Diagnostic accuracies of CTs, X-rays and Lodox to detect blunt force trauma in adults, using a pig model

2021 ◽  
pp. 002580242110495
Author(s):  
Amy Joy Spies ◽  
Maryna Steyn ◽  
Desiré Brits
Keyword(s):  
Gold Standard ◽  
Major Trauma ◽  
Diagnostic Value ◽  
X Rays ◽  
Blunt Force ◽  
Body Regions ◽  
Blunt Force Trauma ◽  
Adult Humans ◽  
Minimum Number ◽  
Pig Carcasses

The accurate radiological detection of skeletal trauma is crucial for the investigation of blunt force trauma (BFT) cases. The sensitivities of CTs, X-rays and Lodox in identifying BFT fractures and minimum number of impacts in pigs, used as proxies for adult humans, were assessed. Ten human sized pig carcasses were struck with a mallet and scanned, after which the number of fractures and minimum number of impacts detected radiologically were recorded. Pig carcasses were then macerated, and the defleshed, skeletonized remains were considered the gold standard as far as number and location of fractures were concerned. CTs were most sensitive in identifying fractures and impacts in all body regions, with overall sensitivities of 55.4% and 71.5% respectively, while X-rays and Lodox had sensitivities of 25.8% and 29.3% for fractures, and 43.5% and 41.1% for impacts, respectively. All modalities were highly specific for identifying fractures (CT: 99.1%; X-ray: 98.9%; Lodox: 99.4%). CTs should be used to analyze blunt force trauma when a radiological assessment is required, but an examination of the defleshed bones remains the gold standard for the deceased whenever feasible. X-rays and Lodox have limited diagnostic value in these cases and relying on them to detect fractures may compromise the accurate forensic investigation of blunt trauma victims. However, the use of Lodox for initial screening of major trauma is still of value. Sensitivities are generally higher for detecting fractures in pigs compared to piglets, indicating that increased diagnostic value is achieved when imaging pigs compared to piglets.

Endovascular Stent Graft Treatment of Acute Thoracic Aortic Transections Due to Blunt Force Trauma

2009 ◽  
Vol 16 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Marc A. Bjurlin ◽  
Eugene M. Tanquilut ◽  
Aswath Subram ◽  
Peggy Kalkounos ◽  
Gary J. Merlotti
Keyword(s):  
Stent Graft ◽  
Endovascular Stent ◽  
Endovascular Stent Graft ◽  
Blunt Force ◽  
Blunt Force Trauma

ASSESSMENT OF OSTEOARTHRITIS INITIATIVE–KELLGREN AND LAWRENCE SCORING PROJECTS QUALITY USING COMPUTER ANALYSIS

2010 ◽  
Vol 13 (04) ◽  
pp. 197-201 ◽  
Author(s):  
Lior Shamir ◽  
David T. Felson ◽  
Luigi Ferrucci ◽  
Ilya G. Goldberg
Keyword(s):  
Image Analysis ◽  
Gold Standard ◽  
Population Studies ◽  
Detection Accuracy ◽  
X Rays ◽  
Analysis Method ◽  
Image Analysis Method ◽  
X Ray ◽  
Osteoarthritis Initiative ◽  
Kellgren And Lawrence

The detection of knee osteoarthritis (OA) is a subjective task, and even two highly experienced and well-trained readers might not always agree on a specific case. This problem is noticeable in OA population studies, in which different scoring projects provide significantly different scores for the same knee X-rays. Here we propose a method for quantitative assessment and comparison of knee X-ray scoring projects in OA population studies. The method works by applying an image analysis method that automatically detects OA in knee X-ray images, and comparing the consistency of the scores when using each of the scoring projects as "gold standard." The method was applied to compare the osteoarthritis initiative (OAI) clinic reading derived Kellgren and Lawrence (K&L) scores to central reading, and showed that when using the derived K&L scores the automatic image analysis method was able to accurately differentiate between healthy joints and moderate OA joints in ~70% of the cases. When the OAI central reading scores were used as gold standard, the detection accuracy was elevated to ~77%. These results show that the OAI central readings scores are more consistent with the X-rays, indicating that the central reading better reflects the radiographic features associated with OA, compared to the OAI K&L scores derived from clinic readings.

scholarly journals Patterns of blunt force homicide in the West Metropole of the City of Cape Town, South Africa

2017 ◽  
Vol 113 (5/6) ◽  
Author(s):  
Courtnee Clark ◽  
Calvin G. Mole ◽  
Marise Heyns ◽  
◽  
◽  
...  
Keyword(s):  
South Africa ◽  
Cape Town ◽  
Future Research ◽  
The West ◽  
Blunt Force ◽  
Blunt Force Trauma ◽  
Lack Of Information ◽  
Salt River ◽  
The City ◽  
Ballistic Trauma

There is currently a lack of information regarding the prevalence of and characteristics associated with blunt force trauma related homicides in South Africa. Information relating to the patterns of blunt force trauma could assist in the development and implementation of interventions targeted at specific areas or individuals as well as direct future research towards areas in need of investigation. This study is a 5-year retrospective review of autopsy reports obtained from Salt River Mortuary (Cape Town, South Africa). The prevalence of blunt force trauma was considered for unnatural deaths with a focus on homicide. The patterns of homicidal blunt force trauma are also presented. A total of 15 519 autopsy cases was analysed. In 1198 (7.72%) of these cases, the cause of death was found to be blunt force trauma and 828 (5.32%) of these cases were classified as homicides. Approximately 11% of blunt force homicide cases occurred in combination with sharp and/or ballistic trauma. Men from poor socio-economic areas were shown to be most at risk of blunt force homicide in the City of Cape Town.

