Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using 𝓍2-test, Fisher's exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage. Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion: In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.
Several types of pain occur following spinal cord injury (SCI); however, neuropathic pain (NP) is one of the most intractable. Invasive and non-invasive brain stimulation techniques have been studied in clinical trials to treat chronic NP following SCI. The evidence for invasive stimulation including motor cortex and deep brain stimulation via the use of implanted electrodes to reduce SCI-related NP remains limited, due to the small scale of existing studies. The lower risk of complications associated with non-invasive stimulation, including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), provide potentially attractive alternative central neuromodulation techniques. Compared to rTMS, tDCS is technically easier to apply, more affordable, available, and potentially feasible for home use. Accordingly, several new studies have investigated the efficacy of tDCS to treat NP after SCI. In this review, articles relating to the mechanisms, clinical efficacy and safety of tDCS on SCI-related NP were searched from inception to December 2019. Six clinical trials, including five randomized placebo-controlled trials and one prospective controlled trial, were included for evidence specific to the efficacy of tDCS for treating SCI-related NP. The mechanisms of action of tDCS are complex and not fully understood. Several factors including stimulation parameters and individual patient characteristics may affect the efficacy of tDCS intervention. Current evidence to support the efficacy of utilizing tDCS for relieving chronic NP after SCI remains limited. Further strong evidence is needed to confirm the efficacy of tDCS intervention for treating SCI-related NP.
Kim, Eun-Ji;Hwang, Eun-Jung;Yoo, Yeong-Min;Kim, Kyung-Hoon
The Korean Journal of Pain
/
v.35
no.4
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pp.361-382
/
2022
The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α2 agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.
Jae Min Lee;Imgyu Kim;Sang Yong Park;Hyuncheol Kim
Journal of the Korean Society of Safety
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v.38
no.2
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pp.87-95
/
2023
On October 29, 2022, a very large number of people gathered in Itaewondong, Yongsan-gu, Seoul, Korea for a Halloween festival, and as crowds pushed through narrow alleys, 159 deaths and 195 injuries occurred, making it the largest crushing incident in Korea. There have been a number of stampede deaths where crowds gathered at large-scale festivals, event venues, and stadiums, both at home and abroad. When the density increases, the physical contact between bodies becomes very strong, and crowd turbulence occurs when the force of the crowd is suddenly added from one body to another; thus, the force is amplified and causes the crowd to behave like a mass of fluid. When crowd turbulence occurs, people cannot control themselves and are pushed into he crowd. To prevent a stampede accident, investigation and management of areas expected to be crowded and congested must be systematically conducted, and related ministries and local governments are planning to establish a crowd management system to prepare safety management measures to prevent accidents involving multiple crowds. In this study, based on national data, a continuous digital topographic map is modeled in 3D to analyze the risk of crowding and present a plan for selecting high-risk walking routes. Areas with a high risk of crowding are selected in advance based on various data (numerical data, floating population, and regional data) in a realistic and feasible way, and the analysis is based on the visible results from 3D modeling of the risk area. The study demonstrates that it is possible to prepare measures to prevent cluster accidents that can reflect the characteristics of the region.
When the eldery with limited mobility and disabled use a wheelchairs to move, it can cause decreased exercise ability like decline muscular strength in upper limb and lower extremities. The disabled people suffers with spinal cord injuries or post stroke hemiplegia are easily exposed to secondary problems due to limited mobility. In this paper, We designed intelligent wheelchair robot system for upper limb and lower extremities exercise/rehabilitation considering the characteristics of these severely disabled person. The system consists of an electric wheelchair, biometrics module for Identification characteristics of users, upper limb and lower extremities rehabilitation. In this paper, describes the design and configurations and of developed robot. Also, In order to verify the system function, conduct performance evaluation targeting non-disabled about risk context analysis with biomedical signal change and upper limb and lower extremities rehabilitation over wheelchair robot move. Consequently, it indicate sufficient tracking performance for rehabilitation as at about 86.7% average accuracy for risk context analysis and upper limb angle of 2.5 and lower extremities angle of 2.3 degrees maximum error range of joint angle.
Accidents involving students are an important cause of death and disability. They also have enormous financial implications. In order to prevent childhood accidents. research and education for safety should be strengthened. The purpose of this study was to determine how often lower grade elementary students have accidents and what factors affect the accident rate. The study population consisted of 676 students who were in the 2nd, 3rd and 4th grades of twelve elementary schools located in Kun Wi Gun. The questionnaires were distributed to all of the 2nd to 4th grade student in the Kun Wi Gun to be completed by their parents about all the accidents which happened last one year and collected during the period of March 19, to March 30, 2001. The data were analyzed by using SPSS WIN 10.0 statistical package. The results of the study are as follow: 1. Among 676 students. 270 students had 540 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were April. Monday. and between 1 and 4 p. m. each. 3. In the analysis of the location where the injury took place, the most frequent place was on school, around their homes and. then inside the home. 4. Most of accidents were caused by carelessness on the part of the students and the most frequent type of injury was an abrasion. 5. Students most injured part of the body was their legs. 6. They were treated at home most often and usually emergency treatment was performed by family members with disinfectant as first aid measure. Cost of the treatment of the accident ranged from 10.000 to 30,000 won in most cases. 7. Students' personality. type of family composition. mother's age and parents' education level were statistically significant. As a conclusion. 1st to 3rd grade rural elementary students need their assessment for accident involving condition. This study gave a very useful and important data to prepare accident prevention teaching program and to prepare accident prevention strategies.
