RESUMO
BACKGROUND: Sharp and penetrating object injuries (SPOIs) are seen frequently in forensic medicine practice. In this study, we aimed to retrospectively investigate cases with SPOIs. MATERIALS AND METHODS: This study investigated the charts of patients treated at Adiyaman University Education and Research Hospital between January 1, 2013, and December 31, 2017. A total of 934 inpatients with sharp object injuries were included in the study. Data were assessed using a suitable computer-aided package program. Cases were examined in terms of age, gender, injury body site, suicide or homicide, radiologic findings, presence of vital danger, and severity of injury. RESULTS: In this study, we examined the charts for 934 inpatients with stab wounds. It was stated that 124 (13.27%) of those injured were female and 810 (86.63%) male; the average age of the injured persons was 29.8 ± 18.2 years. It was found that 214 (22.91%) people were exposed to vital danger and that 720 (77.09%) suffered from soft tissue injuries (penetrating skin and muscle injuries). Also, 69.27% of the cases (n = 647) involved people less than 35 years of age. CONCLUSION: Considering that stab injuries are more frequent in the lower age groups, we believe that such injuries could be reduced by increasing training programs for young people.
Assuntos
Lesões dos Tecidos Moles/etiologia , Tentativa de Suicídio , Violência , Ferimentos Perfurantes/etiologia , Adolescente , Adulto , Fatores Etários , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/lesões , Estudos Retrospectivos , Pele/lesões , Turquia/epidemiologia , Adulto JovemRESUMO
This article reports the results of analysis of the data borrowed from the special literature. They demonstrate the absence of objective forensic medical evidence needed to diagnose injuries to the human body and clothes inflicted by the darts fired from the pneumatic rifles. Meanwhile, the use of the darts differing in the design parameters has the significant influence on the morphological features of the resulting injuries. The knowledge of the dart characteristics creates the prerequisites for the differentiation between the injuries caused by these missile weapons and other metallic objects.
Assuntos
Armas de Fogo/classificação , Ferimentos por Arma de Fogo/etiologia , Ferimentos Perfurantes/etiologia , Diagnóstico Diferencial , Balística Forense , Patologia Legal/métodos , Humanos , Ferimentos por Arma de Fogo/patologia , Ferimentos Perfurantes/patologiaRESUMO
An attempt was undertaken to elucidate the concrete mechanism of wound infliction by a self-made projectile, such as a harpoon with the archery broadhead, based on the entire volume of evidence provided by the inquest. The results thus obtained allowed the potential for differential diagnostics of clothes and body damages caused by arrow-headed projectiles to be extended.
Assuntos
Prova Pericial , Patologia Legal/métodos , Armas/normas , Ferimentos Perfurantes/etiologia , Ferimentos Perfurantes/patologia , Adulto , Fenômenos Biomecânicos , Evolução Fatal , Patologia Legal/legislação & jurisprudência , Humanos , MasculinoRESUMO
PURPOSE: The intention of this study was to compare the efficacy of eyelet wiring and direct interdental (Gilmer) wiring for achieving intermaxillary fixation (IMF). MATERIALS AND METHODS: This study was a prospective randomized clinical trial. The study sample was derived from the population of patients who underwent IMF at the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Wardha, India, between October 2008 and September 2010. The time required for placement and removal (in minutes) was compared between the eyelet wiring and direct interdental wiring techniques. Postoperative stability after achieving IMF was analyzed in the 2 groups. The plaque accumulation in both groups was evaluated using the Turesky-Gilmore-Glickman modification of the Quigley-Hein plaque index. Complications in the form of soft tissue injury, glove puncture, and trauma to the operator's finger were also recorded. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Chicago, IL) using the χ(2) test and Student t test. RESULTS: The mean working time for placement and removal of eyelet wiring (group I) was 18.00 minutes and 9.67 minutes, respectively. For direct interdental wiring (group II), it was 30.50 minutes and 23.12 minutes, respectively. The mean plaque index values were 1.78 and 2.54 for groups I and II, respectively, which signifies a higher plaque deposition in group II. No occlusal disturbance was seen in either group. The incidences of glove perforation, soft tissue trauma, and trauma to the operator's finger were higher in group II. CONCLUSIONS: Eyelet wiring is preferable to direct interdental wiring as evidenced by fewer complications, and requires a shorter operating time in patients with minimally displaced fractures.
