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1.
J Forensic Leg Med ; 69: 101890, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32056808

RESUMO

This retrospective study sought to identify a regular pattern of limb bruising which occurs in association with suicidal or accidental hanging. Following exclusion of cases suspicious for homicide, 82 consecutive cases of hanging from a 10-year period were retrospectively reviewed to identify the pattern of traumatic limb injury in each case. Relevant information such as location, toxicology, and type of suspension was also noted. 72% of the reviewed cases had traumatic limb lesions, the majority of which occurred on the posterior upper limb and the anterior lower limb. Although the distribution of limb injury in our study mirrored that found in the literature, the incidence is much higher than in previous studies (7.4-20%). This could either be due to differences in confounding factors such as intoxication and location of hanging or differences in the practice of recording of limb trauma in hanging between centres. Neither type of suspension nor location of hanging were significantly associated with an increased incidence of traumatic limb injury. Positive toxicology was found to increase the likelihood of sustaining limb injury (p = .044084). In conclusion, the presence of this well documented pattern of traumatic limb lesions in cases of hanging should not always raise suspicion of foul play.


Assuntos
Asfixia/patologia , Extremidade Inferior/lesões , Lesões do Pescoço/patologia , Extremidade Superior/lesões , Adulto , Distribuição por Idade , Asfixia/mortalidade , Depressores do Sistema Nervoso Central/sangue , Depressores do Sistema Nervoso Central/urina , Etanol/sangue , Etanol/urina , Feminino , Ciências Forenses , Humanos , Extremidade Inferior/patologia , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/mortalidade , Preparações Farmacêuticas/sangue , Estudos Retrospectivos , Distribuição por Sexo , Detecção do Abuso de Substâncias , Extremidade Superior/patologia , Adulto Jovem
2.
Curr Sports Med Rep ; 19(1): 24-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31913920

RESUMO

Soft tissue injuries to the head and neck are a common occurrence in sports. These anatomical regions are somewhat predisposed because of the "athletic stance" that is utilized in many close-contact sports. Although appropriate use of protective equipment, including mouth guards, helmets, and face shields, has reduced the incidence and severity of these injuries, they still occur regularly. To provide appropriate medical care, one must possess adequate knowledge of the superficial and deep anatomical structures, fundamental knowledge and skill in regard to wound care, and awareness of potential poor outcomes related to lacerations of unique structures, such as the mouth, eye, or ear.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Faciais/diagnóstico , Lacerações/diagnóstico , Lesões do Pescoço/diagnóstico , Traumatismos em Atletas/terapia , Traumatismos Craniocerebrais/terapia , Traumatismos Faciais/terapia , Humanos , Lacerações/terapia , Lesões do Pescoço/terapia , Volta ao Esporte
3.
Forensic Sci Int ; 307: 110141, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31945737

RESUMO

AIMS: We aimed at analyzing homicide trends and patterns in Italy over the period 1980-2014. METHODS: We collected data from the Italian Mortality Database (Italian National Institute of Statistics), for the study period. Temporal trends were analyzed using joinpoint regression analysis, with estimated annual percentage change computed for each detected trend. The possible effect of the mafia subculture was examined using an indicator of mafia social penetration. Differences between age classes, genders, geographical regions, and homicide methods were also analyzed. RESULTS: The analyses showed an overall reduction in homicides during the study period, including a reduction in homicides by firearm. Further, we found significant differences between homicides involving male and female victims. A peak in male homicides, observed in the early 1990s, was significantly associated with mafia penetration. CONCLUSIONS: The overall reduction in homicides can be interpreted as an expression of a "civilizing process."


