scholarly journals Computing Brain White and Grey Matter Injury Severity in a Traumatic Fall

2020 ◽  
Vol 25 (3) ◽  
pp. 61
Author(s):  
Christophe Bastien ◽  
Clive Neal-Sturgess ◽  
Huw Davies ◽  
Xiang Cheng
Keyword(s):  
Grey Matter ◽  
Injury Severity ◽  
Real Life ◽  
Material Degradation ◽  
Traumatic Injuries ◽  
Impact Location ◽  
Trauma Model ◽  
Grey Matter Injury ◽  
Trauma Responses ◽  
Tissue Material

In the real world, the severity of traumatic injuries is measured using the Abbreviated Injury Scale (AIS). However, the AIS scale cannot currently be computed by using the output from finite element human computer models, which currently rely on maximum principal strains (MPS) to capture serious and fatal injuries. In order to overcome these limitations, a unique Organ Trauma Model (OTM) able to calculate the threat to the life of a brain model at all AIS levels is introduced. The OTM uses a power method, named Peak Virtual Power (PVP), and defines brain white and grey matter trauma responses as a function of impact location and impact speed. This research has considered ageing in the injury severity computation by including soft tissue material degradation, as well as brain volume changes due to ageing. Further, to account for the limitations of the Lagrangian formulation of the brain model in representing hemorrhage, an approach to include the effects of subdural hematoma is proposed and included as part of the predictions. The OTM model was tested against two real-life falls and has proven to correctly predict the post-mortem outcomes. This paper is a proof of concept, and pending more testing, could support forensic studies.

Left ventricular dysfunction is associated with cerebral grey matter injury: An in-vivo brain MRI segmentation study

2012 ◽  
Vol 321 (1-2) ◽  
pp. 111-113 ◽  
Author(s):  
Pratik Bhattacharya ◽  
Fen Bao ◽  
Megha Shah ◽  
Gautam Ramesh ◽  
Ramesh Madhavan ◽  
...  
Keyword(s):  
Left Ventricular Dysfunction ◽  
Grey Matter ◽  
Ventricular Dysfunction ◽  
Brain Mri ◽  
Left Ventricular ◽  
Mri Segmentation ◽  
Cerebral Grey Matter ◽  
Grey Matter Injury

scholarly journals Recovery of Post-Traumatic Temporomandibular Joint after Mandibular Fracture Immobilization: A Literature Review

2021 ◽  
Vol 11 (21) ◽  
pp. 10239
Author(s):  
Carmen Gabriela Stelea ◽  
Doriana Agop-Forna ◽  
Raluca Dragomir ◽  
Codrina Ancuţa ◽  
Roland Törok ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Real Life ◽  
Mandibular Fracture ◽  
Temporomandibular Joint Disorders ◽  
Treatment Modalities ◽  
Mandibular Fractures ◽  
Traumatic Injuries ◽  
Joint Fractures ◽  
Post Traumatic ◽  
Mandible Fractures

Considered as one of the most common traumatic injuries of the maxillofacial region, mandibular fractures remain among the complex causes of temporomandibular joint disorders (TMDs). Due to the complexity of the temporomandibular joint, the management of TMDs represents a challenge in real-life practice; although many treatment modalities have already been proposed, ranging from conservative options to open surgical procedures, a consensus is still lacking in many aspects. Furthermore, despite continuous improvement of the management of mandible fractures, the duration of immobilization and temporary disability is not reduced, and the incidence of complications remains high. The aim of the present study is to (i) review anatomophysiological components of temporomandibular joint; (ii) review concepts of temporomandibular joint fractures; and (iii) describe methods of the recovery of the temporomandibular joint after mandibular fracture immobilization.

A METHOD TO CALCULATE THE AIS TRAUMA SCORE FROM A FINITE ELEMENT MODEL

2020 ◽  
Vol 20 (06) ◽  
pp. 2050034 ◽  
Author(s):  
C. BASTIEN ◽  
C. NEAL-STURGESS ◽  
J. CHRISTENSEN ◽  
L. WEN
Keyword(s):  
Finite Element ◽  
Head Trauma ◽  
Head Injuries ◽  
Real Life ◽  
Element Model ◽  
Organ Injury ◽  
Trauma Severity ◽  
Lagrangian Finite Element ◽  
Trauma Model ◽  
Gray Matters

In the real world, traumatic injuries are measured using the Abbreviated Injury Scale (AIS), however, such a scale cannot be computed to date or the injury precisely located by using human computer models. These models use stresses and strains to evaluate whether serious or fatal injuries are reached, which unfortunately bear no direct relation to AIS. This paper proposes to overcome this deficiency and suggests a unique Organ Trauma Model (OTM) able to calculate the risk to life of any organ injury, focussing in this case on real-life pedestrian head injuries. The OTM uses a power method, named Peak Virtual Power (PVP), and defines a brain white and gray matters trauma response as a function of impact direction and impact speed. The OTM was tested against four real-life pedestrian accidents and proved to predict the head trauma severity and location. In some cases, the method did however under-estimate the trauma by 1 AIS level because of post-impact haemorrhage which cannot be captured with Lagrangian Finite Element solvers. The OTM has the potential to create an important advance in vehicle safety by adding more information on the risk of head trauma.

