Assault-related facial fractures : does the injury mechanism matter?

This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assault-related facial fracture patients were included; demographic factors, facial fracture type, associated injuries, alcohol use, and injury mechanisms were recorded. Assault mechanisms most often included combinations of different mechanisms (57.5%) and resulted in the victim falling (50.1%). The perpetrator was most commonly a stranger (52.5%) and acted alone (57.7%). A total of 123 patients (14.6%) had associated injuries, with the most common being traumatic brain injury. Associated injuries occurred most frequently in patients with combined fractures of the facial thirds (24.2%) and upper third fractures (42.9%). The most significant differentiating factors for associated injuries were the number of perpetrators, falling, the use of an offensive weapon, and if the events of the assault remained unknown. In adjusted logistic regression analyses, statistically significant associations with associated injuries were found for age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.07; P < 0.001), falling due to the assault (OR 2.87, 95% CI 1.49-5.50; P = 0.002), and upper third facial fractures (OR 6.93, 95% CI 2.06-23.33; P = 0.002). A single punch also caused severe injuries and should therefore not be overlooked, as this can be as dangerous as other assault mechanisms.Peer reviewe

School Violence Among a Nationally Representative Sample of Adolescents in Chile

Background: School violence is widely acknowledged as a public health problem with considerable consequences on student learning and social development. There are also a wide range of health consequences. A large share of previous research on school violence has focused on populations in the global north, with significant gaps in the state of knowledge in the world's emerging economies. To this end, the present study provides an examination of correlates for school-based violence in Chile using a nationally representative cohort.Methods: Six independent variables were considered (age, sex, physical activity, sedentary life style, bullying victimization, food insecurity) within a logistic regression model to ascertain the strength and direction of associations with physical fighting.Results: Among the surveyed students, ~13.08% reported being involved in two or more physical fights during the twelve month recall period. Males were significantly over represented among those reporting being involved in a fight OR 2.91 (CI = 1.98–4.27). Those who reported experiencing food insecurity were 5.29 (CI = 1.43–19.50) times more likely to have been involved in a physical fight. Students who reported being bullied were 2.41 (CI = 1.67–3.47) times more likely to have been involved in physical fights. While age provided protection from involvement in physical fights with an adjusted odds ratio of 0.91 (CI = 0.84–0.98).Conclusion: Consistent with previous research, our results suggest that the use of school-based interventions that target multiple risk behaviors may be helpful in reducing rates of physical fighting.</p

Physical Fighting among School-Attending Adolescents in Pakistan: Associated Factors and Contextual Influences

Background: Adolescent physical fighting is a problem of public health importance, with varied consequences in the form of school absenteeism, injury, and, in some cases, death. Although research on risk and protective factors exists, most has been conducted in high-income countries. Methods: The 2009 Pakistan Global School-based Health Survey (GSHS) data were used. Logistic regression models were used to determine the associations. Five independent variables were investigated at the individual level (anxiety, suicide planning, truancy, physical activity, and bullying victimization) and four independent variables at the social level (presence of supportive parental figures, presence of helpful peers, extent of social network, and food insecurity). Results: Among adolescents in this study (N = 5177), 20% reported being involved in two or more physical fights, most of whom were males (79.9%). The factors associated with physical fighting were: being male (OR = 2.78); bullying victimization (OR = 3.14); truancy (OR = 1.63), loneliness (OR = 1.44); and suicidality, as evidenced by having a suicide plan (OR = 1.75). Having few close friends (0–2) as opposed to more (>3) was found to be protective against engaging in physical fighting. Conclusion: Risk factors for physical fighting among adolescents in South Asia seem to corroborate with previously-identified risk factors using samples in high-income countries, while protective factors seemed to differ. More research needs to be conducted to understand why certain factors do not have the same protective effect among South Asian adolescents. Aim: The aim of this study was to examine demographic and contextual factors associated with physical fighting among a nationally representative sample in a rapidly developing South Asian context.</p

Changes in Mortality Related to Traumatic Brain Injuries in the Seychelles from 1989 to 2018.

Introduction: Traumatic Brain Injuries (TBIs) are a significant source of disability and mortality, which disproportionately affect low- and middle-income countries. The Republic of Seychelles is a country in the African region that has experienced rapid socio-economic development and one in which all deaths and the age distribution of the population have been enumerated for the past few decades. The aim of this study was to investigate TBI-related mortality changes in the Republic of Seychelles during 1989-2018. Methods: All TBI-related deaths were ascertained using the national Civil Registration and Vital Statistics System. Age- and sex-standardised mortality rates (per 100,000 person-years) were standardised to the age distribution of the World Health Organisation standard population. Results: The 30-year age-standardised TBI-related mortality rates were 22.6 (95% CI 19.9, 25.2) in males and 4.0 (95% CI 2.9, 5.1) in females. Road traffic collisions were the leading contributor to TBI-related mortality [10.0 (95% CI 8.2, 11.8) in males and 2.7 (95% CI 1.8, 3.6) in females, P &gt; 0.05]. TBI-related mortality was most frequent at age 20-39 years in males (8.0) and at age 0-19 in females (1.4). Comparing 2004-2018 vs. 1989-2003, the age-standardised mortality rates changed in males/females by -20%/-11% (all cause mortality), -24%/+39.4% (TBIs) and +1%/+34.8% (road traffic injury-related TBI). Conclusion: TBI-related mortality rates were much higher in males but decreased over time. Road traffic collisions were the single greatest contributor to TBI mortality, emphasising the importance of road safety measures

La sustitución C>A en el NT 46 en la región 3’ UTR (Alfa Complex Protected Region) del gen ALFA 1 de globina ¿mutación o polimorfismo?

PC-048 Antecedentes: Las regiones no traducidas [UnTranslated Region (UTR)] desempeñan un papel crucial en la regulación postranscripcional de la expresión génica, incluida la modulación del transporte de ARNm fuera del núcleo, la eficacia de la traducción, la localización subcelular y la estabilidad. La estabilidad del ARNm es un factor decisivo para el desarrollo y funcionamiento normal de los glóbulos rojos. En el caso del ARNm de a-globina, los principales determinantes de la estabilidad se localizan en el extremo 3’ UTR; en concreto, se han identificado 3 áreas discontinuas ricas en citosina (C) ubicadas entre los nucleótidos (nt) 25 y 70 corriente abajo del codon de parada. Estas áreas ricas en C son responsables de atraer a una ribonucleoproteína (RNP) llamada a-globina poli (C) de unión o a-complejo proteína (aCP) para estabilizar la molécula de ARNm. Wagoner et al. demostraron a través del análisis in vitro que cualquier mutación en estos elementos ricos en C dificulta la unión del ARNm de a-globina con el aCP y desestabiliza al ARNm. Objetivos: Presentamos 15 pacientes con la sustitución C>A en el extremo 3’UTR del gen a1 de globina, localizada en la región del complejo a (aCP), la cual podría causar a-talasemia no deleción al afectar a la estabilidad postranscripcional (estabilidad del ARNm) o tratarse de un polimorfismo. Métodos: Se han estudiado 15 pacientes pertenecientes a 12 familias, todas de origen español excepto dos, una procedente de Rumanía y otra de Marruecos. Las edades estuvieron comprendidas entre 2 y 67 años. Todos fueron estudiados por presentar microcitosis e hipocromía sin ..

Trends in mortality from external causes in the Republic of Seychelles between 1989 and 2018.

Data on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989-1998, 1999-2008, and 2009-2018. Mortality rates per 100,000 person-years from external causes were 4-5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989-2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and "other unintentional injuries" (males 14.1, females 8.0), the leading external causes of death in 2009-2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden