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Articles Related to injury

An Investigation into the Range of Movement and Forces Involved by the Application of Wrist Flexion Restraint Techniques - Pain Inducing or Not?

Although the use of physical restraint (PR) is accepted, it remains controversial as staff are required to balance professional, ethical and legal tensions between maintaining everyone’s safety, upholding human rights, and minimising harm. One such tension relates to the use of Wrist Flexion Techniques (WFT) used in some health, social care and custodial settings. WFT impose load onto the musculoskeletal structures of the wrist to gain control or compliance from a restrained person, and can result in discomfort, pain, injury, psychological trauma and be detrimental to therapeutic relationships. Current evidence and guidance on WFT are absent with debate existing as to whether WFT can be used without inducing pain. Twenty adults participated in the study. The mean discomfort angle was 90.1° (± 8.6) of flexion with 2.8 Kg (± 1.1) of force, and the mean pain angle was and 98.4° (± 7.9) of flexion with 4.4 Kg (± 1.8) of force, therefore only 8.3° of movement and 1.6 Kg of force separate pain free from pain inducing WFT. Genders did not differ in relation to angle of discomfort or pain. Females experienced discomfort with 1.1Kg less force (p = 0.021) and experienced pain with 1.7Kg less force (p = 0.023). This research challenges the assertion that WFT can exist as non-pain inducing and pain inducing PR techniques since the margin between them may be too small for practitioners to discriminate, particularly during the struggle of real world restraint. Further research may consider other potential pain inducing techniques, and the role and use of PIT during restraint.
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Dysautonomia after Spinal Cord Injury: A Clinical Case

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Preliminary Investigation of the Interaction of Misoprostol and Phenylbutazone on Bone Response to Injury in Horses

Phenylbutazone (PBZ) is commonly used in equine patients for treatment of orthopedic injuries. Phenylbutazone may adversely affect bone healing because of suppression of prostaglandin production. We hypothesized that administration of the prostaglandin analog misoprostol would enhance bone healing and mitigate the untoward effects of PBZ on bone response to injury in horses. The objectives of this study were to determine whether the administration of misoprostol would enhance bone healing and whether concurrent administration of PBZ and misoprostol would mitigate the untoward effects of phenylbutazone. Twenty horses were randomly assigned to one of four groups (n=5 per group): Group 1 (untreated control), Group 2 (phenylbutazone alone), Group 3 (misoprostol, alone), or Group 4 (concurrent treatment with phenylbutazone and misoprostol). A 4.5-mm diameter uni-cortical bone defect was created in one metacarpal III bone of all horses. Fluorochromic bone labels were administered intravenously on Days 0, 7, and 14. Computed tomographic osteoabsorptiometry and histomorphometric analyses were performed on the harvested metacarpal bones. Phenylbutazone treatment caused a decrease in endosteal new bone formation. Administration of misoprostol appeared to mitigate the magnitude of the PBZ effect on new bone formation (endosteal in-growth, p<0.06). Bone specific alkaline phosphatase serum activity decreased throughout the 14-day period of stall confinement. Mineral apposition rates increased in all groups during the period from 7 to 14 days after bone injury. Further research is needed to determine if this effect is significant. The administration of misoprostol may be beneficial to lessen the undesired impact of phenylbutazone on bone healing in horses.
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Displaced Fracture of the Proximal Humerus Causing Axillary Artery Injury and Brachial Plexus Palsy

Proximal humeral fractures account for approximately 5% of fractures seen in the emergency department. Despite this relatively high incidence only 15% of these fractures are displaced with an even smaller proportion being severely displaced enough to cause an axillary artery injury. We report a case of an elderly female patient who slipped and fell at home. She presented to our unit complaining of left shoulder pain and an inability to feel or move the involved limb. Imaging studies confirmed the presence of a severely displaced fracture of the proximal humerus and occlusion of the axillary artery. She was taken for open reduction and internal fixation of the proximal humerus followed by immediate axillary artery endovascular stenting.
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Quality of Life after Accidental Major Vascular Injury and Prolonged ICU Stay - A Case Report

Survival or mortality rate is a reasonable choice of an outcome measure for critically ill patients in intensive care unit (ICU). But it is also important to assess the impact of critical illness and peri-operative complications on health status and quality of life (QoL) after hospital discharge. The QLQ-C30 is a 30-item cancer-specific questionnaire that incorporates five functioning scales (physical, role, cognitive, emotional, and social), eight symptoms scales, perceived financial impact of the disease and a global scale [1-5].
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Splenic Injury after Screening Colonoscopy; Could that Happen Twice? An Unusual Case Report

Iatrogenic splenic injury is a known but rare complication of colonoscopic procedures. Our department describes a very interesting case of the same complication that occurred twice on the same patient. The patient had an elective colonoscopy for microcytic anemia and shortly after the endoscopic procedure she developed excessive abdominal pain and had a syncope episode. She gradually became hemodynamically unstable and needed proper resuscitation. An abdominal tomography scan performed which surprisingly demonstrated active intra-abdominal bleeding pointing a ruptured spleen as the source of the hemorrhage. This finding surprised us given the fact that her past surgical history included a previous splenectomy for the same complication 14 years ago.
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A Case Series on Severe Corrosive Injury of Upper Gastrointestinal Tract