Grey matter injury in preterm infants: regionale Spektral-EEG-Unterschiede zwischen Früh- und Reifgeborenen im Vorschulalter

2008 ◽  
Vol 212 (S 1) ◽  
Author(s):  
A van Baalen ◽  
S Landowski ◽  
T Müller ◽  
E Kruppa ◽  
R Bohn ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Grey Matter ◽  
Grey Matter Injury

Physiologic Features of Brain Death

2017 ◽  
Vol 83 (8) ◽  
pp. 850-854 ◽  
Author(s):  
Eno-Obong Essien ◽  
Kristina Fioretti ◽  
Thomas M. Scalea ◽  
Deborah M. Stein
Keyword(s):  
Brain Death ◽  
Injury Severity ◽  
Organ Donor ◽  
Respiratory Dysfunction ◽  
Traumatic Injuries ◽  
Potential Organ Donor ◽  
Major Mechanism ◽  
Patient Demographics ◽  
Widespread Belief ◽  
Brain Dead

Brain death is known to be associated with physiologic derangements but their incidence is poorly described. Knowledge of the changes that occur during brain death is important for management of the potential organ donor. Thus, we sought to characterize the pathophysiology that occurs during brain death in patients with traumatic injuries. All brain-dead patients over a 10-year period were identified from the trauma registry at a level 1 urban trauma center. Patient demographics, injury characteristics, and clinical data for defining organ dysfunction were reviewed for the 24 hours surrounding brain-death declaration. Three hundred and seventy-three patients were identified. Mean age was 37 years (617.2). Seventy-five per cent were male. Major mechanism of injury was blunt trauma in 66 per cent. Median injury severity score was 34 (IQR 25–43) with a median head abbreviated injury scale score of 5. The most common physiological disturbance was hypotension with 91 per cent of subjects requiring vasopressors. Thrombocytopenia and acidosis both had an incidence of 79 per cent. The next most common disturbances were hypothermia and moderate-to-severe respiratory dysfunction in 62 per cent. Myocardial injury was seen in 91 per cent but only 5.7 per cent of patients manifested severe cardiac dysfunction with an ejection fraction of <35. Diabetes insipidus was diagnosed in 50 per cent of patients. Interestingly, coagulopathy was noted in only 61.3 per cent, and hyperglycemia was seen in 36 per cent despite widespread belief that these occur universally during brain death. This is the first and largest study to characterize the incidence of pathophysiological disturbances following brain death in humans. Appropriate management of these dysfunctions is important for support of potential brain-dead organ donors.

scholarly journals Acute traumatic injuries of the adrenal gland: results of analysis of the Pennsylvania trauma outcomes study registry

2020 ◽  
Vol 5 (1) ◽  
pp. e000487
Author(s):  
Jody C DiGiacomo ◽  
Noam Gerber ◽  
L D George Angus ◽  
Swapna Munnangi ◽  
Sara Cardozo-Stolberg
Keyword(s):  
Adrenal Gland ◽  
Injury Severity ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Severe Injury ◽  
Level Of Evidence ◽  
Trauma Outcomes ◽  
Traumatic Injuries ◽  
Abdominal Organs ◽  
Outcomes Study

BackgroundBlunt injuries to the adrenal glands are considered rare, associated with severe injury, and highly mortal, based on autopsy series and earlier retrospective reviews. Recent studies have reported higher incidence rates associated with lower injury severity and mortality rates.MethodsA 3-year review of the Pennsylvania Trauma Outcomes Study Registry of adults with intra-abdominal injuries after blunt trauma was performed and associated organ injuries, injury parameters and in-hospital mortality were compared between those with and those without adrenal gland injury.Results5679 patient records were identified, 439 with adrenal gland injuries and 5240 without. The liver and the kidney were the intra-abdominal organs most frequently associated with injuries to an adrenal gland, and the spleen was the intra-abdominal organ most frequently injured in those without an adrenal gland injury. There was no difference in mortality rates.DiscussionInjuries to the adrenal gland occur with an incidence of 0.43% after blunt force trauma. The presence of a blunt adrenal gland injury is not a marker of severe injury or associated with an increased mortality rate.Level of evidenceII, Retrospective Study.

scholarly journals Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study

10.2196/25980 ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. e25980
Author(s):  
Helene Lundgaard Soberg ◽  
Håkon Øgreid Moksnes ◽  
Audny Anke ◽  
Olav Røise ◽  
Cecilie Røe ◽  
...  
Keyword(s):  
Health Care ◽  
Service Provision ◽  
Major Trauma ◽  
Injury Severity ◽  
University Hospital ◽  
First Year ◽  
Traumatic Injuries ◽  
Geographical Regions ◽  
Rehabilitation Needs

