Articles: trauma.
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Riding all-terrain vehicles (ATVs) is a popular recreational activity, with approximately 1.5 million users in Canada. Despite legislation aimed at reducing injury rates, ATV-related incidents remain a major cause of trauma and death. This paper reviews the epidemiology of major injury associated with ATV use in Nova Scotia. ⋯ ATV-related incidents are a continuing source of major injury. This paper describes the epidemiology of ATV-related major trauma presenting to the sole tertiary care referral centre in one province. Information gained from this study should be used to influence ATV public education programs.
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Neck pain is considered to be one of the most common chronic pain conditions in modern society. Various structures identified as capable of transmitting pain in the cervical spine include facet joints, intervertebral discs, nerve root dura, ligaments, fascia, and muscles. The prevalence of cervical facet joint pain in patients with chronic pain after whiplash has been determined as 54% to 60%. ⋯ Eighty-one or 70% of the patients (70%) reported a definite response to lidocaine blocks. Confirmatory blocks with bupivacaine were performed in 81 patients with 64 patients with 60% of the total sample, or 79%, of the lidocaine-positive group reporting definite response with improvement in their pain. Thus, a prevalence rate of facet joint pain in chronic neck pain was determined to be 60% (95% CI, 50%-70%), with a false positive rate of controlled diagnostic blocks of 40% (95% CI, 34%-46%).
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To provide a mechanism-based acute pain management strategy for early phantom limb pain following traumatic amputations and to collect first evidence of its acute and potentially preventative effects on the formation and maintenance of phantom limb pain. The combination of continuous brachial plexus analgesia and prolonged block of N-methyl-D-aspartate (NMDA) receptors over 4 weeks aimed to attenuate peripheral and central sensitization, currently thought to be substantially involved in establishing and maintaining phantom limb pain. ⋯ The combination of long-term regional analgesia with prolonged block of NMDA receptors might be effective for treatment and prevention of phantom limb pain following traumatic amputations. The absence of clinically relevant side effects, together with maintained motor function suggests this treatment to be a promising preventive strategy for phantom limb pain following traumatic amputations.
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Clinical prediction rules are decision-making tools that incorporate three or more variables from the history, physical examination or simple tests. They help clinicians make diagnostic or therapeutic decisions by standardizing the collection and interpretation of clinical data. There is growing interest in the methodological standards for their development and validation. This article describes the methods used to derive the Canadian C-Spine Rule and provides a valuable reference for investigators planning to develop future clinical prediction rules.