Assuntos
Homicídio/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Asfixia/mortalidade , Criança , Pré-Escolar , Vítimas de Crime/estatística & dados numéricos , Feminino , Armas de Fogo , Medicina Legal , Homicídio/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/mortalidade , Distribuição por Sexo , Ferimentos não Penetrantes/mortalidade , Ferimentos Penetrantes/mortalidade , Adulto Jovem
4.
Am J Forensic Med Pathol ; 41(1): 18-26, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32000223

RESUMO

The suicide rate in the United States has been increasing steadily over the previous 10 years. In DC, these results are not mirrored. The suicide rate has a tendency to be lower than the rest of the country. During this retrospective review of suicides in DC, factors such as medical history and toxicology results were examined.In this study performed over 8 years (2009-2016), 394 suicides occurred. It was found that decedents committed suicide mostly by hanging (31.2%), firearms (20.3%), or drug intoxication (15.7%). The average age was 44.5 years. Similar to national statistics, male individuals committed suicide at a higher rate (77.9%) than did female individuals (22.1%). The toxicology data showed that ethanol (26.4%), antidepressants (20.1%), opioids (14.9%), and benzodiazepines (12.9%) were the drugs most frequently involved, although the finding of no drugs was most common (33.7%). Ethanol was present in 5 methods of suicide that include death by hanging, drowning, firearm, suffocation, and poisoning.This research provides information that may be useful for public health officials when confronting the issue of suicide. It is hoped that it will encourage other medical examiner offices to perform toxicological analysis and autopsy of all suicide cases.


Assuntos
/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Asfixia/mortalidade , Depressores do Sistema Nervoso Central/análise , Criança , Grupos de Populações Continentais/estatística & dados numéricos , District of Columbia/epidemiologia , Afogamento/mortalidade , Etanol/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/mortalidade , Preparações Farmacêuticas/análise , Envenenamento/mortalidade , Estudos Retrospectivos , Distribuição por Sexo , Ferimentos por Arma de Fogo/mortalidade , Adulto Jovem
5.
Int J Oral Maxillofac Surg ; 49(1): 75-81, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31301924

RESUMO

The aim of this retrospective cohort study was to determine the frequency and risk factors for cervical spine injury (CSI) in patients with midface fractures. Patients ≥18 years of age entered in the Massachusetts General Hospital Trauma Registry from 2007 to 2017 were identified. Those with a midface fracture, computed tomography and/or magnetic resonance imaging of the cervical spine, and complete medical records were included. There were 23,394 patients in the registry; 3950 (16.9%) had craniomaxillofacial fractures and 1822 (7.8%) had a CSI. Craniomaxillofacial fractures included fractures of the midface (n=2803, 71.0%), mandible (n=873, 22.1%), and midface plus mandible (n=274, 6.9%). The overall frequency of CSI in patients with midface fractures was 11.4% (350/3077). Patients with midface fractures had a higher risk for CSI compared to patients without a midface fracture (odds ratio 2.4, 95% confidence interval 2.1-2.4, P<0.001). In a multivariate model, nasal and orbital fractures, chest injuries, age, injury severity score, and motor vehicle crash or fall as the etiology were independent risk factors for CSI. Mortality was two times higher in subjects with CSI. Early and accurate diagnosis of CSI is a critical factor when planning the treatment of patients with these fractures.


Assuntos
Fraturas Ósseas , Lesões do Pescoço , Traumatismos da Coluna Vertebral , Adolescente , Vértebras Cervicais , Humanos , Estudos Retrospectivos
6.
Forensic Sci Int ; 306: 110060, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31785511

RESUMO

In order to investigate potential causal relations between the shaking of infants and injuries, biomechanical studies compare brain and skull dynamic behavior during shaking to injury thresholds. However, performing shaking tolerance research on infants, either in vivo or ex vivo, is extremely difficult, if not impossible. Therefore, infant injury thresholds are usually estimated by scaling or extrapolating adult or animal data obtained from crash tests or whiplash experiments. However, it is doubtful whether such data accurately matches the biomechanics of shaking in an infant. Hence some thresholds may be inappropriate to be used for the assessment of inflicted head injury by shaking trauma in infants. A systematic literature review was conducted to 1) provide an overview of existing thresholds for head- and neck injuries related to violent shaking, and 2) to identify and discuss which thresholds have been used or could be used for the assessment of inflicted head injury by shaking trauma in infants. Key findings: The majority of studies establishing or proposing injury thresholds were found to be based on loading cycle durations and loading cycle repetitions that did not resemble those occurring during shaking, or had experimental conditions that were insufficiently documented in order to evaluate the applicability of such thresholds. Injury thresholds that were applied in studies aimed at assessing whether an injury could occur under certain shaking conditions were all based on experiments that did not properly replicate the loading characteristics of shaking. Somewhat validated threshold scaling methods only exist for scaling concussive injury thresholds from adult primate to adult human. Scaling methods that have been used for scaling other injuries, or for scaling adult injury thresholds to infants were not validated. There is a clear and urgent need for new injury thresholds established by accurately replicating the loading characteristics of shaking.