Background Traumatic injuries, defined as physical injuries with sudden onset, are a major public health problem worldwide. There is a paucity of knowledge regarding rehabilitation needs and service provision for patients with moderate and major trauma, even if rehabilitation research on a spectrum of specific injuries is available. Objective This study aims to describe the prevalence of rehabilitation needs, the provided services, and functional outcomes across all age groups, levels of injury severity, and geographical regions in the first year after trauma. Direct and indirect costs of rehabilitation provision will also be assessed. The overarching aim is to better understand where to target future efforts. Methods This is a population-based prospective follow-up study. It encompasses patients of all ages with moderate and severe acute traumatic injury (New Injury Severity Score >9) admitted to the regional trauma centers in southeastern and northern Norway over a 1-year period (2020). Sociodemographic and injury data will be collected. Upon hospital discharge, rehabilitation physicians estimate rehabilitation needs. Rehabilitation needs are assessed by the Rehabilitation Complexity Scale Extended–Trauma (RCS E–Trauma; specialized inpatient rehabilitation), Needs and Provision Complexity Scale (NPCS; community-based rehabilitation and health care service delivery), and Family Needs Questionnaire–Pediatric Version (FNQ-P). Patients, family caregivers, or both will complete questionnaires at 6- and 12-month follow-ups, which are supplemented by telephone interviews. Data on functioning and disability, mental health, health-related quality of life measured by the EuroQol Questionnaire (EQ-5D), and needs and provision of rehabilitation and health care services are collected by validated outcome measures. Unmet needs are represented by the discrepancies between the estimates of the RCS E–Trauma and NPCS at the time of a patient’s discharge and the rehabilitation services the patient has actually received. Formal service provision (including admission to inpatient- or outpatient-based rehabilitation), informal care, and associated costs will be collected. Results The project was funded in December 2018 and approved by the Regional Committee for Medical and Health Research Ethics in October 2019. Inclusion of patients began at Oslo University Hospital on January 1, 2020, and at the University Hospital of North Norway on February 1, 2020. As of February 2021, we have enrolled 612 patients, and for 286 patients the 6-month follow-up has been completed. Papers will be drafted for publication throughout 2021 and 2022. Conclusions This study will improve our understanding of existing service provision, the gaps between needs and services, and the associated costs for treating patients with moderate and major trauma. This may guide the improvement of rehabilitation and health care resource planning and allocation. International Registered Report Identifier (IRRID) DERR1-10.2196/25980

Does use of a trauma checklist increase discharges from the emergency department?

Trauma ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 52-57
Author(s):  
Amani Jambhekar ◽  
Ryan Lindborg ◽  
Vincent Chan ◽  
Daniel Laskey ◽  
James Rucinski ◽  
...  
Keyword(s):  
Emergency Department ◽  
Healthcare Costs ◽  
Injury Severity ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Exact Test ◽  
Traumatic Injuries ◽  
Before And After ◽  
Discharged Patients ◽  
Unpaired Student

Introduction Emergency department (ED) discharge is appropriate for patients with minor traumatic injuries. The objective of this study is to determine if use of a trauma checklist increases identification of patients with minor trauma who are safe for discharge. Methods Data were collected on trauma patients evaluated between 1 April 2015 and 31 January 2016 in two groups before and after introduction of a trauma checklist. The two groups were compared using age, mechanism of injury, and Injury Severity Score (ISS) using unpaired Student t-tests and Fisher’s exact test. Results A total of 841 trauma patients were included; 197 prior to the introduction of the checklist and 644 afterwards. Following the implementation of the trauma checklist, significantly more patients were discharged from the ED (18.2% vs. 7.6%, p = 0.0004). Discharged patients in the pre- and post-checklist groups had similar ISS (1.93 ± 1.49 vs. 1.87 ± 1.90, p = 0.90) and were of similar age (35.27 ± 11.06 vs. 41.99 years ± 18.20, p = 0.17). There was no increase in ‘bounce-backs’ to the ED in the post checklist group despite a significantly higher rate of discharge. Conclusion Use of a trauma checklist allows for better identification of those trauma patients who are safe to discharge from the ED and widespread use may decrease healthcare costs.

scholarly journals Incidence of Elevated Procalcitonin and Presepsin Levels after Severe Trauma: A Pilot Cohort Study

2017 ◽  
Vol 45 (5) ◽  
pp. 600-604 ◽  
Author(s):  
K. Hoshino ◽  
Y. Irie ◽  
M. Mizunuma ◽  
K. Kawano ◽  
T. Kitamura ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Injury Severity ◽  
Severe Trauma ◽  
Trauma Patients ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Traumatic Injuries ◽  
Early Phases

Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses. In this study, 75 patients were included. PCT levels on days 0 and 1 were 0.1±0.4 and 1.8±6.3 ng/ml, respectively (P=0.02). PSEP levels on days 0 and 1 were 221±261 and 222±207 pg/ml, respectively (P=0.98). As per multivariate logistic regression analyses, packed red blood cell (PRBC) transfusion was the only independent risk factor for higher PCT levels on day 1 (P=0.04). Using PCT to diagnose sepsis in trauma patients on day 1 requires caution. PRBC transfusion was found to be a risk factor for increasing PCT levels. On the other hand, PSEP levels were not affected by trauma during the early phases.

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