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320 records – page 1 of 32.

A 4-year review of severe pediatric trauma in eastern Ontario: a descriptive analysis.

https://arctichealth.org/en/permalink/ahliterature191929
Source
J Trauma. 2002 Jan;52(1):8-12
Publication Type
Article
Date
Jan-2002
Author
Martin H Osmond
Maureen Brennan-Barnes
Allyson L Shephard
Author Affiliation
Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada. osmond@cheo.on.ca
Source
J Trauma. 2002 Jan;52(1):8-12
Date
Jan-2002
Language
English
Publication Type
Article
Keywords
Accident prevention
Accidental Falls - prevention & control - statistics & numerical data
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Age Distribution
Athletic Injuries - epidemiology - etiology - prevention & control
Child
Child Abuse - prevention & control - statistics & numerical data
Child, Preschool
Craniocerebral Trauma - epidemiology - etiology - prevention & control
Female
Hospitals, Pediatric - statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Ontario - epidemiology
Retrospective Studies
Sex Distribution
Time Factors
Trauma Centers - statistics & numerical data
Trauma Severity Indices
Wounds and Injuries - epidemiology - etiology - prevention & control
Abstract
The objective of this study was to describe a population of children admitted to a tertiary care pediatric hospital with severe trauma to identify key areas for injury prevention research, and programming.
Retrospective chart review conducted on all children 0-17 years admitted to the Children's Hospital of Eastern Ontario (CHEO) between April 1, 1996, and March 31, 2000, following acute trauma. Each record was reviewed and assigned an ISS using the AIS 1990 revision. All cases with an ISS > 11 were included in the study.
There were 2610 trauma cases admitted to CHEO over the study period. Of these, 237 (9.1%) had severe trauma (ISS > 11). Sixty-two percent were male. Twenty-nine percent were between the ages of 10 and 14 years, 27% between 5 and 9 years, 16% between 15 and 17 years, 15% between 1 and 4 years, and 13% less than 1 year old. The most common mechanisms of injury were due to motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%). Of those resulting from motor vehicle traffic, 53 (57%) were occupants, 22 (24%) were pedestrians, and 18 (19%) were cyclists. When combining traffic and nontraffic mechanisms, 26 (11% of all severe trauma cases) occurred as a result of cycling incidents. The most severe injury in 65% of patients was to the head and neck body region.
Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.
PubMed ID
11791045 View in PubMed
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[Acute hemorrhage: its classification and the determination of its size and severity (1)].

https://arctichealth.org/en/permalink/ahliterature210002
Source
Voen Med Zh. 1997 Jan;318(1):46-52
Publication Type
Article
Date
Jan-1997

Acute kidney injury following severe trauma: Risk factors and long-term outcome.

https://arctichealth.org/en/permalink/ahliterature267745
Source
J Trauma Acute Care Surg. 2015 Sep;79(3):407-12
Publication Type
Article
Date
Sep-2015
Author
Mikael Eriksson
Olof Brattström
Johan Mårtensson
Emma Larsson
Anders Oldner
Source
J Trauma Acute Care Surg. 2015 Sep;79(3):407-12
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - epidemiology - etiology - therapy
Adult
Female
Humans
Intensive Care Units
Male
Middle Aged
Prognosis
Retrospective Studies
Risk factors
Sweden - epidemiology
Trauma Severity Indices
Treatment Outcome
Wounds and Injuries - complications
Abstract
The trauma patient sustains numerous potentially harmful insults that may contribute to a notable risk of acute kidney injury (AKI). The aim of this study was to investigate the incidence of and to identify risk factors for AKI in severely injured trauma patients admitted to the intensive care unit (ICU). The patients were followed up for 1 year with respect to survival and end-stage renal disease.
Trauma patients admitted to the ICU for more than 24 hours at a Level I trauma center were included. The outcome measure was AKI diagnosed Days 2 to 7 of ICU treatment. Regression analysis was performed to identify factors associated with AKI development.
A quarter of the patients (103 of 413) developed AKI within the first week of ICU admission. AKI was associated with increased 30-day (17.5% vs. 5.8%) and 1-year (26.2% vs. 7.1%) mortality. Risk factors for AKI were male sex, age, nondiabetic comorbidity, diabetes mellitus, Injury Severity Score (ISS) greater than 40, massive transfusion, and volume loading with hydroxyethyl starch (HES) within the first 24 hours. Unexpectedly, sepsis before AKI onset, admission hypotension, and extensive contrast loading (>150 mL) were not associated with AKI development. None of the surviving AKI patients had developed end-stage renal disease 1 year after injury.
AKI in ICU-admitted trauma patients is a common complication with substantial mortality. Diabetes, male sex, and severe injury were strong risk factors, but age, nondiabetic comorbidity, massive transfusion, and resuscitation with HES were also associated with postinjury AKI. Based on the results of the current study, volume resuscitation with HES cannot be recommended in trauma patients.
Prognostic study, level III; therapeutic study, level IV.
PubMed ID
26307873 View in PubMed
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Adrenal response after trauma is affected by time after trauma and sedative/analgesic drugs.

