Does spending matters? Re-looking into various covariates associated with Out of Pocket Expenditure (OOPE) and catastrophic spending on accidental injury from NSSO 71st round data

During the last few decades it has been recognized that cell death is not the consequence of accidental injury, but is the expression of a cell suicide programme. Kerr et al. (1972) introduced the term apoptosis. This form of cell death is under the influence of hormones, growth factors and cytokines, which depending upon the receptors present on the target cells, may activate a genetically controlled cell elimination process. During apoptosis the cell membrane remains intact and the cell breaks into apoptotic bodies, which are phagocytosed. Apoptosis, in contrast to necrosis, is not harmful to the host and does not induce any inflammatory reaction. The principal event that leads to inflammatory disease is cell damage, induced by chemical/physical injury, anoxia or starvation. Cell damage means leakage of cell contents into the adjacent tissues, resulting in the capillary transmigration of granulocytes to the injured tissue. The accumulation of neutrophils and release of enzymes and oxygen radicals enhances the inflammatory reaction. Until now there has been little research into the factors controlling the accumulation and the tissue load of granulocytes and their histotoxic products in inflammatory processes. Neutrophil apoptosis may represent an important event in the control of intlamtnation. It has been assumed that granulocytes disintegrate to apoptotic bodies before their fragments are removed by local macrophages. Removal of neutrophils from the inflammatory site without release of granule contents is of paramount importance for cessation of inflammation. In conclusion, apoptotic cell death plays an important role in inflammatory processes and in the resolution of inflammatory reactions. The facts known at present should stimulate further research into the role of neutrophil, eosinophil and macrophage apoptosis in inflammatory diseases.

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436 Non-accidental injury and abusive head trauma in children – is the COVID-19 pandemic impacting teesside differently?

10.1136/bmjpo-2021-rcpch.247 ◽

2021 ◽

Author(s):

Matthew Davidson ◽

Shashwat Saran ◽

Qasim Mansoor ◽

Thomas Salisbury

Keyword(s):

Head Trauma ◽

Abusive Head Trauma ◽

Accidental Injury ◽

Non Accidental Injury

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Analysis of machete cut fractures in Nigerian civilian trauma setting

Scientific Reports ◽

10.1038/s41598-020-79981-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Njoku Isaac Omoke ◽

Omolade Ayoola Lasebikan ◽

Francis Ndubuisi Ahaotu ◽

Ugochukwu Uzodimma Nnadozie ◽

Gregory Chinedu Nwigwe

Keyword(s):

Hemorrhagic Shock ◽

Hospital Care ◽

Case Fatality ◽

Length Of Hospital Stay ◽

Accidental Injury ◽

Early Presentation ◽

Female Ratio ◽

Prolonged Length ◽

Civilian Trauma ◽

One Year

AbstractMachete cut fracture is an important component of morbidity associated with machete injuries although it is under reported. This was a retrospective study to assess machete cut fractures in patients seen in Federal Teaching Hospital Abakaliki and National Orthopaedic Hospital Enugu from 2009 to 2018. There were 91 patients with 154 fractures, male- to- female ratio was 10:1 and mean age was 31.6 ± 14.6 years. The aetiological factors were assault (57, 62.6%), armed robbery (29, 31.9%) and accidental injury (5, 5.5%). The three top bones involved were ulna, metacarpal and finger-phalanx. Fracture was communited in (17, 11.0%), and Gustilo Anderson grade IIIC in (22, 14.3%). Injury to hospital arrival interval later than 6 h was common and correlated with prolonged length of hospital stay (p < 0.001). Anaemia, wound infection and hemorrhagic shock were the three top complications. Nine (5.8%) fractures ended in extremity amputation. Eleven (12.1%) patients left against medical advice, and 5 (5.5%) were transferred. Normal union in 98.3% of the fractures treated and followed up for a minimum of one year. Case fatality rate was 2.2%; none of the patient that died had pre hospital care, and hemorrhagic shock accounted for all the mortality. These call for appropriate injury preventive mechanisms, and improved rates of early presentation of patients to hospital, and pre hospital care.

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The Removal of Infused Leucine after Injury, Starvation and other Conditions in Man

Clinical Science ◽

10.1042/cs0590275 ◽

1980 ◽

Vol 59 (4) ◽

pp. 275-283 ◽

Cited By ~ 23

Author(s):

M. Elia ◽

Rose Farrell ◽

Vera Ilic ◽

R. Smith ◽

D. H. Williamson

Keyword(s):

Muscular Dystrophy ◽

Blood Concentration ◽

Ketone Bodies ◽

Elective Surgery ◽

Metabolic Effects ◽

Accidental Injury ◽

Sufficient Energy ◽

Branched Chain ◽

Clinical Conditions ◽

Basal Concentration

1. To investigate the effects of starvation, elective surgery, accidental injury and other clinical conditions on the metabolism of branched-chain amino acids in man, we have measured the basal concentration of leucine and the removal and metabolic effects of infused l-leucine. 2. The blood concentration of leucine was significantly increased by surgery, starvation and accidental injury, and decreased in cirrhosis. It tended to increase in diabetes and was unaffected by muscular dystrophy. 3. The half-life of infused leucine was nearly doubled by 4 days of complete starvation, unaltered by surgery and decreased by severe accidental injury. Infusion with Intralipid, which increased free fatty acid and ketone-body concentrations, had no effect on the removal of a leucine load. The clearance rate of infused leucine was reduced in diabetes and muscular dystrophy and increased in cirrhosis. 4. The effects of infused leucine on blood glucose and ketone bodies differed according to the groups studied. 5. Since the traumatized patients were given sufficient energy and nitrogen and disposed of a leucine load at a different rate from the starved patients, the causes of the increase in blood concentration of leucine in these two conditions are different.

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