Assuntos
Fenômenos Biomecânicos/fisiologia , Síndrome do Bebê Sacudido/fisiopatologia , Aceleração , Animais , Lesão Axonal Difusa/fisiopatologia , Medicina Legal/métodos , Traumatismos Cranianos Fechados/fisiopatologia , Humanos , Lactente , Hemorragias Intracranianas/fisiopatologia , Modelos Biológicos , Lesões do Pescoço/fisiopatologia , Hemorragia Retiniana/fisiopatologia
7.
Laryngorhinootologie ; 98(12): 844, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31810102
8.
Zhonghua Wai Ke Za Zhi ; 57(12): 951-955, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31826602

RESUMO

The majority of cervical spine injuries in children occur in the upper cervical spine, of which odontoid fracture is the most common. Odontoid fracture in children is a very insidious injury. Due to the unclear language and incompatible physical examination, the disease is often missed diagnosis. Because the child axis is still in the developmental segment, including 4 synchondrosis and 6 ossification centers, there are obvious anatomical and biological differences between the child odontoid fracture and the adult. Therefore, the choice of treatment is different from that of adults. This article will introduce the development of odontoid in children, and summarize the injury characteristics, clinical classification and treatment of odontoid fracture in children.


Assuntos
Processo Odontoide/lesões , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/terapia , Adulto , Pesquisa Biomédica , Criança , Humanos , Lesões do Pescoço/complicações , Fraturas da Coluna Vertebral/classificação , Fraturas da Coluna Vertebral/etiologia
9.
Codas ; 31(5): e20180238, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31618317

RESUMO

PURPOSE: Verify the correlation between two scar assessment scales and the presence of orofacial myofunctional disorders (OMD) in patients with head and neck (H&N) burns. METHODS: Participants of this study were 16 adult individuals with H&N full-thickness burns. Data were collected through assessment of mandibular range of movement and application of the following instruments: Patient and Observer Scar Assessment Scale (POSAS), Vancouver Scar Scale, and Orofacial Myofunctional Evaluation with Scores (OMES). RESULTS: Results showed moderate negative correlation between the variables deglutition, breathing, total score of the functions, total score on the OMES and scores on the scar assessment scales, indicating that the higher (more severe) the scores on these scales, the lower the scores on the items of the OMES (indicative of greater OMD severity). No correlations were observed between the items of the OMES and the POSAS Patient scale. CONCLUSION: Results suggest that there is correlation between scar severity in burn patients, measured through clinical scales, and presence of OMD. Patients who present scores indicative of H&N pathological scars should be immediately referred to orofacial myofunctional assessment.


Assuntos
Queimaduras/complicações , Transtornos de Deglutição/etiologia , Traumatismos Faciais/etiologia , Lesões do Pescoço/etiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Adulto Jovem
10.
J Spec Oper Med ; 19(3): 31-44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31539432

RESUMO

The 2012 study Death on the battlefield (2001-2011) by Eastridge et al.1 demonstrated that 7.5% of the prehospital deaths caused by potentially survivable injuries were due to external hemorrhage from the cervical region. The increasing use of Tactical Combat-Casualty Care (TCCC) and other medical interventions have dramatically reduced the overall rate of combat-related mortality in US forces; however, uncontrolled hemorrhage remains the number one cause of potentially survivable combat trauma. Additionally, the use of personal protective equipment and adaptations in the weapons used against US forces has caused changes in the wound distribution patterns seen in combat trauma. There has been a significant proportional increase in head and neck wounds, which may result in difficult to control hemorrhage. More than 50% of combat wounded personnel will receive a head or neck wound. The iTClamp (Innovative Trauma Care Inc., Edmonton, Alberta, Canada) is the first and only hemorrhage control device that uses the hydrostatic pressure of a hematoma to tamponade bleeding from an injured vessel within a wound. The iTClamp is US Food and Drug Administration (FDA) approved for use on multiple sites and works in all compressible areas, including on large and irregular lacerations. The iTClamp's unique design makes it ideal for controlling external hemorrhage in the head and neck region. The iTClamp has been demonstrated effective in over 245 field applications. The device is small and lightweight, easy to apply, can be used by any level of first responder with minimal training, and facilitates excellent skills retention. The iTClamp reapproximates wound edges with four pairs of opposing needles. This mechanism of action has demonstrated safe application for both the patient and the provider, causes minimal pain, and does not result in tissue necrosis, even if the device is left in place for extended periods. The Committee on TCCC recommends the use of the iTClamp as a primary treatment modality, along with a CoTCCC-recommended hemostatic dressing and direct manual pressure (DMP), for hemorrhage control in craniomaxillofacial injuries and penetrating neck injuries with external hemorrhage.