https://arctichealth.org/en/permalink/ahliterature262760
Source
Injury. 2014 Aug;45(8):1149-55
Publication Type
Article
Date
Aug-2014
Author
Camilla Brorsson
Per Dahlqvist
Leif Nilsson
Johan Thunberg
Anders Sylvan
Silvana Naredi
Source
Injury. 2014 Aug;45(8):1149-55
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Aged, 80 and over
Analgesics - therapeutic use
Dehydroepiandrosterone - metabolism
Dehydroepiandrosterone Sulfate - metabolism
Female
Humans
Hydrocortisone - metabolism
Hypnotics and Sedatives - therapeutic use
Logistic Models
Male
Middle Aged
Pituitary-Adrenal Function Tests - methods
Pituitary-Adrenal System - drug effects - metabolism - physiopathology
Practice Guidelines as Topic
Prospective Studies
Sweden
Time Factors
Trauma Severity Indices
Treatment Outcome
Wounds and Injuries - drug therapy - metabolism - physiopathology
Abstract
The adrenal response in critically ill patients, including trauma victims, has been debated over the last decade. The aim of this study was to assess the early adrenal response after trauma.
Prospective, observational study of 50 trauma patients admitted to a level-1-trauma centre. Serum and saliva cortisol were followed from the accident site up to five days after trauma. Corticosteroid binding globulin (CBG), dehydroepiandrosterone (DHEA) and sulphated dehydroepiandrosterone (DHEAS) were obtained twice during the first five days after trauma. The effect of time and associations between cortisol levels and; severity of trauma, infusion of sedative/analgesic drugs, cardiovascular dysfunction and other adrenocorticotropic hormone (ACTH) dependent hormones (DHEA/DHEAS) were studied.
There was a significant decrease over time in serum cortisol both during the initial 24 h, and from the 2nd to the 5th morning after trauma. A significant decrease over time was also observed in calculated free cortisol, DHEA, and DHEAS. No significant association was found between an injury severity score = 16 (severe injury) and a low (
PubMed ID
24975481 View in PubMed
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Adult victims of sexual assault: acute medical response and police reporting among women consulting a center for victims of sexual assault.

