J Trauma
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Great emphasis is placed on the lethality of modern high-powered street weapons, and their impact on mortality from firearm injuries. Presented is a case of an air rifle BB injury to the chest, resulting in a penetrating injury of the right heart, with apparent retrograde embolization to the inferior vena cava. ⋯ This case exemplifies three important principles regarding penetrating chest trauma and air guns: (1) Modern air rifles, capable of muzzle velocities as high as 900 fps, are intrinsically lethal weapons; (2) missiles within the cardiovascular system have a propensity for embolization, and often follow an intuitively unexpected course; and (3) young healthy patients with potentially lethal penetrating cardiac injuries, particularly those caused by low velocity firearms, may appear stable and minimally injured in the emergency room. A strong suspicion of cardiac injury and prompt intervention should be extended to airgun injuries of the thorax.
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Comparative Study
Gunshot wounds seen at a county hospital before and after a riot and gang truce: Part Two.
An analysis was undertaken of the number of gunshot wound victims seen at a Los Angeles County hospital both before and after the Los Angeles riot. Since the LA riot the gang truce between the "Bloods" and the "Crips" resulted in a significant decrease in the number of gunshot wound victims seen at a level I trauma center in Los Angeles. Unfortunately, this lasted for only three months. The resurgence of shootings, mainly of the drive-by type (82%), to an occurrence rate higher than ever before, has negated any positive effect of the gang truce and indicates the need for additional measures to control gang violence.
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Comparative Study
Comparison of high-field magnetic resonance imaging with computed tomography in the evaluation of blunt renal trauma.
To compare magnetic resonance (MR) imaging and computed tomography (CT) in radiographic staging of blunt renal trauma. ⋯ Although CT remains the method of choice in radiographic staging of renal injury, MR imaging can complement CT in patients with severe renal injury, pre-existing renal abnormality, equivocal CT findings, or when repeated radiographic follow-up is required. MR imaging could replace CT in patients with iodine allergy and be used for initial staging if CT is not available.
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The changing profiles of spinal cord injuries in South Africa are addressed in this study. ⋯ Gunshots carry a heavier prognosis. Only 32% of our gunshot cases underwent a significant recovery as opposed to 61% of stab cases and 44% of the motor vehicle crash victims.
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To determine if trauma patients qualifying by a 1990 American College of Surgeons (ACS) audit filter have the same outcomes and resource utilizations as similar (matching) patients not qualifying by the filter. ⋯ Additional studies of the efficacy and efficiency of trauma quality assurance filters are needed. Objective criteria should be established for the definition, evaluation, modification, and adoption of trauma audit filters.