J Trauma
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Victims of violence are likely to become repeat victims of violence. Emergency department-based secondary prevention initiatives have been proposed to help break the cycle of violence for these youth. Trauma centers, by nature of their designation, are often charged with the responsibility of developing these prevention initiatives. We hypothesize that the majority of youth who are injured by violence are treated in nontrauma centers. Given the goal is to prevent recurrent injury, trauma center-based initiatives may be misdirected. ⋯ Given the vast majority of patients are not seen at trauma centers, any prevention initiatives located here will not achieve the goals of preventing recurrent injury on a population basis. Secondary prevention initiatives should be implemented and evaluated in nontrauma centers.
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Specific information about the supervision of young children with injuries related to falls is limited. In this study, we describe the supervision and physical environment of falls resulting in medical care in the emergency department. ⋯ Many children were supervised at the time of their fall. Most caretakers had visual contact, and up to a third were touching or within reach of the child. The strategies used in these apparently low-risk situations were insufficient to prevent the falls we report.
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Our goal was to analyze whether radiographic fracture pattern correlates with mortality of patients with lateral compression type 1 (LC1) fractures. ⋯ Sacral fracture pattern does not seem to be predictive of mortality for patients with LC1 pelvic fractures The presence of associated injuries seems to be the key driver of mortality.
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Blunt thoracic trauma including behind armour blunt trauma or impact from a less lethal kinetic weapon (LLKW) projectile may cause injuries, including pulmonary contusions that can result in potentially lethal secondary complications. These lung injuries may be caused by intrathoracic pressure waves. The aim of this study was to observe dynamic changes in intrathoracic hydrostatic pressure during ballistic blunt thoracic trauma and to find correlations between these hydrostatic pressure parameters (especially the impulse parameter) and physical damages. ⋯ The PI(max) is a good predictor of pulmonary contusion volume after ballistic blunt thoracic trauma. It is a useful criterion when the kinetic energy record or thoracic wall displacement data are unavailable, and the recording and calculation of this physical value are quite simple on animals.
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: Injury stimulates an innate airway IgA response in severely injured patients, which also occurs in mice. Tumor necrosis factor (TNF)-α and interleukin (IL)-1β stimulate the production of polymeric immunoglobulin receptor, the protein required to transport immunoglobulin A (IgA) to mucosal surfaces. Blockade of TNF-α and IL-1β eliminates the airway IgA response to injury. IL-6 stimulates differentiation of B cells into IgA-secreting plasma cells at mucosal sites. We investigated the local and systemic kinetics of TNF-α, IL-1β, and IL-6 after injury in mice. We also hypothesized that injection of exogenous TNF-α, IL-1β, and IL-6 would replicate the airway IgA response to injury. ⋯ : Airway levels of TNF-α, IL-1β, and IL-6 increase in a bimodal pattern after injury with peaks at 3 hours and 8 hours, which do not correspond to serum changes. The peak at 8 hours is consistent with the known increase in airway IgA after injury. Intraperitoneal injection of a combination exogenous TNF-α, IL-1β, and IL-6 replicates the airway IgA increase after injury. This effect is not seen with individual cytokine injections.