Injuries From Explosions: More Differences Than Similarities Between Various Types.

Objective: To compare injury patterns of different types of explosions.

Methods: A retrospective study of 4508 patients hospitalized due to explosions recorded in the Israel National Trauma Registry between January 1997 and December 2018. The events were divided into 4 groups: terror-related, war-related, civilian intentional explosions, and civilian unintentional explosions.

COVID-19 Changed the Injury Patterns of Hospitalized Patients.

Introduction: Injury patterns are closely related to changes in behavior. Pandemics and measures undertaken against them may cause changes in behavior; therefore, changes in injury patterns during the coronavirus disease 2019 (COVID-19) outbreak can be expected when compared to the parallel period in previous years.

Study Objective: The aim of this study was to compare injury-related hospitalization patterns during the overall national lockdown period with parallel periods of previous years.

National study: Most elderly patients benefit from earlier hip fracture surgery despite co-morbidity.

Objective: To estimate the potential influence of pre-operative patient condition on the benefit of earlier hip fracture surgery for elderly patients.

Background: Many studies emphasize the benefit of earlier hip fracture surgery for patient survival. However less is known regarding how this relationship is influenced by clinical factors which could serve as potential contra-indicators for earlier surgery.

The reliability of the Glasgow Coma Scale in detecting traumatic brain injury: The continuous effect of age.

: Recent studies noted the limited applicability of Glasgow Coma Scale (GCS) for elderly patients with Traumatic Brain Injury (TBI). However, the dichotomic distinction between "elderly" and "non-elderly" does not cover the full span of influence of age on GCS presentation.: To analyze the influence of age on GCS scores of patients with isolated TBI.

New Trends in Terrorism-Related Injury Mechanisms: Is There a Difference in Injury Severity?

Study Objective: The latest wave of terrorism worldwide has seen significant use by terrorists of mundane, "low-technology" weapons, such as utility knives and civilian vehicles. How do the injuries they produce compare with that of more conventional terrorism mechanisms, such as use of firearms and explosives? We compare injury patterns of the most frequent terrorism-related injury mechanisms in an Israeli data set.

Methods: This was a retrospective study of 1,858 patients hospitalized because of terrorism events, which were recorded in the Israeli National Trauma Registry between January 1997 and December 2016.

The Differences in Stabbing-Related Injury Profiles of Men and Women.

Background: Although women comprise only a minority of patients hospitalized due to violence-related injury, the circumstances of attacks against women may make their injuries more severe.

Methods: We conducted a retrospective study using data of 9173 patients with stabbing-related injuries from 19 trauma centers participating in the Israeli National Trauma Registry between 1 January 1997 and 31 December 2014. Male and female patients were compared in terms of demographic and circumstantial factors, clinical characteristics, and outcomes.

Equipping Public Spaces to Facilitate Rapid Point-of-Injury Hemorrhage Control After Mass Casualty.

In response to increasing violent attacks, the Stop the Bleed campaign recommends that everyone have access to both personal and public bleeding-control kits. There are currently no guidelines about how many bleeding victims public sites should be equipped to treat during a mass casualty incident. We conducted a retrospective review of intentional mass casualty incidents, including shootings, stabbings, vehicle attacks, and bombings, to determine the typical number of people who might benefit from immediate hemorrhage control by a bystander before professional medical help arrives.

Gadolinium-based contrast agents in children.

Gadolinium-based contrast agents (GBCAs) are widely used in medical imaging, with greater than 300 million doses administered since their introduction. The risk of adverse reactions is very low, and GBCAs were thought to be very safe until the discovery of nephrogenic systemic fibrosis (NSF). Since that time, gadolinium has been found to deposit throughout the body, including the brain, where it is visible on non-contrast T1-weighted MR images in people with normal renal function.

The danger of non-exhaustive quality measures: requiring hip fracture repair surgery within 48 hours - a case study.

Quality measures are widely used globally in order to measure clinical performance and organizational efficiency of the healthcare systems. However, in a race to achieve certain numerically defined goal, the more important purpose of any organizational step being aimed at improving clinical outcomes could be overshadowed.The introduction of the requirement to perform most hip fracture surgeries in the first 48 h of hospitalization by the Israeli Ministry of Health (IMOH) provides an interesting example of the complexity of this phenomenon.

Extended diffusion weighted magnetic resonance imaging with two-compartment and anomalous diffusion models for differentiation of low-grade and high-grade brain tumors in pediatric patients.

Purpose: The purpose of this study was to examine advanced diffusion-weighted magnetic resonance imaging (DW-MRI) models for differentiation of low- and high-grade tumors in the diagnosis of pediatric brain neoplasms.

Methods: Sixty-two pediatric patients with various types and grades of brain tumors were evaluated in a retrospective study. Tumor type and grade were classified using the World Health Organization classification (WHO I-IV) and confirmed by pathological analysis.

The correlation between stabbing-related upper extremity wounds and survival of stabbing victims with abdominal and thoracic injuries.

Background: When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation.

Use of gadolinium-based magnetic resonance imaging contrast agents and awareness of brain gadolinium deposition among pediatric providers in North America.