Assuntos
Hemorragia/terapia , Traumatismos Maxilofaciais/complicações , Medicina Militar , Lesões do Pescoço/complicações , Guias de Prática Clínica como Assunto , Lesões Relacionadas à Guerra/complicações , Ferimentos Penetrantes/complicações , Hemorragia/etiologia , Hemostáticos , Humanos
11.
Clin Sports Med ; 38(4): 513-535, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472763

RESUMO

The athletic training room is filled with a multitude of conditions encompassing many different specialties of medicine. When it comes to traumatic injuries in the training room, many of them are not musculoskeletal in nature. Ultrasound in the training room can help identify serious and subtle solid-organ injury and small pneumothoraces. The discussion of these conditions follows a simple outline that helps identify injury/conditions through a proper history and physical. Evidence-based treatment/management/return to play guidelines are discussed.


Assuntos
Traumatismos Abdominais/diagnóstico , Traumatismos em Atletas/diagnóstico , Traumatismos Faciais/diagnóstico , Traumatismos Torácicos/diagnóstico , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/terapia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Traumatismos Faciais/etiologia , Traumatismos Faciais/terapia , Humanos , Boca/lesões , Lesões do Pescoço/diagnóstico , Lesões do Pescoço/etiologia , Lesões do Pescoço/terapia , Nariz/lesões , Exame Físico , Volta ao Esporte , Traumatismos Torácicos/etiologia , Traumatismos Torácicos/terapia
12.
Rehabilitación (Madr., Ed. impr.) ; 53(3): 162-168, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185553

RESUMO

Objetivo: el propósito del estudio fue evaluar la efectividad inmediata de la técnica de liberación de la fascia toracolumbar para aumentar la resistencia muscular del esternocleidomastoideo bilateral, y disminuir el ángulo de anteposición de cabeza y cuello en mujeres jóvenes de la Universidad Autónoma de Chile. Material y métodos: este estudio longitudinal, está basado en la medición inmediata (5minutos) de la resistencia muscular (segundos) a través de la prueba de fatiga mediante electromiografía de superficie en el esternocleidomastoideo bilateral, y análisis del ángulo de anteposición de cabeza y cuello posterior a la aplicación de la técnica de liberación de la fascia toracolumbar (TLFT). Las 35 mujeres evaluadas reunieron los criterios de inclusión de: sexo femenino, edad entre 22 y 27 años, sedentarias, estudiantes de nivel superior de la Universidad Autónoma de Chile, anteposición de cabeza y cuello entre 43,8 y 51 grados, índice de masa corporal normal y sobrepeso, sin enfermedades de columna y firmar consentimiento informado. Resultados: hubo cambios estadísticamente significativos de manera inmediata en la resistencia muscular del esternocleidomastoideo, con un aumento de 27,4segundos promedio (p<0,05) y la disminución del ángulo de anteposición de cabeza y cuello de 2,8 grados promedio (p<0,05), posterior a la aplicación de la TLFT. Conclusión: la TLFT produce un efecto inmediato en el aumento de la resistencia muscular del esternocleidomastoideo bilateral y una disminución del ángulo de anteposición de cabeza y cuello en mujeres jóvenes que presenten anteposición de cabeza y cuello


