Urban drinking and driving: comparison of electric scooter and bicycle related accidents in facial fracture patients.

BACKGROUND: In recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention. MATERIAL AND METHODS: This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries. RESULTS: Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients. CONCLUSIONS: Compared with patients in bicycle accidents, facial fracture patients injured in e-scooter accidents are younger, are more likely under the influence of alcohol, and sustain more severe craniofacial skeleton fractures. Our results for both groups of patients advocate stricter adherence to helmet and road safety legislation as well as public education for injury prevention.

Assault-related facial fractures: does the injury mechanism matter?

This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assault-related facial fracture patients were included; demographic factors, facial fracture type, associated injuries, alcohol use, and injury mechanisms were recorded. Assault mechanisms most often included combinations of different mechanisms (57.5%) and resulted in the victim falling (50.1%). The perpetrator was most commonly a stranger (52.5%) and acted alone (57.7%). A total of 123 patients (14.6%) had associated injuries, with the most common being traumatic brain injury. Associated injuries occurred most frequently in patients with combined fractures of the facial thirds (24.2%) and upper third fractures (42.9%). The most significant differentiating factors for associated injuries were the number of perpetrators, falling, the use of an offensive weapon, and if the events of the assault remained unknown. In adjusted logistic regression analyses, statistically significant associations with associated injuries were found for age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.07; P < 0.001), falling due to the assault (OR 2.87, 95% CI 1.49-5.50; P = 0.002), and upper third facial fractures (OR 6.93, 95% CI 2.06-23.33; P = 0.002). A single punch also caused severe injuries and should therefore not be overlooked, as this can be as dangerous as other assault mechanisms.

Correlation between plasmatic progesterone, endometrial receptivity genetic assay and implantation rates in frozen-thawed transferred euploid embryos. A multivariate analysis.

OBJECTIVE: To ascertain the predictive value of different parameters to determine endometrial receptivity among assisted reproduction treatments in which single embryo transfer of frozen-thawed euploid blastocysts are performed. STUDY DESIGN: Observational study involving 104 patients recruited between September.2018 and June.2019 at a University associated assisted reproduction center. The relationship of different parameters (age, body mass index (BMI), duration of hormonal preparation, plasmatic progesterone levels, endometrial parameters at ultrasound assessment and endometrial receptivity determined by endometrial receptivity assay (ERA) was evaluated by a multivariable logistic (binomial) analysis after hormonal preparation. According to the ERA test results a personalized endometrial transfer (pET) was scheduled and live birth rate was assessed. Only single transfers of frozen euploid blastocysts were performed. RESULTS: ERA test report predicted receptive endometrium (RE) in 54,64% patients and non-receptive (NR) in 45,31% patients. Among NR endometrial samples, 20,62% were classified as pre-receptive or early receptive, whereas 24,74% as post-receptive or late-receptive. The univariate analysis showed a relationship between BMI, doses of progesterone administered before biopsy and the receptivity of endometrium. There was no relationship between age of women, duration of hormonal supplementation, and the results of ERA test. In our series, endometrial receptivity was not related neither to endometrial thickness nor plasmatic progesterone levels. The multivariate analysis showed that both, BMI and cumulative progesterone administered prior to the test are independent predictive factors of endometrial receptivity (p = 0,047 and p = 0,034 respectively). The overall live birth rate after FET of euploid embryos was 62,35%. The odd of pregnancy was higher when ERA test was performed prior to the first embryo transfer (93,10% vs. 46,43%; OR = 15,58;95%CI 3,38-71,89). Overall, ongoing pregnancy rates showed a favorable trend after "non-receptive" endometria had been diagnosed and, thus, a modified (pET) preparation was performed (70,00% vs. 55,56%; OR = 1,87; 95% CI 0,76-4,57). CONCLUSION: Regarding implantation potential of genetically screened blastocysts, the traditional tools used for assessing endometrial receptivity such as transvaginal evaluation of endometrial thickness and pattern or progesterone levels determination were not useful among our patients for predicting a receptive endometrium.