Si Woo Kim;Jung-Youn Kim;Young-Hoon Yoon;Sung Joon Park;Bo Sun Shim
Journal of Trauma and Injury
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v.37
no.1
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pp.13-19
/
2024
Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.
Journal of the korean academy of Pediatric Dentistry
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v.35
no.4
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pp.642-651
/
2008
This study was carried out to give basic information of traumatic injuries of primary and permanent teeth which can be used for diagnosis and management of injured teeth. From January 2003 to July 2007, 570 children with 1394 teeth who came to pediatric dentistry and emergency center of Chonnam National University Hospital due to the traumatized teeth participated in this study. The following data were investigated. : age, sex, causes and places of trauma, position of injured teeth, types of injury, and treatment at the first visit. 1. Trauma prevailed at the age of 1, $6{\sim}8$, $17{\sim}18$ and the rate of males was more likely to be higher than the rate of females(1.9 : 1). 2. The main cause of injury is a fall-down injury for primary and mixed dentition, but is a traffic accident and fighting for permanent dentition, respectably. The place of injury for primary dentition is mainly home(45.3%), while street for mixed and permanent dentition. 3. The position of injured teeth according to the area in the mouth is mainly maxillary anterior teeth in both case of primary and permanent teeth and especially, the ratio of central incisors is high. 4. The periodontal tissue injury occurred the most frequently in the primary and the permanent teeth, but the ratio of hard tissue injury in the permanent teeth increased, compared with the primary teeth. 5. Among treatments at the first visit, observation without actual treatment comprised 75.6% in the primary teeth and 55.4% in the permanent teeth, respectably. The pulp necrosis occurred in 20.3% of the primary teeth and 26.6% of the permanent teeth in the case of the periodontal tissue injuries, respectably.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.2
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pp.290-298
/
2004
In children, change in lifestyles such as an increase in participation of physical activities has increased the chance of receiving an injury, harming the child and their parents. This study was carried out to give basic information of traumatic injuries to the upper anterior teeth which can be used in prevention of future complications that may arise. From June, 2002 to May, 2003, of the 8,799 children in their primary and mixed dentition visiting Department of Pediatric Dentistry, College of Dentistry, Yonsei University 955 upper anterior teeth(primary 543, permanent 412) of 487 children(male 316, female 171) with traumatic injures to the upper incisors were studied. The results were as follows: 1. Trauma to the primary teeth prevailed at the age of 1-3 and to the permanent teeth at the age of 7. The male to female ratio was 1.85:1. 2. Trauma to the upper incisors for both the primary and permanent teeth occurred in the afternoon. Primary teeth were injured most frequently in the home(44.1%) and the permanent teeth outdoors, in the street(17.5%). 3. Both the primary and permanent teeth were most injured by fall-down injuries(39.8%, 12.9%), and next were collisions(22.2%, 6.0%). For the primary teeth, high fall, traffic accident, violence and sports are next in order, and for the permanent teeth, violence, sorts, traffic accidents were next. 4. Average number of 1.6 primary teeth and 2.8 permanent teeth were injured with the right central incisor most prevailing. 5. Crown fracture without pulpal exposure and subluxation injures were highest in frequency in both the primary and permanent teeth.
The following matters were confirmed through the analysis of casualties due to fires in Korea, Japan, and the U.S. in this paper. 1 Korean statistics are not the most detailed of the three countries about casualties due to fires, so we need to have detailed statistics of them on casualties more. 2. Korean deaths are the lowest by 10-11 people due to fires per one million of population. Those of Japan are 15-17 and about 12 people in the U.S.; decreased about 2/3 only for a quarter of a century. 3. Korean deaths are on the decrease about 1.5 people per 100 cases due to fires,3.5 in Japan and 0.2-0.3 in the U.S. Likewise, Korean injuries are on the decrease per 100 cases due to fires From 14.9 in 1977 to 5.1 in 2001 and 5.3 in 2002. In the U.S., the figure was 1.0-1.6. but after the year 1994, it was 1.2 or so. It tends to some increase to 2.6-2.8 in Japan. Therefore, when fires are happened, the death probability is the highest in Japan and 15 times higher than that of the U.S. The injury probability is the highest in Korea and 5 times higher than that of the U.S. 4. Fire deaths rate is the highest in the U.S. about $80\%$ due to home fires (including apartments) among all deaths. Japan tends to decrease of $55\%$. Recently, in case of Korea. it is similar level to that of Japan. 5. Korean aged people of 65 years old and over exceeded by $7\%$ in 2000 and entered an aging society, so It Is time to Investigate and take effect policies to reduce the death of the aged . Japan has ahead a super-aged society that exceeds $20\%$ of the people over the age 65, and many of them die of fire. Consequently, Japan has taken effect policies to reduce deaths from 10 years or more than before. Therefore, it is a good proposal to analyze the policies of Japan deeply and study introduction of them.
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