Objective: the aim of this study was to evaluate the effectiveness of thoracolumbar myofascial release to increase the resistance of the sternocleidomastoid (SCM) muscle bilaterally and to decrease the angle of forward head posture in young women enrolled at the Autónoma University of Chile. Material and methods: this longitudinal study was based on the immediate measurement (5minutes) of muscular resistance (seconds) through the fatigue test by means of surface electromyography in the bilateral sternocleidomastoid and analysis of the angle of forward head posture after the application of thoracolumbar myofascial release (TMFR). The 35 women evaluated met the inclusion criteria of female sex, age between 22 and 27 years, sedentary lifestyle, senior students of the Autónoma University of Chile, forward angle head posture between 43.8 and 51 degrees, body mass index indicating normal weight or overweight, and without spinal abnormalities. All participants provided written informed consent. Results: after the application of TMFR, there were statistically significant and immediate changes in the muscular resistance of the sternocleidomastoid with an average increase of 27.4seconds (P<.05) and an average decrease in the forward head posture angle of 2.8 degrees (P<.05). Conclusion: TMFR produces an immediate effect in increasing the muscular resistance of the bilateral sternocleidomastoid and reducing the forward head posture angle in young women with forward head posture


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Fáscia/fisiologia , Cabeça/anormalidades , Modalidades de Posição , Terapia por Exercício/métodos , Músculos do Pescoço/fisiopatologia , Força Muscular/fisiologia , Lesões do Pescoço/reabilitação , Pontos-Gatilho/fisiopatologia
13.
S Afr J Surg ; 57(3): 54, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31392866

RESUMO

BACKGROUND: Humans come into contact and interact with an array of animals in a number of areas and environments. We set out to review our experience with animal-related injuries in Pietermaritzburg, KwaZulu-Natal, South Africa. METHOD: All patients who sustained an injury secondary to an interaction with an animal in the period December 2012-December 2017 were identified from the Hybrid Electronic Medical Registry (HEMR). RESULTS: There were 104 patients in the study sample. The mean age of patients in the study was 32.8 years, with a range from 1 to 76 years old. 75% (n = 78) were male and 25% (n = 26) female. Out of the 104 animal-related injuries, 67 were blunt trauma, 39 penetrating trauma and 3 a combination of blunt and penetrating trauma. The species causing trauma included dogs (53), horses (29), cows (18), buffalo (1), warthog (1), impala (1) and a single goat (1). The median time from injury to hospitalisation was 46.62 hours (range from 0 to 504 hours). Injuries occurred to the head (n = 32), face (n = 9), neck (n = 32), abdomen (n = 22), urogenital system (n = 6), upper limb (n = 39) and lower limb (n = 39). The Injury Severity Score (ISS) mean for the patients was 8.16, the range 1-4, the median 9 and the standard deviation 6.88. In 49 patients the treatment was non-operative. In the remaining 55 patients, a total of 68 operative procedures were required. Operations included wound debridement/surgical washout (n = 38), laparotomy (n = 9), arterial repair/ligation (n = 8), skin graft (n = 4), craniotomy (n = 5), fasciotomy (n = 2), amputation (n = 1), and placement of an ICP monitor (n = 1). 49 of these operations were for patients with dog bite injuries. The mean hospital stay was 0.13 days with a range of 0-4 days. Four patients were admitted to the Intensive Care Unit (ICU) and two patients died. CONCLUSION: Human interactions with animals may result in injuries which require surgical treatment. The most common animal injury is a dog bite but in the case of the larger domestic farm animals, blunt force type injuries and goring can result in significant injuries which require complex surgical interventions.


Assuntos
Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/cirurgia , Traumatismos Abdominais/epidemiologia , Adolescente , Adulto , Idoso , Animais , Bovinos , Criança , Pré-Escolar , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/terapia , Cães , Feminino , Cavalos , Humanos , Lactente , Escala de Gravidade do Ferimento , Tempo de Internação , Extremidade Inferior/lesões , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/epidemiologia , Lesões do Pescoço/terapia , Estudos Retrospectivos , África do Sul/epidemiologia , Tempo para o Tratamento , Centros de Traumatologia , Extremidade Superior/lesões , Sistema Urogenital/lesões , Ferimentos e Lesões/terapia , Adulto Jovem
14.
S Afr J Surg ; 57(3): 59, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31392871

RESUMO

SUMMARY: A significant number of otorhinolaryngological emergency visits are caused by foreign bodies, and occasionally they can result in life-threatening injury. This report highlights the value of neck CT in the evaluation of suspected radiolucent foreign bodies penetrating the neck from the oral cavity. This guided the surgical approach to remove the foreign body safely without complication.