https://arctichealth.org/en/permalink/ahliterature71299
Source
Acta Obstet Gynecol Scand. 2003 Aug;82(8):750-5
Publication Type
Article
Date
Aug-2003
Author
Berit Schei
Katrine Sidenius
Lene Lundvall
Gyda Lolk Ottesen
Author Affiliation
Center for Victims of Sexual Assault, Rigshospitalet, Copenhagen, Denmark. berit.schei@medisin.ntnu.no
Source
Acta Obstet Gynecol Scand. 2003 Aug;82(8):750-5
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Crime Victims - psychology - rehabilitation - statistics & numerical data
Delivery of Health Care - statistics & numerical data
Denmark
Emergency Medical Services - statistics & numerical data
Female
Humans
Middle Aged
Outpatient clinics, hospital - statistics & numerical data
Patient Acceptance of Health Care - psychology - statistics & numerical data
Police - statistics & numerical data
Referral and Consultation - statistics & numerical data
Sex Offenses - psychology - statistics & numerical data
Time Factors
Trauma Severity Indices
Abstract
BACKGROUND: The medical response to adult sexual assault should comprise: the collection of forensic evidence, the treatment of injuries, and follow-up counselling. In the past, victims of sexual assault reporting directly to the police may not have received this total medical care. The Copenhagen Center for Victims of Sexual Assault at Rigshospitalet, Denmark offers a 24-h service. Medical treatment and psychosocial follow up is offered independent of police reporting. The aim of this study was to assess whether adult sexual assault victims who reported to the police differed from those who did not report to the police. METHODS: Using clinical records, sociodemographics, characteristics of the assault, and type of preventive medical treatment received were obtained for 156 consecutive women consulting the Copenhagen Center (March 1st to December 31st 2000). Comparisons between characteristics of victims who reported to the police or not were determined. RESULTS: Ninety-four (60.2%) of the women reported to the police. Women who sought services within 24 h of the assault, had experienced use of force, were subjected to assault outdoors, and among whom nongenital injuries were observed were more likely to report to the police (p
PubMed ID
12848647 View in PubMed
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Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research.

https://arctichealth.org/en/permalink/ahliterature106604
Source
Lancet Neurol. 2013 Dec;12(12):1200-10
Publication Type
Article
Date
Dec-2013
Author
Andrew I R Maas
Gordon D Murray
Bob Roozenbeek
Hester F Lingsma
Isabella Butcher
Gillian S McHugh
James Weir
Juan Lu
Ewout W Steyerberg
Author Affiliation
Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium. Electronic address: andrew.maas@uza.be.
Source
Lancet Neurol. 2013 Dec;12(12):1200-10
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Brain Injuries - epidemiology - therapy
Canada
Data Collection - standards
Disease Management
Europe
Forecasting
Glasgow Coma Scale
Humans
International Cooperation
Middle Aged
Models, Neurological
Multicenter Studies as Topic - methods - standards
National Institute of Neurological Disorders and Stroke
National Institutes of Health (U.S.)
Prognosis
Randomized Controlled Trials as Topic - methods - standards
Research Design
Symptom Assessment - standards
Trauma Severity Indices
Treatment Outcome
United States
Abstract
Research in traumatic brain injury (TBI) is challenging for several reasons; in particular, the heterogeneity between patients regarding causes, pathophysiology, treatment, and outcome. Advances in basic science have failed to translate into successful clinical treatments, and the evidence underpinning guideline recommendations is weak. Because clinical research has been hampered by non-standardised data collection, restricted multidisciplinary collaboration, and the lack of sensitivity of classification and efficacy analyses, multidisciplinary collaborations are now being fostered. Approaches to deal with heterogeneity have been developed by the IMPACT study group. These approaches can increase statistical power in clinical trials by up to 50% and are also relevant to other heterogeneous neurological diseases, such as stroke and subarachnoid haemorrhage. Rather than trying to limit heterogeneity, we might also be able to exploit it by analysing differences in treatment and outcome between countries and centres in comparative effectiveness research. This approach has great potential to advance care in patients with TBI.
Notes
Comment In: Lancet Neurol. 2013 Dec;12(12):1132-324139679
PubMed ID
24139680 View in PubMed
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Aerobic capacity, orthostatic tolerance, and exercise perceptions at discharge from inpatient spinal cord injury rehabilitation.