Corrosive injuries of the Upper gastrointestinal tract (UGIT) are common in developing countries mostly mortality and morbidity is high in India due to suicidal attempts. In this case series, a 17 years old female and 51 year old male subject intentionally self-harmed by ingesting toilet cleaner containing higher amounts of hydrochloric acid and presented to the emergency department of tertiary care hospital and the different aspects of the case are discussed in detail in this paper.
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Fracture of the Hamate with Interposition of the Base of 5th Metacarpal, a Frequently Missed Injury

We report a case of hamate fracture in the coronal plane with interposition of the base of 5th metacarpal bone. This injury is frequently missed and may results in increasing rate of morbidity and mal-union. In this article, the approach to this type of injuries, the diagnostic modalities, and the management will be discussed with review of the literature.
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Dual Fall, One Before and other after A High Voltage Electric Injury-Case Report

Electric injury by high voltage current is an event that has a very high rate of morbidity as well as mortality. Arcing is unique to high voltage electric injury where current is transferred between two points not in contact.
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The Role of Nutrition in Fighting Free Radicals

This paper aims to review in literature the main mechanisms of oxidative stress, pointing out the major formed metabolites, the mechanisms of cell damage and major antioxidants. Oxygen is essential to human life. The formation of free radicals (FR) is closely related to oxygen consumption, a mechanism that occurs with an incomplete reduction of this molecule.
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Mesenchymal Stem Cells in the Treatment of Patients with Chronic Spinal Cord Injury (ASIA A) with Residual Electrophysiological Function

Bone-marrow derived mesenchymal stem cells (MSC) represent an experimental form of therapy in the treatment of chronic spinal cord injury (SCI), up to two years after trauma.
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Proximity of the Sciatic Nerve in Relation to the Posterior Approach to the Hip, and its Relationship to Femoral Head Size

The posterior approach to the hip joint involves operating in close proximity to the sciatic nerve. Iatrogenic injury to the sciatic nerve has been reported to occur in 0.6 - 1.9% of cases [1]. Stretching, transection or suturing of the nerve may occur during access or while closing the capsule and short external rotators to the hip.
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Penetrating Arrow Wound of the Chest - A Case Report

In ancient India arrow injury was prevalent as it was a one of the most frequently used weapon. With passage of time use of bow and arrow became restricted to tribal area and its use became limited mostly to hunting. But in the recent years with progressively increasing terrorist activity in some areas arrow injuries are becoming more and more frequent.
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Complex Traumatic Facial Degloving Injury

By definition, degloving is detachment of skin and subcutaneous tissue, most often affecting the limbs and extremities and occasionally the scalp. Degloving generally occurs from high-energy trauma. This paper describes an extreme case of traumatic facial degloving injury. This is an extremely rare condition, as the patient survived despite the risk of imminent death. This case report addresses the decisions made regarding the emergency management, prevention of necrosis and infection by surgical debridement and timely repair of the vital soft tissue structures that guided the management.
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Therapeutic Hypothermia Still Effective in Prevention of Anoxic Encephalopathy following Extended Period of Pulselessness during Cardiac Arrest

There are approximately 300,000 out-of-hospital cardiac arrests per year with less than 10% of those surviving. More than half of survivors suffer permanent neurologic deficits. Therapeutic hypothermia has proven effective at thwarting neurologic damage occurring in the 16-hour window following return of spontaneous circulation (ROSC). Despite recommendations by the American Heart Association (AHA), many cardiologists have been slow to implement therapeutic hypothermia. While many trials have discussed the relevance of initial rhythm and delay of cooling, there has been limited discussion of the efficacy of therapeutic hypothermia in the presence of extended pulselessness.
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Editorial Board Members Related to injury

Xiaohong Kong

Professor
Medical & Molecular Virology Laboratory
Nankai University
China

Huangui Xiong

Professor
Department of Pharmacology and Experimental Neuroscience
University of Nebraska Medical Center
United States

Anuradha Ratna

Department of Medicine
University of Massachusetts Medical School
USA

Yuchuan Ding

Professor
Department of Neurosurgery
Wayne State University School of Medicine
United States

DAVID R. BLACK

Professor Emeritus
Department of Health and Kinesiology
Purdue University
United States

Gregory Murphy

Professor
Department of Health Science
La Trobe University
Australia

Li-Ru Zhao

Associate Professor
Department of Neurosurgery SUNY Upstate Medical University
United States

CHRISTOPHER THOMAS WHITLOW

Associate Professor of Division of Radiologic Sciences
Department of Radiology
Wake Forest School of Medicine
United States

Inbo Han

Associate professor
Department of Neurosurgery
CHA University
South Korea

Alfonso Caracuel

Assistant Professor
Department of Psychology and Education
University of Granada
Spain
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