Assuntos
Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Lesões do Pescoço/cirurgia , Ferimentos Penetrantes/cirurgia , Criança , Corpos Estranhos/complicações , Humanos , Boca , Lesões do Pescoço/etiologia , Tomografia Computadorizada por Raios X , Ferimentos Penetrantes/etiologia
15.
World Neurosurg ; 132: e878-e884, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31382064

RESUMO

BACKGROUND: Isolated unilateral alar ligament injury (ALI) is a very rarely diagnosed condition, with only 9 cases reported in the literature. The purpose of this study is to determine clinical, diagnostic, and biomechanical features of unilateral ALI. METHODS: A total of 6 patients diagnosed with ALI were included in this series. The hospital records and radiologic imaging of admission and follow-ups were investigated retrospectively. RESULTS: Rotation of the neck and/or hyperflexion was always present as a mechanism of injury. The patients were neurologically intact. All patients presented with mild neck pain aggravated by head rotation. On computed tomography (CT) scans, the dens was observed to be displaced to the opposite side. Magnetic resonance imaging (MRI) showed a widened lateral dens-atlas space with high signal intensity. All patients underwent lateral flexion-extension CTs for the confirmation of craniovertebral junction (CVJ) stability. The patients were treated with hard collars. The follow-up MRI of 3 patients obtained at the third month showed normal lateral dens-atlas interval and recovered ligaments. All patients were pain free after 6 months. CONCLUSIONS: Unilateral ALI appears to be more common but misdiagnosed than previously thought. Trauma mechanism consists of hyperflexion and contralateral rotation. Neck pain aggravated with rotation is the most significant clinical finding. Dens lateralization is the most important finding in CT scans. An MRI focusing on the CVJ is essential for the diagnosis. The stability of CVJ must be checked with a flexion-extension CT scan. Unilateral ALI is a stable condition and responds to conservative treatment.


Assuntos
Imobilização , Ligamentos/lesões , Lesões do Pescoço/terapia , Osso Occipital , Processo Odontoide , Aparelhos Ortopédicos , Adolescente , Adulto , Idoso de 80 Anos ou mais , Vértebra Cervical Áxis , Atlas Cervical , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
World Neurosurg ; 132: 321-325, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31470149

RESUMO

BACKGROUND: Since the first report about nail gun injuries in 1959, there has been an average of approximately 37,000 patients hurt by nail guns and treated in emergency departments. Carotid arterial injury by nail gun has been reported, but vertebral artery damage is extremely rare. CASE DESCRIPTION: A 42-year-old man was transported to the emergency department after suffering an accidental self-inflicted nail gun injury to the left lateral aspect of his neck. Radiographic imaging of the cervical spine revealed a 3.1-cm metallic nail in the C5 region. A computed tomography (CT) angiogram revealed the nail passing through the left C5 transverse foramen and compressing the left vertebral artery. He was immediately brought to the operating room for removal of the nail. At 1-month follow-up, the patient did not have any neck complaints and postoperative CT angiogram indicated the patient was asymptomatic with no signs of complication or infection. CONCLUSIONS: Based on our experience and a review of the literature, in terms of treating a nail gun injury to the cervical spine, we would like emphasize that preoperative CT scan or CT angiogram is necessary to assess the location and shape of the nail, especially nails with barbers or washers. Improving awareness of the risk from accidental nail gun trauma may lead to better prevention of this rare but potentially life-threatening injury.