https://arctichealth.org/en/permalink/ahliterature113262
Source
Arch Phys Med Rehabil. 2013 Oct;94(10):2013-9
Publication Type
Article
Date
Oct-2013
Author
Chelsea A Pelletier
Graham Jones
Amy E Latimer-Cheung
Darren E Warburton
Audrey L Hicks
Author Affiliation
Department of Kinesiology, McMaster University, Hamilton, ON.
Source
Arch Phys Med Rehabil. 2013 Oct;94(10):2013-9
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Body mass index
Canada
Cross-Sectional Studies
Exercise - psychology
Exercise Tolerance
Female
Heart rate
Humans
Hypotension, Orthostatic - physiopathology
Male
Middle Aged
Oxygen consumption
Paraplegia - etiology - physiopathology - psychology
Self Efficacy
Spinal Cord Injuries - complications
Trauma Severity Indices
Abstract
To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI).
Cross-sectional.
Two inpatient SCI rehabilitation programs in Canada.
Participants (N=41; mean age ± SD, 38.9 ± 13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean ± SD, 112.9 ± 52.5d postinjury).
Not applicable.
Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire.
There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2 ± 3.4;mL·kg(-1)·min(-1) 113.9 ± 19.7 beats/min) and LP (17.1 ± 7.5 mL·kg(-1)·min(-1); 142.8 ± 22.7 beats/min). Peak power output was also significantly lower in the TP group (30.0 ± 6.9W) compared with the HP (55.5 ± 7.56W) and LP groups (62.5 ± 12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (-3.0 ± 33.5 mmHg in TP, 17.8 ± 14.7 mmHg in HP, 21.6 ± 18.7 mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise.
Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP.
PubMed ID
23747647 View in PubMed
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[Age-specific peculiarities of manifestations of a craniocerebral injury in children and adolescents with a combined blunt trauma].

https://arctichealth.org/en/permalink/ahliterature131880
Source
Sud Med Ekspert. 2011 May-Jun;54(3):23-7
Publication Type
Article
Author
V M Karavaev
Source
Sud Med Ekspert. 2011 May-Jun;54(3):23-7
Language
Russian
Publication Type
Article
Keywords
Accident prevention
Accidental Falls - prevention & control - statistics & numerical data
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Age Distribution
Child
Child, Preschool
Female
Forensic Pathology
Head Injuries, Closed - epidemiology - pathology
Humans
Infant
Infant, Newborn
Male
Multiple Trauma - epidemiology - pathology
Population Surveillance
Russia - epidemiology
Trauma Severity Indices
Abstract
This study was designed to estimate the frequency of head injuries and selected manifestations of craniocerebral traumas in children and adolescents with a fatal combined blunt trauma. It is included 289 cases of death from a combined blunt trauma (101 original observations and data of 188 archival documents). The victims were categorized into 3 age groups. One group was comprised of cases from 0 to 3 years of life, group 2 included children aged from 4 to 11 years, and group 3 those at the age from 12 to 18 years. The age was shown to significantly influence both the frequency of head injuries and their severity. The maximum values of the two variables were recorded in the youngest age group. The frequency of head injuries and the number of selected manifestations of the craniocerebral trauma decreased with age.
PubMed ID
21866843 View in PubMed
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Aggravating and mitigating factors associated with cyclist injury severity in Denmark.

https://arctichealth.org/en/permalink/ahliterature257913
Source
J Safety Res. 2014 Sep;50:75-82
Publication Type
Article
Date
Sep-2014
Author
Sigal Kaplan
Konstantinos Vavatsoulas
Carlo Giacomo Prato
Author Affiliation
Department of Transport, Technical University of Denmark, Bygningstorvet 116B, 2800 Kgs. Lyngby, Denmark.
Source
J Safety Res. 2014 Sep;50:75-82
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Adult
Age Distribution
Aged
Alcoholic Intoxication - complications
Bicycling - injuries
Child
Denmark - epidemiology
Female
Head Protective Devices - statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Safety
Trauma Severity Indices
Young Adult
Abstract
Denmark is one of the leading cycling nations, where cycling trips constitute a large share of the total trips, and cycling safety assumes a top priority position in the agenda of policy makers. The current study sheds light on the aggravating and mitigating factors associated with cyclist injury severity on Danish roads by examining a comprehensive set of accidents involving a cyclist and a collision partner between 2007 and 2011.
This study estimates a generalized ordered logit model of the severity of cyclist injuries because of its ability to accommodate the ordered-response nature of severity while relaxing the proportional odds assumption.
Model estimates show that cyclist fragility (children under 10 years old and elderly cyclists over 60 years of age) and cyclist intoxication are aggravating individual factors, while helmet use is a mitigating factor. Speed limits above 70-80 km/h, slippery road surface, and location of the crash on road sections are aggravating infrastructure factors, while the availability of cycling paths and dense urban development are mitigating factors. Heavy vehicle involvement and conflicts between cyclists going straight or turning left and other vehicles going straight are aggravating vehicle involvement factors. Practical applications: The results are discussed in the context of applied policies, engineering, and traffic management solutions for bicycle safety in Denmark.
PubMed ID
25142363 View in PubMed
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Alcohol and drug use among motor vehicle collision victims admitted to a regional trauma unit: demographic, injury, and crash characteristics.