Accuracy of 11 formulae to guide umbilical arterial catheter tip placement in newborn infants

2017 ◽  
Vol 103 (4) ◽  
pp. F364-F369 ◽  
Author(s):  
Wei Ling Lean ◽  
Jennifer A Dawson ◽  
Peter G Davis ◽  
Christiane Theda ◽  
Marta Thio
Keyword(s):  
Gold Standard ◽  
Newborn Infants ◽  
Body Part ◽  
Accurate Method ◽  
Arterial Catheter ◽  
X Rays ◽  
Success Rates ◽  
Common Procedure ◽  
Optimal Position ◽  
Umbilical Arterial Catheter

BackgroundUmbilical arterial catheter (UAC) insertion is a common procedure in the neonatal intensive care unit (NICU). Correct placement of the tip of the UAC at first attempt minimises handling of the infant and reduces the risk of infection and complications. We aimed to determine the accuracy of 11 published formulae to guide UAC placement.MethodsThis was a one-year prospective observational study in a tertiary NICU. Clinicians used their preferred formula for UAC insertion, with X-rays performed immediately post-procedure to check the tip position. Birth weight and measurements included in the 11 formulae were recorded within 48 hours. The gold standard insertion distance was defined as the distance from the abdominal wall to the mid-descending aorta, at T8 level on X-ray (range T6–T10). Insertion length using the 11 formulae was calculated and compared with this gold standard distance.ResultsOne hundred and three infants were included, with median (IQR) gestational age and weight of 28 (26–33.5) weeks and 980 (780–2045) g, respectively. The predicted value of the 11 formulae to place the UAC in correct position ranged from 51.0% to 73.8%. Formulae that involved direct body part measurements showed the highest predicted success rates, smallest mean difference from T8 and narrowest limits of agreement using the Bland-Altman method.ConclusionSuccess rates for accurate UAC placement are highest when formulae that involve body measurements are used. However, even the most accurate method would result in more than 25% of UACs needing manipulation to achieve an optimal position.

scholarly journals Plain Radiography May Be Safely Omitted for Selected Major Trauma Patients Undergoing Whole Body CT: Database Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Sarah Hudson ◽  
Adrian Boyle ◽  
Stephanie Wiltshire ◽  
Lisa McGerty ◽  
Sara Upponi
Keyword(s):  
Major Trauma ◽  
Research Network ◽  
Whole Body ◽  
Trauma Patients ◽  
X Rays ◽  
Database Study ◽  
Primary Survey ◽  
Whole Body Ct ◽  
Plain Films ◽  
Body Ct

Introduction. Whole body CT is being used increasingly in the primary survey of major trauma patients. We evaluated whether omitting plain films of the chest and pelvis in the primary survey was safe. We compared the probability of survival of patients and time to CT who had plain X-rays to those who did not.Method. We performed a database study on major trauma patients admitted between 2008 and 2010 using data from Trauma, Audit and Research Network (TARN) and our PACS system. We included adult major trauma patients who has an ISS of greater than 15 and underwent whole body CT.Results. 245 patients were included in the study. 44 (17.9%) did not undergo plain films. The median time to whole body CT from the time of admission was longer (47 minutes) in patients having plain films, than those who did not have plain films performed (30 minutes),P<0.005. Mortality was increased in the group who received plain films, 9.5% compared to 4.5%, but this was not statistically significant (P=0.77).Conclusion. We conclude that plain films may be safely omitted during the primary survey of selected major trauma patients.

scholarly journals Identifying Blunt Force Traumatic Injury on Thermally Altered Remains: A Pilot Study Using Sus scrofa

Biology ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 87
Author(s):  
Kamryn Keys ◽  
Ann H. Ross
Keyword(s):  
Pilot Study ◽  
Forensic Anthropology ◽  
Sus Scrofa ◽  
Traumatic Injury ◽  
Human Remains ◽  
Fire Damage ◽  
Fire Exposure ◽  
Blunt Force ◽  
Blunt Force Trauma ◽  
Anthropological Literature

In forensic scenarios involving homicide, human remains are often exposed to fire as a means of disposal and/or obscuring identity. Burning human remains can result in the concealment of traumatic injury, the creation of artifacts resembling injury, or the destruction of preexisting trauma. Since fire exposure can greatly influence trauma preservation, methods to differentiate trauma signatures from burning artifacts are necessary to conduct forensic analyses. Specifically, in the field of forensic anthropology, criteria to distinguish trauma from fire signatures on bone is inconsistent and sparse. This study aims to supplement current forensic anthropological literature by identifying criteria found to be the most diagnostic of fire damage or blunt force trauma. Using the skulls of 11 adult pigs (Sus scrofa), blunt force trauma was manually produced using a crowbar and flat-faced hammer. Three specimens received no impacts and were utilized as controls. All skulls were relocated to an outdoor, open-air fire where they were burned until a calcined state was achieved across all samples. Results from this experiment found that blunt force trauma signatures remained after burning and were identifiable in all samples where reassociation of fragments was possible. This study concludes that distinct patterns attributed to thermal fractures and blunt force fractures are identifiable, allowing for diagnostic criteria to be narrowed down for future analyses.

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