Assuntos
Fios Ortopédicos , Técnicas de Fixação da Arcada Osseodentária/instrumentação , Fraturas Mandibulares/cirurgia , Adulto , Fios Ortopédicos/efeitos adversos , Oclusão Dentária , Índice de Placa Dentária , Feminino , Traumatismos dos Dedos/etiologia , Seguimentos , Fraturas Fechadas/cirurgia , Fraturas Expostas/cirurgia , Luvas Cirúrgicas , Humanos , Lacerações/etiologia , Masculino , Mucosa Bucal/lesões , Traumatismos Ocupacionais/etiologia , Estudos Prospectivos , Aço Inoxidável/química , Fatores de Tempo , Resultado do Tratamento , Ferimentos Perfurantes/etiologiaRESUMO
OBJECTIVES: To investigate and analyse epidemiology, demographics and patterns of presentation of assault induced stab injuries in a main Belgian trauma centre. To evaluate surgical management, complications and postoperative follow-up of the stab wound victims. METHODS: One hundred and seventy assaulted patients, hospitalised because of stab injuries from January 2000 to June 2007 are studied retrospectively. RESULTS: Ninety-five percent of the assaults occurred on men and the mean age of the patients was 31.1 +/- 9.7 years. Ethnic minorities represent 77% of the patients hospitalised for assaults and 26.5% of all patients proved to be under toxic influence, predominantly from alcohol (21.8%). A decline of admissions of patients with stab injuries during the period 2002-2004 is recorded. However, the incidence doubled in the next two-year period. A weekend peak and circadian rhythm is apparent with more than 20% of the patients admitted between 4 and 6 am. The trunk is most frequently stabbed (54.5%) resulting in a laparotomy rate of 51%. One third of the patients who underwent thoraco-abdominal surgery revealed diaphragmatic injuries. Seventy-five percent of the patients left the hospital in a good condition while 2.4% had neuromuscular lesions. Two patients had serious vascular complications during follow-up. During the study period, no mortality was recorded. CONCLUSIONS: Stab wounds were recorded mainly in young and middle-aged men from ethnic minorities, whereas almost 27% were under the influence of drugs. A conservative approach was generally used resulting in a low laparotomy and thoracotomy rate without affecting mortality. Neuromuscular lesions are important long-term complications of stab injuries.
Assuntos
Etnicidade , Laparotomia/normas , Guias de Prática Clínica como Assunto , Toracotomia/métodos , Centros de Traumatologia/estatística & dados numéricos , Violência , Ferimentos Perfurantes/etiologia , Traumatismos Abdominais/etnologia , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/cirurgia , Adulto , Bélgica/epidemiologia , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Estudos Retrospectivos , Fatores de Risco , Traumatismos Torácicos/etnologia , Traumatismos Torácicos/etiologia , Traumatismos Torácicos/cirurgia , Ferimentos Perfurantes/etnologia , Ferimentos Perfurantes/cirurgiaRESUMO
Whether you are an aficionado or completely uninitiated, everyone has an opinion on bull-fighting. The bull-fighter is in constant risk of injury. A medical team made up of surgeons, anesthetists, emergency physicians and nurses remains present throughout the show. For the anaesthetist and surgeon, a wounded bullfighter is an emergency because the vital and functional prognosis are engaged. The team must act in conformity with normal practice and the Code of Medical Ethics because any lack of coordination between the practitioners is punishable by law in the same way as technical fault. Several specific aspects of this type of medical procedure should be highlighted: firstly, the legal restrictions within the corrida, and secondly, the nature of the medical team, which may be comprised of doctors normally based within a public health institution and others who practice in a private health establishment. The particularity of the situation reveals differences in the system of liability, and civil liability must be distinguished from administrative liability: both of these allow the victim to obtain compensation for harm caused, but the consequences of each are different according to doctor status. The fact that the anaesthetists frequently work on a voluntary and benevolent basis does not exonerate them from liability. Lastly, a question frequently addressed is whether or not the doctor is covered by his professional insurance when he is on ringside duty.