https://arctichealth.org/en/permalink/ahliterature220578
Source
Accid Anal Prev. 1993 Aug;25(4):411-20
Publication Type
Article
Date
Aug-1993
Author
G. Stoduto
E. Vingilis
B M Kapur
W J Sheu
B A McLellan
C B Liban
Author Affiliation
Prevention and Health Promotion Research and Development, Addiction Research Foundation, Toronto, Ontario, Canada.
Source
Accid Anal Prev. 1993 Aug;25(4):411-20
Date
Aug-1993
Language
English
Publication Type
Article
Keywords
Accidents - statistics & numerical data
Accidents, Traffic - statistics & numerical data
Adolescent
Adult
Aged
Aged, 80 and over
Alcohol Drinking - blood - epidemiology
Automobile Driving - statistics & numerical data
Demography
Ethanol - blood
Female
Humans
Incidence
Male
Middle Aged
Off-Road Motor Vehicles
Ontario - epidemiology
Prospective Studies
Substance-Related Disorders - epidemiology
Trauma Centers
Trauma Severity Indices
Abstract
This study examined the incidence of alcohol and drugs in a sample of seriously injured motor vehicle collision victims, and differences related to pre-crash use of alcohol and/or other drugs on demographic variables, injury severity measures, and crash variables. The sample selected were all motor vehicle collision admissions to the Regional Trauma Unit at the Sunnybrook Health Science Centre in Toronto, Ontario, over a 37-month period (N = 854). Prospective demographic and injury-related information were collected from hospital charts, and crash data were collected from motor vehicle collision police reports. Blood samples were routinely collected on admission and tested for blood alcohol concentration (BAC). We found 32.0% of the BAC-tested motor vehicle collision admissions and 35.5% of drivers tested positive for blood alcohol. The drivers' mean BAC on admission was found to be 145.2 mg/100 ml, and the mean estimated BAC at crash time was 181 mg/100 ml. Drug screens were performed on a two-year subsample (n = 474), of whom 339 were drivers. Drug screens revealed that 41.3% of drivers tested positive for other drugs in body fluids, and 16.5% were positive for alcohol in combination with other drugs. Other than alcohol, the drugs most frequently detected in the drivers were cannabinoids (13.9%), benzodiazepines (12.4%), and cocaine (5.3%). Investigation of differences on demographic, injury, and crash characteristics related to precrash use of alcohol and/or drugs yielded significant findings. In the drug screened sample we found sex, admission type, and occupant status were related to precrash alcohol use. Also, use of drugs was found to interact with admission type and mean BAC on admission. Elapsed time was found to be significantly different for BAC by other drug use, with a greater length of elapsed time found for the subjects testing other drug positive but BAC negative. We found that BAC-positive drug-screened drivers were significantly more likely to be male, involved in a single-vehicle collision, not wearing a seat belt, ejected from the vehicle, and travelling at higher speeds than BAC negative drivers. No significant differences were found between BAC and/or other drug use on injury severity measures.
PubMed ID
8357454 View in PubMed
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320 records – page 1 of 32.