Assuntos
Lesões do Pescoço/diagnóstico por imagem , Lesões do Sistema Vascular/diagnóstico por imagem , Artéria Vertebral/lesões , Ferimentos Penetrantes/diagnóstico por imagem , Adulto , Angiografia por Tomografia Computadorizada , Humanos , Masculino , Lesões do Pescoço/cirurgia , Tomografia Computadorizada por Raios X , Lesões do Sistema Vascular/cirurgia , Artéria Vertebral/diagnóstico por imagem , Ferimentos Penetrantes/cirurgia
18.
Curr Opin Otolaryngol Head Neck Surg ; 27(5): 407-412, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31397694

RESUMO

PURPOSE OF REVIEW: The aim if this review is to provide an update on the existing literature of animal bite treatment strategies and provide a systematic approach to animal bites from presentation to reconstruction. RECENT FINDINGS: Dog bites cause 80-90% of animal bites with 26.8-56.5% occurring in the head and neck. Infection rates may be as low as 5.7-9.7%. Primary closure alone is sufficient in 69.8% of dog bites within the first 24 h. SUMMARY: Animal bite injuries to the head and neck are common, especially in the younger population. Dogs cause a majority of these bite injuries. Injuries can include simple lacerations or punctures, avulsions with tissue present, or avulsions with loss of tissue. The most common locations are the cheek, nose, and lips. It is important to gather the vaccination status of the animal and patient and to administer tetanus/rabies prophylaxis if indicated. Antibiotics are typically prescribed for 3-5 and 7-14 days for uninfected and infected wounds, respectively. These wounds require evaluation, irrigation, and occasionally debridement or repair in the operating room. The type of repair is determined based on the location and extent of injury and can range from primary closure to microsurgical replantation, skin grafts, flaps, or even facial transplantation.


Assuntos
Mordeduras e Picadas/cirurgia , Traumatismos Craniocerebrais/cirurgia , Cabeça/cirurgia , Lesões do Pescoço/cirurgia , Animais , Humanos , Procedimentos Cirúrgicos Reconstrutivos
19.
Forensic Sci Int ; 302: 109891, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400616

RESUMO

The presence of fracture on neck elements is an indication of violence. Both the hyoid bone and the larynx can be damaged by a strangulation mechanism. Thyroid cartilage, more specifically, may present lesions in response to this mechanical stress. These lesions result in fractures at the bases of the horns of the thyroid cartilage. This study focuses on the thyroid cartilage behavior in cases of bi-digital strangulation, using an anthropometric and biomechanical approach. To develop a biomechanical model, we performed an anthropometric study taking into account 14 distances measurements as well as 3 measurements of angles. These measures allowed us to determine a significant sexual dimorphism between individuals. Then, we define 6 morphologies models, composed of 3 females and 3 males individuals. In order to visualize the ossification of the cartilage, each model has been tested with bone properties. Strangulation cases were simulated by applying an imposed velocity of 0.4m/s then 1m/s. We observed different behaviors of the thyroid cartilage according to the sex and the morphology.


Assuntos
Asfixia/fisiopatologia , Fenômenos Biomecânicos/fisiologia , Simulação por Computador , Lesões do Pescoço/prevenção & controle , Cartilagem Tireóidea/diagnóstico por imagem , Cartilagem Tireóidea/lesões , Árvores de Decisões , Feminino , Análise de Elementos Finitos , Medicina Legal , Fraturas de Cartilagem/fisiopatologia , Humanos , Imagem Tridimensional , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Lesões do Pescoço/fisiopatologia , Análise de Componente Principal , Caracteres Sexuais , Cartilagem Tireóidea/fisiopatologia
20.
Arch Pediatr ; 26(5): 298-300, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31281034

RESUMO

Neck abscesses after a cervical trauma rarely occur, especially in children. Cervical abscesses are more generally complications of otolaryngological infections. Progression to severe complication or death may be rapid. We describe a case of a sternocleidomastoid muscle and retropharyngeal abscess that developed after a minor cervical trauma from being struck in the neck. The patient was surgically treated and received antibiotics, but returned with a recurrence of the cervical infection. We discuss the superinfection of the hematoma, cervical abscess management, and its treatment in children.


Assuntos
Lesões do Pescoço/complicações , Abscesso Retrofaríngeo/etiologia , Infecções Estreptocócicas/etiologia , Streptococcus pyogenes/isolamento & purificação , Ferimentos não Penetrantes/complicações , Criança , Terapia Combinada , Feminino , Hematoma/diagnóstico , Hematoma/etiologia , Hematoma/terapia , Humanos , Músculos do Pescoço/microbiologia , Músculos do Pescoço/patologia , Abscesso Retrofaríngeo/diagnóstico , Abscesso Retrofaríngeo/terapia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/terapia
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