Background: Numerous recent articles have reported brain gadolinium deposition when using linear but not macrocyclic gadolinium-based contrast agents (GBCAs).

Objective: To determine the current landscape of gadolinium use among pediatric institutions and the knowledge base of radiologists and referring providers with regard to GBCAs and brain gadolinium deposition.

Materials And Methods: We e-mailed voluntary closed surveys to 5,390 physicians in various pediatric professional societies between January 2016 and March 2016.

Violence-related Versus Terror-related Stabbings: Significant Differences in Injury Characteristics.

Objective: To demonstrate the gap between injury epidemiology of terror-related stabbings (TRS) and non-terror-related intentional stabbings.

Background: Terror attacks with sharp instruments have multiplied recently, with many victims of these incidents presented to hospitals with penetrating injuries. Because most practical experience of surgeons with intentional stabbing injuries comes from treating victims of interpersonal violence, potential gaps in knowledge may exist if injuries from TRS significantly differ from interpersonal stabbings (IPS).

MRI Findings After Surgery for Chiari Malformation Type I.

Objective: Surgery plays an important role in the management of Chiari I malformation. The purpose of this article is to review expected and unexpected MRI findings after the various types of surgery performed during the treatment of Chiari I malformation and associated abnormalities.

Conclusion: Familiarity with optimal MRI techniques and findings is important when evaluating postoperative changes after treatment of Chiari I malformation.

Comparison of Two Successive Earthquake Awareness Campaigns in Israel: Improved Methodology or a Cumulative Effect?

Objectives: An effective way to reduce casualties from earthquakes is to increase population preparedness. During 2011 to 2013, Israeli authorities executed 3 national-level earthquake awareness campaigns. We aimed to assess the impact of these campaigns on the populace and the ability of the campaigns to produce a cumulative effect throughout the study period.

A New Paradigm of Injuries From Terrorist Explosions as a Function of Explosion Setting Type.

Objective: Examine the impact of setting on the magnitude and pattern of civilian injuries from terrorist explosions. This may help surgical staffs anticipate the resources required to treat victims of terrorist attacks.

Methods: A retrospective study of 823 patients from 65 explosive events of the Second Intifada (2000-2005) in the National Trauma Registry.

The impact of a national earthquake campaign on public preparedness: 2011 campaign in Israel as a case study.

Objective: The most effective way to reduce the number of expected victims and amount of damage from earthquakes is by effective preparedness. The Israeli government launched a national campaign to change its citizens' behavior. This study assessed the effectiveness of the campaign on the Israeli population.

An investigation of diffusion imaging techniques in the evaluation of spinocerebellar ataxia and multisystem atrophy.

Multisystem system atrophy and spinocerebellar ataxia are rare neurodegenerative ataxias that can be difficult to diagnose, with important prognostic and treatment implications. The purpose of this study is to evaluate various methods of diffusion imaging and tractography in their effectiveness at differentiating these diseases from control subjects. Our secondary aim is determining whether diffusion abnormalities correspond with clinical disease severity.

Policy encouraging earlier hip fracture surgery can decrease the long-term mortality of elderly patients.

Background: In April 2004 the Israeli Ministry of Health decided to condition DRG payment for hip surgery by time between hospitalisation and operation, giving a fine for every day's delay beyond 48h. An evaluation study performed 2 years after the reform has shown the positive influence of the reform on patient's survival in the hospital. This study evaluates the impact of the reform on the longer-term mortality of patients.

ISS groups: are we speaking the same language?

Background: Despite ISS being a widely accepted tool for measuring injury severity, many researchers and practitioners use different partition of ISS into severity groups. The lack of uniformity in ISS use inhibits proper comparisons between different studies. Creation of ISS group boundaries based on single AIS value squares and their sums was proposed in 1988 during Major Trauma Study (MTOS) in the USA, but was not validated by analysis of large databases.

Base excess as a predictor for injury severity in pediatric trauma patients.

Background: Base excess is considered a predictor of mortality and severity of injury in trauma patients. Base excess had been widely examined in different settings. Only few studies have examined the role of base excess in pediatric trauma patients.

Children and terror casualties receive preference in ICU admissions.

Objective: Trauma casualties caused by terror-related events and children injured as a result of trauma may be given preference in hospital emergency departments (EDs) due to their perceived importance. We investigated whether there are differences in the treatment and hospitalization of terror-related casualties compared to other types of injury events and between children and adults injured in terror-related events.

Methods: Retrospective study of 121 608 trauma patients from the Israel Trauma Registry during the period of October 2000-December 2005.

Nationwide trends in abdominal aortic aneurysm repair and use of endovascular repair in the emergency setting.

Purpose: To analyze nationwide trends in abdominal aortic aneurysm (AAA) repair and the use of endovascular abdominal aortic aneurysm repair (EVAR) in the emergency setting.

Materials And Methods: Data were obtained from the Nationwide Inpatient Sample (NIS) using the International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes for open and endovascular repairs from 2001-2009. Trends in outcome parameters and hospital charges were compared.