Assuntos
Anestesiologia/legislação & jurisprudência , Traumatismos em Atletas , Serviços Médicos de Emergência/legislação & jurisprudência , Seguro de Responsabilidade Civil/legislação & jurisprudência , Responsabilidade Legal , Equipe de Assistência ao Paciente/legislação & jurisprudência , Traumatismos Abdominais/etiologia , Animais , Traumatismos do Braço/etiologia , Traumatismos em Atletas/classificação , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Bovinos , Emergências , Serviços Médicos de Emergência/organização & administração , França , Humanos , Seguro de Responsabilidade Civil/classificação , Traumatismos da Perna/etiologia , Masculino , Imperícia/legislação & jurisprudência , Traumatismo Múltiplo/etiologia , Traumatismo Múltiplo/terapia , Períneo/lesões , Setor Público/legislação & jurisprudência , Sociedades/organização & administração , Esportes/legislação & jurisprudência , Traumatismos Torácicos/etiologia , Voluntários/legislação & jurisprudência , Ferimentos Perfurantes/classificação , Ferimentos Perfurantes/etiologia , Ferimentos Perfurantes/terapiaAssuntos
Serviços de Assistência Domiciliar/legislação & jurisprudência , Recursos Humanos de Enfermagem/legislação & jurisprudência , Saúde Ocupacional/legislação & jurisprudência , Indenização aos Trabalhadores/legislação & jurisprudência , Ferimentos Perfurantes/etiologia , Alabama , Avaliação da Deficiência , Definição da Elegibilidade/legislação & jurisprudência , Humanos , Salários e Benefícios/legislação & jurisprudência , Recusa do Paciente ao Tratamento/legislação & jurisprudênciaRESUMO
Stab-resistant body armour is now becoming a standard item of equipment for police officers in the United Kingdom. In the UK these are usually required to have a stab resistance as specified by the Police Scientific Development Branch KR42 standard [G. Parker, PSDB Stab Resistant Body Armour Test Procedure, Police Scientific Development Branch, Publication No 10/93, 1993]. There are several other test standards, all of which specify that body armour must resist penetration by a specific blade type delivered at a specific energy level or range of levels. However, the actual range of energy levels specified varies over almost an order of magnitude and the basis for these levels is not clearly defined. This paper describes tests to determine the energy range and characteristics of stabbing actions that might be directed against stab resistant body armour by an assailant. The energy and velocity that can be achieved in stabbing actions has been determined for a number of sample populations. Volunteers were asked to stab a target using an instrumented knife that measured the axial force and acceleration during the stabbing. The maximum energy obtained in underarm stabbing actions was 64 J whilst overarm stabbing actions could produce 115 J. The loads produced on contact with the target often approached 1000 N.
Assuntos
Agressão/fisiologia , Braço/fisiologia , Teste de Materiais/instrumentação , Roupa de Proteção/normas , Desempenho Psicomotor , Ferimentos Perfurantes/etiologia , Ferimentos Perfurantes/prevenção & controle , Aceleração , Fenômenos Biomecânicos , Metabolismo Energético , Feminino , Humanos , Masculino , Polícia , Fatores de Risco , Caracteres Sexuais , Fatores de Tempo , Reino UnidoAssuntos
Infecção Hospitalar/prevenção & controle , Equipamentos Descartáveis/normas , Equipamentos e Provisões Hospitalares/normas , Agulhas , Eliminação de Resíduos/instrumentação , Seringas , Ferimentos Perfurantes/etiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Síndrome da Imunodeficiência Adquirida/transmissão , Coleta de Amostras Sanguíneas/instrumentação , Custos e Análise de Custo , Infecção Hospitalar/transmissão , Contaminação de Equipamentos , Estudos de Avaliação como Assunto , Hepatite B/prevenção & controle , Hepatite B/transmissão , Humanos , Resíduos de Serviços de Saúde , Agulhas/normas , Exposição Ocupacional/prevenção & controle , Recursos Humanos em Hospital , Fatores de Risco , Gestão de Riscos , Seringas/normas , Estados Unidos , Ferimentos Perfurantes/economia , Ferimentos Perfurantes/prevenção & controleRESUMO
OBJECTIVE: To perform a decision analysis to determine the thresholds of safety and effectiveness that would justify short-term zidovudine (AZT) administration for persons with accidental percutaneous exposure to HIV-positive blood. DESIGN: Published data were used to estimate the seroconversion rate (0.42%), rate of developing AIDS if HIV-infected (5%/year), and survival with AIDS (50%/year). No information is available on zidovudine effectiveness and little is known about fatal toxicity of zidovudine. Death from AIDS or from zidovudine toxicity was used as the endpoint. RESULTS: For those with exposure to blood known to be HIV-seropositive, the benefits of zidovudine outweight the risks if efficacy is above approximately 3% to 8%. Wide variations in the assumptions have little effect on the thresholds. CONCLUSIONS: Since clinical trials to determine zidovudine effectiveness in this setting will probably never be done, decision analysis offers the only quantitative method for addressing this question. Unless future studies show zidovudine to be both ineffective and toxic, the benefits of short-term administration of zidovudine outweigh the risks immediately after exposure to HIV-positive blood. Zidovudine benefits do not clearly outweigh the risks after exposure to blood of unknown serologic status, or if there is a delay in starting therapy.