidentally occurred between a few hours before and 24 h after radioiodine administration. In 2 patients, a radioiodine concentration in the scab was shown by the disappearance of the radioactivity in the leg after removal of the scab and by detection of radioactivity in the collected material. CONCLUSION: Posttraumatic superficial scabs may be a cause of false-positive WBS findings. High (131)I doses, although providing increased sensitivity, may also increase the number of false-positive results. (+info)
Incidence of injury in amateur rugby league sevens.
OBJECTIVES: To investigate the incidence, site, and nature of injuries sustained in amateur rugby league sevens tournaments. METHODS: A total of 168 players competing in three amateur rugby league sevens tournaments were studied. All injuries sustained during matches were recorded. Information recorded included the name of the injured player and the time, cause, anatomical site, and nature of the injury. RESULTS: The incidence of injury was 283.5 per 1000 playing hours. Some 40% (113.4 per 1000 playing hours) of all injuries sustained were to the lower limb (chi(2) = 5.3, df = 1, p<0.05). Contusions were the most common type of injury (113.4 per 1000 hours, 40%, chi(2) = 9.5, df = 4, p<0.05), with most (198.4 per 1000 hours, 70%, chi(2) = 31.5, df =4, p<0.001) occurring in physical collisions and tackles. An increasing injury incidence was observed over the first (99.2 per 1000 hours), second (198.4 per 1000 hours), third (347.2 per 1000 hours), and fourth (694.4 per 1000 hours) matches played during the tournaments (chi(2) = 9.2, df = 3, p<0.05). CONCLUSIONS: The results of this study suggest that amateur rugby league sevens tournaments, which require players to compete repeatedly on the same day, may hasten the onset of fatigue and predispose to injury. (+info)
Snow sports injuries in Scotland: a case-control study.
OBJECTIVES: To examine the incidence and patterns of snow sports injuries at the three largest commercial ski areas in Scotland and to identify factors associated with injury risk. METHODS: A prospective case-control study of all injured people at Cairngorm, Glenshee, and Nevis Range ski areas during the 1999-2000 winter season. Personal details, snow sports related variables, diagnosis, and treatment were recorded. Control data were collected at random from uninjured people at all three areas. Random counts were performed to analyse the composition of the on slope population. RESULTS: A total of 732 injuries were recorded in 674 people. Control data were collected from 336 people. The injury rate for the study was 3.7 injuries per 1000 skier days. Alpine skiers comprised 67% of the on slope population, snowboarders 26%, skiboarders 4%, and telemark skiers 2%. Lower limb injuries and sprains were the commonest injuries in alpine skiers and skiboarders. Snowboarders sustained more injuries to the upper limb and axial areas. Skiboarders and snowboarders had a higher incidence of fractures. After adjustment for other variables, three factors were all independently associated with injury: snowboarding (odds ratio (OR) 4.07, 95% confidence interval (CI) 1.65 to 10.08), alpine skiing (OR 3.82, CI 1.6 to 9.13), and age <16 years (OR 1.9, CI 1.14 to 3.17). More than five days of experience in the current season and at least one week of experience in total had a protective effect against injury. CONCLUSIONS: Despite a change in the composition of the alpine population at Scottish ski areas, the overall rate and pattern of injury are similar to those reported previously in comparable studies. Several factors are associated with an increased risk of injury and should be targeted in future injury prevention campaigns. (+info)
A prospective survey of patients with presumed accidental ear injury presenting to a paediatric accident and emergency department.
OBJECTIVES: To assess the characteristics of assumed accidental ear injury in children. METHODS: A prospective survey of 111 children presenting with accidental external or internal ear injuries to a paediatric accident and emergency department. RESULTS: The majority of patients were male (73%). Right and left sided injuries were equally common (51% right, non-bilateral). Presentation with accidental ear injury was very rare in children under the age of 1 year (n=1). Most patients were self referred (98%), and presented within six hours of injury (84%). The mechanism of injury was variable, but cotton bud induced injury was common (7%). The most common injuries were lacerations of the pinna, in 63 patients (56%). Fourteen per cent had blood in the external canal. Only three patients required admission. CONCLUSIONS: Lacerations are the commonest form of accidental ear injury. Ear injuries that are bilateral and in children less than 1 year of age are rare and may suggest non-accidental injury. Cotton bud induced injury is common and preventable. (+info)